Where one lives in Ireland is a significant determinant of whether one will survive cancer or die from it. In Ireland today counties and postcodes should have Government health warnings. When a cancer diagnosis happens in a family, a dark cloud descends. While there obviously is hope in terms of treatment, there is no doubt that for serious cancers, every moment of the day is consumed with whether or not one is going to make it. Today the Irish Cancer Society released damning information which shows significant variations with regard to access to cancer diagnostics and treatments. Life-saving chemotherapy and radiotherapy treatments are being denied to patients because of where they live.

On Monday I met with doctors in Letterkenny and they told me that just 12% of cancer patients in that hospital receive treatment within the recommended 15 working day timeframe.

Patients are waiting seven to eight weeks for treatment in Galway at the moment. The National Cancer Control Programme has written to Aontú to say the HSE is failing to meet its own radiation treatment targets. In the year to August 2024, treatment targets were met only once in Galway and only once in Cork. Cancer services in the north west are being shut down and cancer services in Galway, Waterford and Limerick do not have the necessary PET scanners. We have antique radiotherapy equipment breaking down. Treatment is regularly being cancelled because certain scanners are breaking down over and over again.

I have had cancer. I know what it is like to have cancer growing inside you. I know the stress it creates. I know the first thing you want to do is to get it cut out and to get chemo to zap it if you can. I also know that delayed treatments mean radically worse outcomes for people. Delayed treatments mean cancer can spread throughout your body. People are dying in this country for the want of treatment. The Irish Cancer Society has said that the Government has met only one of the six targets it set itself.

Aontú has also discovered that there is a 12% differential in breast cancer survival rates in public and private hospitals in this country. A woman who is diagnosed with breast cancer in a designated centre has an 85% chance of survival. If she is diagnosed in another public hospital, she has an 81% chance of surviving but if she is diagnosed in a private hospital, she has a 93% chance of survival. If you are diagnosed with breast cancer in Sweden, you are 7% more likely to survive than if you had been diagnosed in this State. If you are diagnosed with breast cancer in England, you are 5% more likely to survive than in this country. It is an incredible situation. When is the system going to stop dividing patients by postcode and income? When is the HSE going to deliver cancer treatments on an equal basis throughout the country?

Balance and perspective are required in discussing this issue, which is very serious. The Government is very committed to continuing investment in cancer care. It has invested very hugely in cancer care in recent years. It invested up to €645 million between 2021 and 2024 alone. New treatments such as CAR T-cell therapy, radio-labelled therapy and specialised radiotherapy are now available in Ireland for the first time. We now have top-class radiation and oncology equipment that we did not have five, six, seven or eight years ago. Let us not brand the entire cancer treatment system as antique. That is not fair.

Cancer survival rates are improving. More people are living after cancer than ever before. Today more than 220,000 people in Ireland are living with cancer or after cancer. I appreciate the Deputy's own personal experiences and how he has properly articulated them to highlight issues because cancer diagnoses put enormous pressure on individuals and families. However, that 220,000 is 50% higher than the equivalent figure a decade ago. That is a huge transformation. Survival rates have increased progressively over recent years because of the development of national cancer strategies, which have improved screening services. Over the past two decades, our screening has expanded enormously. I refer particularly to BreastCheck, cervical screening and bowel screening. We have hugely increased staffing and there is greater access to diagnostics and survivorship programmes.

The funding will continue. I will not go through all the figures in terms of those who have been recruited. On capital funding, approximately €140 million has been used over the past eight years. We now have state-of-the-art radio-oncology facilities in Galway and Cork. They are not antique but state of the art. We have a new national cervical screening laboratories and various cancer infrastructure, including chemotherapy wards and lab facilities, across the country. That will continue this year with the oncology units at Cavan General Hospital, Tallaght, Kerry University Hospital and the Midland Regional Hospital in Tullamore. There is further chemotherapy infrastructure in Kerry, Cork University Hospital, Letterkenny University Hospital and so on. We will continue to invest.

On the county-by-county breakdown, one of the better developments of the past two decades was the development of proper cancer centres in the major tertiary hospitals, where the bulk of treatment should occur. I am again concerned about the proliferation of treatment in private hospitals-----

I thank the Taoiseach.

-----because all the experts told us that centres of excellence were the way to go. I would appreciate greater clarity from the Deputy in respect of his assertion that 93% of patients attending private hospitals had a better outcome as against those attending public hospitals-----

I call Deputy Tóibín.

----because the view was - and we have done this at St. James's Hospital, the Mater and Cork University Hospital-----

You are 30 seconds over, Taoiseach. You can come back in.

We have put centres of excellence there. That is where people should go.

We do not have centres of excellence in many places; we have centres of waiting lists. Today, the Irish Cancer Society said that we have centres of bare adequacy. Those are the words it used. The Taoiseach mentioned extra resources but these do not keep up with inflation, with population increases or with the ageing population of the country and, in many areas of the HSE, they are not getting to the front line. They are getting caught up. We also do not have the necessary staff. We in Aontú found out that 13,000 nurses have left this country in the past five years. That is an incredible figure. In some years, the majority of graduating doctors leave the country. Thankfully, cancer survival rates are increasing but that is in large part because there are better medicines, better technology and improved treatments and not necessarily because of the extra services the Government is providing throughout the country. Will the Taoiseach deal with the facts? The facts are stark. The Irish Cancer Society said today that there is a geographic determinant in relation to whether people get the treatment they need on time. Waiting lists in certain counties are five or six times the targets.

I thank Deputy Tóibín and call on the Taoiseach to respond.

People are dying as a result of that geographic difference.

Deputy, your time is up.

We have more work to do. That is acknowledged. In his commentary, the Deputy has acknowledged that there have been improvements but he gives no credence to the fact that there has been very significant investment in cancer services. The number of staff in our health service has expanded dramatically.

So has the number of patients.

The Deputy has just created an image of thousands fleeing the country.

Some 13,000 nurses have left.

He should concentrate on the increases in numbers in the health service. He cannot and should not ignore that because to do so reduces his credibility. He is making good points on one level but he is also using language like "antique" and suggesting that everyone is feeling the hospitals when there are increases in the number of staff year after year. We have invested hugely in increasing the number of people. Close to 30,000 extra people have been employed in our health services over the past four or five years. That is additional people coming in.

With regard to the west, we had issues in Galway, where infrastructure and further investment are required. There is no question about that.

What about Letterkenny?

On Letterkenny, we did work on Altnagelvin, which helps people in the north west both in cardiology and cancer care, which we invested in.