Teresa Costello (Fianna Fail)

I welcome this important motion on supporting services for patients with head and neck cancers and commend Senator Craughwell on bringing it forward and sharing his family's own personal experience. There is nothing more powerful than lived experience. I also thank Senator McDowell for sending out the briefing document, which is very graphic and informative but is something we needed to see. I appreciate that also.

Fianna Fáil welcomes this discussion as it is an issue that affects patients and families across the country. It is one that demands continued focus, investment and reform. Each year in Ireland, more than 760 people are diagnosed with a cancer of the mouth, head or neck. These cancers encompass a broad range of anatomical sites and can have devastating effects on speech, swallow, appearance and quality of life, as the Senator referenced.

Traditionally, head and neck cancers were most commonly in men over the age of 55 but we are now seeing a clear demographic shift. The gap between men and women has narrowed to just 2:1 and the number of younger people affected is increasing. Over the next 25 years, incidences are projected to rise by 30%. This change is due, in part, to the increasing prevalence of HPV which is now recognised as a key factor in many head and neck cancers. Addressing this means continuing our dual approach of primary prevention through vaccination and secondary prevention through screening.

The HPV vaccine has been available to girls since 2010 and to boys since 2019. Under the programme for Government, there is a clear commitment to extend the Laura Brennan HPV catch-up vaccination programme to everyone under the age of 25 who may have missed it. As part of this, the Minister for Health has introduced a schools-based HPV catch-up programme, ensuring students who previously declined or missed the vaccine have another opportunity to receive it. These are vital public health measures that will save lives in the years ahead. I encourage people to avail of it. I had no hesitation whatsoever to ensure my son availed of it and I genuinely worry about the drop in the uptake of it in recent times. I always remember Laura Brennan in that because the work she did was phenomenal.

At the same time, we should ensure those already living with or recovering from head and neck cancer receive the best possible care and support. These patients often face complex oral and dental issues because of their cancer or its treatment. I know from personal experience the effect chemo alone has on dental health. During my chemo, my tooth fell out with no warning. It was so traumatic for me so I cannot begin to imagine the trauma faced by a person dealing with a head or neck cancer diagnosis.

The Government is fully committed to improving oncology-related dental services. The HSE, through the national cancer control programme, has established a working group to define the optimal dental oncology pathway.The NCCP has been engaging with dental representatives at St. James's Hospital, Beaumont Hospital and the Dublin Dental University Hospital to strengthen this pathway. Significant progress has been made in recent years. Since March 2022, out-of-pocket costs for patients attending the Dublin Dental University Hospital for neck and cancer care have been eliminated.

Funding to the Dublin Dental University Hospital has increased substantially from €311,000 in 2023 to €579,000 by year end, excluding education funding of €189,000. A further €594,000 has been provided by the Department of Health to support supplementary dental treatments for cancer patients. In 2024, more than €900,000 was allocated nationally to advance these services and ensure patients can access the care they need.

There have also been key staffing appointments to strengthen the system, including a consultant in medically compromised patients at the Dublin Dental University Hospital and a consultant in maxillofacial prosthodontics and oral rehabilitation at St. James’s. These posts are essential to building a multidisciplinary model of care.

The Department of Health and the NCCP continue to meet on this issue, with the next follow-up scheduled for 21 October demonstrating ongoing engagement and commitment to resolving system challenges and expanding regional care capacity.

Looking ahead, the HSE is considering the inclusion of oral health networks of care within its new regional structures. This is a crucial step, as oral and dental health cannot be treated in isolation; it must be embedded within our broader cancer and community healthcare frameworks.

The Government's wider oral health reform agenda is being driven through Smile agus Sláinte, the national oral health policy, which represents a major reconfiguration of oral health services. The policy is a programme-for-Government commitment and is aligned with the World Health Organization's global oral health action plan.

Developing a clear, consistent patient journey for people with head and neck cancers spanning prevention, diagnosis, treatment, rehabilitation and survivorship will be central to improving outcomes. This requires not only investment, but also co-ordination, skilled staff and clinically led pathways that place patients at the centre of care.

This motion rightly draws attention to the gaps that still exist, particularly around access to dental oncology services, rehabilitation supports and post-treatment care. These are issues that the Government acknowledges and is actively addressing. Progress has been made but there is more to do.

I reiterate that Fianna Fáil welcome's this motion and supports the continued expansion and reform of services for patients with head and neck cancers. The measures under way, whether through enhanced funding, workforce expansion, HPV vaccination or the implementation of Smile agus Sláinte, represent meaningful progress. Ultimately, our focus must remain on ensuring that every patient receives timely, comprehensive and compassionate care from diagnosis to recovery. That is the standard we must continue to work towards. I thank Senator Craughwell for his contribution today.