Dr. Denis McCauley:

On the Senator's question regarding prevention, Covid-19 has had a significant effect on pathways, be those pathways screening pathways or referral pathways, and on the ability to be assessed in a hospital and to be diagnosed, treated and followed up. These have all been affected.

To put it into numbers, while cancer is prevented through public health measures and so forth, screening is an important aspect. With regard to breast screening, reference was made to whether it is best below 50 or above 50. The three screening processes we have are evidence-based and work but last year they did not work as well as they should have. There were 70% fewer mammograms last year. There were 44% fewer smears and 60% fewer bowel screening tests were done. Prevention was impaired because of this. That is probably where the statement came from. It is a fact. There are probably cancers whose treatment has been delayed. In the short term, we must realise we have to accelerate the process so the affected cohort will be a once-off cohort and so the problem will not recur.

With regard to diagnostics, Covid-19 has in a perverse way afforded opportunities. For instance, within two weeks of the Covid crisis, we were not supposed to do online prescriptions for three years. We could do so within two weeks when the Covid crisis started. That was positive. Where radiology is concerned, the Covid crisis and malware problem have meant general practice has been allowed to have direct access to diagnostics. Unfortunately, I anticipate that this will be a short-term measure but it will be interesting to see what materialises. It enhances our ability to test a worried patient to determine whether he or she has cancer. It is part of a national cancer strategy. I hope it will be continued and that it will not just be a short-term force majeuremeasure.