It is good to be back. It is particularly good to be back in the aftermath of the successful campaign of Catherine Connolly. I congratulate her in her position as our new President. It is also good to be back on the day that a socialist gets elected in New York. Signs of hope and portents of the future.

I hope the Deputy is not taking credit for that.

Certainly not. We might learn a few lessons from it though. I also thank colleagues across the House for their kind words today and messages during, before and after my treatment. I also thank the thousands of members of the public who sent very kind messages. They were very heartening and very helpful.

My biggest debt of gratitude is to the fantastic people who work in our health services, particularly the cancer services, in my case in St. Luke's Hospital, and the eye and ear hospital. There are similar people providing cancer services right across the country. They asked me to raise particular issues about the need to properly resource and support cancer services in this country. It is important to say that everybody has a stake in that happening. I did not know this, but 50% of people will have an encounter with cancer during their lives. Some 44,000 people this year will get a cancer diagnosis. The Irish Cancer Society made a whole series of requests pre-budget. It is still not clear whether any of those have been met to fully fund and resource the national cancer strategy.

There is a particular issue for me and for the people who provided me with care in St. Luke's in the area of radiation oncology machines. They are called linear accelerators. They, as well as the staff, infrastructure and so on, have given me my life back. Some 50% of those people who get a cancer diagnosis each year, which is a very high figure, will need these machines. Fairly incredibly, 35% of those machines, which are supposed to be replaced every ten years, are now 15 to 17 years old. Some 40% will need to be replaced in the next five years. This means there is a lot of discomfort and stress for patients and staff who need this lifesaving treatment. What the people who work in radiation oncology are asking for, and they have asked repeatedly for this, is a national radiotherapy replacement programme where there is centralised oversight and procurement and ring-fenced multi-annual funding, going forward, so they do not have to come each year with a begging bowl for money to provide this absolutely vital machinery to save lives.

I thank the Deputy and again welcome him back. I welcome the fact he has raised issues relating to cancer services and the national cancer strategy. It is important just to take a step back and look at the progress we have made over many years since the national cancer strategy was introduced. Over 65% of patients live for five years after a cancer diagnosis, compared with 43% in the 1990s. A lot of the difficult reforms that were introduced by Ministers in previous years around the centralisation of particular services and hubs have yielded much greater outcomes for citizens across the country. Like the Deputy, I commend all the workers across our hospital system who provide that daily care, compassion and support for people as they go through their treatment journey.

We have tried in recent years to build and resource a public health system that responds to the needs from a workforce perspective. That is why in the past five years we have had nearly 30,000 additional healthcare workers in terms of whole-time equivalents working in our public health system to support and rapidly respond to diagnoses or particular incidents as they arise from cancer and a lot of other health perspectives. Next year, we will have an allocation of over €27 billion in terms of the overall allocation to the Department of Health.

The Deputy asked specifically about radiation oncology, which I will respond to. In my negotiations and engagement with the Minister, Deputy Carroll MacNeill, we will have over €9 billion of capital in our health system over the next five years. That is a record level. The Minister is now developing a sectoral investment plan, working with the HSE on the capital needs in our system. Some of that will relate to radiation oncology or treatment interventions around replacing existing equipment. Others will obviously relate to new beds and building bed capacity across our system. As a Government, we have prioritised funding our health system, funding more workers and beds in our health system and also funding the technological improvements that I think will yield greater improvements in life expectancy. That is why we are taking digital health seriously and prioritising that from a capital perspective over the next five years. I will ask the Minister to respond in time to the Deputy's specific question and take a note of the work that is happening and the capital plans for the next five years. However, successive Governments have resourced and significantly reformed our health system and its cancer treatment. We are seeing the positive outputs from that due to the great work of the people the Deputy mentioned.

The professionals in this area stated in the context of the budget that radiotherapy services are operating significantly below capacity due to under-resourcing. They went on to state that our healthcare staff do everything they can to minimise the impacts on care for patients but it is simply not possible to provide optimal care in these conditions.

Sixteen of 24 working days last month were affected by unscheduled downtime. Machines are breaking down because they are too old, putting stress on patients and staff. Some €23 million per year is being spent on outsourcing to the private sector because of machines breaking down and not being replaced, and because of the lack of a national replacement programme. As I said, doctors who should be providing services and care to patients are instead, in their own words, coming to the Minister, the Government and Departments begging for money, resources and so on to replace the machines they need to provide the care to save lives. The Minister needs to respond to the specific request to have a national programme for the replacement of these machines and to have the staff and infrastructure necessary to deliver it.

I share with the Deputy the focus on ensuring that our health infrastructure, including radiation oncology machines or building better bed capacity across our health system, is achieved in the next five years. That is the work we are doing with the sectoral investment plan with the HSE to ensure we replace the equipment that is required and build additional capacity.

We are now funding a public health system which should become less reliant on the private health system over the next series of years in terms of outsourcing and some of what the Deputy referenced. I want to commend the enormous work and leadership of many people in our health system who have transformed outcomes. It is important, when we talk about the national cancer strategy, to note it is a strategy that has worked. It is delivering improved outcomes. Looking at the data over two to three decades, we have had a transformational improvement in that area over the last number of years. I will ask the Minister, Deputy Carroll MacNeill, to respond to the Deputy's specific question about radiation oncology. I believe there is significant scope over the next five years, through the investment we have put aside in the national development plan, to have a significant replacement programme for a lot of the health equipment which is required.