Ms Rachel Morrogh:

I will start and Ms Power may supplement what I say. Deputy Shortall is right. It was the jewel in the crown of all different disease groups and the committee will probably remember that the National Cancer Control Programme, NCCP, used to sit under the Department of Health. It was moved to the HSE and there was a recent article in The Medical Independentwhich outlined that the NCCP lost some of its power in that move. We would like the National Cancer Control Programme to sit under the Department of Health so it has additional powers. The competition between cancer services and other acute services which the health service has to deliver means that it is more difficult, particularly regarding treatment, to be able to guarantee timeliness of treatment. Ms Power mentioned the recent NCRI report on inequalities. Unless we focus on the people who are most vulnerable, most at risk of cancer and have the lowest survival rates, we are not going to make the big improvements we want to see. That is going to require a whole-of-Government approach to tackle health inequalities, rather than just a singular Department of Health issue because of the social determinants of health. It needs that wide focus and it needs to be a Government priority to implement the national cancer strategy.

Sadly, the cancer strategy is going to expire in 2026. We have not seen progress in implementation we would like to have seen at the midway point. The committee may be aware that some of the KPIs do not even have data for us to understand how much progress has been made. As Ms Power said, it is challenging for us to get data on cancer services in real time. All of those things combined mean that cancer services are not in the position we want them to be. Governance is part of that.