Colm Burke (Cork North Central, Fine Gael) | Oireachtas source

I welcome the opportunity to address the House on the issues raised by the Deputies tabling the motion. I would like to begin by echoing my colleague, Deputy Butler, in her opening remarks, and to thank her for the constructive and positive contributions to this important motion on the issue of funding for the national cancer strategy. I apologise that the Minister for Health, Deputy Donnelly, cannot be here this evening, as I understand he is dealing with legislation in the Seanad. I acknowledge the input of all Deputies. It is clear that we are all motivated to ensure that the national cancer strategy is properly supported for the benefit of patients and their families. There were one or two issues - I am going off script in saying this - relating to radiation therapists. I became aware of that issue in September. I arranged for a meeting with the two universities - Trinity College Dublin and UCC - with the Minister in October. There were proposals and submissions by TCD to increase the number of trainees in radiation therapy from 30 to 50 and by UCC to raise the number from 12 to 24. The course in UCC is a master's course of two years. Those proposals were submitted to the Minister in early February. I was involved in making sure action was taken on that.

The National Cancer Strategy 2017-2026 is the third such cancer strategy in Ireland. These successive strategies have shown the benefit of continued investment in national cancer services. It bears repeating that this Government has shown its commitment to implementing the strategy through significant investment in 2021 and again in 2022, for a total of €40 million. The new development funding provided in those years has been added to the total budget for cancer services. Since 2017, more than €230 million in cumulative additional funding has been invested in the strategy. This means that our national cancer services have been strengthened, which is important, as the incidence of cancer is expected to increase in Ireland in the future. When discussing funding for our national cancer strategy, we must remember the 23,000 people who receive a diagnosis of invasive cancer each year. Cancer is a public health issue, as one in three of us can be expected to be diagnosed in our lifetime. The additional funding that has gone into services under this Government has been of direct benefit to cancer patients. Funding of more than €120 million for capital projects has meant that more people can receive radiotherapy in the new facilities in Cork and Galway. Funding of €98 million in the past three years has meant that patients have better access to new medicines, including 61 cancer drugs. The spend on cancer drugs in the past three years alone was more than €600 million. As has been said, there are now more than 215,000 people living in Ireland following a diagnosis of invasive cancer, which is an increase of 65,000 since 2017. This shows how our strategic approach to cancer has made a real difference for people, with strong policy oversight from the Department of Health and implementation by the NCCP.

Under the national cancer strategy since 2020, the Government has invested an additional €30 million in screening services, including €20 million for the national cervical screening laboratory. Our national screening programmes are highly ranked in comparison to other European countries, and we have set the ambitious target of eliminating cervical cancer as a public health concern by 2040.

This is a target we are on track to achieving, thanks to the efforts of everyone involved.

Since the beginning of the current national cancer strategy, there have been improvements in treatment. This includes the introduction of many new treatments, the provision of treatments previously only available abroad and safer delivery of existing treatments. CAR T-cell therapy is now being provided in Ireland for adults, in St. James’s Hospital since 2021 and in CHI Crumlin since 2022. CAR T-cell therapy is a recent groundbreaking therapy which involves infusing patients with a genetically modified version of their own cells. CAR-T-cell therapy is currently available in Ireland for several cancer types. However, it is expected in future that therapies and use cases will grow substantially. This is why investing in CAR-T infrastructure was so important at the early stages. This was made possible through funding of €3 million for anti-cancer therapies provided in 2022. This year, we have had the introduction of radio-labelled therapy or PRRT at St. Vincent’s University Hospital. The treatment is for people with neuro-endocrine tumours and delivers precise radiation to cancer cells, minimising damage to surrounding healthy tissue. The service was launched in March of this year and is planned to expand incrementally over two years to get it fully operational. Once it is fully operational there will no longer be a need for any patients to travel abroad for PRRT. The expected annual cost of treatments is €3.5 million for 50 to 60 patients per year, reflecting the commitment to delivering treatments for rarer cancers, as well as the most common types of tumours.

Along with new treatments there have been many innovations in cancer care delivery. These innovations have allowed for better outcomes for patients. Centralisation of cancer surgeries to a smaller number of high-volume specialist centres is at 85% completion and it is expected to be complete by the end of this strategy. Centralisation of surgery is important for patients as it means that surgeons have the right level of case volume and expertise to provide the best possible outcomes for patients. Most recently, centres have been designated for sarcoma, skull base and gynaecological oncology surgical services. Cancer surgical services are also increasing in activity, with an additional 1,000 surgeries carried out in 2023 compared to 2019. Other recent innovative practices include updated clinical guidelines for treatment of cancer patients which make more effective use of existing resources. An example of this is hypofractionation for breast cancer patients receiving radiotherapy, which ensures effective treatment can be delivered with fewer doses. This allows more patients to be treated using the same resources and reduces potential side effects for patients. Some €9.8 million was allocated in the HSE capital plan last year to support radiotherapy treatment at our centres in Dublin, Cork and Galway.

Alongside all this work, the national cancer control programme, NCCP, has introduced new models of care in many different cancer areas. This was one of the recommendations of the national cancer strategy. Some recent examples include the launch of the systemic anti-cancer therapy model of care in 2022. This provides a blueprint for the development of services and delivers additional treatment regimens which ensure that treatment can be tailored to the needs of the individual patient. Other models of care include those for psycho-oncology for both adults and young people, ensuring that we can provide psycho-social supports which meet patients' specific needs. This is particularly important now as we have so many more people living with and beyond a cancer diagnosis. Survivorship courses are now delivered through the alliance of community cancer support centres and €3 million in funding was allocated to those centres in 2024. At the other end of the cancer patient spectrum, we have the hereditary cancer model of care which has developed a pathway for people who might have an inherited predisposition to cancer to access testing, counselling and potential treatment. These models of care will ensure that our national cancer services continue to be improved for the benefit of patients.

As cancer is expected to affect one in three of us in our lifetime, support for cancer services and for cancer patients will continue to be prioritised as part of overall health budget. The Government has invested heavily in cancer services in recent years and this has resulted in wide-ranging benefits for patients. Once again, I thank all the Deputies involved in today’s debate, both those who made contributions and those who tabled the motion. I will also take a moment to thank those working in cancer services, in hospitals and in the community, for the care and treatment they provide to patients. In fairness, a lot of good points were made by Deputies tonight and I intend to take them back, but a lot of progress has been made and while we have a lot of challenges, we have delivered a very good service to a large number of patients across the entire country. It is important that we work towards continuing to improve that service.

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