Alan Farrell (Dublin Fingal, Fine Gael)
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185. To ask the Minister for Health if he will provide an update on the National Cancer Strategy; and if he will make a statement on the matter. [26539/23]

Stephen Donnelly (Wicklow, Fianna Fail)
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Successive National Cancer Strategies have delivered continuing improvements in outcomes for Irish cancer patients in terms of earlier diagnosis, better treatment, and improved rates of survival. This Government’s commitment to implementation of the National Cancer Strategy is evidenced by significant investment in recent years. €20m new development funding was allocated to cancer services and €15m was allocated for new cancer drugs in both 2021 and 2022. This increased total funding for cancer services to €139m in 2022.

We have seen significant progress on the implementation of the Strategy over the past six years, with clear evidence-based policy direction from my Department and strong implementation by the HSE's National Cancer Control Programme (NCCP). It is important that we continue to invest in cancer services, as the incidence of cancer is projected to grow due to demographic change and improved detection of cancer.

In 2022, 172 new staff were recruited to cancer services from this new development funding, which represent a 20% increase in total staffing for cancer. Cancer surgeries returned to above 2019 thresholds with more than 16,200 surgeries performed, more patients were seen at Rapid Access Clinics with attendances at 104% of 2019 levels, and over 126,000 chemotherapy treatments were administered, more than than ever before.

The National Cancer Strategy 2017-2026 Implementation Report 2022is currently being prepared, and it is expected that this Report will be published very shortly. The annual Implementation Report will outline how this funding was used to support ongoing initiatives and to drive improvements across all stages of the cancer continuum, facilitating further developments across prevention, diagnosis, treatment and patient supports.

My Department continues to work with the NCCP to implement the recommendations of the Strategy in 2023, including the recruitment of staff into cancer services and the improvement of services for patients.

National Cancer Registry Ireland (NCRI) data shows substantial progress being made to control the four major cancers (prostate, breast, lung and colorectal), with mortality rates falling or stabilising for each. These comprise over half of all invasive tumours (not including rarely fatal nonmelanoma skin cancers).

Treatment in our medical oncology, radiation oncology and surgical oncology services also continues to improve, with an estimated 200,000 people in Ireland living with and beyond cancer.

The implementation of the National Cancer Strategy 2017-2026 is a Government priority and continued improvements in cancer services will be driven by both my Department and the National Cancer Control Programme within the HSE. Priorities for 2023 will include the further centralisation of cancer services which has a direct impact on positive outcomes for patients, and the implementation of models of care for areas such as medical oncology and psycho-oncology, which ensure continuity of care and support for cancer patients and their families.

Alan Farrell (Dublin Fingal, Fine Gael)
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186. To ask the Minister for Health if he will provide an update on the National Dementia Strategy; and if he will make a statement on the matter. [26540/23]

Mary Butler (Waterford, Fianna Fail)
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The National Dementia Strategy contains a range of actions to increase awareness and understanding of dementia; to improve diagnosis and provide integrated services, supports and care; and to improve education and research on dementia. The National Dementia Office was established in the HSE in 2015 to provide leadership on, and coordinate the implementation of, the Strategy across the dementia care spectrum

Work has continued in 2023 to further implement the National Dementia Strategy, with a focus on assessment, diagnosis and post-diagnostic supports and care initiatives to ensure timely access, reduce waiting times and improve the quality of care provided to people with dementia.

A Model of Care for Dementia diagnosis and post-diagnostic support has been developed by the National Dementia Office and is being launched today, 31 May. The Model of Care sets measurable targets and practice recommendations to advance treatment, care and support for people living with dementia in Ireland. It outlines best practice for diagnosis, communication of a diagnosis, care planning and post-diagnostic support.

Over the past three budgets, the Government has invested significant resources to support the implementation of the new Model of Care. Funding was provided for nine new Memory Assessment and Support Services, two new Regional Specialist Memory Clinics and and an Intellectual Disability Memory Service in locations around the country in 2021 and 2022, and the HSE aims to have most of these services operational by the end of this year. For 2023, the Government has funded a tenth Memory Assessment and Support Service and provided increased staff resources for all of the new memory services and the existing Regional Specialist Memory Clinics in St. James’ and Tallaght Hospitals.

In addition to investing in diagnostic memory services for dementia, Government has also made funding available for a variety of post-diagnostic support services in recent years. There are now 29 Dementia Advisers throughout the country providing free and confidential supports and signposting to help connect people with dementia and their carers with essential services.

The Government has also funded a national network of 23 Memory Technology Resource Rooms (MTRRs) which provide free occupational therapist assessments and advice on assistive technology to help people adapt to their condition and maintain a degree of independence for as long as possible, while also providing support to family carers. These MTRRs form a key component of the post diagnostic pathway.

Funding has also been provided in 2023 for the appointment of dementia service leads in each Community Healthcare Organisation to improve the coordination and integration of dementia services.

Establishing these essential services will ensure that there is timely access to both diagnosis and post-diagnostic supports, and a reduction in waiting times.

New funding of €2.1 million has been allocated in Budget 2023 to ensure that dementia-specific day care centres can return to full operational capacity. Dementia in-home day care supports will also continue for those who are unable to attend centre-based day care. Furthermore, the proportion of new home support hours allocated to people with dementia will increase to 15% in 2023, up from 5% in 2021 and 11% in 2022. This increase is valued at €5.2 million.

The National Dementia Office has conducted two audits of dementia care in acute hospitals in recent years which have highlighted the need for a range of improvements in care for people with dementia. The Government has provided resources over the past three budgets for the appointment of nursing specialists to improve dementia care pathways in acute hospitals so that people with dementia can receive the best possible care and be discharged back to the community as early as possible and as appropriate.

Arising from the results of the acute hospital audits, a National Clinical Guideline on the appropriate prescribing of psychotropic medications for non-cognitive symptoms of dementia has been developed. It is now being rolled out progressively across acute, community and residential care settings to ensure that psychotropic and antipsychotic medications are only prescribed when needed and that people with non-cognitive symptoms of dementia are provided with alternatives to medication where appropriate.

In order to improve the quality of home supports provided to people with dementia, the National Dementia Office, together with DCU, has developed a QQI Level 5 programme for home support assistants and, with ongoing Government funding from 2023, will progressively roll out the programme to HSE home support staff countrywide.

The Model of Care recognizes the importance of statutory, voluntary and community partners working together to meet the broad spectrum of social needs of people with dementia. Understand Together in Communities, through its network of partner organisations and community champions, has been instrumental in opening up opportunities for engagement for people with dementia, who are more likely than other older people to experience social isolation.

Community resources like dementia cafés, dementia and carer support groups provide information and connection, and combat isolation. All of these resources form part of the dementia model of care and people can be referred to the supports most suited to their own needs and individual preferences.

Research is recognised as a priority in the National Dementia Strategy. The Health Research Board (HRB) funds the Dementia Research Network Ireland (DRNI), which aims to support and facilitate collaborative interdisciplinary research on dementia and thereby to positively impact knowledge translation and policy development. The HRB is also funding Dementia Trials Ireland over a five year period to establish a national infrastructure to develop, attract and conduct dementia clinical trials across the State and ensure that people with dementia have the opportunity to take part in clinical trials.

The Government has also provided funding to the HSE to develop a National Dementia Registry which will gather important data on dementia assessment, diagnosis, treatment and care. The Registry’s minimum dataset will have a particular emphasis on timely access to diagnostic and post diagnostic supports provided under the new Model of Care.

I am confident that these measures will continue to make a real difference to the lives of people with dementia and their families.