Pádraig Rice (Cork South-Central, Social Democrats)

We have a bit of time left so we can do another round of questions. I will put a few first and then we will hear from Deputy Cahill.

On radiation therapy, and the infrastructure in particular, my understanding is the internationally accepted lifespan of radiation therapy machines is ten years. Of our public machines, eight are already more than 15 years old, with two approaching 17 years. There are nine that will be required to be replaced within the next five years and, overall, 75% of the machines require replacement now or within five years. It is my understanding, however, that there is no national replacement programme. These antiquated machines are being replaced on an ad hoc basis, with some reaching breaking point first. In Rathgar, there are two machines that are 15 years old and another two that are almost 17 years old. That centre is limited to the use of three machines at any one time to mitigate these frequent breakdowns, which means a quarter of the capacity there is being lost. A replacement programme is under way in the St. Luke's network, which includes Rathgar. Why was the situation allowed to deteriorate so badly before anything was done? These machines need to be replaced every ten years. It is a predictable problem and one we should have a plan for.

I have a number of questions I will put to the executive together. Why is there not a dedicated replacement programme for radiation therapy machines? The need for this was identified in the evaluation of the 1996 cancer strategy. As I said, the replacement programme for Rathgar, St. James's and Beaumont hospitals has been approved. How long will it take? I put in some parliamentary questions on this and the HSE responded that the procurement process would only commence in 2026. Rathgar already has two machines that are 15 years old and another two that are 17 years old. We need to get information on the timelines.

Is any preliminary work being carried out on replacing the machines in Cork? These machines are already six years old. We do not want the same thing to happen as happened in Rathgar where we have machines breaking down and limited capacity. If we have a repeat of the situation in Dublin either in Cork or Galway, further outsourcing will be inevitable. Is the HSE not of the view that this is a poor use of public moneys, especially given the need to replace these machines is entirely predictable? As I noted earlier, the outsourcing costs are staggering. Between 2020 and 2024, €75 million was spent outsourcing radiation therapy to private providers and up to July of this year, €17 million was spent. These are huge sums of money because we are allowing the public system to be run down. It seems to be a predictable problem and if we had a plan, we could have saved that money and invested in the services instead of outsourcing to the private sector. It is a real cause of frustration. I am interested in hearing the witnesses' thoughts on that.