Professor Paddy Broe:

I am saying that in terms of recruitment. In 2006, we all agreed that the national cancer control programme, NCCP, was a terrific development for the treatment of cancer. That resulted in eight hospitals being developed to the highest level but also in reducing our ability to recruit high-quality staff to other hospitals. In surgery, for example, we have a training programme through which we train our own surgeons here in Ireland and encourage them to go away to train in fellowships and so forth. Due to the recession and cuts, particularly those directed at consultants’ salaries, our ability to recruit those people back to Ireland is a problem. Then one must factor in that, if they are highly trained, the difficulty will be whether they will be able to do the work they are fully trained for outside level 4 hospitals. The fact is that they are not.

Our job within the group is to develop linkages between hospitals in order that a surgeon can do highly complex work at a level 4 hospital and less complex work in some of the smaller hospitals. As Dr. Pat Nash said, the challenge there is geography and obliging people to travel.