Mr. Damien McCallion:

Good morning. I thank the committee for the invitation to discuss the current issues relating to health services for cancer. I am joined today by Professor Risteárd Ó Laoide, national director of the national cancer control programme, NCCP; Mr. Tony Canavan, regional executive officer, HSE West North West; Fiona Murphy, CEO, national screening services; and Dr. Triona McCarthy, assistant national director of our national cancer control programme.

Cancer is one of the most significant health challenges we face as a country. Each year more than 24,000 people are diagnosed with invasive cancer and that number will continue to rise over the next two decades as our population grows and ages. One in two people will experience cancer during their lifetime. These facts underline the continuing need for a strong, well-governed national approach to cancer control.

Turning to the national cancer strategy implementation, the delivery of cancer services has had clear policy direction provided through the three national cancer strategies published in 1996, 2006 and 2017. Each strategy aims to set out the steps required over the subsequent ten years to deliver a cancer control system that meets the needs of the people of Ireland. The continued focus on a data-driven and evidence-based policy, that considers the needs of the entire population and applies the best, innovative approaches to cancer control, is essential to ensuring we continue to build on the strides made over the last 20 years in cancer mortality and quality of life. It is the intention of the Department of Health and the HSE to review the implementation of the current cancer strategy and commence the development of a new strategy in 2026.

Moving to funding, cancer services are funded in a number of different budget lines. It is included in the HSE's drugs budget, and in lines for cancer screening, hospital treatment, primary care, palliative care, support services, diagnostic services and community aids and appliances, and indeed in other areas like primary care. In addition, there is specific funding for the current national cancer strategy. Since it was published in 2017, approximately €90 million has been put into cancer services, including €20 million in 2025. This investment has supported the creation of over 800 posts across the public cancer service, including approximately 120 consultant doctors, 300 nurses and 300 health and social care professionals.

In terms of implementation, the HSE has now established six health regions in the HSE and it is important they take on responsibility for the implementation of the national cancer strategy, under the oversight of the NCCP. As we move into 2026, with further autonomy for the health regions in the allocation of resources, the national service plan will set out very clear targets for the health regions in performance across our key indicators for cancer.

The NCCP will be strengthened going into 2026 with a primary role in the planning of cancer services, enabling performance oversight and providing assurance in relation to the quality of our cancer services. In addition, where key strategic decisions need to be made such as in the placement of new services, deployment of digital solutions or development of national solutions such as the acute haematology oncology nursing service, these will be directed by the NCCP.

In the interest of time, I will not go through the improvements in cancer services but I will give headlines of some of the areas around rapid access clinics, cancer surgery being centralised with better outcomes, guidelines, pathways, various models of care, new radiation oncology facilities in Cork and Galway, molecular diagnostics and cancer genetics services, substantial investment in cancer medicines and also in areas like the acute haematology oncology nursing service, the alliance of cancer support centres and the cancer information system that has been deployed in 22 of our 26 hospitals, with the remaining to be rolled out. There is a huge amount done but recognition that further work is needed.

Screening services are reshaping cancer-related screening and care through the delivery of its five-year strategic plan, which my colleague Ms Murphy can talk to later, to strengthen quality, equity and accessibility across all our screening programmes. The four programmes continue to make an important contribution to the reduction of cancer-related deaths and illness in our population. Through CervicalCheck’s delivery of high uptake of HPV cervical screening, Ireland is on track to eliminate cervical cancer by 2040.

However, there are challenges and the committee will have heard some of these earlier. Cancer services in the country do face many challenges. We want to ensure the best treatments are available to patients as early as possible, by enabling timely access to innovative and targeted therapies. We want to support people living with and through cancer with improved follow-up pathways, and more supports for the psychological impact of cancer and the many physical effects of cancer and its treatment on survivors of cancer.

Increased population growth, heightened awareness of symptoms and improved detection are all placing significant demand on existing services, as evidenced by performance data. The development of capital infrastructure capacity for cancer services is one key enabler to improving the timeliness of cancer diagnosis and treatment. While there have been some excellent advances, such as the new radiotherapy centres in Cork and Galway, we recognise there is a need to invest in our equipment.

Our estates teams are working with the national cancer control programme and the relevant health regions to address this as part of our national equipment plan. We are working on theatres, oncology day wards and on our overall diagnostic capacity. Our national radiology strategy, which will be endorsed under the 2026 national service plan, will allow us to plan forward on that basis.

In summary in the interests of time, looking to the future, Ireland’s experience over the past two decades has shown that national leadership in cancer control delivers measurable results. Regional delivery can best succeed when guided by clear national standards through the national cancer control programme. This will protect the coherence of cancer policy, ensures equity across regions and supports the regional structures now emerging within the HSE to deliver care within a single national framework. The next national cancer strategy will provide the opportunity to reinforce that approach. We are a relatively small country and it is critical that we maintain a national focus when planning cancer care.

I want to acknowledge the commitment of our staff across our cancer control services, including the staff providing cancer services in hospitals community and voluntary services. Their dedication and commitment to quality and to delivering the best care they can for patients, often with mounting challenges, demonstrates the commitment that has facilitated the improvements in cancer care and survival in Ireland.