Funding of €27.4 billion, as the Deputy knows, has been allocated to the health service for 2026, an increase of 6.2%. Next year a new approach is being taken to funding allocation with health budgets being devolved to the HSE regions, giving them greater autonomy to meet local needs while holding them accountable for ambitious targets and national standards. The National Cancer Control Programme will continue to lead on service design nationally and implementation of the national cancer strategy. The programme also monitors performance and works closely with the regions to ensure the delivery of safe effective cancer services, continuing to work towards the delivery of multi-annual budgets in health over the coming years. Capital investment already operates multi-annually and it is a priority for me to introduce this across all areas of the budget. Since its launch in 2017, the Government has allocated €105 million to the national cancer strategy itself to support cancer services and improve outcomes for patients. That, of course, is not the totality of funding for people who have cancer but to the cancer strategy itself. Since then, very significant progress has been made in improving cancer services and there are now over 220,000 living with or beyond cancer, 50% more than a decade ago. One in two people is expected to receive a cancer diagnosis in their lifetime. We are seeing tremendous advances in cancer care and I am committed to ensuring that patients can take advantage of these developments. Work will begin shortly on an evaluation of the cancer strategy, which will inform the development of a new strategy next year. The budgetary situation is that the letter of determination has been sent, which will indicate very clearly, as the Deputy outlined, that there is inequality of access to diagnostics and treatment within the different regions. It is a priority to try to achieve better equality. In the service plan, we will see the specifics of trying to acknowledge and achieve that in a better way.
Sentiment score: -0.03
We are talking about services that go beyond the cancer strategy. The Deputy correctly identified regional gaps that need to be filled by the regions, particularly where they are not meeting their targets or the same standard as other parts of the country. For example, this week, I was in Bantry, where there are two endoscopy suites, which are really important for bowel cancer and gastric cancers generally, but are under-utilised, although there are two theatres. That is a form of investment in cancer and in preventing, diagnosing and ultimately treating cancer. The two suites are there but are under-utilised. One of them is running for half of one week and the other is not being utilised at all, yet there is a list in Cork. The facility is there and we have to reorganise the resources. It does not necessarily need new people. It needs consultants from CUH to come out. Some of them are already doing that; others need to come out. The totality of investment in cancer is around treatment, drugs, diagnostics and, as the Deputy correctly identified, utilising the infrastructure we already have in a more complete way. I am trying to do that, hospital by hospital and region by region, to make sure that is maximised. In the letter of determination in the service plan, it will be for the region to recognise where it is coming up short and to make sure it is allocating its resources in an appropriate way.
Sentiment score: -0.12
That is absolutely fair enough, except that this will happen under this service plan. On new money, we have additional money for new drugs, for example, in the drugs budget. We have an additional 3,300 people, which at a cost of €90,000 is all new money. They are all people who can be allocated not just to people with cancer, but people who have cancer with other things. This is the new money and the new investment. The distribution of that, which is what the Deputy is asking for, will be apparent in the service plan, which we expect in the coming weeks, having sent the letter of determination. It is a completely reasonable question. There is a process to work that out, particularly in this year 1 of a change. There will still be funding for the strategy itself, which of course is different. It is about research, programming and strategy. That is slightly different from the delivery of services, which we all understand, and that will be apparent. We have to get away from, in particular in the regions, the idea that you can only do something if you have a new person. I gave the example of the endoscopy suites in Bantry for the very reason that there is no point asking for new things at CUH when these exist at Bantry for the convenience of patients, who can get an endoscopy there instead of having to travel to CUH. It is the consultants who must go to the patients to make sure that diagnostic equipment is delivered and used in accordance with Sláintecare.
Sentiment score: -0.00
I thank the Deputy for raising this with me again. We should always acknowledge the extraordinary role, as the Deputy has done, of our healthcare workers and the role they played during the pandemic. They went far beyond the call of duty. Treating Covid in a front-line way at that time was an exceptional thing to do. In recognition of that, especially from 2020, a temporary special scheme was introduced in July 2022 to support eligible staff who were affected by long Covid, in particular, in the public health sector. This was a scheme that no other sector had, which was important and appropriate. The scheme was designed to support those who had worked in high-risk environments, particularly before PPE and vaccinations were widely available and community transmission became more prevalent. At present, about 159 employees, as I understand it, remain on the scheme, the majority of whom have been supported with full pay for almost five years. My Department has consistently worked to ensure these staff were looked after. At my Department's request, the Department of Public Expenditure, Infrastructure, Public Service Reform and Digitalisation agreed to extend the scheme several times since its introduction. Following a Labour Court hearing in June of this year, a final extension was recommended to run until 31 December 2025, when it will formally conclude. Importantly, that does not mean all supports will end. Staff who remain unfit to work will move seamlessly into the public service sick leave scheme, which I appreciate is different but will ensure some measure of continuity of care and financial protection. Under that scheme, staff receive full pay for three months, followed by half pay for three months, and then have the option to apply for temporary rehabilitative remuneration, which can provide up to a further 547 days of paid leave. In addition, the critical illness protocol may provide supports for up to three years. I am aware that the Minister for Social Protection has reviewed the EU recommendation on recognising Covid-19 as an occupational illness. It has been determined that Covid-19 does not meet the criteria required for recognition under the social welfare Acts.
Sentiment score: 0.18
I appreciate what the Deputy is saying. I will make a couple of points in response. The public health sector recognised the risk that staff faced and because of that introduced a scheme that no other sector had. It was appropriate that it did, but it is important to state that so people have a full understanding of what was done. Eligible healthcare workers have had full pay for five years, which is important. The provisions now provide paid supports for a number of years beyond this current period. Recognition of Covid as an occupational illness falls within the Department of Social Protection. The Deputy has alluded to other EU countries. Many EU countries recognised Covid-19 as an occupational illness, but not necessarily long Covid. I am open to correction, but it is not clear to me that any country sustained full pay for workers suffering from long Covid in the way Ireland did with its public health workers through the special scheme. I am open to correction, but that is the information I have. It is important to set out how Ireland tried to treat its care workers in contrast to Europe and for the duration it has.
Sentiment score: 0.02
I recognise the sufferers of long Covid and the change for 159 people who have been receiving full pay and are going onto a different scheme. While there are supports available on that scheme and its duration is also considerable, it is a change and I recognise that. My Department has championed the extension of that scheme, which enabled them to have full pay for as long as they did, on a number of occasions with the Department of public expenditure. As we thought that would end in June, there has been an additional six-month extension. That is in recognition of the work they did, the significance of long Covid and the impact it has on their lives. As the Deputy has stated, it is not feasible to sustain that in perpetuity and there has to be a transition to a different scheme. That is simply the way it is, and we are trying to put those supports in place for as long as possible.
Sentiment score: 0.10
Waiting times for radiology and diagnostic services have been an issue for some time and the Government committed to the implementation of the Sláintecare report of 2017, which included a maximum wait time target of ten days for a diagnostic test. A key step to achieving that is fully understanding the current position. Implementation of the NTPF’s national radiology diagnostic waiting list management protocol by all hospitals is the step to ensuring that patients are administratively managed in a safe, timely, fair and equitable manner while waiting, as well as facilitating approved data collection and reporting. Publication of the validated radiology diagnostic waiting list information will enable full analysis of the diagnostic waiting lists and provide a more complete understanding of how many patients are waiting, how long they are waiting and the specific services they are waiting for. This year, the productivity and savings task force published an action plan for 2025 that commits to a range of services being available seven days per week, including diagnostics activity. It will also ensure that all publicly funded diagnostics are captured within the national integrated medical imaging system, NIMIS, by the end of 2025, thereby improving core co-ordination and reducing duplication of tests and procedures. I am informed that St. Vincent's hospital is going on that this weekend. That will have a bit of an impact, but it is important. More important than anything else, as all of us here visit our local hospitals and different hospitals in the health system, is that question about the utilisation of diagnostics. It is that heat map of use. I have seen better clarity and analysis throughout this year. It was a source of considerable distress to me, for example, to be in one hospital and see that map going from red to blue at 4.30 p.m. on a Friday, when of course it should be driving hard on Friday evening into Saturday and so on. That is what we all want to see, although I do see more of that happening. I am seeing extended hours in diagnostics. I am seeing real efforts to make sure we are rostering five over seven. There is particular pressure in relation to radiologists and radiographers but we need to focus on the management of the assets and resources we have at the moment and make sure the culture is one where you should be able to get those scans as quickly as possible, and that is enabled in part by workforce planning.
Sentiment score: 0.23
I completely agree with the Deputy. Looking at the number of diagnostic scanners and machines in public systems, we have 550 scanners of different forms, including 62 CT scanners, 28 MRI scanners and so on, but it is about the use of them. One of the things we need to consider is how we might use the scanners available in a complementary local injury unit sitting alongside a hospital and how we can maximise the use of all of those diagnostics in different ways. That is another opportunity to expand capacity. I happened to be in County Mayo, and we were talking to staff about how that might be better integrated. In theory, the machines are capable of being used 24 hours per day. That is obviously unrealistic, but you would like to get to the point where they are being used for between12 and 14 hours per day at a minimum. That is entirely dependent on the staff and the way in which it is organised, and the Deputy correctly identified the shortage there. It is important to make sure, as we go hospital by hospital, that everyone is using the deployment of those staff in the most efficient way. I see examples of great improvement on that, and I hope to be able to report more thoroughly to the House after the series of regional meetings in January.
Sentiment score: 0.33
I agree with the Deputy. I am also conscious that we have increased the referral pathways for diagnostics, from physios for example. They are all good things, but they increase the number of referrals and, therefore, the waiting time. It is particularly important that the Deputy highlighted a case like that of his mother, who was referred for a scan and really needed it. There is the contrast with an emergency scan in a hospital that might step across her scan. So many people in Ireland are quietly waiting for a scan and are concerned by that. The focus on urgent and emergency care can take from that in some ways, so we have to try to do both. I fully respect what the Deputy says about the expansion of diagnostics, the referral pathways, the ease with which people can get the scans more quickly, how we can utilise our existing efficiencies and then, as we build, including with the surgical hubs, how we can consider using those diagnostics in the broader way. We really need more radiologists and radiographers as well. We also need them to be rostered five over seven.
Sentiment score: 0.29
The hearing care plan working group was established to develop recommendations for a holistic and sustainable model of hearing care across Ireland. The group initially had a focus on the appropriate linkage of public and private provision to meet increasing demand for services in the short term and to consider the recommendations of the WHO World Report on Hearing in the development of the national hearing care plan. As the group carried out its work, it realised, through its research efforts and deliberations, that the scope of the work needed to create a holistic model of care, as mandated by the published terms of reference, was greater than initially anticipated. The group saw that as an opportunity to ensure that every aspect of the national audiology service was being addressed thoroughly and, as such, the deadline needed to be pushed back. While it is unfortunate that the final recommendations are delayed, as per the terms of reference, the group, I believe, will now be in a position to deliver a much more comprehensive and encompassing plan that factors in all aspects of the audiology space and ensures that patients will receive a greater benefit as a result. In response, the group has adjusted its focus and timelines to ensure that all relevant areas of hearing care are appropriately considered. A structured work stream has been established to support this goal, comprising a number of subgroups focusing on key priorities within the overall scope of the project. The areas being examined by the group include: the existing level and distribution of hearing care provision across Ireland; capacity constraints and opportunities for service enhancement within the HSE; examining the current education structures in place to ensure an adequate number of graduates in public audiology services; workforce planning, with a particular focus on improving recruitment and retention within the public system; the appropriate level and framework for regulation for the audiology profession; improvements to referral pathways in the integration of services between acute and community settings; and mechanisms to strengthen linkages between public and private hearing care aimed at improving patient outcomes and reducing waiting time. It is wide-ranging work and it is the intention of the group to ensure the final report is comprehensive in the treatment of those matters.
Sentiment score: 0.64
The Deputy is right to identify the difficulty that would create. I do not have an answer at the moment as to the timeline of the public consultation, but I commit to getting that to the Deputy as soon as I can. The revised timeline for submission of a final report is quarter 1 in 2026 but that is more about the timeline for the broad work, as I understand it. Today or tomorrow, I will have a better answer for the Deputy on his very reasonable question on the public consultation element of it. I will also have clarity for him on the question of people reporting on themselves and making sure there is sufficient independence to be able to analyse what needs to be done, particularly on the regulation of professions.
Sentiment score: 0.28
I would like to have a bit more detail that I do not have to hand but I commit to getting it to the Deputy today or tomorrow if that is all right.
Sentiment score: 0.41