Niamh Smyth: Commitment to Better Cancer Services Across Ireland

Comhairle, I can thank you to all colleagues who have made such personal contributions not only about their own personal experience but obviously about facilities and I suppose gaps that remain on the island within cancer services. If I could be indulged just to acknowledge a wonderful young girl from Béla Braithwaite called Orla Lennon. At 24 years of age she has lost both of her parents, her dad only a month ago, and had the bravery to go out on Friday like so many other volunteers across the country for Daffodil Day to do some fundraising for the Irish Cancer Society and I just don't know where people gather the strength when they've had such personal experiences to do things like that and I just want to acknowledge her incredible work. But also I know colleagues around the house have talked about the volunteers of so many cancer groups particularly if you live in a rural part as I do in Cavanagh and Monaghan and there is Béla Braithwaite Cancer Comfort and again they provide the volunteers as we talked about how transport can be such a huge issue for cancer patients who have to get to more the main urban centres to the specialised hospitals for treatment and the incredible work that's done by volunteers but also the fundraising that's done by volunteers to make sure that that compassion and care and transport is provided for patients. I want to thank you all of my colleagues around the house who've contributed on this most important topic of cancer services right across the island of Ireland. While many of our service deliver excellent high quality care I do also acknowledge and recognise that there can be sometimes delays in getting cancer treatment for some of our patients and I want to acknowledge the distress felt by them and their families when they face such delays. Where hospitals are challenged to meet service targets they're typically respond by a mix of local improvement plans, additional clinics, outsourcing of diagnostics and review patient pathways where needed. As clinics typically run at full capacity any disruption to services can lead to a backlog which can take time to clear. Where centres fail to meet their performance targets the NCCP works closely with hospitals to ensure that improvements to services are achieved and sustained and the patients are quickly seen to as quickly as possible. Every effort is made to address waiting times and patients are prioritised on the basis of clinical need. Often not meeting performance targets arise from staff shortages or problems in accessing diagnostics or radiology services. Deputies will be aware that there is a global shortage of health care workers and where we have very specialised services like those cancer care it can be difficult to recruit immediately when vacancies arise. In addition to local measures the NCCP continues to monitor performance nationally and has implemented a range of initiatives to optimise capacity for rapid access clinics particularly for those with breast cancer. Updated referral guidelines have been introduced aimed at ensuring standardised access to across the country and where appropriate post-cancer patients are participating in stratified self-management follow-up rather than attending unnecessary specialist appointments. These will reduce variation in the management of patients and will lead to more appropriate referrals within cancer services. The HSE is also working to expand capacity and the HSE capital plan introduces funding for the design and construction of oncology day units and chemotherapy infrastructure at Midlands Regional Hospital Tullamore and University Hospital Limerick and University Hospital Kerry. I know Deputy Cahill asked very specific questions and I will ask the Minister that any issues that have been raised specifically around the infrastructure will be responded to. A major radiotherapy equipment replacement programme is also in place and work is underway to update equipment across St Luke's Radiation Oncology Network in Dublin. Long term the delivery of surgical hubs and three elective treatment centres will, once operational, increase overall surgical capacity in our acute hospitals. In Budget 2026 the first steps have been taken towards a new approach to funding intended to strengthen performance by devolving health budgets to the new health regions. This provides greater autonomy to meet local needs while holding them accountable for their targets and national standards. This will enable the HSE leadership to target resource allocation where it is most needed to address regional variation. The NCCP will continue to lead on cancer service design and development nationally and will monitor performance and work closely with the REOs to ensure this delivery of safe, effective cancer services in all regions, working to reach the same high standards across the country. This new budget approach will build on the success of our national cancer strategy, which has over the years fostered a culture of improvement and innovation as seen through the developments of pioneering services. In the last 10 years we have seen the rollout of cutting-edge therapies, including radiolabelling therapy, CAR T cell therapy for adults and specialised radiotherapy treatments, and will reduce the number of treatment sessions compared to conventional radiotherapy treatments. More recently, and supported by our 2025 programme for our government commitments, the acute oncology nursing service has expanded, keeping more and more cancer patients out of emergency departments when they feel unwell. The rollout of the SSMFU framework is also helping recovering patients avoid unnecessary hospital outpatient appointments and provides better management in their aftercare. In recognition of the incredible contribution of the voluntary and community sector, which I know we have all referred to here tonight, in providing services to cancer patients and their families, the programme for government made a commitment to continue to invest in community cancer support services. To support this commitment, the NCCP Alliance of Community Cancer Support Centres was allocated £5.5 million in funding for 2025 and is now recurring. We also have provided access to new and innovative medicines. Between 2021 and 2024, Ireland allocated an additional £128 million for new medicines, allowing the introduction of 74 new medicines for cancer. Budget 2026 also allocates £30 million specifically for new medicines. New treatments have been introduced. CAR T cell therapy became available in Ireland in 2021, removing the need for patients to travel abroad for treatment. The service is being expanded to the University Hospital Galway this year, and recruitment is currently underway. This would provide CAR T cell therapy for adult patients in the south and the west of the country and increase overall capacity nationally. We are also seeing an improvement and new developments for patients with the creation of the Comprehensive Cancer Centres. This designation requires very close collaboration between hospitals, universities and research centres, bringing care, teaching and clinical research together in a deeply integrated way. Patients attending these centres have greater access to clinical trials and the important benefits that that brings. I am delighted that all of our eight cancer centres are participating in the EU project to gain accreditation and access to the EU network of Comprehensive Cancer Centres. Membership of this project will enhance our treatment, our teaching and our research work, and this will in turn help attract the best international experts. We have a strong track record of supporting cancer care with investment in research, and I am determined that we will build on this. The cross-border cancer consortium research partnership between Ireland, Northern Ireland and the US National Cancer Institute has seen 25 years of progress, with over 35,000 patients participating in clinical trials. Annual investment in cancer research by the Health Research Board has increased significantly in recent years, from £5.4 million in 2017 to the start of the current strategy of £9.4 million in 2025. Since 2020, the Health Research Board has awarded £43.7 million in cancer research funding, including £21.6 million in clinical trials infrastructure. We are also creating and embedding a culture of innovation in health research more broadly. In November last year, the final report and recommendations of the National Clinical Trials Oversight Group was published. Implementation of these recommendations aimed to streamline the regulatory processes needed to establish clinical trials, enhance public and patient engagement, to establish clear, consistent approaches to conducting clinical trials and grow the clinical trial staff around the country. The current national cancer strategy was launched in July 2017 with a 10-year implementation framework. This year, the Department of Health will commission an independent evaluation of that strategy. While the details have not yet been finalised, the previous strategy was evaluated by a three-person panel of international experts. Their report provided detailed analysis and recommendations to guide the development of the next strategy. The evaluation process will examine the full continuum of cancer care, from preventing to screening, diagnosis, treatment, survivorship and palliative care. Patients are of course at the heart of our services, and there will be opportunities for meaningful stakeholder involvement, including patients, their families, our healthcare staff and all the cancer advocacy groups, amongst others. To conclude, I want to thank the deputies again for their thoughtful, measured and considered contributions this evening. We all share an absolute commitment to deliver the best outcomes for patients, and the new national cancer strategy will be a critical step in planning our services for the decade ahead. Thank you.