Dr. Gabrielle Colleran:

It is very hard to put a concrete figure on it. Given the additional impact of the cyberattack, we will be doing recovery on follow-up of the cases that were being looked after during the cyberattack to make sure things were not missed with the lack of access to prior imaging and labs. There is a huge body of work around reconciling that to make sure we can stand over the care that was provided during that period.

In terms of capacity, it comes back to the staffing issue again. Many people have not taken their leave. They are exhausted after Covid. We just do not have enough staff. We need to get the specialists into post and they have to get access to the diagnostics and the theatre spaces to get through the backlog. We and our colleagues in the IMO and the ICGP have done quite a lot on public messaging and communications on the importance of going to your GP with symptoms. It is very understandable that people were nervous about engaging. However, we have been encouraging them not to sit on symptoms because we do not want the delayed diagnoses, which we know will happen. We need to keep up the public messaging on that and to keep encouraging people to present with symptoms so that we can investigate them.

Ultimately, it is about addressing the bottlenecks in our hospitals through having enough doctors to see people, enough radiographers to do CT and MRI scans, radiologists to read them, pathologists like Professor Landers and Dr. Kilgallen to read the specimens, and for everything to be going at full tilt. However, the reality is it is like fielding half a team against the All Blacks and being surprised we are not winning and getting through the backlog. We are running to stay still. We are like swans. We may look calm above the water but we are not, because we are constantly in crisis mode.

I must mention that in respect of burnout before the crisis, the figure among Irish consultants was 44% in 2018. That would compare with about one in three worldwide. That figure was at 77% in January. That was before the impact of the cyberattack. I have multiple colleagues who are off on sick leave due to the impact of the excessive workloads. Other colleagues are considering leaving the system. We do not just have an issue with recruitment, we also have an issue with retention. The knock-on impact of that for patients is a lack of slots and outpatient and diagnostic capacity. The critical issue is having the people power and having enough people on the team.