Pádraig Rice (Cork South-Central, Social Democrats)
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2. To ask the Minister for Health if her attention has been drawn to the failure of a number of symptomatic breast disease clinics to see newly referred patients within ten working days (details supplied); the steps being taken to ensure that these clinics meet their targets; if the required resources will be allocated to these clinics to ensure there is adequate staffing; to provide an update on the programme for Government commitment to ‘protect diagnostic pathways and invest in infrastructure and equipment to meet target treatment times outlined in the national cancer strategy; and if she will make a statement on the matter. [35169/25]

Pádraig Rice (Cork South-Central, Social Democrats)
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Access to symptomatic breast disease clinics has become a postcode lottery. Following an urgent GP referral, a person should be seen by a clinic within two weeks. However, timely access to these clinics varies widely. Last year, only four out of nine hospitals met the target of seeing 95% of urgent referrals within two weeks. The other five failed. The Mater Hospital only reached 29%, St. James's Hospital 51% and Letterkenny 58%. Some of these are shocking failures. It should not matter where one lives; no person should have to wait more than two weeks. These are urgent referrals. Where is the sense of urgency?

Jennifer Carroll MacNeill (Dún Laoghaire, Fine Gael)
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There are nine HSE rapid access symptomatic breast disease clinics nationally, as the Deputy knows. The HSE has set a target of 95% of urgent referrals being seen within ten working days. Non-urgent referrals should be seen within 12 weeks. The HSE national cancer control programme monitors the performance of these clinics. Last year, national compliance with targets was 76% for urgent and non-urgent referrals but I recognise the variations the Deputy described. While five centres generally met or exceeded the targets during the year, four did not. This is often caused by staff shortages or problems in accessing diagnostics or radiology services.

These clinics consistently operate at full capacity. Unfortunately, any disruption to services can lead to a backlog, which can take time to clear. Where a performance issue arises, the HSE implements site-specific measures, but it may also need to implement regional measures, which we can discuss further. These can include funding additional clinics or providing locum cover where necessary.

The national cancer control programme is also developing new or modified pathways for certain patient cohorts. These aim to make better use of available capacity and provide appropriate access for high-risk patients such as those with a family history of breast cancer. My Department is also reviewing diagnostic services to ensure that capacity is fully maximised. The Government's commitment to cancer services is reflected in significant investment, with more than €105 million provided for cancer services under the national cancer strategy, including €23 million in 2025. Nevertheless, there is a great deal more I would like to say about it. Perhaps I can do so in a supplementary reply.

Pádraig Rice (Cork South-Central, Social Democrats)
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One report states that one in four people waited longer than recommended for an appointment at these urgent clinics. I would like to share with the Minister the experiences of two women from north Dublin. They had to wait for in excess of the two-week period to be seen by the matters symptomatic breast clinic. In February, one woman was referred by GP due to the presence of two lumps in her breast. However, when the Mater Hospital received the referral, she was told the waiting time to be seen had risen to three months.

Let us imagine receiving this news at a time of extreme uncertainty and fear. It was May before she received her appointment at the Mater. Another symptomatic patient in the Mater who had been waiting for an appointment since April was seen last Monday, two months later. During these agonising two months all these women were told was that the Mater's BreastCheck clinic was understaffed and there was no estimated appointment date to be provided. In what world is this acceptable? What has happened to this country's cancer services? Cancer care used to be regarded as the jewel in the crown of our health services.

Jennifer Carroll MacNeill (Dún Laoghaire, Fine Gael)
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The Deputy is right. Yesterday I was at St. James's Hospital and it and Trinity College have become one of the accredited cancer centres of the Organisation of European Cancer Institutes. There are many accredited centres but this is at a different level. It is the most prestigious award for cancer control. The Deputy is correct that we have very good services. He asked in what world is this acceptable. There is no world in which it is acceptable and there is no world in which the Mater's figures are remotely acceptable.

Let me also say that like the Deputy I have correspondence from the breast health unit in the Mater and I am deeply disappointed with the content and the tone of the letter being sent to women who are not just going for BreastCheck but who are going because there is a problem. I have written to the CEO of the Mater hospital to express my concern about this and to ask for the number of people waiting on it. I have also asked the regional executive officers for that area and the adjoining area, which includes St. Vincent's University Hospital and Tallaght University Hospital, to come up with a regional solution that meets the needs because this is absolutely unacceptable.

Pádraig Rice (Cork South-Central, Social Democrats)
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We absolutely need better planning here. A lot of this comes back to staffing. Greater resources must be allocated specifically to breast clinics to ensure adequate staffing throughout the country, regardless of where people live. To secure cancer care pathways greater workforce planning is required but this cannot be siloed in the Department of Health. We need joined-up thinking. The Departments of Health and higher education must work together to ensure people are able to access places on various healthcare courses, especially radiology given its key role in diagnostics. The HSE also has a role as it must ensure there are enough clinical placements for trainees. Crucially, we need to ensure people can stay in Ireland to work in our healthcare system after qualification. As the Minister has said, these are very concerning findings. These are women who have symptoms and who are waiting for too long to be seen. It needs to be addressed urgently.

Jennifer Carroll MacNeill (Dún Laoghaire, Fine Gael)
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I thank the Deputy and I agree with him on all of these points. Yesterday at the health committee we covered some of the workforce planning issues and the expansion of training places. It is also a workforce management issue and the variation between hospitals is well noted. I am told that in the Mater there have been long-standing recruitment challenges but they have been stabilised. There has been a consistently high volume of urgent referrals with difficulty in accessing radiology in St. James's Hospital. A lean project is under way to improve efficiencies. In Letterkenny the hospital has met the urgent KPI targets for the past three months, although the figure for the year to date is 85% following a poor performance in January. St. Vincent's Hospital has been meeting the urgent KPI since last September and it is at 99%. Cork University Hospital remains in the 80% to 90% range for urgent referrals.

I know the Deputy did not raise this necessarily in the parliamentary question but Galway University Hospital's performance this year has averaged 33% but it is expected to show improvement in May because of the appointment of a replacement breast surgeon. He and I are having to discuss this on a hospital-by-hospital basis and we have to make sure the system is across itself.