I want to raise a very alarming and distressing case. It is the case of a woman from the west of Ireland left to wait six weeks to start her chemotherapy. At the end of November last, this mother of two young children received the devastating news that she had breast cancer, the same cancer her mother had died of in her 40s. To get a diagnosis of cancer is traumatic enough but to be told you have the same cancer that took the life of your mother is really terrifying. However, she did not give in to fear, she was up for the fight and she expected the health system would have her back. She was referred to University Hospital Galway for chemotherapy and expected to commence her treatment with the urgency required. However, as she waited the days rolled into weeks. Christmas came and went and still no appointment. The stress and anxiety of having cancer, worrying about it growing and spreading but not being treated got worse for her day by day. Her husband says they began, to use his words, "begging for chemo". She even offered to travel to other hospitals but her wait continued.

By the second week of January this woman was still waiting for her chemotherapy appointment. Then she presented at the accident and emergency department in significant pain. She was left, by the way, to wait on a trolley. Only after being admitted to hospital did she begin her chemotherapy and it is very shocking that she started treatment only after she was admitted to hospital as otherwise she would have still been waiting.

No cancer patient and no family should ever have to go through what this woman and her family went through. We all know early treatment is vital when it comes to surviving cancer. The National Cancer Strategy 2017-2026 states treatment should start within 15 days of diagnosis but patients are being left to wait way beyond that timeline. Last summer the Irish Cancer Society rang the alarm bell loudly. It raised the major regional disparities that exist in accessing cancer treatment, with patients in the west often waiting seven or even eight weeks for their chemotherapy. That is terrifying.

This is not the first time I have raised serious concerns about access to chemotherapy. The Taoiseach will recall the scandal of 800 children’s chemotherapy appointments being cancelled in 2023. The National Cancer Strategy was designed to guarantee prompt diagnosis and treatment but while Ireland has come a long way experts Dr. Michael McCarthy have warned that it is getting tougher and tougher to deliver care on time. He says we are now behind the curve and we are slipping back. Advocates have repeatedly warned we do not have enough staff, space or equipment to cope and the human cost is being paid by patients and families. This has to change because lives are on the line. Níor chóir go bhfágfar aon duine a fhaigheann diagnóis ailse le fanacht ar feadh seachtainí roimh ceimiteiripe a thosú. Caithfidh an Rialtas a chinntiú go bhfuil fáil ag othair ar chóir leighis chun a mbeatha a shábháil gan mhoill.

I want the Taoiseach to tell me how many other cancer patients are currently left waiting and waiting like this. I want him to tell us what action he is going to take in this regard to guarantee not a single patient is left to wait weeks and weeks to start their lifesaving chemotherapy.

First of all, I thank the Deputy for raising this issue, which is an extremely important one. Obviously I am not familiar with the background of the specific case she has referenced just now. If she wishes to send me the details of the case, with the permission of the person concerned, I perhaps will be in a position to interrogate the issue more with the NCCP, which is the national cancer control programme, and indeed with the HSE and the hospital. We have invested very significantly in cancer care.

Cancer is a very traumatic diagnosis for any individual or family and, obviously, given the levels of investment in our services, we want the best possible outcomes. Thankfully, over the last number of decades, we have improved outcomes of cancer diagnoses significantly, particularly in terms of breast cancer. Breast cancer survivors are now the largest cancer survivor group in Ireland, making up 22% of all cancer survivors. Almost 50,000 women have had a breast cancer diagnosis. That does not mitigate or take from the trauma that the individual person the Deputy referred to this morning has experienced.

As the Deputy knows, there have been a variety of new treatments, new drugs and so on for cancer. We have invested significantly in all of that. In the last three to four years, close to €650 million has been invested in new drug therapies for cancer alone and the radiation-oncology centres have been established and so forth.

On the waiting times, symptomatic breast disease clinics operate in approximately nine hospitals around the country - the eight cancer centres and a satellite clinic in Letterkenny. The HSE national cancer control programme, NCCP, has set a target of 95% of urgent referrals being seen within ten working days and 95% of non-urgent referrals to be seen within 12 weeks. To date, 62% of urgent referrals have met the timeframe of ten working days. That needs to improve. Of that, there is no doubt. In October, three cancer centres - St. James's Hospital, University Hospital Waterford and University Hospital Limerick - exceeded the 95% target for urgent referrals. An additional three centres - St. Vincent's, University Hospital Galway and the Mater - reported that they expected to meet the target by the end of the year. Galway, which I think is the hospital involved in this case, has said to the NCCP that it expects to meet the target by the end of 2025. Certainly, if the Deputy sends me on the details of the case, I will pursue that with the hospital and the NCCP because the NCCP is working with various hospitals in terms of restoring the service within the agreed timeframes. When there is a particular performance issue, the HSE works with the hospital on site-specific measures. That could mean funding additional clinics or additional medical cover, where necessary.

In terms of the variation across the country, the NCCP has introduced a range of guidelines aimed at ensuring standardised access to cancer services across the country leading to more appropriate referrals within cancer services. It is examining the national symptomatic breast disease pathway, including triage, review of key performance metrics and updating the national clinical guidelines.

We need to work out the specific issue here because University Hospital Galway, I have been informed, has indicated it would be on target by the end of last December-----

Thank you, Taoiseach.

-----following recruitment and the running of additional clinics.

The issue is that it is not a specific or isolated incident. I would like to know the extent of this. I know about the case of this woman in particular. I have given the details of it. Dr. Michael McCarthy, who is president of the Irish Society of Medical Oncology, during the summer said:

The reality in Galway is that patients are now typically [and I emphasise "typically"] waiting seven to eight weeks for their first session. With every week that passes, the risk increases that their cancer will grow, or worse that it will spread to other parts of their body.

This is not an isolated phenomenon. I have set out the profound terror and distress this woman and her family experienced, but she is not on her own. I want to know more from the Taoiseach. We need numbers-----

Thank you, Deputy. The Taoiseach to respond.

-----and to know exactly how widespread this experience is and, more important, what the Government will do to fix this urgently.

As I said earlier, I would appreciate if the Deputy could give us the specifics of the individual case she has identified because then we could track that with the hospital. It is important to do that because Galway hospital said late last year that it would meet the NCCP targets by the end of December.

That is a different target.

That is for referrals.

Yes, but also in terms of treatment. We need to get-----

No.

In any event, I think it would be useful if the Deputy could send us the details of the case-----

I can certainly do that.

-----with the permission of the person, obviously. Confidentiality will apply, without question. There has been a lot of investment in cancer services, and quite rightly so. Symptomatic breast disease was one of the first areas that we identified a long time ago as requiring a specific allocation of resources and investment from cancer screening right through, and, from a national point of view, it has had very improved results in terms of outcomes, which is what we all want for cancer. It is important that, overall, survival rates have improved very significantly. That needs to be said as well-----

Thank you, Taoiseach.

-----to ease any concerns that people who might have been recently diagnosed will understandably have.