Ms Averil Power:

There are a number of them. Part of it is, as I mentioned, the lower uptake of screening in disadvantaged areas. For example the uptake of breast cancer screening is much lower in disadvantaged areas than in more affluent ones where almost everybody takes their appointment. That is part of the challenge. Other things like access to diagnostics is a big one. If somebody goes through the public system and their GP tries to get them a public appointment for an MRI, an x-ray or other scans to find out if they have cancer and they realise they will have to wait for a long time, if they can afford it they can get the test privately, perhaps in a week rather than waiting for months through the public system. So access to diagnostics is a crucial one. There are other issues around, for example health behaviours are different in disadvantaged areas so there are much higher rates of smoking. It is complex. There are factors such as health literacy and diet and as Deputy Shortall knows inequality is very complex and multifaceted. For that reason we need a multifaceted approach to make sure everybody is empowered to live their lives as healthily as they can without being put off by the cost. Healthier food is more expensive. To be truly empowered to engage with healthcare professionals is something many people struggle with. I think all of us can sometimes feel intimidated when we try to engage with our GP or consultant but it is a greater challenge for people with lower levels of education. The key one we can fix and that the Irish Cancer Society has highlighted is the diagnostics piece. The ability to pay privately for tests means other people can jump the queue whereas those from lower backgrounds cannot.