David Cullinane (Waterford, Sinn Fein)
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4. To ask the Minister for Health her plans for a new cancer strategy; and if she will make a statement on the matter. [17629/26]

David Cullinane (Waterford, Sinn Fein)
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This question is on cancer services and the national cancer strategy. We have had two strategies, the one coming to an end and the previous one, and they have added real value and are among the best success stories in the Irish health service. I am blown away by the work people do in this area, with research, development, new technology, new drugs and new treatments. It is mind blowing and it is of benefit to patients. There has been slippage in some of the key performance indicators, KPIs, and some of the access times and wait times. I will go through them later. We should accept any slippage and we cannot afford any slippage. We really need to keep the focus on what has been a real success story for the health service.

Jennifer Carroll MacNeill (Dún Laoghaire, Fine Gael)
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I agree with the Deputy. The two strategies have changed the landscape for people who are diagnosed with cancer. Today nearly 250,000 people in Ireland are living with or beyond cancer, 50% more than a decade ago. The evidence is that the chances of survival for more than five years for someone diagnosed with cancer in the 1990s was considerably less than what it is now. This is on foot of the extraordinary work done by clinicians and researchers, and the way in which cancer services are delivered. This has enabled a very considerable shift. Nevertheless, we know we will have more and more people diagnosed with cancer in the years to come. This is because we are living longer and we are diagnosing better, and we need to make sure that the services are available for them, for all of us and for everybody we represent who will face a cancer challenge at some point in their lives, particularly as we live longer.

The Deputy is right to identify the strengths in some of the KPIs as well as the slippages in them. I certainly want to highlight both of these things. One of the reasons we are changing to this regional funding model is so we can have better regional transparency. It is correct that public representatives have the ability to see this regional variation and that there is a pressure linked to the performance framework in relation to the regions achieving the best performance and matching the best performance around the country.

The cancer strategy had 52 recommendations, 43 of which have been delivered or continue to be in the process of being delivered, as will be the case to the end of the strategy. We want to reflect on and evaluate the strategy and its efficacy as we develop a new strategy. What will be very interesting, and where we are open to every suggestion, is how much the world has changed in terms of research and the role AI can play. Some of the extraordinary research being done in Galway, for example, is where they have learned to manipulate cancer cells against themselves and how this works. Treatment has become so individual and personalised. The next cancer strategy can be genuinely ambitious and different again, and I welcome every suggestion relating to it.

David Cullinane (Waterford, Sinn Fein)
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We would all accept that early intervention in healthcare is very important, especially for cancer patients, from the first GP referral to a consultant, diagnostics, treatment and surgery. I acknowledge that in some of the areas we are still doing very well but there are areas where there is slippage. Data from 2025 shows that 15% of chemotherapy patients and 21% of radiotherapy patients did not start their treatment on time. It also shows major delays in surgical care, which is concerning A total of 61% of prostate cancer surgeries were not carried out in the recommended time frame, which is the gold standard we all want and we all accept. A total of 45% of breast cancer surgeries and 39% of lung cancer surgeries did not happen in the recommended time frame in 2024 and 2025. There are also issues in relation to diagnostic equipment and radiotherapy equipment. Much of it is out of date, particularly radiotherapy equipment. I see this and hear about it from local representatives and from hospitals. The key issues are staffing and equipment. If we put these in we can improve the areas where we are not doing as well as we should.

Jennifer Carroll MacNeill (Dún Laoghaire, Fine Gael)
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The Deputy is right to highlight the variance. It is very different between hospitals. For example, the time for chemotherapy is within 15 days, which is so important. This information has been provided to him. In Cavan hospital, there were 174 patients and 174 of them were seen within 15 days. It was similar in Connolly hospital with 1,717 patients. Naas hospital is at 98%. I do not want to just highlight the good ones and I will pick at random. Tullamore hospital is at 93%, St. James's Hospital is at 91% and Drogheda hospital is at 83%. Then we get to Waterford hospital, which is at 66%, which is the area the Deputy represents. CUH is at 68%. There is variance. Most of the hospitals are concentrated at way over 85% and then there are hospitals such as Portiuncula hospital in Galway, St. Luke's hospital in Kilkenny, CUH, Waterford hospital and St. Luke's Hospital in Dublin, which are at less than 75% and this is not good enough. This is the sort of visibility and transparency we need, and we need to continue to drive to ensure everybody is at a rate of well over 95%. I recognise the variance in this.

David Cullinane (Waterford, Sinn Fein)
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One of the benefits of having health regions is that we can have this type of focus, we can drill into the data and we can have real accountability. There are regional imbalances, county imbalances and very localised imbalances. The cancer strategy is a national strategy. We have specialist centres. I want this to be maintained, of course. It is really important. Where the areas of chemotherapy and radiotherapy are a problem, and where we are slipping, we have to fix the problem. From what I can see, part of this is due to equipment being out of date and not having staff to operate some equipment. I have tabled parliamentary questions on this and gone through it in detail. In some places the problem is that we do not have the staff to operate equipment, and somewhere else equipment is not being used because it is out of date, breaking down and needs to be replaced. We have these issues. Surgery is where I think the Minister's own attention is very important. We are seeing slippage in prostate cancer surgeries and breast cancer surgeries. Again, there may well be regional variations but the focus needs to be on where it is slipping and where we are not doing as well. The health regions can add real value from this perspective.

Jennifer Carroll MacNeill (Dún Laoghaire, Fine Gael)
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This is very important. We have 58 seconds to have this conversation but it would be good to have a session at the Oireachtas health committee where we can go through all of the various regions and KPIs and recognise the variance. For example, we spoke in December about Galway, where there was a particular challenge. It reported 86% within the target in December, which was up from 68% in November. Local management is so important. Significant additional resources in terms of people and equipment are included in the annual plan and in the capital plan. Sometimes this is the issue and there is a question later on recruitment and replacement when we can deal with this. It is also about local management. Deputy Charles Ward spoke earlier about access to surgery. This is why I am putting in additional oncology chairs and surgical hubs in Letterkenny hospital to make sure there is better access. It is a combination of various things but as long as we are focused on what is different and why it is different, we are all likely to achieve a better and more consistent outcome.