David Cullinane (Waterford, Sinn Fein)
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75. To ask the Minister for Health the level of new funding to be made available for the national cancer strategy; if she will implement multi-annual funding frameworks in 2026; when a review of the strategy will commence; and if she will make a statement on the matter. [64612/25]

David Cullinane (Waterford, Sinn Fein)
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My first question is in relation to the national cancer strategy. The Minister might be aware the Irish Cancer Society has been raising concerns over the past number of weeks and months in relation to access to diagnostics, staffing shortages across cancer centres and cancer services but also insufficient and inconsistent funding for the national cancer strategy. The Minister might outline to the House, if she can, what additional funding has been made available for the national cancer strategy and for cancer services in budget 2026.

Jennifer Carroll MacNeill (Dún Laoghaire, Fine Gael)
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Funding of €27.4 billion, as the Deputy knows, has been allocated to the health service for 2026, an increase of 6.2%. Next year a new approach is being taken to funding allocation with health budgets being devolved to the HSE regions, giving them greater autonomy to meet local needs while holding them accountable for ambitious targets and national standards.

The National Cancer Control Programme will continue to lead on service design nationally and implementation of the national cancer strategy. The programme also monitors performance and works closely with the regions to ensure the delivery of safe effective cancer services, continuing to work towards the delivery of multi-annual budgets in health over the coming years. Capital investment already operates multi-annually and it is a priority for me to introduce this across all areas of the budget.

Since its launch in 2017, the Government has allocated €105 million to the national cancer strategy itself to support cancer services and improve outcomes for patients. That, of course, is not the totality of funding for people who have cancer but to the cancer strategy itself. Since then, very significant progress has been made in improving cancer services and there are now over 220,000 living with or beyond cancer, 50% more than a decade ago.

One in two people is expected to receive a cancer diagnosis in their lifetime.

We are seeing tremendous advances in cancer care and I am committed to ensuring that patients can take advantage of these developments.

Work will begin shortly on an evaluation of the cancer strategy, which will inform the development of a new strategy next year. The budgetary situation is that the letter of determination has been sent, which will indicate very clearly, as the Deputy outlined, that there is inequality of access to diagnostics and treatment within the different regions. It is a priority to try to achieve better equality. In the service plan, we will see the specifics of trying to acknowledge and achieve that in a better way.

David Cullinane (Waterford, Sinn Fein)
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The Irish Cancer Society was before the Oireachtas health committee a number of weeks ago. It raised very serious concerns in relation to major delays in diagnostics and treatment, particularly in the areas of colonoscopy, breast and prostate clinics, imaging, surgery and radiation therapy. It raised concerns about severe staffing shortages in radiology, cancer nursing and radiation therapy.

I put down a parliamentary question on the number of scanners and the diagnostic equipment that is lying idle, is not being fully utilised or has reached end of life. It is staggering to look at some of the details that have come back. For example, in Sligo hospital, a CT scanner is not fully utilised because one additional whole-time equivalent radiology post is needed, which was approved, and the hospital is still waiting for that appointment to be made. In University Hospital Limerick, one CT scanner is under-utilised; there is a staffing requirement for two whole-time equivalent radiologists needed to run it full time. In Ennis, one CT scanner and one ultrasound machine are under-utilised because four whole-time equivalent radiographers are needed, as well as a radiographer assistant, nurses and so on. At St. Luke's Radiation Oncology Network, and this was very helpfully raised by Deputy Boyd Barrett a number of weeks ago, linear accelerator, LINAC, equipment is out of date and needs to be replaced. There is a dire need for investment in equipment and diagnostics in our cancer services. I have not heard from the Minister what additional funding, either capital or current, has been made available, specifically for the national cancer strategy.

Jennifer Carroll MacNeill (Dún Laoghaire, Fine Gael)
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We are talking about services that go beyond the cancer strategy. The Deputy correctly identified regional gaps that need to be filled by the regions, particularly where they are not meeting their targets or the same standard as other parts of the country. For example, this week, I was in Bantry, where there are two endoscopy suites, which are really important for bowel cancer and gastric cancers generally, but are under-utilised, although there are two theatres. That is a form of investment in cancer and in preventing, diagnosing and ultimately treating cancer. The two suites are there but are under-utilised. One of them is running for half of one week and the other is not being utilised at all, yet there is a list in Cork. The facility is there and we have to reorganise the resources. It does not necessarily need new people. It needs consultants from CUH to come out. Some of them are already doing that; others need to come out.

The totality of investment in cancer is around treatment, drugs, diagnostics and, as the Deputy correctly identified, utilising the infrastructure we already have in a more complete way. I am trying to do that, hospital by hospital and region by region, to make sure that is maximised. In the letter of determination in the service plan, it will be for the region to recognise where it is coming up short and to make sure it is allocating its resources in an appropriate way.

David Cullinane (Waterford, Sinn Fein)
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I fully understand that cancer services go beyond the national cancer strategy. Of course that is the case. Across all of our acute hospitals, cancer services are provided that are outside the remit of the national cancer strategy. That strategy is also important in bringing together stakeholders. It is meant to bring consistency in services and it looks at where gaps are and so on. I had this discussion with the Minister at the Oireachtas health committee yesterday. I do not need to know exactly how the money is going be spent because that is a matter for the regions. I do not have a quarrel with that. I supported the health regions and I believe in regional health budgets, but it is important for us to know what additional money has gone into any of those strategies or not. It is not what the health regions will spend the money on; it is how much new money they have been given, in addition, to invest in these services. That is what the Irish Cancer Society is trying to find out. It is what other organisations advocating for cancer patients are trying to find out. I cannot tell them. I have told them I have asked the question so many times and I cannot seem to get any answer. I do not know what other way I can raise it other than in here directly with the Minister.

Jennifer Carroll MacNeill (Dún Laoghaire, Fine Gael)
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That is absolutely fair enough, except that this will happen under this service plan. On new money, we have additional money for new drugs, for example, in the drugs budget. We have an additional 3,300 people, which at a cost of €90,000 is all new money. They are all people who can be allocated not just to people with cancer, but people who have cancer with other things. This is the new money and the new investment. The distribution of that, which is what the Deputy is asking for, will be apparent in the service plan, which we expect in the coming weeks, having sent the letter of determination. It is a completely reasonable question. There is a process to work that out, particularly in this year 1 of a change. There will still be funding for the strategy itself, which of course is different. It is about research, programming and strategy. That is slightly different from the delivery of services, which we all understand, and that will be apparent.

We have to get away from, in particular in the regions, the idea that you can only do something if you have a new person. I gave the example of the endoscopy suites in Bantry for the very reason that there is no point asking for new things at CUH when these exist at Bantry for the convenience of patients, who can get an endoscopy there instead of having to travel to CUH. It is the consultants who must go to the patients to make sure that diagnostic equipment is delivered and used in accordance with Sláintecare.