Dr. Gabrielle Colleran:

We have seen today the patient perspective and advocacy from the Irish Cancer Society, the professional clinical expertise from ourselves and the political leadership from members of the committee. What we need now, for the next step, is to have everybody available and working together to build forward better so we really deliver for patients. It would be wonderful if the revised national doctors training and planning, NDTP, coming out in July was discussed by the Committee on Health before then, so those of us involved in delivering and receiving the care could have an opportunity to help shape that. It is critical that is successful and has the capacity in terms of staffing and infrastructure to deal with the impact of the cyberattack, Covid and the lists that pre-existed so it works for patients.

To address the point about patients not attending appointments or taking up the opportunity for screening, it is very important that we centre the patient and the patient experience in that and not take a judgmental approach.

There are many reasons people struggle to engage with services or might be afraid of services. Travellers in Ireland have experienced a lot of systemic discrimination, as have other vulnerable groups, where their experience when they deal with the medical establishment has, historically, not been a positive one. There is a body of work around trust. We see this with the vaccination programme and vaccination hesitancy in certain groups, where we must take an inclusive health approach. We must also recognise that not everybody has the educational ability to interact with all of the public health measures. A person might have a reading age of 12, for example. Our colleagues, Dr. Clíona Ni Cheallaigh and Dr. Austin O' Carroll, do a lot of work in this area. It is important when people do not engage that we do not judge them for that, and that we are curious about the reasons behind it so that we adapt our service to meet them. Too often in the past we expected people to adapt to the service, but the HSE shaping our service for people's needs is where we need to go.

Deputy Durkan made a point about how much the health service costs and about it not being as good as it should be. When we surveyed patients' experience of the system our satisfaction ratings for care were up in the high 80s, at 84% or 96% in the last survey. I have worked in the best children's hospital in the world. Ireland has fantastic staff here who are second to none. Our issues are around capacity, not having enough staff and not having enough infrastructure. We have a population the size of the greater Manchester area. This is totally fixable. Covid showed us that when we have the politicians, the Department of Health, the HSE and the front-line staff working together with the public, we could change things. As my colleague, Dr. McCauley, pointed out, e-prescribing, which people have been working on for years, was transformed overnight when there was a will to work together. Our health service is fixable. We can go from the longest waiting lists in the EU to the shortest if we get everybody's shoulder to the wheel and working together. We just need to have that collaboration. It must be led from the front line, from the patients and the staff who are at the point of care.