Cancer Services

The Minister of State, Deputy Dillon, is very welcome to the House. When somebody has advanced cancer, being told that another treatment exists brings real hope. Discovering they cannot access it in Ireland brings an entirely different feeling of desperation. That is why I am raising the urgent need for a funded national plan for radioligand therapy, with the infrastructure, staff and access to medicines needed to deliver it. I acknowledge the progress being made in our cancer services and the commitment to delivering them, but we have to be honest about where the system is falling short. The radioligand therapy advisory group of the national cancer control programme, NCCP, recommended the development of a national plan, yet I understand that this group has not met since March 2025. The responses to my parliamentary questions indicate that this work has not been prioritised by the Department of Health or the office of the chief clinical officer of HIQA during 2025 and 2026. Why has that expert recommendation not been translated into a funded programme of work? I ask this question with real concern. How can we prepare for and deliver the next generation of cancer treatments if the planning needed to deliver them is not being prioritised? We need to know who is responsible, what resources are required and when the national plan will be delivered. Separately, I was recently informed that the HSE senior leadership team has reached a final decision not to reimburse Pluvicto, a radioligand treatment for certain patients with advanced prostate cancer. I understand that Novartis spent four years seeking reimbursement and, while disappointed, has accepted the decision. It is probable that our patients in Ireland will never gain access to this treatment. Four years is an enormous length of time for patients looking for an advanced treatment, only not to get it now. These are people hoping for another Christmas, another birthday and more time with their families. It would be helpful to have an explanation of why this application failed. This debate, however, is about more than one drug. It tells us about our wider reimbursement system. Our processes are not equipped to assess and introduce advanced therapies in a timely, fair and sustainable way. The health policy partnership White Paper identified practical work that is required, including national leadership, workforce planning, infrastructure investment, better data collection and co-ordinated access pathways. Those recommendations deserve a focus. We need suitable treatment facilities, diagnostic capacity, radiopharmacy services, radiation protection arrangements and trained specialist teams. We also need access to the medicines themselves. A treatment room without funded treatment will do nothing for patients. The new national cancer strategy has to address this properly and be ambitious. Radioligand therapy needs to be an explicit commitment, backed by capital investment, recurring funding, workforce targets and delivery dates. Planning services and accessing medicines have to proceed alongside each other. We cannot keep waiting until a treatment arrives before asking whether we have the capacity to deliver it. For patients in Louth and throughout the country, access must depend on a clinical need and be supported by clear referral pathways. I hope the Minister of State can bring back this issue to the Minister for Health to seek a commitment to reconvene the radioligand therapy advisory group of the NCCP, to progress a funded national plan concerning how the Department and the HSE are planning to keep pace with science, and to request that they also start looking at how advanced therapies are being denied to our loved ones who have cancer. We have made real progress in cancer care. Our responsibility is now to ensure that treatments will reach patients when they still have time to benefit from them.

I thank Deputy McGreehan for raising this important issue in regard to radioligand therapy provision here in Ireland. I am taking this matter on behalf of the Minister for Health, Deputy Jennifer Carroll MacNeill. I assure the Deputy that her steadfast advocacy in respect of the provision of treatment services for cancer patients is appreciated by all. I also assure her that the Government is committed to providing timely access to new and innovative medicines to all patients, including those with cancer, alongside the planned development of the infrastructure required to safely deliver such therapies. In 2024, St. Vincent's University Hospital in Dublin was designated the initial site in Ireland for the delivery of radioligand therapy. In 2025, that site received European certification as a centre of excellence in theranostics. This certification is a testament to the exceptional work being done in this area, serving to reinforce the growing importance of radioligand therapy in Ireland and underscoring the Government's efforts to advance progress in this important field. To build upon this progress, the HSE's NCCP has engaged with cancer centres and nuclear medicine specialists and established the radioligand therapy advisory group to support consideration of service requirements. Established in 2025, the group is chaired by the national director of the NCCP, and its membership is drawn from across the health spectrum, including representatives from the NCCP, consultant clinicians, radiation oncologists and specialists. The purpose of the group is to consider, on the basis of the need identified, plans for the future development of radioligand therapy services, including recommended norms in relation to service provision, planning and staffing considerations for facilities. In its initial stages, membership of this group is expected to last for a period of three years, within which the group will meet to consider approaches that may be taken for the furtherance of planning necessary to best advance this treatment. There are numerous interdependencies to be considered. The HSE has advised that challenges persist in the delivery of radioligand therapy in Ireland, particularly in terms of infrastructure and capacity. As with any complex area of service delivery, a measured and well-considered approach to planning is paramount. It is towards the progression of this objective that the NCCP's radioligand therapy advisory group is currently engaged, and work remains ongoing in this regard. I accept and understand the concerns the Deputy raised in her opening statement regarding the pace and prioritisation, and I will certainly ensure that those concerns are conveyed to the Minister and that the Department continues to work on making progress on the Government's commitments. The Government has demonstrated its appetite to deliver innovative cancer treatments through significant investments in recent years in regard to medicines. Supporting the development of radioligand therapy is also an important priority.

I thank the Minister of State for that response. My question was one that I would like to be conveyed to the Minister. The NCCP radioligand therapy advisory group recommended a national plan. It has not met since March 2025. It is now October, nearly November, 2026. It is going to be stood down. It is going to be in existence for only three years. If its members are not meeting, they are not working. The Department of Health has not implemented the group's current asks. Of course, it is welcome that since 2024 St. Vincent's University Hospital has been a centre of excellence for theranostics. However, one centre is not enough. The Lancet states that the patient pool across Europe could rise from the current 11,000 to 13,000 people a year to nearly 200,000 a year across Europe. We, through a lack of investment in infrastructure, a lack of planning and a lack of a robust reimbursement scheme, are going to fail future patients. We need our next national cancer strategy to be very ambitious and keep pace with science, and we need to ensure it is absolutely fully funded, not only on the infrastructural, clinical and diagnostic sides but also on the treatment side.

I acknowledge Deputy McGreehan's continued advocacy on this issue on behalf of all the cancer patients who are seeking access to the latest treatment options. I said in my opening remarks that her persistent voice in this area is very welcome. I recognise the importance of the concerns she has raised in regard to the ongoing engagement of the advisory group and the fact that it has not met since last year. The issue very much surrounds the clinical capacity, the infrastructure and the evidence base necessary to support a safe and sustainable national service. Everyone in this House shares the same objective, which is that we want Irish patients to receive timely access to innovative cancer treatments and get the best possible outcomes. That is really the point the Deputy is raising here today. It is clear that the delivery of these services involves significant considerations. I hope that this work will advance in the next national cancer programme and that we will have specialist staff, capacity, long-term service planning and, indeed, the infrastructure to deliver the services. I will ensure that the Deputy’s concerns, which are understandable and deserve to be heard, are brought back to the Minister for Health for further consideration.