Seán Canney (Galway East, Independent) | Oireachtas source

I am glad that the Minister of State is here to hear what I am going to say because it has all to do with her own part of the world and I know that I am speaking to the converted.

The probability of receiving a timely diagnosis of cancer and of surviving the disease differs substantially across Europe. Because of the major inequity in the access to cancer diagnostics and treatments, the chances of surviving cancer are reduced in the west of Ireland relative to the rest of the country and Europe. That is a fact.

The Saolta cancer centre, based in the model 4 hospital at University Hospital Galway, UHG, delivers a programme of cancer care to an overall catchment of approximately 1 million people across the area for which the Saolta Hospital Group has responsibility. This includes Connacht and Donegal, with substantial numbers from the Clare, Tipperary, Limerick and the midlands, including Longford, Offaly and Westmeath. The Saolta region consists of some of the most rural and deprived areas nationally. Those areas are associated with the western seaboard. Saolta has a larger, older population compared with the position nationally. Cancer is a leading cause of premature mortality in the region in which the Saolta Hospital Group operates.

According to the National Cancer Registry Ireland, cancer patients from this region have the worst cancer outcomes in Ireland. In addition, with the impact of Covid-19, the mortality rate is estimated to increase by 20% due to delayed diagnosis and the lack of access. This implies that more patients will die from cancer than from Covid-19.

Cancer services in the Saolta group were working at full capacity and above, with no resilience within the cancer programme to deliver a safe staffed and sustainable service, prior to Covid-19. While Ireland introduced a national cancer control programme in 2006 and designated eight cancer centres, the cancer programme for the west has not received any infrastructural support over the past 12 years and has not been able to develop into a sustainable, staffed, secure programme. The lack of resilience within the cancer programme can be strongly linked to what is described as serial underinvestment in infrastructure for the development of cancer services at UHG and at the model 3 hospitals across the region.

A review of the national service plan of historical capital expenditure in the period 2017 to 2021 demonstrates that only 7% of the national infrastructural investment was allocated to Saolta.

The 2019 KPMG options appraisal for UHG highlighted serious deficits in cancer infrastructure at the hospital and specifically identified critical interim developments that need immediate investment because those buildings were classified as being unacceptable in their present condition. KPMG recommended that the ambulatory cancer care centre be progressed as a matter of urgency.

The case for investment in cancer infrastructure is self-evident and requires fast-tracking and urgent action in order that we might optimise and improve outcomes for our population. Such action will not be sufficient, however, because Covid-19 has exposed other infrastructural deficits at UHG in the context of a lack of inpatient beds, dedicated cancer theatres and ICU capacity and at the model 3 hospitals across the Saolta region.

A person with cancer in the west of Ireland should expect the same outcome as any other patient in Ireland or Europe. In the absence of the required infrastructure to develop the cancer care programme this is not possible, regardless of what efficiencies are put in place in the hospitals. We need to ensure that patients in the west of Ireland have an equitable chance of early diagnosis and appropriate and timely access to the comprehensive cancer care programme and the cancer centre for complex therapies, including surgery and radiotherapy. The national development plan contains this and its words needs to be actioned immediately.

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