Pádraig Rice (Cork South-Central, Social Democrats)
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79. To ask the Minister for Health the steps she is taking to address the serious deficits in staffing and equipment in public radiation therapy services; if she will instruct the HSE to offer all radiation therapy graduates employment; and if she will make a statement on the matter. [52861/25]

Pádraig Rice (Cork South-Central, Social Democrats)
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I wish to ask the Minister about cancer services. Over 50% of cancer patients require radiation therapy at some point in their care. It is routinely used to treat the most common types of cancer such as breast, cervical and lung cancers. It is the cornerstone of modern cancer treatment and yet, it is neglected. We have ageing machines. In other areas, newer machines have no staff to operate them. Qualified radiation therapists cannot get jobs and there are shocking levels of outsourcing to the private sector. As of July, €17 million has been spent this year alone contracting-out radiation therapy. What action will the Minister take to address deficits in both staffing and equipment?

Jennifer Carroll MacNeill (Dún Laoghaire, Fine Gael)
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I thank the Deputy. The Government is obviously committed to improving cancer care generally. As the Deputy is aware, a total of €105 million has been invested in the strategy since 2017, including €23 million in budget 2025.

Under the national plan for radiation oncology, state-of-the-art radiation oncology centres have opened in Cork and Galway in 2019 and 2023, respectively, which was €120 million capital investment. In Dublin, the St. Luke's Radiation Oncology Network, which includes St. James's and Beaumont Hospitals, were developed under phase 1 of the national plan in 2010. The design of the phase 1 facilities made provision for future expansion for phase 2, is now under way at Beaumont Hospital as a priority.

On staffing, I wish to acknowledge the incredibly important role of radiation therapists in the provision of cancer services in this country. There are currently 220 radiation therapists in Ireland, an increase of over 20% since 2020. While recruitment for radiation therapists is challenging globally, radiation therapist staffing vacancies in the HSE have improved from 30% in 2024 to about 15% to 22% at present. It is not fully staffed but it is going in the right direction, notwithstanding a challenging global environment.

There are currently 40 radiation therapy student places available annually across Trinity College, Dublin and University College, Cork. In the last six years, the radiation therapy training programme has grown by 32% and more than 20 additional specialty training posts have been established in the last three years. The national radiation therapist review, completed in 2024, provides a strategic review of the profession in Ireland and recommendations are being progressed by the HSE. The review recommended the development of new advanced practice radiation therapist roles and those posts are expected to be advertised in the coming weeks. To maintain improvements, NSP 2025 included 5.5 radiation therapy posts and six advanced practice radiation therapists.

Pádraig Rice (Cork South-Central, Social Democrats)
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First, on machinery, I accept there is a replacement programme under way for St. Luke's but why are machines breaking down before action is taken? The internationally accepted lifespan for a treatment machine is ten years but in St. Luke's, Rathgar, they have two machines that are 15 years old and another two that are almost 17 years old. They are limited to using three machines at a time. This means that a quarter of the capacity in Rathgar is being lost. Why? It is to mitigate breakdowns. These machines need to be replaced every ten years. It is entirely predictable, so why is there not a national programme in place to support a ten-year replacement programme? This ad hoc replacement of antiquated machines coming too late in the day is compromising patient safety. Nationally, 35% of machines are already 15 years old, with two more approaching 17 years old. Some 40% of machines will require replacement in the next five years and overall, 75% of the machines will require replacement now or within five years.

We need greater investment and we need a programme to replace these machines.

Jennifer Carroll MacNeill (Dún Laoghaire, Fine Gael)
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There are five public radiotherapy treatment centres with a total of 22 linear accelerators across the services. Galway has four, Cork has five and St. Luke's has 14 machines across the three sites in Dublin. The HSE also contracts radiation oncology services for public patients to centres in Waterford and Limerick and has a service-level agreement with the North West Cancer Centre in Altnagelvin to provide radiotherapy services for patients within a 90-minute road journey of Derry.

Under the National Plan for Radiation Oncology, NPRO, Ireland has developed state-of-the-art radiation oncology centres, as the Deputy is aware. I will look into the examples the Deputy has given relating to the management and replacement of different machines. I just need to spend more time doing that. I thank the Deputy for highlighting it.

Pádraig Rice (Cork South-Central, Social Democrats)
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Regarding staffing, Cork and Galway both have new builds and new machines, but not enough staff. St. Luke's network has a CT scanner with no staff, a skin cancer treatment service operating at reduced capacity because it has insufficient staff, and at the same time, we had 30 graduates in radiation therapy from Trinity College last year. Only ten of them secured posts in Ireland, a further ten left the profession, and ten more have no employment. Radiation therapy graduates need a guarantee of employment from the HSE. At the moment, we are just training them to leave the country, leave the profession or go to the private sector. We also have the ludicrous situation where radiation therapists hired by the HSE do not get incremental credit for previous service in the private sector. How can the Minister justify this policy where radiation therapists are so desperately needed? Why would they move from the private sector to take a pay cut? To address these staffing issues, we need two measures. We need a guarantee of graduate employment for those qualifying and we also need incremental credit for radiation therapists.

Jennifer Carroll MacNeill (Dún Laoghaire, Fine Gael)
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There are a couple of different things. Staffing vacancies have decreased considerably, from 30% in 2024 to 14% in Dublin, 15% in Galway and, I acknowledge, 22% in Cork. CORU has changed some of the registration requirements, which has brought Ireland closer to international standards, providing access to work in Ireland for more radiation therapists generally. We have funding allocated in 2025 for the development of advanced practice roles in radiotherapy, which, again, is an effort to help people to work at the absolute top of their profession, which is really important. Recruitment is ongoing for vacancies in radiotherapy services. We are actively looking for people to come and work in these services. We are trying to enhance the workforce through advanced practice opportunities and to really drive in that direction. We know how much people have to offer. We have the funding for the additional posts. We want people to come and work in this service. We are taking all of the steps we can to try to attract them. We cannot compel people to be in the public health system either.

Pádraig Rice (Cork South-Central, Social Democrats)
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Graduates are looking for jobs, Minister.

Jennifer Carroll MacNeill (Dún Laoghaire, Fine Gael)
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I have jobs.