Insíonn Cumann Ailse na hÉireann dúinn go mbeidh ailse ar dhuine as achan beirt uair éigin le linn a saoil. Tá aithne againn uilig ar dhuine inár bpobal, nó b’fhéidir inár dteaghlaigh, a raibh ailse orthu nó a bhfuil ailse orthu inniu. Tiocfaidh sé mar bhuile throm agus iad ag léamh inniu go bhfuil innealra radaiteiripe ina luí folamh in ospidéil ar fud an Stát mar nach bhfuil an Rialtas sásta an maoiniú agus an pleanáil ceart a thabhairt do straitéis ailse na tíre seo agus nach raibh an Rialtas ábalta é sin a dhéanamh le cúig bliana ón seacht mbliana atá imithe thart.

The sobering reality is that one in two people will have cancer at some point in their lives. When you get that diagnosis, you deserve the best possible chance of surviving the disease and having a good quality of life afterwards. However, people with cancer in Ireland are not being given that chance because of the political choices of the Government.

The Irish Cancer Society yesterday issued a stark warning in respect of cancer services in the State. It pointed out that the cancer strategy has been underfunded in five of the past seven years, leading the CEO of the Irish Cancer Society to say, "Ireland's cancer outcomes may have stagnated or even disimproved". Deputy Harris did not properly fund the cancer strategy in any of the years he was the Minister for Health and it has been underfunded in most of the years since.

The HSE yesterday confirmed that it sought €20 million in additional money to improve cancer services this year. What did the Government give it? It gave zero. Instead, it deliberately underfunded the health service with disastrous consequences for patient safety.

The cancer strategy needs multi-annual funding. The Government's decision to deny adequate funding to the cancer control programme means that progress has been piecemeal and partial, and proper workforce planning has not been possible. The Government's other failures across the health services are also having serious consequences for cancer patients. Emergency department overcrowding is overwhelming hospitals and driving cancellations.

All of us know somebody with cancer. It may be a partner, brother, sister, child, parent or friend. Many of us have put our hands in our pockets to support events to fund cancer services in our communities. The fact that lifesaving, vital and expensive cancer equipment is lying idle in many hospitals across the State is a punch in the gut to those families and their friends.

The Irish Cancer Society yesterday told us that radiation equipment is lying idle in hospitals across this country. A spokesperson for the Irish Institute of Radiography and Radiation Therapy said there have been forced machine closures in public facilities due to staff shortages at a time when demand for radiotherapy service is greater than what a fully operational service could provide. This is happening on the watch of the Tánaiste and that of the Minister for Health, Deputy Donnelly, as it happened on the watch of former Minister for Health, Deputy Harris. These are deliberate decisions. The Government made a deliberate choice not to have proper workforce planning. It deliberately made a choice in the budget to underfund the service, as it has done in five of the past seven years. As the CEO of the Irish Cancer Society said to the Joint Committee on Health, and she was absolutely right to say so:

Without proper funding, the national cancer strategy is a plan without action, and a plan without action is not a plan; it is just words. Words are no comfort to someone languishing on a waiting list for a cancer test, getting more worried by the day ...

May I ask the following questions to the Tánaiste? Will the Government reverse its disastrous budget and the decision it consciously made not to provide the €20 million the HSE required to meet the needs of the cancer strategy? Will the Government reverse that decision, as a starting point? What is the Government going to do to ensure that vital radiation equipment is not lying idle in hospitals across the State, which at the committee meeting yesterday we heard is happening? Will it fund the 1,500 additional beds that are so desperately needed to tackle waiting lists and make our hospitals safe?

Ar dtús báire, ní aontaím leis an Teachta maidir le cúrsaí a bhaineann le hailse sa tír seo mar is léir le blianta beaga anuas – deich mbliana anuas – go bhfuil dul chun cinn ollmhór le feiscint ní hamháin i seirbhísí ailse agus sláinte ach sa mhéid daoine a bhfuil ag teacht slán ón ailse. Tá dul chun cinn le feiscint againn. Tá sé soiléir agus níl aon fhianaise ann go bhfuil sé ag laghdú ag an nóiméad seo.

The first point I would make, which the Deputy did not reference at all, is that there has been a dramatic improvement in cancer care in this country in recent years. In the four years since this Government was formed, significant investment has gone into the implementation of the cancer strategies. Our mortality rate for all cancers, including cancer of the trachea, bronchus and lung, has dropped by 11% in the past ten years. Cancer of the female breast has dropped by 19% and 10%. Survival rates are improving significantly. Some 65% of patients lived for over five years after a cancer diagnosis between 2014 and 2018, compared with 44% between 1994 and 1998. That is the result of successive cancer strategies and the centralisation of cancer services, which many of the Deputies opposite opposed in their day. I know that, as a former Minister for Health. I had to fight political battle after political battle across the country when the centralisation of services occurred. That has been probably the most impactful policy evolution on survival rates in respect of cancer.

In 2021 and 2022 alone, an additional €40 million was invested in national cancer services. That brought in new treatments for cancer patients and has reduced waiting times to access diagnosis and treatment. Funding of €70 million for new radiation oncology facilities in Galway has been provided. We can look at the example of cancer drugs. We put in an additional €30 million for additional drugs at the beginning of this Government because there was a period when new medicines were not sanctioned as quickly as they could have been. The HSE has approved 148 new medicines in the past three years and there has been new medicine funding of approximately €98 million. The total expenditure at the end of last year was approximately €327 million.

That is 61 new drugs or new uses of existing drugs specifically in the area of oncology. New treatments have been funded. For the first time ever, CAR T-cell therapy is available at St. James's Hospital and radiolabeled therapy and peptide receptor radionuclide therapy, PRRT, can be accessed at St. Vincent's University Hospital. These services will expand, which means cancer patients will no longer have to travel abroad to receive these specific treatments. As the Deputy knows, the expansion of the radiation oncology facilities in Galway under the national programme for radiation oncology means that patients can received stereotactic ablative radiotherapy, which targets intensive doses of radiation at tumours while avoiding damage to surrounding tissue, again reducing potential side effects for patients.

In essence, there have been very progressive advancements in treatment and cancer care. There have been dramatic improvements in survival rates following cancer diagnoses and a significant reduction in mortality rates from all forms of cancers. In some forms of cancer, there has been a significant reduction in mortality rates.

I do not know if the Tánaiste heard that Professor M. John Kennedy, who is the chair of the third cancer strategy steering group, told the health committee yesterday that cancer surgeries are being cancelled because hospitals are overwhelmed. That is happening on the Government's watch. The improvements that were made many years ago are not being sustained. The proportion of people contracting and dying from cancer is still significantly higher than in other EU states. This State is a laggard, especially among countries in western Europe.

The Tánaiste talked about the cancer strategy. I have given him some facts. In the past seven years, the cancer strategy has not been funded properly. It has been underfunded for five out of the past seven years. The former Minister and new Taoiseach, Deputy Simon Harris, did not fund it properly in the first two years. These are not my words; they are the words of experts in the field. It is not funded. Last year, the HSE sought €20 million from the Government for the cancer strategy. The Government provided zero funding. One wonders how it is that surgeries are being cancelled and people with cancer who have appointments have to wait months on end because the capacity is not there. Then we have the scandal - it is an absolute scandal, and the Tánaiste completely ignored that point - where we have vital radiotherapy equipment in hospitals across the State that is lying idle because the Government is deliberately underfunding the cancer strategy. Who is being put at risk here? It is patients and our loved ones in our communities.

Will the Tánaiste indicate what the Government is going to do to make sure the equipment is utilised?

I thank the Deputy. The time is up.

Will it open the 1,500 beds, and provide the €20 million that the HSE is asking for?

We have provided over 1,000 new beds. Since coming to power, the Government has provided significantly increased allocations to the HSE. An extra €7.7 billion on the 2019 figures has been provided. Just because the HSE or any agency comes in and says it wants X, is it the Deputy's policy that he gives everything that people ask for and he does not ask about value for money or efficiency? Does he not ask-----

Efficiency. The equipment is lying idle.

Hear me out a second, please. I am talking about numbers. We have dramatically increased the numbers of people employed. In fact, the HSE could not recruit the numbers of people that were provided for in successive rounds of funding to the health service over the past two to three years.

The Deputy is in opposition. I look at his party's alternative budgets. Every now and then, his party condemns aspects of our budgets. When we look at its particular formulations, however, they do not reflect the realities at all.

Can the Tánaiste answer the question?

No, it is an important point because-----

Can the Tánaiste answer the question on the machines lying idle?

-----equally, the Deputy must accept-----

And the €20 million.

-----that every agency in the country will come in looking for additionality, and so on.

So the answer is "No".

The idea that the State just responds to every submission it gets is, of course, not a sustainable position.

Could the Tánaiste please answer the question about the machines lying idle?

The bottom line is this: €7.7 billion has gone in. The mortality rate fell by over 10% over the decade.

I thank the Tánaiste. Time is up.

Our life expectancy is now about 82.

The machines are lying idle in our hospitals.

Hold on, please. We are in a small group of only seven EU member states, and the Deputy calls us a laggard. That is because everything with the Deputy has to be negative.

The machines are lying idle. The Tánaiste has ignored the question.