Ms Averil Power:

I thank the Chairman and the committee members for inviting the Irish Cancer Society before the committee this morning. My colleague, Mr. Donal Buggy, the society's head of services, and I appreciate the opportunity to outline the patient perspective on the national cancer strategy.

Thirty years ago, when we first celebrated Daffodil Day, only three out of ten Irish patients survived a cancer diagnosis. Today, six out of ten do. That is thanks in no small part to investment in cancer research - by ourselves, Cancer Trials Ireland, the Health Research Board, HRB, and others - as well as the significant improvement in cancer services in Ireland under the two previous national cancer strategies. For example, the centralisation of cancer surgery, under the national cancer strategy of 2006, has ensured that more patients are being treated by healthcare professionals with more experience and expertise in their particular type of cancer and thousands of lives have been saved as a result.

However, Ireland's cancer outcomes still lag behind other European countries. It was this lag that the 2017 national cancer strategy set out to tackle through a focus on prevention, early diagnosis, providing an integrated model of care where patients get the package of supports from multi-disciplinary teams and improving treatment, particularly in rare cancers and those where our outcomes are still poor. Crucially, the 2017 strategy also recognised the importance of patient involvement in their care and of improving quality of life for cancer survivors. It stressed the importance of investment in cancer research, as a key driver of innovation and a way, as Ms Mulroe of CTI has pointed out, of ensuring access for patients to life-saving medicines that they simply would not get otherwise. It also highlighted that sufficient support for the national cancer control programme and effective workforce planning were essential to delivering change.

The Irish Cancer Society was proud to sit on the steering committee for the development of the 2017 cancer strategy under the leadership of Professor John Kennedy, who is a former chairman of the society. It is a visionary document that puts the needs of patients at its heart and which, if implemented, would reduce the number of Irish people getting cancer in the coming years and would increase survival rates and quality of life for those who do.

That is why it is so disappointing that there seems to be very little momentum behind its delivery. According to the implementation report published in February, six out of seven interim targets due to be met by the end of 2018 were missed. Even worse, the HSE's 2019 services plan explicitly states that the NCCP allocation for this year will not enable the service to match referral demands in areas such as radiotherapy, rapid access clinics and diagnostics. Not only have resources not been provided to the NCCP to deliver the new initiatives promised in the strategy, inadequate funding has been given to deliver existing services to an increasing number of cancer patients. This is truly shocking and will have a major impact on cancer patients and their families.

One of the six missed targets was to ensure patients are diagnosed earlier, thereby increasing their chances of survival. We recently heard from a woman whose GP had recommended she attend a breast clinic to investigate some worrying symptoms. She told us that her doctor had told her that her case was urgent and as such she should be seen at the clinic within two weeks. Still waiting for an appointment, she rang our Nurseline very upset. She was incredibly worried, anxious and distressed, thinking about a possible cancer growing inside her while she was still waiting to be seen.

At the end of 2018, 95% of people classified as having breast cancer symptoms needing urgent investigation were supposed to be seen within two weeks but only 75% were. Nine out of ten patients with certain cancers were to have surgeries within the timelines set out in the strategy and only seven out of ten did. Nine out of ten patients starting radiotherapy treatment were meant to start within 15 days of being ready to do so and only eight out of ten did. Every missed target affects real people - the mother with a lump in her breast, the father with blood in his urine, the healthcare professionals trying to do their best for their patients in a chaotic health service. Publication of the National Cancer Strategy 2017-2026 was a step forward but underfunding and underperformance are two steps back.

One in two of us will be diagnosed with cancer in our lifetime. When we are, we deserve the best chance. We deserve the standard of care promised in the 2017 national cancer strategy. Unless action is taken now, this will not happen. Instead, with more cancer patients and insufficient resources, standards will slip.

That is why we are calling on the committee today to help us ensure that the strategy is implemented by pushing for: a more detailed implementation plan with clear funding, including for the big infrastructural and capital projects called out in the strategy; increased investment in cancer research, including clinical trials and investment in CTI to provide the essential basic infrastructure for those trials to take place; a clear plan and timeline for the delivery of at least one comprehensive cancer centre; completion of the centralisation programme; and action to fill gaps in data and baseline figures in order that implementation of the strategy can be properly monitored. The committee members' constituents, friends, families and communities deserve nothing less.