John McGuinness (Carlow-Kilkenny, Fianna Fail)
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We are now moving to Deputy John Connolly under Standing Order 38A. He might make a better fist of it.

John Connolly (Galway West, Fianna Fail)
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Last week, the Irish Cancer Society launched its pre-budget submission, which highlighted that patients in the west and north west face the longest wait time between cancer diagnosis and commencement of appropriate treatment. Dr. Michael McCarthy, president of the Irish Society of Medical Oncology and a consultant oncologist at University Hospital Galway, said:

Working in the West of Ireland, I see the human cost of the postcode lottery in Irish cancer care every day. Once chemotherapy is prescribed, the National Cancer Strategy states that it should start within fifteen working days. The reality in Galway is that patients are now typically waiting seven to eight weeks for their first session. With every week that passes, the risk increases that their cancer will grow, or worse that it will spread to other parts of their body.

Dr. McCarthy went on to describe the conditions of the facilities in Galway as follows:

In 2016, the day ward in Galway University Hospital had 13,000 visits. By 2024, that had increased to 25,000. Our doctors, nurses, hospital pharmacists and others have done everything they can to minimise waiting times. However, we simply don’t have enough staff, space, or equipment to cope and patients are paying the price.

The report went on to note that at University Hospital Galway there is no PET scanner, meaning scans are being conducted privately at a higher cost. The hospital also needs a new CT scanner and facility. One CT scanner is 17 years old and keeps breaking down. Visit volumes have increased as patients require more intense treatment over longer durations.

The Tánaiste and I spoke previously about the work of the capital programme oversight board at University Hospital Galway and the need for progression of the infrastructure master plan it has developed. University Hospital Galway is the only model 4 hospital in the HSE west and north west region. It serves a population of more than 850,000 people and that patient population increases to 1.1 million for cancer services for which it also covers County Clare and parts of the midlands. The Saolta group stated during the development of the master plan that the outdated and suboptimal facilities in the hospital make the provision of adequate care more challenging.

Recently, the Minister for Health launched the master plan for the hospital in Galway. Among the proposals in the master plan are additional beds, a new accident and emergency unit, a new maternity and paediatrics facility, new laboratories and a new cancer centre. I understand that the preliminary business case for the new master plan will be delivered to the Department of Health by the end of July. Interestingly, in the Irish Cancer Society's pre-budget submission, it calls on the Government to address the deficits in cancer care by prioritising cancer infrastructure in the new national development plan.

I noted that in an earlier response, the Tánaiste mentioned the social infrastructure that will be included in the new national development plan. I am looking for a commitment that the implementation of the master plan for the hospital in Galway will be included in the national development plan and will specifically include all aspects of the progression of the master plan, including the new cancer facility.

Simon Harris (Wicklow, Fine Gael)
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I thank Deputy Connolly for the question. I also thank the Saolta group and the Irish Cancer Society for the work they do, much of which the Deputy referenced. It is good work on highlighting the issue for the Deputy's constituency and region. The Government that the Deputy and I are part of is committed to improving cancer care. We are committed to ensuring better prevention, maintaining improvements we have seen in Ireland, thankfully, in many cancer survival rates and protecting and improving timely access to treatment.

As the Deputy stated, cancer services in the west and north west are delivered through a designated cancer centre in Galway, with local services operating out of smaller hospitals in the region. University Hospital Galway also supports a satellite centre for breast cancer at Letterkenny University Hospital. I am pleased to say there has been significant investment in cancer services in the west in recent years. This year, 14 additional posts were allocated to the region, which support surgical oncology, radiotherapy, survivorship and CAR T-cell immunotherapy and those with a family history of breast cancer. My understanding is that the acute haematology oncology service is also being expanded this year, with the allocation of an additional advanced nurse practitioner. These nurses provide a dedicated telephone service for patients undergoing systemic anti-cancer therapy, enabling those who are ill to avoid attending the emergency department. The additional staff will help to expand the services further and to further improve access for patients. These posts will build on growth in cancer services in recent years. Seventy-six additional staff were allocated to University Hospital Galway under the national cancer control programme between 2017 and 2022.

However, the Deputy is right to highlight the issue of capital investment, which is at the core of his question. We have seen some recent capital investment in cancer services in Galway, including the new state-of-the-art radiation oncology centre, which opened in 2023 and was a €72 million investment in cancer services. It has allowed the development of new stereotactic radiotherapy programmes to commence in January this year. As the Deputy said, a number of major capital projects are under consideration now for Galway, including a new cancer centre alongside a new emergency department, replacement laboratories and inpatient ward blocks.

I met some of the medics who were involved in the proposal for the cancer centre when I was in Galway in the recent past. I acknowledge the huge amount of work being done by them in good faith with the Saolta Group, the HSE and the Department of Health. I am aware of the new master plan for the hospital. It is an exciting proposition. It could be a game-changer for the west.

The statement of fact at the moment is that we are working on finalising the national development plan. We expect to be in a position to bring it to the Government on Tuesday. It will provide a significant uplift in capital investment for our health services and will provide the Minister for Health, the HSE and the Saolta Group with the certainty they need to decide on their next steps. The Minister for Health will keep in close contact with the Deputy as that progresses in the days ahead.

John Connolly (Galway West, Fianna Fail)
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I appreciate the Tánaiste's response greatly. The one line that really gives me hope is his comment that the master plan for the development of the regional hospital in Galway will be a game-changer. It certainly will. Some of the preliminary works to enable it have started. Some of the outpatient services have moved to Merlin Park University Hospital and there are plans to move more services there to ensure we have a top-class facility for acute requirements and that we also have outpatient and elective services in Merlin Park University Hospital.

However, I ask that the Government look at a commitment under the social infrastructure aspect of the national development plan to make sure this master plan is fully developed and comes to fruition. My understanding is that the preliminary business case highlights that the annual financial contribution required will be 1% of the annual health budget over a ten-year period. We will see substantial benefit from that investment. It will give us the type of facility the Irish Cancer Society talks about in its pre-budget submission and reassure the patients of the west and north west.

Simon Harris (Wicklow, Fine Gael)
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I genuinely believe, like the Deputy does, that the master plan has the potential to be a game-changer for the health service in Galway and the western region. I am also taken, from a policy point of view, with the division of acute and elective services. That is how we address the challenges that patients and clinicians experience with overcrowding and access times. We all say our health service is great when you get into it. We need to improve the ways of getting into it and decoupling acute emergency care from elective care is a game-changer. It is a Sláintecare direction and the Saolta group in University Hospital Galway has done a huge amount of work to prepare for that.

The Minister for Health is passionate about delivering on elective hospitals, one of which is earmarked for Galway. I am pleased to hear the Deputy use the word "investment" because we talk a lot about how much things cost. This is an investment in people's health and health reform because capital can be a huge reform enabler for our health service. The decisions will be taken under the national development plan next week.