I move: That Dáil Éireann: notes that: — the National Cancer Strategy 2017-2026 is due to end this year, and a new strategy is needed to drive improvements in access to, and the quality of, care from 2027; — in 2025, 15 per cent of chemotherapy, and 23 per cent of radiotherapy, patients did not get access to treatment in the target timeframe; — in 2025, 45 per cent of breast cancer surgeries and 39 per cent of lung cancer surgeries, and in 2024, 61 per cent of prostate cancer surgeries, did not happen within the target timeframe; — a postcode lottery exists in access to care, with access within target timeframes ranging from as low as 60 per cent in some areas, to upwards of 95 per cent in other communities; — this State has below European Union average levels of diagnostic and imaging equipment, such as Magnetic Resonance Imaging, Computerized Tomography, and Positron Emission Tomography scanners, which is leading to significant delays in access to care, particularly surgeries, and this is caused by a combination of a low density of equipment, out-dated equipment, and poor utilisation of existing equipment; — there has been a highly concerning shortfall in the number of women screened for breast cancer, with BreastCheck only screening 75 per cent of the anticipated number of women in 2025, which already assumes a 30 per cent fall off from the number of women invited for screening; and — the most recent implementation review found that only 1 of 23 National Cancer Strategy objectives had been met; considers that: — cancer services need a clear roadmap and guaranteed funding levels for the next decade to deliver key enablers, detailed planning, and turn gold standard targets from aspirations into real deliverables; — the mission of the new cancer strategy must be to improve standards, timely access to care, patient outcomes, quality of life, efficiencies, and innovation; — a new strategy must include a strong emphasis on prevention, early detection, and proactive treatment of primary drivers, as well as of cancers themselves; — a new strategy must address access to care, workforce challenges, equipment and infrastructure deficits, research, innovation, all-island planning, and the post-code lottery which currently exists for services; — a new strategy presents a significant opportunity to drive all-island collaboration in improving cancer care and outcomes, and all-island planning, training, and delivery should feature prominently in a new strategy; and — clearly identified, protected, and guaranteed new developments funding should be provided to underpin a new strategy, through a multi-annual funding framework averaging €30 million a year, each year, in additional new developments funding; condemns the failure of Government to provide and clearly identify ring-fenced new developments funding for the National Cancer Strategy in 5 of the 10 Budgets over the lifespan of the current strategy; resolves that a new cancer strategy should: — guarantee timely access to cancer diagnosis, treatment, recovery, and follow up care; — end postcode and income-based inequality; — provide multi-annual funding certainty; — expand capacity in line with projected demand; — strictly manage expenditure to ensure cost-effectiveness without losing sight of the critical social and economic benefits of health investment; — strengthen all-island cancer cooperation; — reduce the financial and social burden of cancer; and — position Ireland as a leader in research and innovation; and calls on the Government to: — commit to a new cancer strategy, to cover the period 2027 to 2037; — guarantee €30 million in additional new developments funding each year, to underpin delivery of the new strategy; — end the postcode lottery in access to cancer care, through targeted investment; — implement a specific campaign to increase uptake of BreastCheck, catch up on women who did not attend screening invitations, and provide the option for information on breast density through BreastCheck; — implement a managed programme for replacing outdated equipment; — mandate Health Service Executive Regions to implement site specific equipment utilisation plans, including roster reform agreed with workers, to maximise use of existing equipment; — extend service hours in the evening and over weekends, following constructive engagement with workers, for diagnostic imaging, laboratories, and treatment options, and ensure a commensurate increase in staffing levels, to maximise utilisation of equipment and capacity; — fund additional training places in areas of strategic need in the health workforce, and work with graduates to ensure employment in the Irish health service; — abolish hospital car parking charges for patients and visitors; — immediately increase medical card thresholds in line with GP visit card thresholds, and increase funding for discretionary medical cards, to widen compassionate access; — increase the health capital budget to €2.5 billion per annum for the remainder of the National Development Plan, to ensure sufficient funding for all of the Government's infrastructure commitments in Health; — adopt a systematic approach towards clinical trials and life sciences innovation, aiming to make Ireland a world leader in clinical trials and the development of new medicines and therapies; and — place Sláintecare wait time targets into law. I will be sharing time with colleagues. I start by thanking all those working in our healthcare system who provide the very best cancer services they can. I commend all the nurses, doctors, radiographers, radiation therapists, those who work in primary and community care, and those who provide diagnostic scans. The problems with the national cancer strategy are not down to the hard work of those staff. In terms of research in cancer care, I am blown away by what I see right across our healthcare system and also advances in new medications, a lot of which are produced here by pharmaceutical companies and their workers. I want to put on the record my appreciation of all those working in our healthcare services who provide first-class services to cancer patients. Cancer care was one of those areas where we were hitting our targets and people were getting rapid access to care. However, in an area where we were doing so well, we are now beginning to see slippage which really disappoints me. Replies to parliamentary questions that I have tabled over the last year or so, particularly over the last number of months, show slippage in the key performance targets and the gold standard access times for diagnosis, chemotherapy, radiotherapy and indeed surgeries. There are a number of reasons for that but first I just want to go through some of the figures. In 2025, 15% of chemotherapy patients and 23% radiotherapy patients did not get access to treatment in the target timeframe. In 2025, 45% of breast cancer surgeries, 39% of lung cancer surgeries and 61% of prostate cancer surgeries were not done on time, and people were not seen within the gold standard. They are shocking figures and represent a dramatic reduction on where we were only a number of years ago. I have spoken to healthcare professionals, the Irish Cancer Society, advocates and cancer patients themselves. They tell me that one of the problems is we do not have enough staff. We know we have a shortage of radiographers and radiation therapists but we also have a shortage of surgeons in some hospitals which is why we are seeing a postcode lottery. For example, in Cavan, people are waiting much longer for chemotherapy than they are in other areas. In Waterford, for example, the majority of patients were not seen within the proper timeframe. It is unacceptable to have a postcode lottery that depends on where someone lives and depends on the surgery as to what access and how quickly they will get that service. One of the problems is that we do not have the staff. The second problem is with the cancer machinery and equipment. I again discovered through parliamentary questions that we have a lot of cancer equipment which is out of date. In fact, in some hospitals, the majority of equipment is out of date. It could be chemotherapy equipment, radiotherapy equipment or diagnostic equipment. A lot of the time it is not functioning property. Hospital equipment is at partial capacity, again because we do not have the staff. We do not have the radiographers, radiation therapists and so on. It is a problem to have very expensive equipment either lying idle or only operating at partial capacity. The current national cancer strategy ends next year. In five of the past ten years, the national cancer strategy received no additional funding. It cannot operate in a piecemeal way like that. If we want the national cancer strategy to work, it has to be funded consistently every single year which is why our motion calls to ring-fence €30 million each year for the next five years, a total of €150 million. We also want to increase the capital healthcare budget because we know there is not enough money to build elective hospitals, a new maternity hospital, finish the children's hospital and deliver the beds that were promised. That is why we do not have the money to replace equipment and allow for new equipment for cancer care in hospitals, and that is hurting. Our motion also calls for cutting the cost of cancer care for patients. That is a big issue which comes up a lot. We want to abolish the car parking charges but we also feel that cancer patients should have a medical card. Sometimes cancer patients who apply simply do not get it even though they have a cancer diagnosis which is deeply unfair. We all signed up to the principles of Sláintecare where money should not be an issue and people should have access to high-quality care. It makes no sense years on from Sláintecare that cancer patients still do not have access to a medical card. Our motion today is a call for action from the Government. We do not want half-measures. We do not want slipped targets or slippage. We want a new national cancer strategy that is robust, that is properly funded and that works for cancer patients.

Sentiment score: -0.22

First of all, I will correct something I said in my opening remarks when I was talking about chemotherapy patients in Cavan. In fact, 100% of those were seen on time; it was in Waterford that 66% of patients were seen on time, which means 33% were not. For radiotherapy, 98% of patients in Waterford were treated on time, compared to just 67% in St. Luke's Radiation Oncology Network, which covers Dublin, the east and the midlands. They are two examples of the postcode lottery I was talking about. I thank everybody for their contributions. There were some really strong contributions. People told stories of their personal experiences of cancer and of their family members' experiences. My mother died of cancer and it was a very long year for my family having to watch her suffer as she did. She showed tremendous resilience and did not show any emotions. Maybe when she was alone she did, but when she was with us, she was really strong. I got that from every contribution that was made. Deputy Gould spoke about how family members were very often the ones who feel it most. I feel passionately about cancer services because they were and still are one of the areas where this State is doing well. Nowhere in the motion does it not recognise that there is a lot of good work being done. I said that in my opening contribution. I am blown away by the healthcare services given by first-class healthcare professionals in cancer care. I see it in every hospital I visit: the research done; the facilities in some hospitals; the staff who provide the services, from oncologists to nurses, radiation therapists and so on; robotic technology; and AI, which is now going to become a feature. We are seeing huge innovation, changes and progression in cancer care, which is fantastic. That has to be matched by a Government and political system that back that up and provide the supports and resources that are needed. Far too often, hospitals are not getting those supports. If we have expensive hospital equipment lying idle part of the time because we do not have the staff, that does not make sense. That is an inefficiency. People look at that and ask what is going on when they are waiting and waiting for access to chemotherapy, radiotherapy or surgery. The figures in the motion came from the HSE through parliamentary questions. In some surgeries, we have slippage, we are not meeting the targets and more and more patients are not being seen as quickly as they should be. Those gold-standard targets of 20 to 25 days set for access to surgery, for example, and even less for a diagnostic scan, chemotherapy or radiotherapy, are things we should be proud of and should not be allowed to slip. They are targets we should try to make sure we meet. In some hospitals, they do not have the equipment or staff. The motion does not state the cancer strategy was not funded, but it was not given new development funding for half of the lifetime of the previous strategy. For five years, it got some funding, piecemeal as it was. For the other five years, it got no funding. That is a matter of fact and I think that is wrong. That is why multi-annual ring-fenced funding is so important. It is so that the health service can plan. Reducing the cost of care for patients is important, which is why abolishing the car parking charges and more discretionary cards are needed. The motion is about a new national cancer strategy. That is what we need. I will certainly work with the Government. Everybody in this House wants to achieve the best possible outcome for every cancer patient.

Sentiment score: 0.03