A unique service provided by a team of doctors and dentists in Cork which enabled patients who lost part of their face to tumours have those parts artificially restored is now being discontinued due to a lack of funding.
The service had been provided by Cork University Hospital and the Cork University Dental School and Hospital on a pilot basis for the past three years and the team behind it drew up a service plan to put it on a permanent footing.
Their plan was submitted to the former Southern Health Board (now the Health Service Executive Southern Area) 18 months ago but there is still no sign of funding being provided for it.
Dr Finbarr Allen, a consultant in restorative dentistry at Cork University Dental School and Hospital, said yesterday he believed the service plan had been "shelved" and he has therefore stopped taking referrals of new patients.
He is, however, continuing to see patients whose treatment programmes have already begun.
Patients who now had tumours removed or who lost facial body parts in accidents would have to go to the UK to have prosthesis work undertaken, he said.
He said the service plan, which would cost about €1 million a year to implement, was drawn up by a multidisciplinary team including a medical oncologist, a plastic surgeon, consultants in ear, nose and throat and maxillofacial surgery and himself.
"This kind of integrated service is not provided elsewhere in the country to the best of my knowledge," he said.
A national maxillofacial surgery service is provided, however, out of Dublin's St James's Hospital.
Up to now patients in the south who have had to have facial tumours removed would visit the team who drew up the service plan in advance and have an impression of the area from which the tumour was being removed taken. A maxillofacial technician who visited Cork from the UK every six weeks would then make a silicone prosthesis for the patient, matching the patient's skin tone. After surgery it would be fitted. In this way, parts of ears which have been removed have been replaced and dents on patients' faces have been filled in.
"The patients we have seen have been very grateful. I would be very unhappy that patients would now have to go to the UK for this service as all the models now for managing cancer indicate people should have facilities close to home. Care can perhaps be co-ordinated from a major centre but patients should have access to support services more locally than having to go to England for them," he said.
He added that, to date, 25 patients had been successfully treated under the pilot programme. "That seems a relatively small number but often people will require between 10 and 30 visits so they consume a lot of time."
He said putting the service on a permanent footing would involve the appointment of a consultant and some junior staff.
The service would benefit not just cancer patients but also those who lost facial parts in accidents or who had congenital abnormalities, he said.
The Health Service Executive Southern Area said in a statement last evening that a plan for the development of a cranio-facial rehabilitation service was presented to the Cork University Hospital executive management board and forwarded to the Department of Health and Children.
"The development of the service, in conjunction with University College Cork, would require the input of a consultant maxillofacial surgeon. Cork University Hospital received approval in the December 2004 Letter of Determination for the recruitment of a dental and maxillofacial surgeon and the recruitment process is currently underway. The next stage in the process is the submission of a consultant post application form to the National Hospitals Office," it said.