Dr. Gabrielle Colleran:

Again, it all comes back to capacity and having enough staff and equipment and whether the service is provided in the hospitals or community diagnostic centres. My husband, a radiologist, works in an acute hospital with a community diagnostic centre that is very much integrated with primary care. It is all about the patients getting access when they need it, or as soon as possible. Our number of radiologists is among the lowest in Europe. We have huge issues with radiologists and radiographers. Therefore, it is about getting the staff and using them to meet patient need.

With regard to the issue of screening versus diagnostics, the burden of disease is greatest in the symptomatic population, as alluded to by Ms Power. Therefore, while we are very focused on screening and the importance of preventing cancer, to do the most good and preventing further harm, the symptomatic population has to be addressed first. For example, of the women with postmenopausal bleeding who are awaiting access to gynaecological outpatient facilities for further evaluation, one in ten will have cancer. That involves a huge burden of disease, so much more than among the screening population.

I probably sound like I am banging the same drum but we have the lowest number of consultants in Europe. It is a major issue for capacity when there are just not enough specialists. The answer is getting the specialists. The infrastructure is the next issue. There was a comment earlier about consultant surgeons with access to theatre only once per week. When people cannot use the skills they have, they have a choice between deskilling and leaving the system to work in another that allows them to use and keep their skills. It is about getting the capacity so patients will have access when they need it.