Seanad debates
Wednesday, 7 February 2024
Nithe i dtosach suíonna - Commencement Matters
Cancer Services
1:00 pm
Gerard Craughwell (Independent)
Link to this: Individually | In context | Oireachtas source
The Minister of State is welcome to the House to discuss this important matter. At the end of 2022 there was an announcement awarding €900,000 to dental schools for head and neck cancer treatments. This would have been the first time funding was made available for pre-radiation and rehabilitation of head and neck cancers. These are the only cancers where patients had to pay for their own treatment. The Dublin Dental University Hospital stopped charging head and neck cancer patients in March 2023 on foot of funding that had been announced. The funding announced was earmarked for dental schools in Dublin and Cork. The Cork University Dental School and Hospital ceased offering this treatment so the Dublin Dental University Hospital put in a bid for €815,000 of the €900,000 that had been earmarked, which it estimated would be the cost to run the service. This was approved by the HSE group that controls dental service level agreements and by the national cancer control programme, NCCP. I understand, however, that the national oral health office decided without consultation with the Dublin Dental University Hospital, the HSE or the NCCP to review the budget and unilaterally reduced it to €315,000, a reduction of €500,000. In fairness, many groups have been trying to restore the funding but over the past couple of months they have been totally exasperated. This is just a recap.
The Minister for Health, Deputy Stephen Donnelly, announced at the end of 2022 an allocation of €900,000 of recurrent funding for the two dental schools for the treatment of patients with head and neck cancers. The Dublin Dental University Hospital sees more than 350 new patients every year and this is on the increase, in particular with new patients every year as a result of HPV in young people. Young people are the increasing numbers. Before the funding, head and neck cancers were the only cancers where the State's input ceased once the tumour was removed. There was no funding provision for rehabilitation. Patients paid for their own rehabilitation or went without it. The funding would have been a great start and hugely appreciated by the Dublin Dental University Hospital, working closely with the NCCP, to develop and expand the much-needed services. This really is a first step in developing a comprehensive service for this very deserving patient group. Ongoing resources are critical.
I must tell the Minister of State that I have a personal interest in this. When my daughter was 19 years of age, she was diagnosed with cancer of the tongue. She had radical surgery and over the past 24 years, she has been in and out of the dental hospital so often it is not funny. Today she is in the Royal Victoria Eye and Ear Hospital having encountered difficulties with her swallow over Christmas. She is currently being PEG fed through her stomach. Given what she has gone through over the past 24 years, I cannot believe the courage, strength and good humour of the woman. The medical team she has in the dental hospital are just an incredible group of people. The patients they deal with are in the most horrendous situations including trying reconstructive surgery after osteoradionecrosis in their jawbones. I really would like to hear some positive news with respect to the Dublin Dental University Hospital.
Mary Butler (Waterford, Fianna Fail)
Link to this: Individually | In context | Oireachtas source
I thank the Senator for raising this serious issue. I wish his daughter the best of health. It cannot have been easy for her over the past 24 years. I had my own brush with cancer last year with skin cancer. It is not easy when one is going through it. I am taking this debate on behalf of the Minister for Health. I thank the Senator for opportunity to address the issue of funding for head and neck cancer services.
This Government's commitment to implementation of the national cancer strategy is evidenced by significant investment in recent years. New development funding of €20 million was allocated to cancer services and €15 million was allocated for new cancer drugs in 2021 and 2022.This increased total funding for cancer services in 2022 to €139 million. To date, this funding has supported the recruitment of 393 additional staff in cancer services across eight designated cancer centres and 18 systemic anti-cancer therapy hospitals.
There has also been significant additional investment in oral healthcare services in recent years, including the allocation in budget 2023 of €900,000, which Senator Craughwell spoke about, to support the provision by the dental hospitals of reconstructive care to patients following treatment for head and neck cancer. This funding is available in full to the HSE, which engages with the dental hospitals on the use of the funding to ensure the needs of patients for vital reconstructive work are met.
The reply does not give me any detail in relation to Dublin Dental University Hospital, so I will have to follow it up afterwards. I was not aware Senator Craughwell would raise the matter when I read the question and the transcript of the reply, and it does not deal with it but the reply states that funding is available in full to the HSE. Patients undergoing head and neck cancer treatment need a range of dental supports, as Senator Craughwell knows. They may require routine dental care before treatment to ensure they are ready for treatment. During cancer treatment, they may experience a range of dental or oral symptoms which are commonly experienced following radiotherapy and chemotherapy.
Patients who have a medical card, who are aged 16 and over, are entitled to access a range of treatments free of charge under the dental treatment services scheme, DTSS. Head and neck cancer patients are eligible for a wider range of dental treatments under the DTSS, including periodontal care, additional fillings, and dentures. Each dental hospital has an access pathway in place, which allows them to provide care to medical card holders through the DTSS. Care can also be accessed via dentists in the community who operate the DTSS, but we know there are challenges there. Within the framework of the legislation, every effort is made by the HSE to support applicants in applying for a medical card, in particular to take full account of difficult circumstances in the case of applicants whose income may be in excess of the income guidelines. In such circumstances, the HSE may exercise discretion and, for example, grant a medical card. Discretionary medical cards are issued to patients with significant medical expenses. Emergency medical cards are issued to patients who are terminally ill and medical cards are issued to persons who are terminally ill and have been certified by their treating consultant as having a prognosis of 24 months.
There is a lot of detail there but it does not answer the specific questions Senator Craughwell asked me. Some €900,000 was allocated. I have been told that funding is available in full to the HSE but I will follow up in regard to the Dublin Dental University Hospital. Senator Craughwell said it sought in excess of €800,000 and I think he said €315,000 has been allocated. He might confirm that.
Gerard Craughwell (Independent)
Link to this: Individually | In context | Oireachtas source
I thank the Minister of State for her comprehensive answer, albeit that she did not have the full detail until she came here today. It is correct that the service was allocated €315,000. In light of the fact that Cork University Dental School and Hospital has withdrawn from that service, the only centre in the country now is the Dublin Dental University Hospital. It is looking for €815,000.
I listened to the Minister of State speak about her own experience. I am conscious of the beautiful young people going into the dental hospital having been diagnosed and the radical surgery they go through. We have some marvellous maxillofacial and dental surgeons in this country who do a tremendous job of reconstruction and restore these people to the beautiful people they were before the radical surgery. I urge the Minister of State to do anything she can to give Dr. Michael O'Sullivan down in the dental hospital reassurance that the additional €500,000 will be made available.
It is shocking to think that there is an increase of up to 350 patients per year and that a significant number of these are a direct result of HPV. I hope that if we send any message out today, apart from the need for funding, that it will be that people should take up the HPV vaccine and try and protect themselves as much as possible. I thank the Minister of State. I would appreciate it if she could come back to me fairly soon on it.
Mary Butler (Waterford, Fianna Fail)
Link to this: Individually | In context | Oireachtas source
I again thank Senator Craughwell. I assure the House that the Government is committed to the implementation of the national cancer strategy, as evidenced by significant investment in recent years. Cancer survival rates continue to improve, with around 215,000 patients living after an invasive cancer diagnosis, which is equivalent to one in 23 people in Ireland.We really welcome that. There is also the fact that we have the highest life expectancy in the EU, as deemed by the World Health Organization. It does not happen by accident. We know good work is going on in respect of cancer across the centres of excellence.
I wish to flag one issue. There was an initial €900,000 allocated but we do not know how much of that was spent across other Departments. I cannot assume that all of it is available to one particular facility. When I go back, I will ask for an update on that and see whether we can provide some clarity, especially for Dr. Michael O’Sullivan and his team, who do phenomenal work, as they all do across the dental hospitals. They are an important facet, especially for someone who has to undergo treatment. It is amazing how the teeth are affected first and foremost. I am glad the Senator raised this matter.
Martin Conway (Fine Gael)
Link to this: Individually | In context | Oireachtas source
I am sure the House would agree with me in sending our very best wishes to Senator Craughwell’s daughter. Please give her the good wishes of the House. Clearly, she is a very courageous and inspiring young lady.
Mary Butler (Waterford, Fianna Fail)
Link to this: Individually | In context | Oireachtas source
Hear, hear.