We move finally to Deputy Mattie McGrath on behalf of the Rural Independent Group.

Ar an gcéad dul síos, I want to be associated with the Ceann Comhairle's remarks of compliments and congratulations to the team here at the convention centre and, indeed, to the chairman of the board, an tUasal Uí Dhubhuir ón Bóthar Leathan in Tipperary. I compliment them and wish them well for the future.

I am quite concerned about the answers the Taoiseach has given to Deputy Tóibín. More than 450 cancer cases and 1,600 pre-cancer cases are likely to go undetected during the pause in screening during Covid but we have to deal with this. The Taoiseach stated he gets the point and he understands but I do not think he does. I am calling on his Government to sort this out urgently because it is not good enough for the people. It may well take years to comprehend fully the misdiagnoses and the hundreds of people who will have died due to neglect and not being seen in time. I do not say that lightly. Hundreds of people would have got life sentences. Professor John Crown, a former Seanadóir whom I have great respect for, has said that treatment delayed is treatment denied. The old adage was that justice delayed is justice denied. I salute the professor and his colleagues. Treatment delayed is treatment denied. It is shocking that cancers can be growing inside people and they are not aware of it. They are waiting and they might have attended their GPs. They are nervous and they are worried. The Government must swiftly address this problem. Pre-Covid-19 we were not meeting anything like the targets we had. We had targets of 95% for new patients attending rapid access breast, lung and prostate cancer clinics within the recommended timeframe - this is pre-Covid. Those are the HSE's own targets. Last year, however, the rate was only 71%. We were missing 24% of people in any case before Covid hit. It is alarming and it has to be dealt with.

Similarly, early intervention systematic breast disease clinics for urgent breast cancer patients and rapid-access clinics for prostate cancer patients were both 26% below the HSE target in 2019. The HSE, therefore, was not fit for purpose even before Covid hit and it certainly is not now. I ask the Taoiseach really to deal with this. There is no point in him telling Deputy Tóibín and myself he knows, he is aware and that we are going to catch up and about all the letters that have been sent out inviting people in. People are scared to go in now because the Taoiseach and RTÉ have frightened the life out of them by telling them morning, noon and night that they should cocoon and stay at home. People who want to go cannot go. They get the letters but they may not respond because they are so worried about going anywhere, especially elderly people. It is time that there was a balance in the Government's attitude to Covid and to the rest of the health service and to the economy, people's mental health, cancer diagnoses - you name it. It was already accepted internationally that we are way behind and under-resourced in our health system and especially in our cancer care treatments. Many recent graduates have looked outside the public service for jobs because of pay and conditions. We need to support them. We are short 500 consultants and they must be recruited. The Government needs to catch up quickly here. I do not believe that the Minister for Health, Deputy Stephen Donnelly, or his Department are capable of doing this. We are slipping backwards and hundreds of people will lose their lives as a result; not one but hundreds or maybe even thousands.

We all need to be careful with language and how we describe things. People are not scared to attend screening services. People are not scared to go to hospital and many are going. As we moved into level 5, one of the key objectives was to keep normal health services open. That has been one of the clear differences between this level 5 lockdown, if we call it that, and the first lockdown. That is understandable too because for a lot of people, the whole experience of this virus was that it was new, unprecedented and essentially whole wards were affected and Covid dominated the hospital experience. Yes, there were delays and backlogs have been created because of delays occasioned by the first lockdown. That is the reality but we have to deal with that. That is why an unprecedented allocation of €600 million was given for the winter initiative and the resumption of services and that has been followed through on with a €4 billion allocation - I repeat, a €4 billion allocation - to the health services for 2021, €2 billion of that to deal with Covid and €2 billion to deal with the health service system itself. That will lead to an additional acute bed capacity of over 1,200 beds. It will lead to additional procurement of activity from the private hospitals. It will allow for more intermediate care beds. It will allow for greater additional access to diagnostics for GPs. It will allow for additional community healthcare networks and community specialist teams, particularly for older people and those with chronic disease. All of the national screening programmes have restarted a phased reintroduction of screening services. If we take, for example, BowelScreen, over 39,000 new invitations have been issued, 10,900 sample kits have been returned to the lab and almost 400 patients have been referred for a colonoscopy. These are people who are using the screening services right now and who are responding to the services.

I take the Deputy's point that some people are obviously still afraid of getting Covid. They are right to be afraid of getting it because no-one should want to get Covid because it can damage a person's health. It is not fair to say people are on the television screens every night scaring the life out of people. They are not. It is important to keep the national effort to get the numbers down. The Deputy should look at what is happening on the Continent at the moment. There are real challenges and pressures on ICU beds right across Europe. Thankfully we have been spared that by timely intervention by Government in the form of going first to level 3 and to level 4 in some counties, by restricting household visits and then going into level 5. A combination of all of that has meant that Ireland now has the third-lowest incidence rate in Europe. We should all work together to maintain that low incidence of Covid right through to the end of the month because that will ensure we can retain the bulk of our hospital, community care and primary care capacity for non-Covid illness. It is the most effective way we can do this and we should all row in behind it.

The bulletins are not daily, I think they are twice-weekly. They are important to keep up the level of national awareness and alertness to the dangers of Covid-19.

The Taoiseach does not get it. Almost 150,000 people have not been seen by the main cancer screening services in the last six months because of Covid. Over 12,400 more people are waiting for an inpatient day case endoscopy at the end of September compared to the same month last year. That is an increase of 56% in the number of people waiting, on top of the already bad situation we had. According to the Irish Cancer Society, social distancing has meant that capacity is reduced by 50% in hospitals. There are now 2,400 people on the urgent waiting list for endoscopy services, almost a quarter, 24% or 580 people of whom have been waiting more that three months. That is totally intolerable. The health services may be writing letters and inviting people back in but they are not coming in because it is a dysfunctional service and was previous to this as well. The Government can throw all the money it likes at it but it will not work.

We need 71 additional consultant oncologists over the next number of years. Have they been recruited? They will not come into the services because of the conditions there. I am very concerned, as are the people out there. We are listening and are supporting the situation but there has to be balance and there is no balance or logic to a lot of the decisions the Government has taken. Trying to get these people back into the hospitals to be seen is vital for their own health and that of their families as well. I repeat - I do not say this lightly - that hundreds of people will die because of this neglect.

As I said to the Deputy, Covid has had an impact. It has resulted in delays. The first lockdown resulted in very significant delays. I do not know what the Deputy's alternative is in terms of what happened in the last number of months. If we take diabetic retinal screening as an example, it resumed on 1 July. Some 20,000 people had been screened by the end of October, so people did come through and it is important to say that. People are turning up for screenings. People are turning up in our hospitals for elective procedures and diagnostic tests. The message we should send out is do attend for screening appointments or diagnostic tests and do go to hospital if not feeling well. It is important we send that message out.

The only issue is to start now affirming those working on the front line because Covid-19 is a once in a 100 years event. It is impacting all strands and strata of society. It is extremely important we affirm people who work on the front line as well. Restrictions have to be in place. Deputy Mattie McGrath attacks social distancing but it must happen. Have we any chance of reducing Covid-19 if people say we do not have to socially distance?

I did not say that.

The Deputy said social distancing is reducing the number of operations.

The Taoiseach's time is up.

There have to be procedures and protocols in place. The Deputy must accept that.

That concludes Leaders' Questions. We are already running significantly behind time. On Questions on Promised Legislation, 20 Deputies have indicated.