Peadar Tóibín (Meath West, Aontú)
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945. To ask the Minister for Health the reason cancer treatment services will not resume in full until the end of 2021. [16651/21]

Stephen Donnelly (Wicklow, Fianna Fail)
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The National Action Plan on Covid-19 identified the continued provision of cancer care as a priority. Due to the ongoing need for physical distancing and related infection prevention and control measures, capacity across many cancer services has been reduced. However, cancer services are continuing to operate in line with guidance issued by the National Cancer Control Programme (NCCP).

The principles underpinning cancer care delivery during the pandemic remain key to efforts to mitigate the impact on services:

- continuation of diagnostic services, particularly patients referred to Rapid Access Clinics;

- continuation of treatment, considering the risk: benefit ratio for each individual patient;

- prioritising time-sensitive treatment across the cancer pathway;

- reviewing the location of the delivery of cancer services to optimise patient safety and infection control;

- minimising any non-essential face to face patient contact, e.g. through the use of virtual assessment and triage where appropriate;

- optimising the potential for providing cancer services in private hospitals; and

- adherence to national guidance for all services as laid out by NCCP and the HSE’s Chief Clinical Officer.

The total number of patients seen across all Rapid Access Clinics in 2020 (44,233) amounted to 88% of the 2019 figure (50,249). In regard to 2021, GP e-referrals to Rapid Access Clinics for weeks 2-10 this year stand at 112% of the activity in the corresponding weeks in 2020.

Medical Oncology services continue in all 26 hospitals and guidance has issued to clinicians regarding the provision of Systemic Anti-Cancer Therapy (SACT). This includes details on treating cancer patients with Covid-19, or with potential Covid-19. The number of patients receiving chemotherapy up end 2020 was approximately 88% of 2019 levels.

Radiation oncology services in the public hospitals are currently operating at >90% of 2019 activity levels. Radiation oncology units are accommodated in buildings that are largely separate from other hospital services, which may reassure patients who are nervous about presenting to hospitals in the current climate.

Urgent surgical oncology is being prioritised and there is an emphasis on maintaining safe patient pathways for this. Private hospitals have been key to ensuring that time-sensitive surgery continues. Surgery numbers in public hospitals in 2020 were 76% of the 2019 levels (this does not include public case surgeries undertaken in private hospitals).

Funding of €12m has been allocated this year for the restoration of cancer services to 95% of 2019 (pre-Covid) levels. This funding will support hospitals in addressing backlogs, extending clinic times, providing additional clinics, increasing diagnostic capacity and providing locum/temporary support. It will also support virtual clinics and more accurate triage, and facilitate infrastructure and minor equipment purchases to increase capacity across Rapid Access Clinics and surgical oncology, medical oncology and radiation oncology services.

In addition, as part of Budget 2021, an extra €20m has been allocated for the continued implementation of the National Cancer Strategy this year. This funding will facilitate developments across prevention, diagnosis, treatment and patient supports.

Peadar Tóibín (Meath West, Aontú)
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946. To ask the Minister for Health if his Department has carried out an assessment of the impact of Covid-19 upon cancer screening and cancer treatment in terms of missed diagnoses, advanced diagnoses, terminal cancer diagnoses, cancer deaths and treatment delays. [16652/21]

Peadar Tóibín (Meath West, Aontú)
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1061. To ask the Minister for Health if his Department has undertaken a study to investigate the impact of Covid-19 and lockdowns on the provision of cancer services. [17011/21]

Stephen Donnelly (Wicklow, Fianna Fail)
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I propose to take Questions Nos. 946 and 1061 together.

The National Action Plan on Covid-19 identified the continued provision of cancer care as a priority. Cancer services continue to operate in line with guidance issued by the HSE's National Cancer Control Programme (NCCP).

The NCCP is continuing to closely monitor trends in numbers coming forward to diagnostic services, and the level of attendances for appointments for treatment. The NCCP is focused on engaging with cancer services, and with hospital management, in the designated cancer centres (and beyond in the case of medical oncology) with a view to ensuring the continuation of services for cancer patients.

The number of people coming forward to their GPs, being referred to Cancer Rapid Access Clinics (RACs) and attending these clinics decreased significantly in mid-March to May 2020 due to the fears in regard to Covid, and the reaction of people to restrictions in place at that time.

These figures increased over time - the total number of patients seen across all RACs in 2020 (44,233) amounted to 88% of the 2019 figure (50,249) and GP e-referrals to RACs for weeks 2-10 this year stand at 112% of the activity in the corresponding weeks in 2020.

Medical and radiation and oncology services are continuing, utilising the safeguards of social distancing and infection prevention & control measures built up in the past year. The number of patients receiving chemotherapy up to end-2020 is at approximately 88% of 2019 activity, while radiation oncology is operating at >90% of 2019 activity.

BreastCheck, CervicalCheck and BowelScreen resumed their services last year and service continues, albeit at reduced capacity, during the current level 5 restrictions. The focus is on getting services resumed to achieve the maximum screening rates that are compatible with a safe and controlled follow-up treatment capacity in the health service. Throughout the pause in screening and the restart, those who were already scheduled for further assessment or treatment were prioritised, and follow-up clinics continued.

The safety of screening participants and staff continues to be the highest priority at this time. Safety precautions are in place throughout the National Screening Services to protect against the spread of Covid-19 and screening services have implemented advised safety measures to reduce the risk of infection. I’d like to take this opportunity to emphasise that screening is for healthy people who do not have symptoms.

An important message to everyone now is that, if you have any concerns about cancer please go to your GP, who will arrange appropriate follow-up care. Our cancer diagnostic and treatment services are open, and our healthcare staff will provide any necessary care.

Funding of €12m has been allocated this year for the restoration of cancer services to 95% of 2019 (pre-Covid) levels. This funding will support hospitals in addressing backlogs, extending clinic times, providing additional clinics, increasing diagnostic capacity and providing locum/temporary support. It will also support virtual clinics and more accurate triage, and facilitate infrastructure and minor equipment purchases to increase capacity across Rapid Access Clinics and surgical oncology, medical oncology and radiation oncology services.

In addition, as part of Budget 2021, an extra €20m has been allocated for the continued implementation of the National Cancer Strategy this year. This funding will facilitate developments across prevention, diagnosis, treatment and patient supports.