Gerard Craughwell (Independent)

I welcome the Minister of State, Deputy Murnane O'Connor. This is the first time I have addressed her since her elevation, on which I congratulate her. We are joined in the Distinguished Visitors Gallery by the chairman and the CEO of Dublin Dental University Hospital, along with staff involved in the treatment of head and neck cancer.

I speak on this matter not only as a legislator but as a parent. My daughter Rebecca's journey through head and neck cancer has been one of unimaginable strength and quiet suffering. It is her experience and that of so many others that compels me to speak today. Head and neck cancer is not just a clinical diagnosis; it is a life-altering reality that affects how a person speaks, eats, breathes and sees himself or herself in the mirror. I know this intimately as it hits close to home. Rebecca has lived it and still lives it every day. Her journey through Ireland's healthcare system has been marked by courage but also by struggle. We waited for scans, referrals and answers. In those long, uncertain days and years, we learned that time is not a luxury cancer patients can afford.

The national oral health policy was first published in 2019, yet six years on, its implementation plan remains at the draft stage and was released for initial consultation in the summer of 2025. While it is encouraging that head and neck cancers are recognised as a priority, the proposed care pathway will not be outlined until the end of 2026 and no national funding commitments have been disclosed. Critically, the designation of the advanced care centres is deferred to phase 3 of the implementation plan, which is scheduled for 2031 to 2032.

This timeline is unacceptable, as I am sure the Minister of State will agree. Head and neck cancer patients cannot afford to wait another decade for access to safe, timely and specialised care. Already, patients face long delays for pre-radiation treatment, often leading to avoidable post-operative trauma. The struggle to access dental specialists prior to the commencement of radiotherapy can, as I said, lead to post-operative complications. Patients often begin radiotherapy without the dental care that is essential to their safety.

Approximately 400 new patients are referred each year to Dublin Dental University Hospital, which has only one consultant-led service. Similarly, Cork University Dental School and Hospital manages 160 patient referrals annually with only a single specialist-led service. This bottleneck is not just inefficient; it is dangerous. Every four-week delay in radiotherapy increases mortality by 9%. That is not just a statistic. It represents the life of a daughter, son, father or mother. It represents a person who is somebody's world. Behind every percentage point is a person whose chance of survival is slipping away because of systemic delays that are preventable. Timely access to treatment is not a luxury but a lifeline.

There is growing evidence that the human papillomavirus, HPV, is associated with head and neck cancers, and it is on the rise, particularly among younger individuals. This demographic shift is deeply concerning as these patients face lifelong consequences from both the disease and its treatment. This trend represents a significant national health issue, driven by the increased prevalence of HPV. Currently, HPV-related cases account for approximately 25% of pre-radiation dental referrals, with that figure projected to surge to 66% by 2025. Delays in pre-radiation dental oncology assessment and treatment are directly contributing to postponed initiation of radiation therapy. These setbacks not only reduce survival rates but also severely diminish patients' quality of life.

Severe capacity constraints are causing critical delays in radiotherapy, inadequate dental preparation and heightened long-term risks for patients, including osteoradionecrosis, which is the decay of facial bones, known as dead jaw, and radiation-induced dental caries. Alarmingly, 43% of patients present without a regular dentist and are severely limited in terms of access to essential post-treatment care.Currently, 181 patients are awaiting post-radiography review, with some delays extending up to 14 months. Young patients often have a better prognosis but face lifelong side effects. Many start radiotherapy without proper dental clearance, risking complications like osteoradionecrosis and radiation caries. Osteoradionecrosis, as my daughter Rebecca will tell you, is a painful incurable condition of the jawbone caused by radiation requiring complex ongoing care and repeated surgeries that severely strain patients' physical and emotional being. This conditions hinders gentle rehabilitation, making implants or dentures difficult and severely impacts nutrition, speech, appearance and well-being. The hardest part is not the treatment, it is what follows – lost speech, altered appearance, altered speech and the fear of being forgotten in an overstretched system.

This motion urges statutory recognition of dental oncology care as part of cancer treatment, mandating timely access, adequate staffing, regional equity, structured rehabilitation and national oversight, so surviving cancer does not mean suffering in silence.

We seek an immediate €556,000 increase in the Dublin Dental University Hospital, raising its annual budget to €1.3 million. In addition, €4.2 million is required in national funding to expand dental oncology services across north Dublin, Cork and Galway. The sum of €4.2 million I speak of only covers staffing, excluding the vital infrastructure needed to meet the rising patient demand.

The national cancer control programme, the HSE Dublin and South-East have been key supporters of dental oncology, with multiple engagement over six years and vital backing for initial head and neck cancer funding. Previously, Government support for head and neck cancer ended at abolition, with no national reconstruction provision, despite reconstruction being as essential as it is in breast cancer. Breast cancer reconstruction often focuses on restoring the form and femininity, rebuilding the chest to reflect identity and symmetry. In contrast, head and neck cancer reconstruction is a fight to reclaim function, speech, swallowing and facial recognition. While one journey is about reshaping the silhouette, the other is about rebuilding the very tools of human connection. Both are acts of survival, but each tells a different story of resilience. However, as dental oncology services take place in primary care, no national funding mechanism is in place to support these patients on a countrywide basis.

I raised the funding issue in a Commencement matter in February 2024. I revealed that the national oral health office cut the budget by €500,000. This was done without consulting key stakeholders like the Dublin Dental University Hospital, the HSE or the national cancer control programme. Ireland's current approach to dental oncology care is critically underfunded, under-resourced and unsafe. It is failing to meet the needs of patients, many of whom face delayed, inequitable and inadequate treatment during some of the most vulnerable moments of their lives.

This Private Members' motion seeks that the Minister would enshrine in law the provision of comprehensive dental oncology services as a core component of cancer care. Legislative action and immediate investment are essential to ensure timely, safe and equitable treatment for all patients, aligning Ireland with best practice international standards and preventing avoidable harm.

I ask this House to support the motion, not just for my daughter Rebecca, but for every patient who deserves better. Let us act now with compassion and conviction to build a system that truly cares. The system is the cause of its own behaviour to a large extent. Rebecca was diagnosed with cancer of the tongue at just 19. No one prepares for what comes after. The follow-up is not a single moment; it is a relentless series of appointments, fillings, procedures, and every imaginable effort to save her teeth, but despite it all, by the age of 30 she had lost them. It was not just the surgeries; it was heartbreaking to watch her fight to preserve not only her smile but her jaw, which was threatened by osteoradionecrosis. Through it all, her dentist stood beside her, just as devastated, just as determined. They were not just treating her, they were fighting to save her.

The Dublin Dental University Hospital has been a lifeline for us. They have never sugar-coated the truth, but they have always stood with us – with me, Rebecca and my wife Helen. My wife Helen and Rebecca took the brunt of it. I was privileged insofar as I could walk away every day and work and leave it behind me. I feel like we are a team – the Craughwells and the Dublin Dental University Hospital – united on a mission to save every bit of Rebecca's smile and her beauty. The staff who are sitting here today will never truly know how deeply my family appreciate them and their support. It is nearly 30 years since we first met the people in the hospital and they have been our lifeline.

When it comes to head and neck cancer care across Europe, the contrast between countries is striking. Sweden stands out as a leader. Patients there begin treatment within weeks of diagnosis. Survival rates are among the highest in Europe and access to cutting-edge therapies is swift and widespread. Ireland, while making great progress still faces challenges. Treatment delays are more common and access to innovative medicine is slower. Our survival rates, though improving, remain below Sweden's benchmark. These gaps are not just numbers, they represent lives. They represent outcomes and the urgency for reform. If we aspire to match the best, we must invest in faster assessment and treatment, better infrastructure and policies that prioritise timely access to care, because every patient deserves the best chance, not just the best intentions. I thank the Minister of State for taking the time to come here today. I look forward to her response.