Ms Averil Power:

We often hear about key roles that go unfilled, where the resources have actually been allocated and the roles cannot be filled because we cannot attract people to take them up. As Deputy Shortall knows, that is happening at every level within the health service and it happens a lot in cancer services. In the briefing we circulated to the committee we highlighted particular areas including radiotherapy and other areas where we have far less staff per capitacompared with other countries. That is a huge challenge affecting both the workload on the remaining staff and making the situation intolerable for them, and patients cannot get access. Deputy Shortall mentioned training, for example, and whether we are training enough people. As we all know, the people we are training vote with their feet and decide not to stay here because of the conditions in which they would be working. Between January and May 2022, 402 Australian work visas were issued to Irish doctors and in all of 2019 it was 272. That has been an issue for years but has gotten a hell of a lot worse and we hear from recent medical school graduates that almost their entire class is going to Melbourne or to the US where they will have enough time with their patients because it makes doctors and nurses really distressed when they try to provide care and cannot do it to the best of their abilities. As Ms Morrogh said there are huge levels of burnout. Cancer staff come to us really upset saying they go home from work feeling guilty and stressed because they could not do their jobs. Who would want to work in those conditions? Understandably, people are voting with their feet and leaving Ireland but it is a viscous circle. I think the Deputy hit the nail on the head as regards to the staff. It is about giving people confidence that things will change. We still do not have that despite Sláintecare and the national cancer strategy. People in Ireland do not have confidence the health service will get better. I think if the staff had that confidence they would stay and that would end the viscous cycle of the more people leave the worse it gets and the less attractive it is for graduates and for others to stay.