No skin specialists at public hospitals in South Island

There has long been only a skeleton dermatology service in the South Island, a Dunedin GP says, and even that has now been pulled.

There are now no skin specialists working in public hospitals in the whole of the South Island, after the only two locum dermatologists in the South Island resigned last month.

Since then, Health NZ/Te Whatu Ora has not been accepting any dermatology outpatient referrals or appointments, referring patients back to their family doctor.

Health NZ said it was actively seeking locum cover and trying to recruit permanent dermatologists.

Dunedin GP Dan Pettigrew told Nine to Noon GPs can deal with the majority of dermatology patients, but if the case was very severe it should be referred to a specialist.

"They need specialist assessment and specialist medications. So we need a specialist service to deal with these severely affected patients. And that is the service which has been effectively pulled out from under us. It was just a skeleton service, but now even that is gone."

Pettigrew said affected conditions include eczema, psoriasis and other rare skin conditions.

Melanoma was dealt with separately, and specialist care was still available in the South Island.

Dermatological Society president Dr Louise Reiche said the impact of skin conditions can be hugely disruptive to people's lives.

"It means we have a lot of suffering out in the community. It disrupts families, so people with dreadful itch, often children, can't sleep and often that means the whole family can't sleep. They can't perform, and their mental health deteriorates, some unfortunately to the point of suicide."

Reiche said there was a small ray of hope with Te Whatu Ora looking at setting up a number of dermatology departments throughout the country, including in Christchurch.

There was an acknowledgement that the current system, which often has a sole dermatologist working in an isolated DHB area, was leading to people leaving the roles due to the workload, she said.

"That person is on-call a hundred percent of the time, they often have leave that is declined, they are working incredibly long hours and are unsupported, and they've end up departing due to utter fatigue and burnout."

Having departments in the bigger centres was more sustainable, and it was hoped they could have more outreach, Reiche said.

The shortage of dermatologists was highlighted ten years ago in health workforce survey and again two years ago, and both times there was a call for urgent action but little done, she said.