Laura Harmon (Labour)
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I welcome the Minister of State to the House. My question concerns radiation therapists and machines that are currently not operating in some hospitals throughout the country. Some are not operating at full capacity due to staffing issues. I am aware my question overlaps the Departments of Health and further and higher education. There is an estimated shortfall of between 30% and 35% in radiation therapists nationally and the unfortunate consequence of this staffing deficit means a number of linear accelerators, which are cancer treatment machines, have been out of service. I am aware of four, from meetings I have had with the Irish Cancer Society. As of March this year, it is my understanding that one linear accelerator machine and one CT scanner were closed in Cork University Hospital. One linear accelerator machine has been closed in St. Luke's in Rathgar, Dublin, with a skin cancer machine also closed for 50% of the week. One linear accelerator machine and one CT scanner are closed in St. James's in Dublin. One linear accelerator machine is closed 60% of the time in University Hospital Galway, with one CT scanner being used only 20% of the time in emergency cases. I want to check if there is more information relating to these, or if there are more up-to-date figures. It is estimated these closed machines can result in some 120 missed appointments per day. This is according to SIPTU representatives operating on the ground. We know from Irish Cancer Society figures that an estimated one in three patients is not getting the cancer care he or she needs on time and in a timely manner.

I am aware that this is also a higher education issue. It relates to course places and having people to operate these machines and this equipment, and ensuring posts are being created. It is also about ensuring that we are keeping our graduates in Ireland once they finish their courses, and that they have clear career pathways. I know this issue is costing the State. We recently saw in The Irish Times that private outsourcing of radiotherapy services cost €23 million last year. This week, it was welcome to see the HSE capital investment plan for 2025, which provides for €12.13 million for radiation oncology projects under the national cancer control programme. Perhaps I will follow up with the Department on where exactly that is being spent. I welcome the Minister of State to the House and I look forward to his reply.

Kieran O'Donnell (Limerick City, Fine Gael)
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I thank Senator Harmon for raising this Commencement matter, which I am taking on behalf of the Minister for Health, Deputy Jennifer Carroll MacNeill.

There are three public radiation therapy services that operate linear accelerator machines in Ireland. These are located in Galway, Cork and Dublin across the St. Luke’s Radiation Oncology Network. There are a total of 22 linear accelerators across three services: Galway has four machines, Cork has five machines and the Dublin network has 14 machines. The HSE also contracts radiotherapy services from two private providers in Limerick and Waterford. There is also a service level agreement between the HSE and Health and Social Care Northern Ireland to provide radiotherapy on a cross-Border basis at the North West Cancer Centre in Altnagelvin Area Hospital, Derry.

In 2024, the HSE provided more than 6,600 patients with radiotherapy treatment. The HSE national cancer control programme has advised that Galway, Dublin and Cork all record inactivity rates equal to 0.5 of a machine, and this is largely due to staffing issues. I have checked that and it is 0.5 of a machine within each area. I have given the Senator the data that Galway has four machines, Cork has five machines and Dublin network has 14 machines. I sought clarification on that point. The linear accelerators are used for an average of nine hours a day and up to 11 hours when necessary. This time utilisation is similar when compared with international counterparts such as Sweden, Canada and the UK.

Evidence shows that providing timely therapy to patients improves outcomes. The HSE recognises the importance of this and, where deemed clinically necessary, patients are referred to private service providers and an investment of around €10 million per year is spent on outsourcing radiotherapy appointments to ensure timely treatment.

As Senator Harmon noted, there was a staff shortage of 30% in radiation therapy posts in March 2024, and I am pleased to note the efforts of the HSE in making improvements in the past year. By last month, this deficit had been reduced to 14% to 22% across the three services and work is being done to improve this further.

In budget 2025, €23 million was secured for the national cancer strategy. Funding will be used to recruit additional staff, including two consultant radiation oncologists, six advanced practice radiotherapists and a number of other clinical positions. The recruitment process for these posts is due to commence before the end of this month.

A national radiation therapist review report was completed in 2024. The review made 16 recommendations that are intended to support and enhance the radiation therapy profession. In line with the recommendations of the review, the professional registration requirements for radiation therapists have also been reviewed. This brings Ireland into line with international comparators.

The demand for radiotherapy services is increasing year by year in line with expectations identified by the National Cancer Registry Ireland and the national cancer control programme. The Government remains fully committed to the continued implementation of the national cancer strategy and to improving radiation therapy capacity to ensure timely treatment for patients. This will build on the progress already made in improving survivorship and quality of life for cancer patients.

Laura Harmon (Labour)
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I thank the Minister of State for the response and for providing clarity on my questions. It is welcome that the deficit in radiation therapy posts has been reduced from 30% down to 14% to 22%. That is still quite a high deficit, but it is welcome that progress has been made on it. Regarding the 0.5 of a machine inactivity rates in the areas the Minister of State mentioned, is that daily, weekly or annual? I wanted to get clarification in regard to that. It is good to get clarity in regard to the €23 million and that six advanced practice radiotherapists and a number of other clinical positions will be recruited. As I said, I understand there is a link with the Department of further and higher education in this in terms of course places. I will follow up with that Department.

Kieran O'Donnell (Limerick City, Fine Gael)
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I thank Senator Harmon, and she will be following up the Department of further and higher education. On the 0.5 rate, I am not precisely certain what the date is but it is perhaps something the Senator might follow up on directly with the Department. I will bring it to the attention of the officials and ask that they respond to the Senator on that point. I am assuming it is a relatively up-to-date because the figure we have quoted in terms of staffing is an up-to-date one.

I thank Senator Harmon for her contribution on this matter. Successive national cancer control programmes have delivered continued improvements in outcomes for Irish cancer patients, developing radiotherapy services and ensuring improved outcomes for patients with less invasive treatment and fewer side effects. The benefit of our strategic approach to cancer control is shown by the improvement in the number of patients living after receiving a cancer diagnosis, which currently is 220,000 compared with 150,000 when the strategy was brought to the Government in 2017.

On the point the Senator made about the 0.5 rate and what date, I will follow up with the officials on that and have them correspond with her. Might I suggest that she writes to the Minister, Deputy Carroll MacNeill, as well seeking clarification on that particular point.