Ms Averil Power:

I thank the committee for inviting me and my colleague, Rachel Morrogh, to the meeting. The Irish Cancer Society is pleased that the Joint Committee on Health is continuing to focus on the impact of Covid-19 on cancer services and cancer patients. We are incredibly worried for current and future patients, as well as for those who provide their care.

Cancer is a disease where time matters, but hammer blow after hammer blow to cancer services over the past 15 months means that patients are not guaranteed to get the care they need when they need it. Cancer is a continuum and Covid has disrupted every aspect of it, from screening to diagnosis and treatment. International experts are warning that these disruptions will lead to an increase in cancer deaths over the next ten years.  We are here today, however, to tell the committee that if we act and put in place the right resources and make the right investments, we can reduce the level of suffering and loss that lies ahead.

GPs, our first line of defence against cancer, have been pleading alongside the Irish Cancer Society for anyone with niggling health concerns to seek medical advice during Covid. Our research shows that one in four people did not go to see their GP in 2020, even though they said that they needed to. Our most recent research, which was conducted in May, shows that one in six people reported that they are still choosing not to attend a GP with health concerns. Our healthcare professionals are already seeing the results of people presenting later, with patients presenting at more advanced stages for certain types of cancer.

We are also seeing delays to diagnosis for symptomatic patients after they have been referred by their GPs. The long waiting times that characterised public healthcare before the pandemic have been further compounded by Covid. We do not yet have the full picture of the numbers of cancers that have gone undiagnosed during Covid, but figures from the national cancer control programme for the referrals to breast, prostate and lung rapid access clinics imply that diagnoses in 2020 were at least 10% lower than expected. This means that potentially more than 2,000 invasive cancers went undiagnosed last year.

Covid is not the only enemy that cancer services are battling. The devastating cyberattack on the HSE is crippling a system that was already on its knees. In a tweet, St. Vincent's University Hospital has said that referrals to its skin cancer clinic were down by more than 90% due to the cyberattack.

Some rapid access clinics that we have spoken to report that the cyberattack has had a much worse impact on their services and patients than Covid.

As I speak to the committee, our health system is under intolerable strain. Our cancer services are delivered by some of the most passionate and dedicated healthcare professionals in the world but members will hear from the IMO and the IHCA that our healthcare professionals are burned out. Cancer patients are also at breaking point. Every day on our support line, our cancer nurses hear the stress, anxiety and exhaustion in their voices. For 15 months they have cocooned and socially distanced from their loved ones. They have attended appointments and heard the worst kind of news completely alone. They have recovered from surgery and attended chemotherapy and radiotherapy without anyone to hold their hand. The psychological and emotional effects of Covid on cancer patients will stay with them and their loved ones for the rest of their lives.

While there has been a drop in cancer diagnoses in Ireland since the start of the pandemic, those cancers have not gone away. They are hiding underneath the chaos that Covid has visited on an already overwhelmed healthcare system. Those cancers will eventually surface, but for some, at a much later stage. That means more difficult treatment options for patients, reduced survival rates and a devastating impact on our stretched cancer services. We need to prepare for a surge in more advanced cases of cancer in the coming months and years. At the Irish Cancer Society, we appreciate that the Government started to do that at the end of last year when it provided significant extra funding for the national cancer strategy in budget 2021. However, much more will be needed in the years ahead.

We also need much better data to ensure we are tackling the right issues and investing in the right places. We are in the Stone Age when it comes to collecting real-time information on cancer services. That means we are fighting Covid and cancer blindfolded. Therefore, I appeal to members to support the adoption of the individual health identifier across cancer services and the development of robust data systems to inform policy as a priority.

What we do today really matters to the future of cancer patients in our country. This is an opportunity to blunt the worst impact of Covid and simultaneously revolutionise how we deliver cancer care. We have made such advances in cancer care in this country in recent decades but, as things stand, our healthcare and social care systems are not ready for the cancer epidemic that is coming down the tracks. We must act now and build a sustainable and resilient cancer service that can cope with the inevitable surge in cases in the years ahead.

Cancer screening needs to return to 100% screening capacity as soon as possible. We need to establish diagnostic centres that can provide predictable and timely cancer diagnoses. We need dedicated cancer infrastructure so that cancer services no longer have to compete against emergency and unscheduled care. We need dedicated theatres, beds, day wards, ICU capacity, staff and equipment to ensure predictable pathways to treatment for cancer patients. Underpinning this revolution needs to be a focus on our healthcare workers and future-proofing this vital workforce. We need to rethink the way that cancer care is delivered, not just play around the edges. There is so much to do and it must be done urgently. With sufficient priority and investment, we can reduce the long-term impact of Covid on cancer services and stop lives being needlessly lost in every community in Ireland.