Ms Averil Power:

The cancer figures are predicted to double in the next 25 years by the NCRI. There are two main reasons for that. One is demographics. Cancer is predominantly a disease of older people so as the population lives longer more people are likely to get cancer. The other key reason is lifestyle factors. Factors such as obesity, alcohol and tobacco increase the likelihood of getting cancer. We are all born with a certain risk of getting cancer and, as Professor Hennessy mentioned, while many cancers occur randomly, others are genetic. However, by drinking alcohol excessively, not exercising enough and being overweight, we increase our likelihood of getting cancer. The NCRI prediction of cancer numbers doubling is just a prediction and it is within our power as individuals, as an Oireachtas and as a society, to change that prediction and make sure it does not happen. Investment in cancer prevention is one of the main pillars of the national cancer strategy and it is very important. By addressing cancer prevention, we can save lives by ensuring fewer people get cancer in the first place.

Regarding patients being sent home when they have presented for appointments, it happens for all types of appointments and not just those for chemotherapy. The same happens for surgeries due to capacity issues in the hospitals. It is a constant source of distress for patients who call our Nurseline or present at daffodil centres in hospitals and even when patients are referred to rapid access clinics because they have urgent symptoms. The additional distress that comes from not being treated within the required timeframe is incredible. On diagnostic tests when people have been told that they have symptoms that require urgent investigation and they had the test, it is a massive relief to find out that they do not have cancer, but they will have spent that entire period worrying about a possible cancer growing inside them. That is unnecessary and incredibly upsetting for patients. Tragically, others will find that by the time they have got a diagnosis their cancer may have progressed and be harder to treat than it would have been if they had been seen within the required timeframe, which is shocking.

There are a number of reasons for that. One is capital infrastructure. That is why it is important that the capital projects promised in the national cancer strategy are delivered on time and are not delayed by issues such as the overrun for the children's hospital, which the committee discussed earlier. It is also essential that workforce issues in the health service are addressed. Research investment is a key part of that. One of the reasons many Irish-trained consultants, nurses and other healthcare professionals who have gone abroad to get experience do not come home is that they will be unable to do research here because they do not have protected time. We train amazing healthcare professionals to a very high standard in this country. They go abroad to get further experience in some of the best cancer centres in the world but then they must face the choice of coming home and not being able to do the type of research they can carry out in New York, Australia, New Zealand and other countries. That is crazy.

As Professor Hennessy and Ms Mulroe said, patients do better in research active environments and one of the reasons is that research active hospitals and healthcare settings attract the best healthcare professionals. The best people want to be able to carry out research and ensure their patients get access to new treatments and medicines. They want to work in an environment where they have time, head space and access to treatment facilities that deliver the best care. They do not want to work in a system that is chaotic. Providing investment in research and protected time will also address the wider issues around attracting people home and filling the gaps in consultant, nursing and other posts in the health service.