Professor M. John Kennedy:

I will address the few points made there. The numbers of cancers are increasing all the time. We are probably seeing a year-on-year increase of about 3%, and that is for a number of reasons. First, we have an increasing population. Second, we have an increasingly ageing population and most cancers - about half of all cancers - are occurring in people over 65. There is going to be a huge increase in the number of people over 80 over the next decade or so, and all of those things are feeding into an increased number of patients who need to be treated.

Third, there is a hugely increased need for resources, not just because of numbers but because the complexity of therapy available is increasing all the time, producing better outcomes for people. We have more and more people surviving cancer, so we need to provide services for more people who have, happily, survived cancer. We have now got around 250,000 people in Ireland who have survived cancer and who need ongoing services due to complications with therapy, complications of disease, ongoing toxicities, etc. There is an ever-increasing and ongoing need for resources to provide the services that people expect and deserve, and that produces better outcomes all the time for patients.

With regard to things we can do quickly to sort out our problems, I am very leery of buying services from the private sector in general. In the long run, I think that is not a solution to these problems. It is a sticking plaster. However, we can do things better. We have problems, for instance, getting visas in a timely fashion for people who are coming to take up jobs in this country, in places like nursing, radiation therapy, etc. We can look at processes for expediting accreditation for people who are seeking to come and work here as radiation therapists, nurses, etc. Our biggest problem at the moment is the recruitment and retention of staff, and having resilience in the system that allows us to provide the services because we have the staff here to do it. We must recognise that we have a very female workforce, and that many of those are young. We have great difficulties with services that collapse when one or two people are not here because they are on leave of some form or another, such as maternity leave, etc.