Ms Averil Power:

I thank the Chairman and the committee for inviting the Irish Cancer Society here today. My colleague Ms Rachel Morrogh and I thank the members for continuing to focus on cancer services and for listening to how the performance of these services affects patients and their families.

I start by sharing our central concern, which is that in Ireland today, people are not being given the best chance of surviving cancer and having a good quality of life. As we know, the earlier cancer is caught, the easier it is to treat and the greater the person’s chances are of surviving the disease. For example, when a person has their colorectal cancer picked up at stage 1, they have a 95% chance of survival. However, if it is not detected until stage 4 their likelihood of surviving the disease is just 10%. Similarly, the five-year survival rate for breast cancer is 94% at stage 1 but only 19% at stage 4. Similar patterns are found with many other cancers.

Early diagnosis can literally be the difference between life and death, yet we know that 2,500 fewer cancers than expected were diagnosed in 2020 alone. That is 2,500 real people with loved ones for whom a cancer diagnosis is not a statistic; it is a whole world collapsing. We know that other cancers will have been missed in 2021 and 2022. While we do not have official data, we know that others will have been missed as our services struggled to catch up.

Thousands more people are waiting for periods far in excess of the official targets for vital diagnostic tests after visiting their GPs with potential cancer symptoms. Others are so discouraged by the current state of Ireland's health services that they are putting off seeking help until they end up presenting at an emergency department in extreme pain caused by an advanced cancer. Opportunities to pick cancer up early are being missed and patients and patients and their families are paying the price.

Covid did not create this problem. Our health service was struggling to keep up with rising demand for cancer diagnostics and treatment prior to the pandemic but it has made things worse. Previously, Ireland's cancer services were running to stand still. Now they are sprinting and cannot catch up.

Radiology tests such colonoscopies, CT scans, MRIs and X-rays play a vital role in the diagnosis of cancer. Despite this, the Irish Cancer Society understands that there are currently more than 200,000 people on the waiting list for radiology appointments. A total of 150,000 of these have been waiting longer than three months for a vital scan, despite the target in Sláintecare being just ten days.

One in four people who are sent to rapid access clinics with symptoms of breast, prostate and lung cancers are waiting longer than the HSE target. On 31 October last year, it was reported that the then Taoiseach, Deputy Micheál Martin, warned his parliamentary colleagues of a frightening wave of delayed cancers. This was not a Hallowe'en scare, but the reality faced by people we know, people we love who will have worse outcomes, poorer quality of life, more invasive treatments and less time with their families, all because of the existing barriers which deny people timely access to cancer tests and treatment.

The burden of this is being felt the most by those on lower incomes who cannot afford to skip the public queue by paying for tests privately. The current crisis in our health service is also impacting cancer treatment and having a hugely detrimental impact on patients' physical and mental health. Cancellation and postponement of surgery is causing huge anxiety for patients as they worry that the chance to remove their tumour before it has spread may be missed. Patients, many of whom are elderly, are being left standing for hours in hospital corridors waiting for a chair. Pressure has increased and a medical oncologist recently described the current situation on his day ward as being inhumane. Healthcare workers are doing their very best in intolerable conditions but they simply cannot give each patient the time they would like to. Ongoing visitor restrictions in our hospitals are depriving patients of vital emotional support. Irish Cancer Society nurses and counsellors are supporting people who are hugely distressed and anxious, far above levels normally associated with a cancer diagnosis. The conditions in our hospitals are compounding the fear and worry that comes with cancer. On top of this is a feeling of helplessness and frustration at being disempowered by a system that simply cannot cope. This is the reality of cancer in Ireland today. This is the chaos that the members' constituents face. This cannot go on. It is simply not good enough and we need the help of our elected representatives to change it.

Cancer care used to be the poster child for Ireland's health service, with improvements in cancer prevention, detection and treatment delivering a doubling in the overall survival rate in just 30 years. Our national cancer strategy set out clear and achievable roadmaps and our politicians provided both the resources and the leadership needed to expand services and to push through vital changes such as the centralisation of cancer surgeries, which improved outcomes dramatically for patients.

Prior to Covid, our cancer outcomes were still behind those of many other European countries but we were closing the gap. The Irish Cancer Society was hopeful that, if sufficient resources were provided to implement Ireland's third national cancer strategy, patients and their families could look forward to a brighter future. Now, however, we are worried not only that progress has stalled but also that we are going backwards in so many areas. We need the committee's help in highlighting the impact the current delays and disruption to cancer diagnostics and treatment are having on patients and their families and ensuring they are addressed.

There has never been a more urgent need to focus on cancer services. We are deeply grateful for the funding injection into cancer services the Minister, Deputy Donnelly, has delivered in recent years and we hope the services plan will confirm that sufficient development funding will be provided in 2023 to empower the national cancer control programme, NCCP, to implement the national cancer strategy. However, we need so much more. We need investment in bricks and mortar, beds and equipment. We need protected surgical time for oncology cases so that vital and often time-sensitive cancer surgery is not competing for theatre time against other life-saving unscheduled care. We need a strong and resilient cancer workforce who make an active choice to work here and whose conditions are not deterrents to delivering public health care. We need more investment in cancer research and trials to find new and better ways to prevent, detect and treat cancer and, ultimately, to save lives. We also need proper data because it is outrageous that we are planning in 2023 on the basis of the National Cancer Registry Ireland, NCRI, data from 2020 on cancer instances and survival. Indeed, the data published today on cancer inequalities are only on the period ending in 2018. We know that inequalities have got so much worse since then during Covid-19 and have affected people on lower incomes and people from disadvantaged areas a lot more than those who are better off. We simply cannot plan properly without proper and up-to-date data.

A cancer diagnosis is devastating and the prospect of treatment and the inevitable side effects that follow is terrifying. In addition to the physical and emotional suffering, the knock-on effect on family life, finances and work is considerable. That is before the stress of delays, cancellations, financial barriers, crowded corridors, overworked healthcare professionals and ultimately the worry that your care is not as good as it should be. Cancer patients and their families deserve so much better. The Irish Cancer Society believes everyone here today can play a role in delivering that and we are grateful to the committee for prioritising this area.

Ms Morrogh and I are happy to take any questions members may have.