Sarah O'Reilly (Aontú)
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I welcome the Minister of State to the Chamber and thank her for coming in. I have a letter in my hand from the national cancer control programme, NCCP, detailing how the HSE is failing to meet its radiation treatment target of 90%. This target aims to have those who are deemed fit for radiation treatment to begin the treatment within 15 days. The 10% buffer is there to allow for exceptions where a patient is too ill for treatment, does not show up or dies in the interim. The NCCP has told us that in 2024, the national rate of compliance with the target was a mere 72.8%. It has given us a snapshot of the data for each month from September 2023 to August 2024 in Beaumont Hospital, Galway hospital and Cork University Hospital. The 90% target was never met in any of those months in Beaumont Hospital. It was met once in Galway hospital and only twice in Cork University Hospital. The target is being missed by a scandalous margin and, as a result, patient care is being compromised.

Nearly every family in Ireland has gone through the experience of a loved one being diagnosed with cancer. Having to wait for treatment brings additional and unnecessary stress to patients and their family members. Timely access to cancer treatment is critical in achieving the best possible patient outcomes. The earlier treatment begins, the greater the chance of success, significantly improving survival rates and quality of life. Any delay in initiating therapy can allow the disease to progress, reducing the effectiveness of interventions.

International research has demonstrated severe consequences of treatment delays. Studies indicate that even a four-week delay in starting cancer treatment can increase the risk of death by approximately 10%. Four weeks might not sound like much on paper, but for a person battling cancer it is an eternity. It is four weeks of stress, uncertainty and potentially the disease advancing while they wait. Delays due to resource shortages, administrative inefficiencies or a lack of capacity can have life-threatening consequences.

Ensuring adequate staff and facilities and streamlined processes is essential in giving every patient the best possible chance of survival. We need to ensure that when a person is diagnosed with cancer and is deemed fit for treatment, there is absolutely no delay on the part of the health service. When a person has cancer, it is often a race against time. Even the language of the response issued to us from the NCCP is concerning in that it talks about working days. We in Aontú believe that cancer treatment should be available on weekends and public holidays. Cancer does not stop spreading on a Friday evening and resume on a Monday morning. Therefore, treatment should not either.

Staffing is, of course, an issue here, with a 30% shortage of radiotherapists in the country. The national radiation therapist review report was completed in 2024. The recommendations of this review include opportunities to improve staff recruitment and retention, including the implementation of new roles such as advanced practice and aid roles and a review of the grading structure for the radiation therapist profession.I call on the Minister of State to provide proper and decent pay and conditions for nurses and doctors, who are currently voting with their feet and leaving the country, to ensure the highest standard of care for these vulnerable people.

Jennifer Murnane O'Connor (Carlow-Kilkenny, Fianna Fail)
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I thank Senator O'Reilly for raising this matter. Successful national cancer strategies have delivered continuing improvement in outcomes in Irish cancer patients. The benefit of our strategic approach cancer control is shown by the improvement in the number of patients living after having received a cancer diagnosis: more than 200,000 people now compared with 150,000 when the strategy was brought to Government in 2017.

Significant funding has been provided to cancer services over a number of years. In budget 2025, €23 million was secured for the national cancer strategy, including funding for the expansion of cancer screening and community cancer support centres. This will mean that in excess of €105 million will have been invested in the strategy since 2017, which will have enabled the recruitment of more than 670 staff to our national cancer services.

Capital funding of more than €140 million has been used to provide state-of-the-art radiation oncology facilities in Galway and Cork, to update chemotherapy wards and lab facilities, and to invest in the new national cervical screening laboratory. The HSE national cancer control programme, NCCP, has set a target of 90% of patients commencing radiotherapy treatment within 15 working days of being deemed ready to treat by a radiation oncologist. In 2024, the national compliance with this target was 73%. In January 2025, the most recently available data indicated that the national compliance rate has risen to 81%. The NCCP advises that a range of factors can impact the HSE's ability to reach the target, including, in particular, challenges in the radiotherapy workforce.

Staff shortages were actively addressed in March of this year. The shortfall was between 14% and 22% compared with a shortfall of 30% at the same time last year. A national radiation therapist review report was completed in 2024 and made 16 recommendations. These recommendations are intended to support and enhance the radiation therapy profession. Funding was allocated in 2025 to support actions arising from the review. This includes funding for additional staff and six advance practice posts for radiation therapy. Additional training places are being made available and professional registration requirements have been reviewed to bring Ireland into line with international comparators.

The HSE recognises the importance of timely access to treatment. Where deemed clinically necessary, patients have been referred to private service providers. Investment of around €10 million per year is spent on outsourcing radiotherapy appointments to ensure timely treatment. Additional measures to improve waiting times and patient outcomes also include the clinical implementation of stereotactic ablative body radiotherapy, SABR, and stereotactic radiosurgery, SRS. These treatments have the benefit of being delivered in fewer sessions compared with conventional radiotherapy.

The Government remains fully committed to continued implementation of the national cancer strategy and improving radiation therapy capacity to ensure timely treatments for patients. This will build on the progress already made in improving survivorship and the quality of life for cancer patients.

Imelda Goldsboro (Fianna Fail)
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As there is a vote in the Dáil, I ask the Acting Leader to move to suspend the House for the duration of the vote. Is that agreed? Agreed.

Sarah O'Reilly (Aontú)
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I welcome the good news which the Minister of State has come with here today in that the deficit in staffing has reduced from 30% to between 14% and 22%. I do not really know what that means but it is good that it is improving and that has to be welcomed. The faster treatments are not always suitable for patients because they are more concentrated. As they take a shorter time, they are more concentrated, which means that there are more side-effects. Not all patients are suited to taking these faster treatments. I want to remind the Minister of State that this is a very important issue for many people. It is good to keep on top of it, keep an eye on it and ensure that we are making improvements where we can. I thank the Minister of State for coming into the House today.

Jennifer Murnane O'Connor (Carlow-Kilkenny, Fianna Fail)
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I thank the Senator for her contribution on this matter. I acknowledge the efforts made by the NCCP and the HSE to improve compliance with radiation therapy targets of having at least 90% of patients beginning their treatment within 15 working days of being deemed fit for treatment.

The most up-to-date figures, from January 2025, show compliance of 81% compared with last year's compliance of 73%. I know that we need to do more, I totally understand the concerns there and it is something we are working on. As I mentioned earlier, staffing shortfall can be a significant factor in hospitals meeting the treatment target. While staffing continues to improve, more progress is needed and funding has been given this year to the implementation of recommendations of the national radiation therapist review report. Downtime and the servicing of radiotherapy equipment can also result in challenges to treatment times and that seems to be another issue. The HSE makes every effort to address this, including through the use of outsourcing where required. This enables more timely access while improvements regarding staffing and other issues are being made.

The additional €23 million made available in budget 2025 for the national cancer strategy will support a further expansion in cancer services. This funding means that over €105 million has been invested in the strategy since 2017. I again thank the Senator for raising this issue. I understand that there is not a family in Ireland that has not been affected in some way by cancer. It is a priority for us as a Government.