2026-06-10

Currently in Ireland, we have 23 linear accelerators in Galway, Dublin and Cork. Of those 14 linear accelerators in Dublin, 12 are more than ten years old and eight are more than 15 years old. It is clearly established that any machine that is more than ten years old is going to cause delays and breakdowns are far more frequent and as a result, the service cannot be delivered. In fact, the figures for 2025 are quite frightening where the radiation that people required was not delivered within the 14-day time period, which is the guideline. Paragraph 22 of the National Cancer Strategy 2017-2026 set out that a rolling replacement programme would be put in place. This has not occurred. In relation to radiation therapy, we have a whole team of people. We have radiation oncologists, radiation therapists, medical physics, dosimetrists and nurses. There is a whole team. If a linear accelerator breaks down, treatment is not provided and a whole team wastes one, two or three days. Radiation therapy cures about 40% of cancers. The European Society for Radiotherapy and Oncology, ESTRO, sets out quite clearly that the lifetime of these machines is ten years. Some of these machines are 18 years old. There is a programme, to start in 2027, which talks about replacing two machines per year but that is not enough. We now need to set out a clear programme of action so that the number of replacements is four per year over the next three years and not two per year. This needs to be put in place. We have had a huge increase in population. We will also have an increase in the number of people who require treatment. We have the expertise. We have good and dedicated staff. It is important that we give them the support they require. There are 14 machines in total in Dublin. If St. Luke's replaces two machines every year, some of them will be over 21 years old by the time they are replaced. It is time that we looked at this. It is not a big cost in real terms because there would be a huge saving. We are wasting staff time when a machine is not working. Over the past 12 months, we have also had to have patients receive treatment in the private sector. This cost over €17 million last year alone. Why are we delaying the replacement of these machines? Recently, I opened the cancer summit in Croke Park, which was attended by more than 300 people from hospitals, pharmaceutical companies and a whole range of services in the healthcare area. There was a big discussion about the fact that we are delaying putting new equipment in place.

I thank Deputy Burke for raising this very important issue. The Government is committed to improving cancer care, ensuring better prevention and maintaining improvements in cancer survival rates and timely access to treatments. The availability of appropriate, fit-for-purpose facilities and equipment is critical to the safe and timely delivery of cancer care. Since the launch of the national cancer strategy in 2017, the Government has allocated €105 million to support cancer services and improve outcomes for patients. Under the national cancer strategy and the recommendations of the national plan for radiation oncology, two state-of-the-art radiation oncology centres have opened in Cork and Galway, in 2019 and 2023 respectively, representing a €120 million capital investment. Expansion and equipment replacement programmes are progressing across Ireland's public radiation oncology network. Deputy Burke spoke about the phased expansion that is under way. This is at Beaumont Hospital, where formal tender documents have already been issued to advance the project. A dedicated equipment replacement programme is also active across the St. Luke's Radiation Oncology Network to upgrade essential linear accelerators. On a national scale, the Department of Health and the HSE are actively developing a strategic infrastructure programme to systematically plan for the future replacement and expansion of radiation therapy equipment at all public facilities. To progress this strategic initiative, formal engagement between the Department and relevant stakeholders is scheduled to begin on 12 June 2026, which is in two days' time. Centralised planning for this programme and subsequent oversight in its implementation will enable cost-effective procurement and efficient delivery of enabling works. The programme will also align with the national cancer strategy and Sláintecare, supporting sustainable, high-quality radiotherapy services nationwide. As advised by the HSE, replacement of equipment takes into account not only age but also performance linked to use and ongoing maintenance regimes - end of life and end of support, as designed by the manufacturer - and the availability of spare parts. This is a critical consideration in replacing radiation oncology equipment. As such, the replacement of this equipment in the St. Luke's Radiation Oncology Network in Dublin is a priority. The majority of radiation oncology services in Ireland met or exceeded the KPI targets across 2025, with the exception of the St. Luke's Radiation Oncology Network which performed below target across the year. As I have previously stated, an equipment replacement programme is in place to address this issue. In November 2025, the Department of Health's sectoral plan for 2026 to 2030 was launched under the national development plan. The sectoral plan sets out infrastructure investment priorities for the next five years, building on a strong track record of delivery to support the provision of equitable, accessible and high-quality healthcare across Ireland. A key strategic priority under the sectoral plan is continued investment in cancer care, including radiation oncology. I welcome this opportunity to discuss equipment replacement and expansion. The Government recognises the importance of the timely replacement of equipment as its effectiveness decreases.

In 2016 access to radiation therapy within 15 days was 86.4% and in 2019 it was 86.5%. Last year it was 78.7%. It has dropped. In fact, in 2024 it was down to 64.7%. Part of the problem is machines breaking down. There is a need for a national radiotherapy equipment replacement programme. I know the programme is starting but it is about whether we can do it faster over the next four years. We will be in Government for this period of time so let us make a serious effort. We have the expertise and we need to make sure we have ring-fenced capital funding to replace four machines per year over the next three to four years so that we have a large number of machines replaced. This will create efficiency. As I said earlier, all of the figures clearly indicate, because the population has increased dramatically over the past 20 years and we also have people living longer so we have an older population, that we are more likely to have more people identified with cancer. Therefore, more people will require treatment. Time is of the essence in providing treatment and it is very important that we have the best quality machines available so the staff can do this. This treatment cures up to 40% of cancers. It is extremely important that we give it priority over the next three to four years and set out a clear plan of capital funding. We must remember that when we are replacing the machines we will have delays because one or two fewer machines will be available. This is why we need to roll it on as fast as possible.

I thank Deputy Burke. As he said, this is a serious issue. I know the Government is committed and I will certainly bring it back to the Minister, Deputy Carroll MacNeill. Ensuring better prevention, maintaining improvements in cancer survival rates and timely access to treatment are priorities for the Government. Access to state-of-the-art and fit-for-purpose facilities and equipment is fundamental to the safe and timely delivery of such care. Deputy Burke is right that timely delivery is so important. He spoke about the machines that have broken down. As I have previously set out, a replacement programme for radiation therapy equipment is under way across St. Luke’s Radiation Oncology Network in Dublin, funded under the HSE's capital plan for 2026. The replacement programme will conclude in 2030. To address future radiotherapy equipment replacement, the Department of Health and the HSE are developing a strategic infrastructure programme to plan for the replacement and expansion of radiotherapy equipment at public radiation oncology facilities. Engagement between the Department and relevant stakeholders will begin this week to advance this work. I assure the Deputy this will happen and I will definitely keep him updated, as that is important. Under the current strategic plan, direct investment of €120 million has been made in state-of-the-art radiation oncology centres in Cork and Galway to address radiotherapy equipment needs. A key strategic priority under the Department's health sectoral plan for 2026 to 2030 is the continued investment in cancer care, including radiation oncology. The plan will also progress national cancer infrastructure planning for oncology day wards, inpatient oncology, cancer diagnostics and outreach and community service delivery consistent with Sláintecare and the national cancer strategy. I again thank the Deputy for highlighting this matter. I will definitely go back to the Minister. As the Deputy said, timely care is so important. I assure him the Government is committed to that.