Seán Kyne (Fine Gael)
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I thank the Cathaoirleach's office for choosing this issue for debate. I welcome the Minister of State, Deputy Feighan, to the Chamber to discuss, once again, healthcare matters in the west of Ireland. As I always say, it is great to have a Minister of State from the west, who has an interest in this particular area, answering the questions. As he knows, the national development plan, NDP, under Project Ireland 2040 objectives, states: "In accordance with balanced regional development, a cancer care network for the Saolta region (West, North West) with a Cancer Centre at Galway University Hospital with appropriate infrastructure will be delivered." This is a welcome commitment for which many people fought, including politicians, practitioners and those with expertise in the field of cancer care in the west. Those people do a tremendous job in the region with the resources and facilities they have.

Unfortunately, as the Minister of State knows, cancer care outcomes in the west of Ireland are not as good as elsewhere in the country. That is the unfortunate reality. The survival rates from cancers are lower in the region than they are in other parts of Ireland. It is not acceptable that any part of the country would be left behind in this fashion. That is why I welcome the commitment in this regard in the NDP. One in two of us will get cancer during our lifetime. This is a frightening statistic but it reflects the reality. It is the reality because we have an ageing population and people who live longer are more likely to suffer from a number of illnesses.

We need to get the best results we can in the west of Ireland. Unfortunately, the survival rates for such conditions as lung and colorectal cancer are lower than the average for the country. This is not good enough. Figures from HSE west show that for breast cancer, there is a cumulative five-year standardised average net survival rate of 80%, compared with the average for Ireland of 85%. In the case of lung cancer, the survival rate in the HSE west area is 16.7%, compared with the national average of 19.5%. For colorectal cancers, the survival rate in the west of 62.6% is just below the national average of 63.1%. The survival rates in the region are worse than the average for the whole country. These statistics are no reflection of the wonderful work consultants and staff do, but it is a wake-up call on the need for a cancer care strategy and facilities in the west.

I welcome the commitment in the NDP but we need to see progress on it. It is a long way out to 2040, under Project Ireland 2040, and a long way out, under the NDP, to 2030. We have seen with other projects that actions are put down on paper but their progress and delivery through all the various stages is very slow. It is incumbent on all politicians in the west of Ireland to drive and push this project forward. As I understand it, following a great deal of deliberation, it has been agreed that the site will be located at University Hospital Galway, UHG, as stated in the NDP. There have been larger debates for years on the best use of appropriate sites and, in this instance, whether UHG or Merlin Park University Hospital should be used. The commitment is now in place for the development of the centre in the grounds of UHG. We need to see progress and we need timelines that can be adhered to and achieved in order to ensure delivery.

Frank Feighan (Sligo-Leitrim, Fine Gael)
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I thank the Senator for raising this important issue. The model of care for hospital cancer treatment is centred on eight designated cancer centres, each serving a defined population and geographic area.University Hospital Galway, UHG, is one of the eight designated cancer centres. The centralisation of specialist services into designated cancer centres aims to optimise patient outcomes through case volume, multidisciplinary working and infrastructural supports. As part of the Saolta University Health Care Group, UHG is the Saolta model 4 hospital delivering 24 hours a day, seven days a week emergency medicine, acute medicine, acute surgery, critical care, maternity, neonatal, paediatric, cancer, laboratory and radiology, alongside a wide range of tertiary referral services for the Saolta Group.

Recommendation 15 of the National Cancer Strategy 2017-2026 sets a goal of ultimately developing at least one comprehensive cancer care centre in Ireland that will optimise cancer prevention, treatment, education and research during the strategy period. It was always envisaged the development of such a centre could only be achieved towards the latter part of the strategy period. The Department of Health and the national cancer control programme, NCCP, have had preliminary discussions on the best way forward, including the possibilities for comprehensive cancer networks across regions or internationally. These issues are also the subject of much debate in other EU countries in the context of the Europe's Beating Cancer plan. It is envisaged that proposals on a way forward in Ireland will be defined shortly, at which stage the matter will submitted to Government for approval.

With regard to the development of a comprehensive cancer centre at University Hospital Galway, the National Development Plan 2021-2030 sets out, "In accordance with balanced regional development, a cancer care network for the Saolta region (West, North West) with a Cancer Centre at Galway University Hospital with appropriate infrastructure will be delivered." The Saolta cancer managed clinical and academic network, MCAN, has been formulating proposals for the development of the cancer infrastructure at UHG, with the goal of becoming a comprehensive cancer centre, along with a network of enhanced ambulatory cancer services at Letterkenny, Sligo, Castlebar and Portiuncula. Both the NCCP and the Department acknowledge the work that has been initiated in this regard. However, the national policy in regard to a comprehensive cancer centre and cancer structures nationally has yet to be worked up and agreed. It is most important that developments in UHG and Saolta fit in with the national approach and take realistic account of the overall limitation on resources.

Furthermore, a new €56 million radiation oncology facility is under construction at UHG under the national programme for radiation oncology, NPRO. The facility will include seven radiotherapy treatment vaults, a brachytherapy suite, two CT rooms, MRI, on-treatment support and ancillary physics, treatment planning and administration facilities. Construction of this new facility is expected to be completed in 2023.

The Department of Health and the NCCP continue to work closely with UHG on short-term actions to continue to support the delivery of cancer services through UHG and the Saolta hospital group.

Seán Kyne (Fine Gael)
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I thank the Minister of State for the reply. I acknowledge and welcome that there are plans and a commitment to develop this very important centre, although the timeline is not spelled out. According to the experts, what is urgently needed is the functional cancer centre at University Hospital Galway, including inpatient beds, operating theatres, cancer ICU, an ambulatory rapid access diagnostic centre, a haematology oncology day ward and outpatients department, and modern laboratories, as well as functional regional cancer infrastructure, including ambulatory cancer centres at regional Saolta hospitals, supporting diagnostics, imaging pathology and multidisciplinary teams across the network, supported by a regional network of GP and primary care facilities.

I welcome the response the Minister of State has given but, as I said, we need to progress this and ensure there are no undue delays. Obviously, when the time comes, funding will be an issue but it is committed to and contained within the national development plan and Project Ireland 2040. We need to see progress in regard to the site, the various strategic assessment reports and preliminary business cases, all of the various stages of the spending code of the Department of Public Expenditure and Reform and the lodging of the planning application.

Frank Feighan (Sligo-Leitrim, Fine Gael)
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I thank Senator Kyne for his contribution on this matter. Galway University Hospital provides diagnostic services for breast, lung and prostate tumours, with a satellite service for breast cancer at Letterkenny University Hospital. The hospital has a reputation for the delivery of high-quality, innovative and safe care for patients, particularly through the provision of medical, surgical and radiation oncology services.

As the Senator knows, over the past two years more than €40 million in new development funding has been secured for the ongoing implementation of the national cancer strategy. It is the largest investment in the strategy since its launch in 2017. The funding is also being used to increase and bolster existing services, including those delivered through University Hospital Galway, while also facilitating the development and implementation of new services in all cancer clinical programmes. Furthermore, a new €56 million radiation oncology facility is under construction at the hospital. This facility will include all of the various services. I believe it will be completed in 2023.

While no decision has yet been made on the development of a comprehensive cancer centre as outlined in the national cancer strategy, the Department of Health and the national cancer control programme continue to engage with University Hospital Galway to ensure it continues to deliver high-quality cancer services to patients in the west and north west.