Dr. Clive Kilgallen:

I support everything that has been said by the other guests. My job and that of my colleague Professor Landers involves looking down microscopes and diagnosing cancer. We are in the thick of it. We know what is going on and we talk to our clinical colleagues. One story they tell us is that patients are presenting late because they have been at home worried, which goes back to what Dr. McCauley was saying. We need a public health programme to tell patients that if they are at home and have symptoms, they will be cared for and that it is safe for them to come to the hospital environment and be seen.

One issue with cancer surgery is that it is more complicated than the simple elective surgery for, say, a hernia, so the backlog will need complicated surgery. In some units throughout the country, surgeons have access to surgery for only about half a day a week. Imagine if a senior plasterer or master craftsperson was allowed to work for only half a day a week. I know what the response in north Dublin would be. That has to change. Surgeons need to have access to theatre space to do their work. This is so frustrating. They are becoming deskilled and worried and they want to leave for the private sector. On the issue relating to elective work proposed in Sláintecare, there obviously needs to be room for less complicated surgery but there also needs to be provision for "bigger" surgery for cancer, and that may require intensive care units.

In regard to local responsibility, where I work at the Royal College of Surgeons in Ireland, RCSI, centre at Beaumont Hospital we have access to some elective beds. In skin cancer and plastics, that comes through and we are really busy in that regard. Where there is capacity to perform to look after patients and carry out complicated surgery, patients are seen. Professor Landers and I look at and diagnose the slides under the microscope and then also deal with the cancerous section specimens. The faculty of pathology at the Royal College of Physicians of Ireland is working to examine the cancer biopsies and cancerous sections. Every time a patient has a new cancer, he or she has to have a biopsy, and when he or she has a cancer removal, he or she has to have a cancerous section specimen. All those data are examined at the Royal College of Physicians and it will produce a report in two or three weeks that will show exactly what has been happening since Covid, mathematically, down to the last histological slide.