The Western Health Board has been criticised for allegedly neglecting 14,500 arthritis sufferers - many of them children - in Co Mayo. The service, according to the Mayo Arthritis Foundation, is so sub-standard that it can only be described as "Third World".
Statistics obtained by the organisation show the waiting list for rheumatology assessment is at 1,021 people.
Of those, 16 have been waiting to be called since 1997, 215 since 1998, 189 since 1999, 207 since 2000 and 196 since last year.
Only one rheumatologist, Dr Robert Coughlan, is attached to the WHB, which covers counties Galway, Mayo and Roscommon.
The Mayo Arthritis Foundation has been campaigning for years to have a specialist appointed to Mayo General Hospital in Castlebar.
Ms Mary Healy, chairwoman of the Mayo Arthritis Foundation, said: "What is being done to these people is a monstrosity and the Western Health Board continues to turn a blind eye to their plight.
"When Dr Coughlan is on holiday or sick leave there is no one to cover for him, so the list grows and grows.
"I am calling on the Western Health Board, yet again, to bring about an end to this grave injustice by appointing a rheumatologist to Mayo General Hospital so people with arthritis can be treated in their own county.
"This is a public scandal that is being allowed to go unnoticed for too long."
Ms Healy detailed how one arthritis suffer was treated in a "most appalling" manner by the health board.
She explained that a woman from Belmullet contacted her about difficulties she was having due to the severe pain and discomfort with her arthritis.
"I encouraged her to seek a referral to the rheumatologist. When eventually she got an appointment to see Dr Coughlan she had no transport to take her to Galway," Ms Healy said.
"She checked with the taxi company, who would charge €100 to take her there. As she could not afford this, she contacted the Western Health Board and they said they could only reimburse her €30 and she would have to pay the balance of €70 herself.
"She explained that she lived alone and could not afford the €70 and of course this would be ongoing. So they suggested to her that as she had a free pass she should get a bus from Belmullet to Castlebar, wait there and get another bus to Galway and wait there again and get another bus to Merlin Park.
"This suggestion was made by the Western Health Board to a lady who is suffering great pain and discomfort and is nervous of travelling on her own.
"Given the long wait to be seen in Merlin Park, where up to 90 people are called weekly to the clinic which starts at 2 p.m. and where a four- to five-hour wait is not unusual, it is highly likely that this lady could miss her bus home.
"Nevertheless the Western Health Board thought it was quite acceptable for a lady, in great pain and discomfort, to use inaccessible public transport for a 200-mile round trip and hang around in both Castlebar and Galway for buses.
"The lady had no alternative but to cancel her appointment which has caused her great distress.
"I am absolutely outraged at such a suggestion from a health board to someone who is suffering so much and I am appalled by this act of man's inhumanity to man.
"Their suggestion reflects their total lack of compassion or understanding for the problems faced by people with arthritis in this county who are enduring so much hardship and being denied treatment for their condition because they are unable to get to Galway," Ms Healy said.