Seanad debates

Wednesday, 19 June 2024

10:30 am

Photo of Maria ByrneMaria Byrne (Fine Gael)
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I welcome Members for our Private Members' motion on national cancer services. Before I call on Senator Kyne to move the motion I welcome a group from Aghada National School from Youghal. You are all very welcome here today visiting the Dáil and the Seanad. I hope you are enjoying your day. Thank you very much indeed.

Photo of Seán KyneSeán Kyne (Fine Gael)
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I move:

“That Seanad Éireann:

- the success of the National Cancer Strategies since their inception;

- there are more people surviving cancer in Ireland than ever;

- the importance of screening programmes such as BreastCheck and BowelScreen;

- the success of the HPV immunisation programme;

- the work of the National Cancer Registry Ireland; -one in two of us will get cancer in our lifetime;

- that unfortunately one in three of us will die from cancer;

- based on the most recent EU data available, Ireland has the third highest mortality rate from cancer in Western Europe;

- lower survival rates from cancer in the West of Ireland compared to the national average;
acknowledges that:
- the work and advocacy of the Irish Cancer Society, the largest voluntary funder of cancer research in Ireland;

- the generosity and fundraising of cancer survivors, their families, friends and of Irish people in general for cancer charities;

- Government commitment to continue to discourage smoking and new measures to discourage vaping;

- the work of the network of Community Cancer Support Centres nationwide;

- the funding of €3 million provided in Budget 2024 to support the work of these centres;
calls for:
- continued investment and monitoring of the National Cancer Strategy;

- consultation in advance of a new National Cancer Strategy;

- the inclusion of the Head of the National Cancer Control Programme on the HSE Leadership Team to ensure cancer treatment receives the focus required;

- the expansion of the age ranges for cancer screening programmes, including BreastCheck (to 45 to 74 years of age), BowelScreen (to 50 to 74 years of age) and the introduction of new screening programmes for prostate, lung and gastric cancers;

- the resourcing and staffing of diagnostic services so that the Sláintecare targets for testing waiting times (e.g., no more than 10 days for a diagnostic test) are met;

- meeting the co-funding target for the Night Nursing Service for cancer patients of at least half of the cost of this vital service;

- improved participation in cancer research and trials with additional staffing, including nursing and administrative staff, for trials in Ireland;

- continued investment in single occupancy rooms within hospitals, to reduce the risk of infections;

- a new national cancer centre for the West of Ireland, within the grounds of University Hospital Galway with dedicated beds for cancer patients;

- additional funding in Budget 2025 for the network of Community Cancer Support Centres nationwide; and

- multi-annual funding for cancer support centres nationwide.”

I move this motion in the name of Fine Gael Senators. I will share my time with Senator Martin Conway. I welcome the Minister of State, Deputy Colm Burke, and I acknowledge the presence of Averil Power, a former Member of this House and currently CEO of the Irish Cancer Society. I thank her for her advocacy and support on this issue. Ms Power was before us at the health committee in April and that was followed by a meeting with all 26 of the network of cancer support centres nationwide. I will speak to that in a moment.

The national cancer strategy is hugely important. It is fair to say that since its inception it has saved lives over a long number of years. More people are, thankfully, surviving cancer in Ireland than ever before. Because of the strategy and the funding of the strategy, particularly in earlier years, such programmes as BreastCheck, Bowel Screen, and the HPV immunisation programme have revolutionised healthcare and cancer care in the State. Unfortunately, one in two of us will get cancer in our lifetime - and I will touch wood on that. Unfortunately, one in three of us will die from cancer.

Based on the most recent EU data available Ireland has the third highest mortality rate from cancer in western Europe. Speaking as someone from the west of Ireland, we have lower survival rates from cancer in the west of Ireland compared to the national average. I acknowledge Professor Michael Kerin and his advocacy. Professor Kerin always highlights this unfortunate statistic on survival rates from cancer in the west of Ireland. Part of the issue in the west of Ireland is the lack of a fit-for-purpose national cancer centre. There is now agreement on the development of a national cancer centre in the west on the grounds of the University Hospital Galway. It is part of a current design that will include other facilities such as new laboratories, a ward block, an emergency department and a pediatric and maternity unit. It is welcome that there is at least commitment to develop that and we hope to see progress on the national cancer centre for the west based in University Hospital Galway over the coming years. This is hugely important because every part of the country deserves the best facilities, the best treatment, the best care, and the best and equal chances of surviving cancer.

I acknowledge the work and advocacy of the Irish Cancer Society, which is the largest voluntary funder of cancer research in Ireland. I acknowledge also the work and the charity of the Irish people, of cancer survivors and their families, of their loved ones and of their neighbours who around this country will go to great lengths, be it for Daffodil Day or coffee mornings and various other projects and initiatives that take place to fund cancer research in the State. They are to be commended. This is giving back to the Irish Cancer Society and also to the community organisations such as in my own area with Cancer Care West with the wonderful facilities in Inis Aoibhinn in the grounds of University Hospital Galway, where free of charge they provide accommodation for those travelling long distances - be it from Donegal or Sligo - to Galway for cancer treatment.

The network of community cancer support centres nationwide do tremendous work. They were in before the health committee a number of weeks ago and they would like to acknowledge the funding that was provided by the Minister for Health and the Government in the last budget for 2024 of €3 million. It was classed as once-off funding but certainly I believe that this should not be once-off funding. It cannot be just once-off funding. We need to show a commitment to have at least €3 million - or possibly up to €5 million - to support the community cancer centres nationwide. I spoke to the CEO of Cancer Care West, Mr. Richard Flaherty, at the committee and I asked at what point do people look for and contact their services. He said that it varies. It can be the individual who hears the news "You have cancer" and immediately reaches out, in some cases before they even talk to family, to try to process what this means. There are other individuals at the early stages of treatment or post treatment who need to reach out. These services are part of the voluntary and community sector. More people are surviving, and living with and beyond cancer, but there are impacts. Community cancer centres provide information, psychological support, survivorship programmes, complementary therapies, exercise and relaxation classes, support groups, financial advice and drop-in services. All of that is positive in relation to what can be very difficult and challenging news for anybody who is diagnosed with cancer in this country.

The numbers show that some 42,000 people will get cancer in Ireland every year. That is an anticipated increase of 100% in the number of cancer diagnoses by 2040 compared to 2015. Thankfully, people are living longer so later in life they may develop cancer but that is still a staggeringly high figure. Unfortunately, in 2023 there were 10,380 people who died from cancer. Ireland has the third highest mortality rate from cancer in western Europe and Ireland's ranking in mortality compared to EU average is 13th. There are now 215,000 people in Ireland who are living beyond a cancer diagnosis. Every three minutes a person in Ireland is told "You have cancer". Those are some of the statistics we have on something that impacts so many families and so many communities across our country every year. While the national cancer strategy has worked, the argument could be made that the next stages will be more difficult. We have seen the level of commitment by successive Governments to combatting smoking, and now vaping, and the harmful effects of nicotine products on people's health. There is still more to do in regard to cancer services. The Irish Cancer Society, which held a briefing today in Buswells Hotel, has said we need an additional €20 million in 2025 in new and recurrent funding for the national cancer strategy. It has called for an assessment of the funding needs of cancer services above that extra €20 million per annum minimum funding level to ensure full implementation of the national cancer strategy by 2026. It has also called for the ending of the recruitment embargo by allocating the necessary funding to fill crucial healthcare sector posts based on up-to-date workforce plans.

There was some good news today in regard to the embargo on the recruitment of healthcare staff. The Minister of State might have some further information on that. I hope some of the new posts will be in oncology services. At the briefing by the Irish Cancer Society earlier, I met individuals from the west who talked of the need for more radiation therapists. It goes back to first basics. The numbers in our third level colleges need to increase. There are capacity issues. There must be funding of teaching posts to allow for an increase in radiation therapists, whether in Trinity College or elsewhere, or by way of dedicated programmes, if they can be developed, in, for example, the University of Galway. That is something the Minister of State might pursue, as I and others will, with the Minister for further and higher education. The Departments need to collaborate on the provision of additional posts in this area. It is hugely important that we ensure there are sufficient numbers working in our hospitals. There has been major investment in radiation equipment in many locations. It is a shame if that equipment is lying idle, as it is in some cases, for want of radiation therapists. We must ensure this issue is progressed and solved. It is eminently solvable with funding and planning. It may require a certain lead-in time but a difference can be made to the situation we face.

The motion calls for the inclusion of the head of the national cancer control programme in the HSE leadership team to ensure cancer treatment receives the required focus. If that can be considered, it would be a positive step towards acknowledging the importance of cancer services and screenings. There is also a need to look at the expansion of age ranges for cancer screening programmes, including BreastCheck and BowelScreen, and the introduction of new screening programmes for prostate, lung and gastric cancers. These would be positive developments that would assist in the earlier detection of cancer.

As the Acting Chairperson has indicated my time is up, I will give way to my colleague Senator Conway.

Photo of Martin ConwayMartin Conway (Fine Gael)
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I second the motion. I welcome the Minister of State. From working with him for many years, I know his commitment to this area. I thank our good friend and colleague, Senator Kyne, for the work he has done on this motion. I echo his commendation of Professor Kerin and all the people in the west of Ireland who do such phenomenal work.

This motion is important because it seeks fairness and geographical equality in the treatment of cancer. I acknowledge the thousands of volunteers who help out in this area, including those volunteering in hospitals and the people who drive patients to their chemotherapy and radium treatments. They do that in their own time. I acknowledge the thousands of people associated with Daffodil Day who work with our former colleague Averil Power. Her organisation does phenomenal work. However, really and truly, such voluntary efforts should not be needed. We must move to a situation where we do not rely on volunteers, particularly on the west coast, including in the Acting Chairperson's county, my county and Senator Kyne's county. All along the coast, people living in places like Ennistymon, Moycullen and places in west Limerick have to travel for their treatment. I fully support the plans to develop a cancer centre in the west. It is absolutely necessary.

I acknowledge the great work being done in cancer care provision. I did not agree with a lot of what the former Minister for Health, Mary Harney, did over the years. The one point on which I did agree with her was in regard to the establishment of centres of excellence. Those centres have worked. They have saved thousands of lives and they continue to save lives. However, we can and should do better. We need to be fair to people in rural Ireland. People living in Dublin do not really have an understanding that those living in rural areas may have to do a two-hour trip to receive chemotherapy treatment and another two-hour trip home. That is not the case in Dublin and the other cities. We need a lot more supports for people in rural areas, including overnight provision and hospitality supports.

The motion is designed to put these issues on the agenda. I fully support the screening programmes. There have been many challenges and difficulties in that area over the years. Tragically, people lost their lives because their diagnosis was missed and so on. Overall, however, the screening programmes have saved thousands of lives. I fully support Senator Kyne's point about introducing further screening programmes for cancers of the bowel, prostate and so on. There is not a family in this country that has not been touched by cancer. We owe it to our loved ones who have suffered from cancer, some of whom have died from it, to ensure we provide the best possible practical support to people diagnosed with that unfortunate disease.

The national cancer strategy is a good strategy but it probably does need to be updated. I am interested to hear the Minister of State's views in that regard. There should be no need for fundraisers to pay for petrol for volunteers who take people to clinics for treatment. We are a better society than that and we should do better.

I acknowledge the wonderful work being done in County Clare by Sláinte an Chláir and by Mary, who set it up 15 years ago. I recently attended the organisation's 15th anniversary celebrations in Ennis. It does what the State should be doing. The most important service it offers is providing emotional support. Unfortunately, not everybody has a family network. There are people living alone who contract cancer. Sláinte an Chláir gives invaluable support to people in that situation. It provides them with a home in the organisation's house in Kilnamona, which is 5 km or 6 km outside Ennis. The support it gives to elderly people in particular, who may be widowed or whatever, is absolutely phenomenal. The organisation receives Government support but most of its funding comes through fundraising. The Acting Chairperson will agree with me about the importance of the service provided in Raheen and Milford. The support provided by hospice services is absolutely incredible. We can never thank those involved enough or give them enough acknowledgement.

I am delighted to second the motion. I thank Senator Kyne for the work he has done on it. The Minister of State understands these issues. I know he is deeply committed to improving services and supports.

Photo of Maria ByrneMaria Byrne (Fine Gael)
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I thank Senator Conway. I acknowledge the presence of Ms Averil Power, CEO of the Irish Cancer Society, and her colleague. I apologise that I did not spot them earlier. They are very welcome here this evening.

Photo of Lorraine Clifford-LeeLorraine Clifford-Lee (Fianna Fail)
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I, too, welcome our colleagues from the Irish Cancer Society. I thank them for all the work they have been doing. They are assisting us in our work in the House. I thank them on behalf of everybody who has felt the benefit of the Irish Cancer Society. I thank the Minister of State very much for coming to the House to discuss this very important motion tabled by Fine Gael colleagues. I commend all of them on working on this, in particular Senator Kyne.

I know the Minister of State and the Minister, Deputy Donnelly, are very committed to cancer services and the Government has been delivering continued improvement over the past four years. There has been additional investment of €456 million in cancer prevention screening treatment, cancer medicines, etc. Capital funding of more than €120 million has been used to provide state-of-the-art radiation oncology facilities in Galway and Cork. There has been an increase in the rate of survival from cancer. That is to be welcomed because we all know somebody who has been touched by cancer in our families or communities. As people live longer, they are going to get cancer and that is just a fact of biology and science. We need to be able to support people who get cancer to access prevention and other services. The screening services have been brilliant. My mother's cancer was picked up at a BreastCheck mobile unit very early and dealt with excellently. However, we need to do more to encourage people to attend for screening across all the cancer areas and invest more in that.

The work the Government has done with regard to smoking and vaping has been excellent but we need to go further. There is no reason for anybody to smoke. We need to be cutting it out. Anybody who is currently a smoker needs to be supported to come off it. I actually do not know any smoker who is happy being a smoker. They all want to come off it. We need to support people to come off that awful addictive substance that is pushed on them by a massive money-making industry. We need to do more about vaping because evidence is emerging that it is as harmful as smoking to young people in particular. All these things need to be looked at and I know the Government will do that.

There are other issues not touched on in this motion, however. Colleagues in the House have raised the issue of medical cards for cancer patients. It is something I would like the Government to look at coming into budget negotiation season. It would make a huge difference to people with cancer to get a medical card without having to jump through hoops and appeals. They have enough on their plate.

This motion was focused on cancer services in the west and the points have been very well made. However, I point out that, even in Dublin, where we are closer to cancer services, there are big differences in outcomes depending on where people live and depending on their economic circumstances. That is not acceptable. I would like the Government to have a special task force to look at improving outcomes and narrowing those gaps for people. It should not be that people are more likely to get cancer if they live in a lower income area or come from a lower income family. It should not be that their survival rates are lessened. This is happening in Dublin and other urban centres that have cancer facilities close by. That is a glaring gap in our thinking and in our approach to cancer services.

I commend the many cancer support groups that provide such a valuable service. The Balbriggan cancer support group in my constituency is a wonderful service. The Rush Daffodil Day fundraising committee has ensured more than €1 million has been raised in the town of Rush in recent years for the Irish Cancer Society. It is the largest amount of money to the Irish Cancer Society per capita in the country. We are very proud of that. Many people are working towards improving cancer services. While the Government has done an awful lot, there is more to improve. I look forward to hearing the Minister of State's response and to working with him to deliver better cancer services for everybody.

Photo of Annie HoeyAnnie Hoey (Labour)
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I thank the Fine Gael Senators for introducing this motion into the Seanad Chamber. In particular, I welcome Ms Power and others from the Irish Cancer Society who are here in recognition of the enormous work they do and the contribution they make. I could say there is nothing else to say other than these are the things we need to see.

Many of us in this House and this building have been affected by cancer. I do not think there is a single person in Ireland who has not been affected by it. We see that in the figures for the number of people who are likely to develop cancer in their lifetime. I note in particular the call for the expansion of the age ranges for cancer screening programmes. We all know cancer screening programmes are essential for early diagnosis and intervention. Therefore, we need to ensure these screening programmes are properly funded and resourced and are reaching the appropriate and correct age brackets.

The lung cancer screening programme is something I have spoken about on numerous occasions in this Chamber and at the Joint Committee on Health. We currently do not have a national lung cancer screening programme. The Royal College of Surgeons in Ireland has announced a trial programme for lung cancer screening and I hope we will see the success of that. Ideally, lung cancer screening programmes would be similar to BreastCheck or CervicalCheck in that they would be accessible and readily available. The data from the National Cancer Registry Ireland report indicates that instances of lung cancers are higher in more deprived areas. We have to act in light of this and give people a fair chance. We might look at the lung cancer screening programme that has been rolled out or trialled by the NHS in Manchester and Liverpool. It is like mobile testing. It is something we are familiar with in terms of the mobile testing units that go around testing for breast cancer. With lung cancer it would be a lot more specific in that a person would be identified by his or her GP as someone who would be at risk of it, for instance, someone who has smoked.

I have said it before and I will say it again: if we had had lung cancer screening, my dad would probably still be here today because, by the time his lung cancer was picked up, it was far too late. It was stage 4. It had spread all through his body, yet there was not a single symptom for that lung cancer. He would have been a prime suspect, however. Even though he gave up smoking in the 1990s, he would have been someone who would have been on the radar, who perhaps could have had that lung cancer screening and who could possibly still be here with us today.

We know lung cancer is one of the leading causes of death in Ireland and is very treatable if caught early. It is typically diagnosed at a very late stage in Ireland. Two out of every three lung cancers are diagnosed at stage 3 or 4. It does not have to be that way. Very often with lung cancer, as was the case with my dad, it is when people are in an accident and emergency department or they get a completely innocuous unrelated procedure, such as an X-ray, that it is caught. Someone might go into the accident and emergency department because they have a cough that just has not gone away and the cancer is at a much later stage.

I am particularly passionate about lung cancer screening programmes. I will quote Mr Gerard Fitzmaurice, consultant cardiothoracic surgeon at Trinity St. James's Cancer Institute:

The vast majority who have lung cancer, by the time they present, and have symptoms, it has already spread or metastasised or become too advanced to have an opportunity to have a treatment with a means of curing them. One of the biggest focuses for everyone who is looking after lung cancer patients is how we can try and find the patients who have lung cancer earlier.

This is something about which I am very passionate. I would love to see that screening rolled out. The evidence from the NHS shows it is a worthwhile investment. It catches lung cancer at an earlier stage. With every cancer, the earlier it is caught, the better the outcome. I would also like to see the roll-out of screening programmes for prostate and gastric cancers. Not every cancer can be screened for. Maybe some day science will develop so that we will be able to screen for every single cancer, and that will be an entirely different world. However, if there are cancers we can screen for, and we have had great success with breast, cervical and bowel cancer, then I would love to see us here in Ireland roll out a meaningful campaign for the cancers that can be screened for.We know Ireland's two-tier health system has a severe impact on the most disadvantaged in society. It is the same story here. If you can pay, you can have access to screening services and early intervention and care, and if you cannot, it can sometimes feel like very tough luck. Almost every family in the country has been affected by cancer but the reality is that screening can save lives.

I refer very briefly to a report from the European Cancer Organisation and the Irish Cancer Society which highlights the inequality that continues to have an effect on people in the least well-off areas. Reference has been made to that in the debate. In the least well-off areas there is a greater risk of dying from the disease. One of the key phrases used is that cancer patients face a postcode lottery, with survival rates being lower in poorer areas. We simply cannot have a society where that continues to be the case.

I will speak very briefly about the funding of the national cancer strategy, which has somewhat stood still since 2017. That means we have potentially gone backwards in some key areas and we need more investment just for the national cancer strategy to stand still. We need to see the €20 million investment in the national cancer strategy but there are lots of other areas the Government must address. There is great potential for us to tackle cancer, whether it is through investment in the national cancer strategy or rolling out meaningful screening programmes. We can and must do better in providing cancer care and funding for national cancer services. Once again, I thank the Fine Gael Senators for bringing forward this important motion.

Photo of Maria ByrneMaria Byrne (Fine Gael)
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I thank Senator Hoey. I welcome a former Member of this House, Lorraine Higgins, and the representatives of Mobility Partnership Ireland. They are very welcome here this evening. I hope they enjoy their visit to the Seanad.

Photo of Fintan WarfieldFintan Warfield (Sinn Fein)
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I welcome the Minister of State, Deputy Burke, back to the Seanad. I thank Fine Gael for bringing forward this very important motion.

Cancer is the leading cause of death in Ireland. It is a sobering fact that one in two people will develop it in their lives. To put it another way, 42,000 people a year will get a cancer diagnosis. What is even more sobering is the fact that Ireland has the third highest mortality rate from cancer in western Europe, yet despite this, approximately 70 out of 240 radiation therapy posts are vacant. Meanwhile, current radiation therapists are facing burnout as they work longer days just to make up for staff shortages. The shortage of staff is also having an impact on the operation of equipment in St. Luke's Radiation Oncology Network, where one linear accelerator is closed and a skin cancer machine is only operating part time. In Cork University Hospital, both the linear accelerator and a CT scanner have lain idle for three years and are no longer used. University Hospital Galway has recently acquired a new scanner but it faces uncertain operation due to staff shortages and the recruitment embargo.

These issues have not happened by accident. They are a direct result of conscious political decisions that have been made by this Government and previous governments that have failed to properly fund the cancer strategies, as Senator Hoey mentioned, for five out of the past seven years. They failed to properly plan and grow the workforce and to resolve overcrowding. They also failed to meet 22 of the 23 objectives laid out in the cancer strategy. These failures see staff work excessive hours to overcome staff shortages. They also mean expensive lifesaving equipment lies idle due to staffing shortages. The failures further mean that cancer surgeries are cancelled because of hospital overcrowding. These failures mean we are now in a position where there is a real risk that services will not improve and will regress in many areas. These are not just my views or those of Sinn Féin. They are the views of the Irish Cancer Society, clinicians and medics who work in cancer care. They are the views of our experts, who cannot be brushed aside.

The service can be fixed. We know what works and what needs to be done. The first and second national cancer strategies were the poster child, as it were, of the health service, and rightly so. Many of us commended the real progress made under them. The reason progress was made was funding was given to put in place the additional supports, staff, infrastructure and healthcare capacity that could deliver better health and cancer outcomes for patients.

The amount needed is equally evident. The motion acknowledges the €3 million provided in budget 2024 to support the work of the community cancer support centres, but this is a drop in the ocean when compared with the €20 million that was needed in 2024 to fund the national cancer strategy properly. The fact is that, for the past several years, the national cancer strategy has not got any additional funding and this means all the additional staff who are needed and all the additional measures that need to be implemented to ensure cancer patients have the optimal healthcare outcome have not been put in place. The crisis in our health service and in cancer services has got worse during 13 years of Harris, Varadkar and Donnelly as health Ministers. We need to adequately fund the cancer strategy on a multi-annual basis. We also need to end the recruitment embargo, engage with workers, and recruit and retain enough radiation therapists and radiographers. In addition, we must fund the 1,500 beds needed to make our hospitals safe.

Photo of Tim LombardTim Lombard (Fine Gael)
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I acknowledge the presence of members of the Irish Cancer Society. It is very important they should be here for this debate. I also welcome the Minister of State. I acknowledge especially the work of Senator Kyne in the preparation of the motion, which is a very appropriate one, especially given the day that is in it.

We must examine the key structures of the cancer strategy to make sure they are funded so that it can be a key plank of our approach going forward. I wish to raise two issues. One is about new drugs and how we must put a scheme in place to make sure new drugs are a major part of the cancer strategy and are available when needed. We must look beyond Ireland in that regard and have a European focus when it comes to new drugs. We are a small country with just over 5 million people and our purchasing power is quite small. The European Union must play a role in making sure new drugs are made available in a similar way to how it acted when the vaccine for Covid was made available and purchased. We need a change of policy because we face an unfortunate dilemma at the moment due to the current rebate system that is slow, to say the very least.

There is also a clash between private and public cancer care. Patients in the private system can get new cancer drugs faster than on the public system, which unfortunately has a knock-on effect and leads to a two-tier system. We must take a different view on how we will ensure new drugs are made available to patients. The pharmaceutical industry in Ireland is a world leader. We have the drugs in Ireland, or they could be made in Ireland, and we must find a solution to the fact that patients in this country cannot avail of them. I appeal for a change in strategy in that regard.

The other issue I want to raise is one I have continually raised, namely, skin cancer. Unfortunately, it is the commonest cancer in Ireland. We are very much aware of the issue. I lost a brother to skin cancer in 2009. He was only 37 years of age. More work needs to be done on education about skin cancer to make sure people are aware of what needs to happen. We all know about moles and that they might need to be examined. Sunscreen is another issue that needs to be raised. It baffles me that we have a VAT rate of 23% on sunscreen. It is considered to be a lotion. I do not even think we should charge for sunscreen. It should be given out free of charge because of the potential it could have to save people's lives. A different approach is needed to skin cancer in particular. We must redouble our efforts and have a campaign on it. We must ensure there is education on sunscreen for kids. It is a basic thing we need to start talking about. It must start in the schools but it must also happen in industry, for example, construction, fishing and agriculture. They need to be a major focus in dealing with the issue. Those involved in construction do health and safety courses but that is not so much the case in agriculture. Education on skin cancer must be a key plank of the approach to make sure people are aware of what they need to do daily to protect themselves if they are working outdoors. A campaign in that regard must be devised because there could be real benefits if we get it right.

This is a very important debate. Unfortunately, cancer has touched every family in this room and in this House. We must try to ensure we can have meaningful change to have the outcomes we seek and desire.

Photo of Aisling DolanAisling Dolan (Fine Gael)
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I welcome the Minister of State. I acknowledge Senator Kyne, as a Senator from the west of Ireland, for tabling this motion.

In 2022, we attended a presentation by Professors Michael Kerin and Maccon Keane. These consultants took time out of an unbelievably precious schedule to visit Buswells Hotel and give a presentation. Senator Kyne raised a key point about a cancer centre in the west of Ireland. As Senators who represents counties Roscommon and Galway, we can inform the Minister of State that there are worse outcomes there than if you live in the east or south. They are the worst outcomes. People have been looking for a cancer centre plan for the west of Ireland for I do not know how many years. They were looking for it in 2022. The investment we need to see must be balanced across the country. We talk about balanced regional investment, and the phrase spins off our lips so easily. We talk about these things when it comes to schools, school transport and buildings and all of the crucial things we need. We are talking about the health of people's lives and survival rates.

It has long been a challenge for me to look at investment across health service. We say to people who live in the west of Ireland that the chances are that survival rates are potentially not as good. I know Professors Keane and Kerin, and I know their teams. I have many family members who have gone through cancer treatment and thank god received excellent treatment at their hands. However, they are struggling if they are not able to access the same levels of support and services in the west as they can in the rest of the country. I look to the Minister of State and the Government to see what can be done.

Another point raised by Senator Kyne in his motion relates to the national cancer strategy and the supports offered by different community cancer centres across the west. I am speaking only of the area I know. We have cancer support services that try to take people to get their chemotherapy. At my offices in Ballinasloe and Roscommon, I deal with people who cannot get to the hospital because of a lack of bus and train services. The Minister of State will tell me that this is obviously not his bailiwick. I want to see integrated supports in the context of people accessing our hospitals such that when we deliver services, the HSE and Department of Health work with the Department of Transport to ensure that Local Link bus services should connect to Portiuncula University Hospital or Roscommon University Hospital. At the moment, there are not as many of those services as people would like to see. That is all part of people being able to access the service and get to Galway, Roscommon, Portiuncula, Letterkenny, Castlebar and all of these facilities that cover the north-west and the west.

I support of Senator Kyne. I thank him, our colleagues in Fine Gael, our Government partners and those who have spoken here and who have experiences in their own lives of dealing with this matter. We need to fight for balanced investment. I am not saying this is simple. We need to see that service and to fight for it across all the regions.

Photo of John McGahonJohn McGahon (Fine Gael)
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I will raise two or three issues before I get into the wider context. The first is the issue of palliative care, which I raised in the House a year ago. This is the result of a HSE decision. The CHO 8 area, as the Minister of State knows, covers counties Louth, Meath, Laois and Offaly. A decision was made by the HSE that in the Louth and Meath areas, only clinical nurse specialists would be able to administer palliative care. In every other health service area, public health nurses are able to administer palliative care. I will give an example of how this is silly. If I live on the border of counties Louth and Monaghan, in County Louth, I have to have a clinical nurse specialist deliver palliative care. If I live two miles away in Inniskeen, County Monaghan, a public health nurse can do it. What is the difference? Public health nurses, of whom we have more, are able to come into people's homes and administer end-of-life care. It is part of the cancer strategy going back a number of years that somebody has the right to die in their own home if they so wish. What happens when we only have clinical nurse specialists providing palliative care is that people in counties Louth and Meath end up having to go directly to hospital when they get close to the end-of-life stage and have to receive palliative care there. That is just a decision by the HSE in this particular area of CHO 8. In counties Offaly and Laois, for example, which are also part of CHO 8, public health nurses administer palliative care. It is a clear discrepancy, based on the postcode lottery of whether someone lives in counties Louth or Meath or Cavan and Monaghan. That is not a decision made by the Government, but by the HSE. It is something I raised a year ago and about which I wrote to the HSE. There has not been much movement on it. Given the Minister of State's track record on health in this House over the past decade and a half, it is something I would perhaps like to speak with him about privately to see if we can get some movement.

The other issue I want to raise is the Leave Our Leave campaign, of which the Minister of State is also aware. People and women who are pregnant have to use up their maternity leave to undergo treatment. A man in the same situation would not have to do so. What is happening is down to a discrepancy in the legislation. It would take a simple amendment to fix that. The Minister, Deputy O'Gorman, said at the Green Party conference last October that he would fix and change that. I am not criticising the Minister, but it has still not been fixed. I raised the matter at a meeting of the Fine Gael Parliamentary Party, at which the Minister of State was also in attendance, with the Taoiseach, Deputy Harris, and directly with his office. The issue is that while we clearly want to fix it, the Government is in extra time, for want of a better phrase. We all acknowledge the political reality. We may be here for a certain number of months or less, but we are getting close to the end. At this point, what the Government wants to do with the Leave Our Leave campaign is amend and fix it, but it is including it with a lot of other legislation that is not really being processed. Can we please make a simple amendment to the Act from 2015 or 2016, rather than lobbing that amendment in with a lot of other legislation? It is a simple fix and one I am keen to see progressed before the end of this Government's term. It is important to deal with this before the Government leaves office because there are so many young mothers who have gone through chemotherapy and have not had the time to spend with their newborn babies that other people have had because they are undergoing lifesaving treatment. They will have to tell their stories again once a new Government comes in, regardless of its make-up or the parties involved. These women will have to start from scratch. That is tough for them. We know what the issue is. We know how to fix it and we should try to do that as quickly as possible with a simple amendment before the end of this Government's term.

I raise something I saw with my mother who passed away 16 July last year. We are coming up on one year from it. Our family has experienced the HSE and how wonderful it is, and how well it works when you are in the system. When you are in the system, it works really well. I have seen that first hand. I have seen how incredible our nurses, doctors and other staff are in the HSE and our cancer services, particularly where I am from in County Louth. They are owed a massive debt of gratitude by families across this country for how they treat our loved ones with such dignity, respect and compassion when people go through some of the hardest moments of their lives. I pay tribute to our health staff.

Photo of Maria ByrneMaria Byrne (Fine Gael)
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I welcome the second group from Aghada National School in County Cork. I hope they enjoy their visit to the Seanad and the Dáil.

Photo of Mary Seery KearneyMary Seery Kearney (Fine Gael)
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I welcome the Minister of State. I commend my colleague Senator Kyne on drafting and bringing forward this motion. It is excellent and aptly timed. I reiterate the asks. The idea that your probability and possibility of surviving cancer is dependent on where you live, your socioeconomic grouping or your geographical location is awful. It should not be that way in 2024.It is shocking that there would be any sort of disparity in treatment and access to treatment.

There are key things that the Senator has outlined in the asks, for example, the issue of vaping. The piece I do not understand is that we can have such a widespread product that is on the increase in its use but there is no standard. There are shops and the products are sold at every possible outlet, yet there are no standards and no moves to ban them. What are we going to find? Are we going to find in 30 years time that we look back and there will be a generation that has been affected? Will it be like asbestos or smoking? We need to move more quickly with regard to our attitudes to vaping.

I also want to raise the issue of children with particular skin types and issues such as moles, skin tags and so on. If someone brings a child to the GP and asks for them to be mapped so their consistency or difference can be measured, the waiting list for that is anything up to two years in Dublin, if they are lucky. That is not okay if there is something going on. Parents are not in a position to decide if they have the knowledge or competence to know whether their child is predisposed to developing skin cancer.

That brings us on to the whole topic of skin cancers. Senator Lombard spoke eloquently about lotions. The fact is lotions are prohibitively expensive. If someone is in a particularly disadvantaged socioeconomic group, what are the chances that they are going to pay the prices that have to be paid for skin lotion? Lotions should be accessible. I would venture to say that they are like period products and there should not be any disadvantage for people who cannot afford them. Lotions to protect children’s skin should be as freely and frequently available as the dispensing of sanitiser in public bathrooms across our city and country.

The probability of developing skin cancer is high but there are issues even for those who have skin cancer. I have people close to me with skin cancer and their treatment has been postponed on three occasions in one instance and on two occasions in another. There is clearly a delay in the roll-out or there is understaffing, and that is in Dublin where, allegedly, everything is much better.

I do not understand how we still have sunbeds, how people can rent them to their homes and how people are going to salons. Why did we not shut them down a long time ago? Again, there is a slowness to react. As with vaping, there is a knowledge that this is doing harm yet we are slow to react. It is something we need to address and treat with the urgency it deserves. Our responses are way too slow.

Where someone is in the system, there is no doubt it is exceptional. The support of families where cancer is terminal is extraordinary. The work of the Irish Cancer Society is extraordinary and the level of support it gives to a family is amazing. However, that is due to a lot of fundraising and work that goes on outside the services of the State. Outside of our own health service, we are reliant on the work of others. All the support that can be given to the Irish Cancer Society, I believe it deserves that and all the rest of it, twofold.

I want to address the Leave Our Leave campaign. We need to address this issue as a matter of urgency because there is a disparity. If someone is on maternity leave or long-term sick leave, there is a disparity in how entitlement to holidays is calculated. There are real employment law issues that need to be addressed. If women are forced to sacrifice their maternity leave with their child, then they do not have the same protections, in particular if they are going into the latter part of an extended leave and are reliant on reasonable accommodation in going back to work. There is a lot of employment law within that where women are being disadvantaged. I am surprised it has not become an equality case at this stage. We need to act on it. Senator McGahon has given a very short and quick answer. There is no reason it cannot be acted upon.

Photo of Joe O'ReillyJoe O'Reilly (Fine Gael)
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I welcome the Minister of State, Deputy Burke. I had the privilege of working with him in the Seanad when he was a Member and it is wonderful that he is back as a Minister of State.

I congratulate and thank my colleague, Senator Kyne, for bringing forward the motion and taking the trouble to write it up very effectively. Senator Kyne is a conviction politician and he is very sincere about this issue. I thank him for doing that.

I salute the volunteers, the people in towns and villages all over this country who do voluntary work for patients with cancer and their families. I am thinking, in my own village, of Eugene and Edel Fox, who, with others, are on the executive committee of a group, Bailieborough Cancer Comfort. They provide a taxi service to Dublin for people undergoing chemotherapy and other treatments and provide support to families undergoing chemotherapy in Cavan when it is available there. These are wonderful people. I met them yesterday and, as I should and as anyone else in the House would have done, I made a voluntary contribution to CUAN Cavan. It is a support group for cancer patients in Cavan town that is currently fundraising for a new drop-in centre where people will have the support of peers with cancer, people who have recovered from cancer, family and volunteers. There are also psychological and counselling supports. It is a wonderful set-up operated by wonderful people and was spearheaded initially by a wonderful friend of mine, Helen Quinn. Those people are great in what they do.

I, of course, salute the Irish Cancer Society. The daffodil nurses - the cancer care nurses it provides - are very important. The society gave us some interesting statistics which bring the reality of the whole thing into perspective. Its brochure, Cancer by Numbers, shows that some 42,000 people get cancer in Ireland every year. We are 13th of the 27 EU states in terms of recovery, which is disappointing and needs to be addressed. There are on average some 10,308 cancer deaths every year in Ireland and 215,000 people are living beyond cancer diagnosis - we meet them every day as we walk around. A person in Ireland hears the words “You have cancer” every three minutes. Those are all major statistics that show the reality.

We give a medical card to people with cancer, which is as it should be. I ask the Minister of State to look at the prospect of medical cards for women who are diagnosed with breast cancer and men who are diagnosed with prostate cancer. The Minister of State can correct me if I am wrong, but my understanding is that in both cases people have to undergo a means test unless the cancer has spread. To be truthful, I think that is wrong, particularly given how rich the country is at the moment. In terms of prioritising expenditure, it is wrong. I know the Minister of State has a personal interest in this so he might respond on the medical cards. It is very important.

I agree with all of the talk on prevention. Senator Seery Kearney said we need to deal with vaping and a Private Members’ Bill did go through the House recently. In fairness, there has been great focus by the Government on the vaping issue. It needs to deal with this.As for the loss of income in costs associated with suffering from cancer, the Irish Cancer Society estimates it costs a family anywhere from €756 to €1,000 per month. They can lose up to €1,500 per month in income. That is a really big one.

I am very proud and I salute the work it does. I thank the Acting Chair for doing what he did as it is important we put this on the record. My wife is a public health nurse. She does some of these calls at the weekend. The palliative care people in the HSE and the palliative care nurses do extraordinary work. It merits saluting. It should be supported and it needs universality. Generally, they need to move in as early as possible when families will accept them. Together with the Irish Cancer Society nurses, this is a very important initiative. Certainly, I am proud of my wife's work and the work of other colleagues who specifically work in palliative care full-time, which is extraordinary.

My time is nearly finished. Basically, medical cards, practical supports for transport and all of that should be in place. It should not just be a question of volunteers; there should be a support network transport-wise for people to receive treatment. Income supports should be provided where a family can prove the whole family income is gone and that it is down money. They can sometimes get in as a preventative measure or get sick pay and so forth. While it is great when they do, these things can be phased out.

It is a great debate and I congratulate Senator Kyne in this regard. We have to follow this up with actions. For that reason, the Minister of State's response will be interesting. We need actual results from this. We need to salute what is good already and to try to improve what is not and make more efforts.

Photo of Maria ByrneMaria Byrne (Fine Gael)
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I thank the Minister of State for coming before the House today to discuss this important issue. I thank our colleague, Senator Kyne, who put a lot of work into putting this motion together. I compliment all who work in this area. Where I come from, we have the Midwestern Cancer Foundation as well as Milford hospice on our doorstep. The wonderful work which the support workers and the volunteers carry out on a day-to-day basis is phenomenal. They are there to support families when they are going through a turbulent time. From my own experience, my father died from pancreatic cancer. It was a very rare form of pancreatic cancer which was hard to diagnose. In actual fact, he was a very sick man before any symptoms turned up. It can be very traumatic for families when that happens.

Medical cards have been referred to here by colleagues. I am on record on more than one occasion as saying that people who are diagnosed with a terminal diagnosis such as cancer should automatically receive a medical card because it is a very turbulent time for people. It depends on a means-tested application. The bottom line is that a person is in the middle of their treatment, and their family is trying to support the person who is having the treatment, and then that person is refused a medical card. That needs to be looked at and brought in for people under the treatment of cancer, whether on a phased or a full-time basis.

No family has been left unmarked by cancer. It does not matter whether you are young or not so young. A daughter of a friend of mine was diagnosed with a cancerous tumour in the brain. Thank God for the treatment she received here in Ireland. She had the tumour removed and had all the treatment and has come out the other side of it. While she still has some defects, such as her speech being affected, she goes out and is a very happy girl every day. She received a lot of support during her treatment locally but also nationally in Crumlin hospital and in the different hospitals she was in. Overall, Ireland provides a very good service but we need to look to do more. When the removal of the prosthesis was looked at, that is, the bras for people who had a breast removed, it caused uproar. The threat of removing supports in cancer services should never be allowed to happen again.

I wish to compliment the staff and the doctors who work in the units, both in the hospital and hospice settings. I am aware the HSE has cut funding to places like the Midwestern Cancer Foundation, which was set up by Professor Rajnish Gupta, who is a cancer specialist in his own right. Much of the work it does is carried out based on fundraising efforts. While it is great the work is being carried out, it should be better supported. As far as I am aware, the funding that other similar foundations receive from the HSE has been cut. This is something the Minister of State may be able to look into. These foundations give a very good service and need to be supported. Every family relies on them in some shape or form at some stage in their lives.

Photo of Diarmuid WilsonDiarmuid Wilson (Fianna Fail)
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Before I call on the Minister of State, Deputy Burke, I wish to say that this is the first opportunity I have had to congratulate him on his appointment as a Minister of State. He is a former distinguished Member of this House and I am delighted to welcome him and ask him to make his contribution.

Photo of Colm BurkeColm Burke (Cork North Central, Fine Gael)
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I thank Senators Kyne and Conway for bringing forward this motion. Twelve Senators contributed to the debate and I thank each and every one of them for detailing their concerns and setting out how we need to roll out and improve our current cancer care plan. I will touch on some of the points raised because it is important that I deal with them as they arose. I may not be able to get through all of them but I have no difficulty with anyone emailing me if there are issues people wish to raise with me.

My understanding is that a proposal has been received for the development of cancer services and a new unit in Galway. A significant and ambitious proposal for a new cancer centre in University Hospital Galway has been developed by the hospital group outside of normal HSE capital development processes and the Department of Public Expenditure, NDP Delivery and Reform's infrastructure guidelines, previously known as the public spending code. Delivery of any cancer centre proposal will also depend on the completion of a number of enabling projects to decant and relocate existing services, including laboratory facilities. Currently, at appraisal stage in the capital plan for 2024, the Department is engaging with the HSE and the hospital to proceed with it. Progress is being made on that issue.

One of the other issues raised was the need for a screening programme for lung cancer. The group which oversees the screening programmes is giving consideration to introducing an additional programme. One of those being considered is a screening programme for lung cancer.

Another issue raised is around the sale of tobacco and tobacco products. We are currently drafting legislation so that shops will not be able to sell cigarettes to anyone under the age of 21. That legislation will be coming forward in the not-too-distant future. The Department is currently working on that.

The Department of children is dealing with amending legislation on the maternity leave issue which was raised by one Senator. That is being looked at. The issue of radiation therapists was also raised. I arranged for representatives from Trinity College Dublin and UCC to meet with the then Minister for higher education, the current Taoiseach, in October of last year. Proposals were made whereby the number of places in Trinity College would be increased from 30 students per year to 50 and the proposal in Cork was to increase the number from 12 students per year to 24. The course in Cork is a masters degree. A person on the radiation training course in Cork will already have a primary degree and would do this as a masters degree. My understanding is that it is currently with the Department and we are hoping to progress the issue. It is an important issue because we need radiation therapists. We do not have enough of them qualifying every year and we need to improve the situation. All of those issues are being dealt with.

The prosthesis issue arose previously in 2016, when there was a proposal to regularise it across the entire country because of the different arrangements in place in different parts of the country. As a result, areas that were really ahead of the curve were going to end up with what they were providing being reduced and other areas would be improved. Then it happened a second time and it has happened a third time. So far we have left it as is. I think we should now go back and re-examine it and try to come up with an overall proposal for the entire country so that the same level of services and supports is available right across the country rather than the mix we have at the moment. We need to work on that and come up with a solution. This has been going on since 2016, more than eight years ago. In fairness to the Department, it is working on the matter.

Successive national cancer strategies have shown the benefit of continued investment in national cancer services. The benefits for Irish cancer patients come from earlier diagnosis, better treatment and improved rates of survival. The Government's commitment to the implementation of the national cancer strategy is evidenced by significant investment in recent years. We have seen good progress on the implementation of the strategy through the past seven years. This progress has been driven by clear, evidence-based policy direction from the Department and strong implementation by the HSE's national cancer control programme, NCCP. At this time, 40 of the 52 recommendations have been implemented and work is progressing on the remaining recommendations.

Since 2017, there has been an additional investment of €456 million in cancer services, including €81 million on cancer prevention, screening and treatment. A total of €316 million has been spent on cancer medicines and €59 million on cancer research grants through the Health Research Board. The Government has allocated substantial funding of €50 million for national cancer treatment and screening services over the years 2021 to 2023. In the same period, the Government has allocated additional €98 million for new medicines, facilitating the introduction of 61 new cancer medicines .

Capital funding of more than €120 million has provided state-of-the-art radiation oncology facilities in Galway and Cork and updated cancer infrastructure in chemotherapy wards and lab facilities for the benefit of patients. A further €20 million has been invested in the new national cervical screening laboratory. The funding since 2017 has enabled the recruitment of more than 670 staff to our national cancer services. This includes an additional 200 nursing staff, 100 consultants and 180 health and social care professionals in designated cancer centres. Taken as a whole, this represents a significant investment in the implementation of the aims of the national cancer strategy and providing improved access to cancer care for patients in Ireland.

The strategy recognises the positive impact of early detection on patient prognoses and the importance of preventing cancer, where possible. Current estimates show that four out of ten cancer cases can be prevented by a change in lifestyle or environment. Since the beginning of 2020, the Government has spent more than €60 million on measures to assist people to quit smoking. This funding has allowed people to receive smoking-cessation medications, access to the national quit line and provided staffing and other programmes. In 2022 the NCCP launched the Early Diagnosis of Symptomatic Cancer Plan 2022-2025. The plan focuses on raising awareness of the signs of cancer among health professionals and the general public, with a particular emphasis on marginalised groups. I note that some Senators raised that issue earlier on. Nine out of ten cancers are diagnosed when individuals present to their GP with symptoms. This highlights the importance of those worried about any health symptoms attending a GP.

For healthy people without symptoms, population-based screening programmes are in place. I am pleased to advise that the national screening advisory committee has commissioned the Health Information and Quality Authority to review and assess the evidence for potential expansion of the age-range eligibility for the bowel screening and breast check programmes. This important work is currently in the planning stages, and will soon be under way.

The national cancer strategy sets out a vision for continuous improvement of cancer services, following on from the progress under the two previous cancer strategies. A particular focus is the centralisation of cancer surgery, which is now 85% complete. This means that expertise and resources are concentrated in designated centres, ensuring that patients have the best care available for cancer surgery. It goes back to the issue that if consultants are doing a particular procedure, the more procedures they do, the more expertise they acquire. That is the whole point about centralisation and it has worked very well.

Since 2020, new cancer treatments and models of care have been lodged in Ireland thanks to the increased funding from the national cancer care strategy. Among these are specialised treatments, such as CAR T cell therapy, radioligand therapy and advances in radiotherapy treatment. This is on top of the funding for cancer medicines. As I mentioned, 61 new medicines are now available.

Since 2020, more than 1,200 additional acute inpatient beds have been opened as of March 2024. This represents the largest expansion of public acute hospital capacity in the history of the health service. As well as an increase in bed capacity, hospitals have received an unprecedented uplift in funding and workforce since 2020. The figure for the HSE has gone from 103,000 in 2014 to more than 145,000 whole-time equivalents in 2023. That is an increase of almost 45,000.

Even with this support for additional acute inpatient capacity alongside investment in community care, reform and innovation, the health service is experiencing an increase, year-on-year, in demand for acute hospital care. The Minister for Health recently published the acute inpatient hospital bed expansion plan, which aims to deliver more than 3,300 acute inpatient hospital beds by 2031. The plan recognises capacity already delivered and committed to by the Government while also addressing medium- to longer-term capacity needs. We recognise that our bed capacity needs to be increased to meet the healthcare needs of our growing and ageing population. Under this plan, in recognition of the role of single-occupancy rooms in infection prevention and control, it is intended that all new beds will be in single-occupancy rooms. There may be some instances where this is not possible and where some provision of multi-occupancy rooms is appropriate.

The role of palliative care in cancer care is highlighted in the national cancer strategy. People with cancer are considered to comprise the majority of palliative care patients. In 2010, a clinical programme office for palliative care was established within the HSE. The aim of the national clinical programme for palliative care is to ensure that patients with life-limiting conditions and their families can easily access a level of palliative care services that is appropriate to their needs, regardless of the care setting or diagnosis.I acknowledge the presence of Averil Power from the Irish Cancer Society and of those from the Irish Hospice Foundation. In partnership with the Irish Cancer Society, the HSE delivers night nursing care to patients receiving specialist palliative care to enable people to die at home. This invaluable service also provides respite to carers during end-of-life care.

The HSE has taken over a number of hospices previously run by independent organisations. That has happened over the past 12 months and is a welcome development under HSE management. When this strategy was brought to Government in 2017, 150,000 people were living after a cancer diagnosis. That number is now 215,000, a 43% increase under the strategy. This is a massive achievement, and it means that the aim in the strategy to increase patient involvement and maximise quality of life becomes even more important.

Over the lifetime of the strategy, the NCCP has developed models of care for psycho-oncology which incorporate best international practice and ensure psychosocial supports for cancer patients and their families are of a very high standard. This has included specific models of care for children, adolescents and young adults and recognises their needs differ from those of adults. These models of care have the aim of improving outcomes for cancer patients who face a heavy burden throughout their treatment and recovery.

The NCCP has also developed guidelines for community services which have been adopted by the NCCP alliance of community cancer support centres. The Minister for Health has allocated €3 million in funding to these centres for 2024, recognising the impact the centres have for cancer patients and their families in communities throughout Ireland. Senator Kyne referenced this.

The ongoing transformation of cancer services is a priority under the strategy. This is enabled by integrating research into cancer care where possible and making use of innovative methods to improve how our national cancer services provide care.

HRB investment in cancer research since 2020 represents almost 14% of its total health research investment. This funding has gone towards support for developing cancer clinical trials infrastructure to help achieve one of the aims of the strategy, which is to increase patient participation in clinical trials. The HRB has also provided funding towards a national cancer clinical trials network as well as research projects and programmes and clinical trials. In addition to this funding, this year the HRB announced a provision of €1.2 million for cancer research projects operating on a North-South basis as part of the Cancer Consortium, which is a co-operation between Ireland, Northern Ireland and the United States National Cancer Institute. The all-island approach is extremely important and we need more co-operation between both sides in developing additional services.

Ireland has made important developments in improving the clinical trials and health research landscape, including the development of a national health research data protection impact assessment template. This template is being rolled out in HSE sites. More recently, the HSE has agreed on a clinical trial contract template for commercial organisations, clinical research organisations and public healthcare providers.

The HSE commenced the development of a national strategy for radiology in January of this year. A national steering group and working group have been set up to develop this strategy. Its aim is to set the future direction of radiology in Ireland. This will be done through examining current radiology capacity and existing and forecasted demand, identifying strategic priorities and defining a future service delivery model to meet the needs of patients. I expect this to be delivered later this year.

Under the strategy, there has been an improvement in cancer survival rates. The five-year survival rate for patients diagnosed with cancer between 1994 and 1998 was 44%. This increased dramatically to 65% for people diagnosed with cancer between 2014 and 2018.

For 30 years, the National Cancer Registry has been helping us to better understand cancer. Since it started data collection in 1994, the registry has published annual reports on cancer incidence and epidemiology in Ireland. Extensive work is done across our hospital system in providing the information for these reports. These reports are an invaluable tool for policymakers because we can see what effect our actions have on cancer incidence and outcomes. The registry is also involved in benchmarking partnerships across Europe and internationally.

Ireland is performing strongly in the reduction of cancer mortality in comparison with other European countries. European comparisons for the period 2011 to 2019 found that Ireland reduced cancer mortality by 14% for men and 13% for women compared with the EU average of 10% for men and 5% for women. In addition, recent estimates by the European Cancer Inequalities Registry suggest that Irish cancer mortality rates have fallen below the EU 27 rate. This is proof of the benefits of our long-term strategic approach to cancer, with strong policy oversight from the Department of Health and a national cancer control approach led by the NCCP. With improvements in symptom recognition, access to screening programmes and improvements in treatment, five-year survival rates have increased for almost all cancers.

Stage at diagnosis plays a significant role in treatment and, ultimately, in survival rates. This is why early diagnosis is so important. The key message for anyone concerned about cancer is to discuss concerns with your GP in the first instance so that you can start on a patient pathway.

I thank Senators for their contributions. It is important we discuss this. Last week was men's health week. We need to highlight the need for people to go for regular health checks. Men are slower to go to their GP or look for healthcare. It is important we continue to raise the issue, give out more information about living healthily and well and ensure that, where people suspect they have a health problem, they do not delay it for two, three, four or five months, as happened in a number of cases I have come across recently. I look forward to working with Senators on continuing to deliver and improve the strategy and deliver the best possible healthcare for all diagnosed with cancer.

Photo of Diarmuid WilsonDiarmuid Wilson (Fianna Fail)
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I join the Minister of State in welcoming our former colleague, Averil Power, and her colleagues from the Irish Cancer Society to this important debate.

I did not want to interrupt the Minister of State but I was asked by Senator Maria Byrne, who was Acting Chairperson earlier, to welcome the group that came into the Public Gallery while the Minister of State was speaking. It is the Gorey Little Theatre group and Gorey Musical Society. They are guests of Senator Malcolm Byrne. Also in the Gallery are his parents, Myles and Mary Byrne, and his sister, Aoife Clarke.

I call Senator Kyne to sum up.

Photo of Seán KyneSeán Kyne (Fine Gael)
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I thank the Minister of State for his comprehensive response and thank all contributors for their support for the motion. It is safe to say this issue affects every family and community and goes to the hearts of many who have a vested and very personal interest in cancer survival.

I acknowledge Senator Clifford-Lee's concerns about medical cards, which Senator Maria Byrne also raised. It is always difficult where there are thresholds and means tests. That will be looked at in forthcoming budgets. Senator Clifford-Lee also raised income inequality in disadvantaged communities versus affluent communities.That is prevalent in all local regions. It is a particular issue in the west that has been highlighted to me and that is why I included that important point. She also spoke about early screening programmes. Senator Hoey provided personal testimony regarding her late father, lung cancer and early screening. She also mentioned the postcode lottery. Senator Warfield spoke about underfunding of the strategy and vacant posts, notwithstanding the significant level of funding that has been provided and detailed in the Minister of State's piece.

Concerns have been expressed by the Irish Cancer Society about the need for additional funding for vacant posts. Senator Lombard spoke about the need for a European focus on new drugs, sunscreen and the VAT on lotions, skin cancer being the largest killer. Senator Seery Kearney raised that, as well as vaping and sunbeds. Senator Dolan spoke about the very important issue of a cancer centre for the west, which is slowly progressing. There is an overall master plan for the University Hospital Galway campus. As the Senator said, this will not be just for Galway; it is for Roscommon, Mayo, Sligo, Leitrim and Donegal.

Senators McGahon and Seery Kearney spoke about the Leave Our Leave campaign. One would imagine a short Bill could deal with that, something the Minister of State could take up and champion in his Department. If a small change to one piece of legislation is what is required, that could be progressed very quickly before the end of term. That would provide some equality to the situation.

Senator O'Reilly spoke about volunteers. They are important in terms of the work they do raising funds. Survivors and families are fundraising for support centres. Senator Byrne spoke about the importance of support centres and the work they do. That is acknowledged. I raised the issue of the €3 million in the 2024 budget, which is welcome. We need that to continue and to be increased, if possible. It is something that would be of benefit. There are currently 26 centres nationwide. The level of funding they receive was determined by the NCCP based on its work and the numbers of referrals to it. It works hand-in-hand with HSE and other organisations.

On the Minister of State's comments on the national screening advisory committee, it has commissioned HIQA to review and assess the evidence and the potential expansion of the age range and eligibility for the bowel screening and BreastCheck programmes. That is to be welcomed. The Minister of State also mentioned that 40 of the 52 recommendations of the NCCP have been implemented. Work is ongoing on the remaining elements of the cancer strategy, which is to be welcomed and acknowledged.

The Minister of State also mentioned single occupancy rooms, which provide privacy, dignity and infection control. Cancer sufferers are more prone to picking up infections. Single en suite rooms came into their own during the Covid pandemic in terms of infection control. Overall, this is an important topic that affects one in two of us in our lifetimes. While the outcomes are improving, we cannot rest on our laurels and that is what the strategy and work of the Irish Cancer Society, volunteers and support centres around the country is about. I commend the motion to the House.

Photo of Diarmuid WilsonDiarmuid Wilson (Fianna Fail)
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I thank Senator Kyne for tabling the motion.

Question put and agreed to.

Photo of Lorraine Clifford-LeeLorraine Clifford-Lee (Fianna Fail)
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I propose that we suspend until 6 p.m.

Photo of Diarmuid WilsonDiarmuid Wilson (Fianna Fail)
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Is that agreed? Agreed.

Cuireadh an Seanad ar fionraí ar 5.34 p.m. agus cuireadh tús leis arís ar 6 p.m.

Sitting suspended at 5.34 p.m. and resumed at 6 p.m.