Pádraig Rice
Cork South-Central · Social Democrats · Ireland
“There is no clinical reason this should not be extended to oral contraceptives. Pharmacists are highly trained healthcare professionals. They should be allowed to operate at the top of their licence. They are available in every community and are very accessible.”
“I welcome the Bill. We spend a lot of time inside these Houses talking about other parts of reproductive healthcare and not enough about contraception, so it is really welcome that we are having a focus and discussion on it and are moving forward with changes.”
“The oral contraceptive pill has been around for well over half a century and is one of the safest and most well-studied medicines available. In 2019, the World Health Organization publicly stated that oral contraception should be available without needing prescription.”
“I move amendment No. 8: In page 5, between lines 20 and 21, to insert the following: “Report on prescription-free oral contraceptives 4. The Minister shall, within six months of the passing of this Act, prepare and lay before Dáil Éireann a report on a proposal to allow registered pharmacists to dispense prescription-free oral contracepti…”
“We are talking about the prescription of oral contraceptives as called for by the World Health Organization, as set out by the Irish Pharmacy Union and as endorsed by the previous health committee. We are looking for a report on that with the detail of the various elements, if more detail is required.”
“It is important that we allow pharmacists to operate at the top of their licence and give them as much power as possible, and alleviate pressures on GPs. As I said, this is recommended by the World Health Organization and endorsed by the previous health committee and the IPU. That is the background to this amendment.”
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“Only now is that finally addressed in this legislation, two and a half years later. This is despite the fact that my colleague, Deputy Whitmore, has been raising this with Government for years. In 2024, two years ago, a European School Survey Project found that 4% of 15- to 16-year-olds in Ireland were using nicotine pouches with 8% having used them at some point. Why has there been such reluctance to act decisively? For years, we have had more than just compelling anecdotal evidence, we have had the data. When it comes to banning disposables, the pace of change has even been slower. It took the Government until December last year to finally introduce that legislation, and although it has passed all Stages in the Dáil, we are still waiting for it to pass through the Seanad.”
“I welcome this long overdue legislation to further regulate vapes and to finally regulate nicotine pouches. As has repeatedly been the case with these new nicotine pouches, regulation arrives too late. The use of vapes and nicotine pouches has surged with a new generation increasingly dependent on nicotine. The Minister of Health and her predecessors have not shown the level of urgency required with a piecemeal approach to regulation that is consistently behind the curve. It took the previous Minister of Health, Stephen Donnelly, until the very end of 2023 to ban the sale of vapes to under 18s. While welcome, this was hardly bold policymaking. At the time, most people assumed that the sale of vapes to under 18s had already been prohibited and understandably so, and even the bare minimum interventions failed to include nicotine pouches.”
“We need a health-led approach, greater addiction services, decriminalisation and a safe injection facility. We should not have to wait for the review of the service in Dublin. Last night, the drugs committee heard that 40 years of evidence shows that these are effective. They reduce on-street drug use, reduce the spread infectious disease, prevent overdoses and connect people to services. I have one simple question. Does the Taoiseach support a safe injection facility for Cork city and what will he do to make it a reality?”
“I want to ask about drugs policy. On-street drug use is a significant issue in Cork city. Local residents feel unsafe and intimidated. Needles have been found at bus stops, at playgrounds and outside schools. Problem drug users have been pushed from one part of Cork city to another. They were in the city centre and now, as the Taoiseach will know, they have been in Turner's Cross and Ballyphehane in recent weeks. We are next. The Government's drug policy has failed with devastating consequences for individuals, families and communities. A UCC study shows that 35 people a year die from problem drug use in Cork city. These are preventable deaths. We need an enhanced community policing response but crucially we need a long-term solution.”
“It is too limited, with a limit on the number of fillings but no limit on the number of extractions. There needs to be engagement with the Irish Dental Association to develop a scheme that works for patients, dentists and the public purse.”
“Children in particular are being failed here. Too many children are leaving primary school without receiving a screening. We know that children should be screened in second, fourth and sixth classes. Some of them are not being screened until fourth year in secondary school or later. We know that, in 2023, only 104,000 out of an eligible 208,000 children were screened, so half of them were not screened that year. There are real issues with workforce planning and having adequate staff in place to do that. It is a real failure by the State that we are not providing those services to children. Equally, the medical card scheme is not working. Dentists are leaving it. The number of dentists in the scheme has halved over a decade, which is a real signal that there are failures in this scheme.”
“We have heard of cases of an unregistered person convicted of a sexual assault who may be practising as a dentist, as well as an unregistered dentist offering dental treatments, including X-rays, from a sitting room in an apartment in Dublin. We have also heard about three unregistered dentists offering pop-up clinics in Munster. We want to see a new dental Act and for the Dental Council to be given the real powers that it needs and has been calling for since 2008.”
“I thank the Minister. It is welcome that progress is being made because it is now seven years since the national oral health policy, Smile agus Sláinte, was published and we still do not have that implementation plan. I was not impressed by some of the excuses we received from officials at the committee, one of which was to blame Covid-19 for the failure to do this over the last number of years. We have been here before. Previous Ministers have promised an implementation plan, but it was never delivered. I hope that the current Minister does so, with clear actions, targets and timelines. Crucially, we need a new dental Act. The Dental Council is currently toothless. It needs powers to investigate, inspect and regulate.”
“There is a deepening crisis in dental services. Last week, the Committee on Health produced a report setting out 19 recommendations as to how this crisis can be tackled. Has the Minister had a chance to consider the report? Will she implement the recommendations?”
“I do think it is a situation of the Government's making. People absolutely have the right to take cases but people do not want to go before the courts. These families do not want to have the legal costs and the stress imposed on them by going before the courts. I think the Minister would agree with me that we need to expand personal freedoms generally in this republic. We need to vindicate the right to procreation, the right to private and family life and reproductive freedoms. There is much work left to be done, in particular the rights of the child, the rights of their parents and greater equality more broadly. This is a key part of that. I really hope that we get this legislation enacted and commenced, and that we are not waiting and waiting because we have waited long enough.”
“We need to pass the Bill. I have no doubt that, in some cases, there are people threatening the Minister with legal action who would withdraw that, but it is the absence of legislation. We have created this mess by delaying the legislation and by not progressing it in the 26 years since the commission published its report.”
“I thank the Minister. I welcome the commitment to advance it because the pace of change has been far too slow. It is now 26 years since the commission on AHR, four years since the Oireachtas Committee on International Surrogacy, and seven months since the health committee published our report providing pre-legislative scrutiny of the legislation. There is real frustration about the delays here. We need to see urgent progress. In relation to the case, and I mentioned this to the Minister of State, Deputy Butler, when we debated this in December, the State's failure to legislate has resulted in these cases. In the absence of legislation, people had no option but to go to the court to try to vindicate their rights. This will continue. We will have more people going to the courts trying to vindicate their rights in the absence of legislation.”
“I begin by welcoming the commencement of section 232 of the assisted human reproduction Act which took place yesterday, and the changes to the Children and Family Relationships Act that resulted. This provides a pathway to parentage for some donor-conceived children. I know there were celebrations in many households across the country who benefit from those changes, which are welcome. When does the Minister intend to commence the rest of the Act and what is the update on the supplementary legislation that is required?”
“They put in a lot of work, effort, research and campaigning. They reached out to people and went through historical records. The amount of work that has gone into this has been phenomenal, and I commend them on doing all of that work. I know some of the same individuals are involved in many of the other campaigns I mentioned, and they continue to advocate for those as well. I thank everyone who paved the way for the Ireland we have today. I commend the campaigners and activists who continue to call on the State to do better because the State can do better.”
“I ask the Minister of State, in his concluding remarks, to make that commitment to the community tonight. The only way we are going to achieve true restorative justice is by tackling the issues faced by the community. Today, there are people who are left on waiting lists for trans healthcare and experience hate crimes out in the community. We have issues today. This is not just about the past; it is about the present and the future. I urge the Government to take action on it. Finally, I thank the campaigners on this - Karl Hayden, Kieran Rose, Brian Sheehan and Ciarán Brady - as well as the Gay Project in Cork which partnered with the legal firm, Clifford Chance. I also thanks its barristers, Ms Céile Varley and Mr. Ciaran Bracken, and the whole team of people involved in this campaign over a very long period of time.”
“I reminded him that Ireland is ranked 15th in Europe in terms of LGBTQI+ human rights and policy protections by ILGA-Europe, an international body that ranks all the countries across Europe. We have been stuck in the mid leagues on LGBT rights for far too long. We are not making progress. I ask the Government to come out and set an ambitious goal in this regard. The Social Democrats have called on the Government to set a policy goal of being the best place in Europe to be LGBTQI+. It should set that as a goal and take the steps over the remaining years of this Government to achieve that. If the Government truly means what it has said around the disregard scheme and supporting the community, it will set that as a policy aim. It will put a policy in place and try to achieve that goal and move up through those rankings.”
“These include but are not limited to access to timely trans healthcare; banning conversion practices; robust hate crime prevention; improved sexual and mental health services; and commencement of the Health (Assisted Human Reproduction) Act. It has sat on the books for far too long. The Minister for Health, Deputy Carroll MacNeill, needs to get her finger out and commence and introduce a second Act because people are waiting. LGBT families exist today who are waiting for their rights. We are waiting far too long and I am getting very frustrated with the delays. We also need to have a discussion about intersex rights, and the list goes on. We have raised these issues repeatedly and I frankly feel ignored by the Government when we raise them. I do so time and again. On the last occasion I spoke about this, it was with the Tánaiste.”
“The State has failed to provide these services, and I have no doubt that criminalisation is one of the key reasons the State has never stepped in to support the community during those 70 years under criminalisation. These community organisations have fallen behind. They do not receive the same level of support that other community organisations receive. That wrong must be righted. We must provide additional supports. There are whole counties across the country that have no dedicated community services and supports. I ask TDs from those counties to start advocating for those services for the communities they represent. If truly restorative justice is to be adopted, it must address a wider set of policy issues.”
“For example, all staff working in the scheme should be trained in the areas of trauma and human rights. In addition, we should look abroad to see how this is best carried out in other countries. Most importantly, for the disregard to be effective, it must be placed within a broader context. We must consider the full impact that criminalisation has had on LGBTQI+ people, communities and wider societies. Many of our current LGBTQI+ community organisations across the country are under-funded. They struggle to support people and communities who were hurt by these anti-LGBT laws, policies and practices. Additional State funding must be provided to create and sustain services, particularly for older people. That level of funding and support is currently not in place. Parts of the country have no existing services.”
“Any scheme set up by the Government will not be worth it unless we ensure participation and make it possible for people who suffered under these laws to meaningfully participate. It is important that this process is as accessible as possible and that the person appointed by the Minister undertakes a trauma-informed approach in line with international best practice. It is important that if there is any onus to provide information or documents, it rests with the State rather than the individual. If information or documents are not available, the person’s testimony should be accepted. Care must be taken not to retraumatise people during the disregard process. The disregard working group set out an extensive list of human rights and equality principles. In its next step, it should set out how the principles will be put into practice.”
“It is important, therefore, that the scheme is promoted widely, is open and accessible and ensures confidentiality. A large number of LGBTQI+ people left Ireland to find safer places to live. Efforts should be made to promote the disregard scheme abroad, including in countries such as the UK, US, Canada, New Zealand and Australia. Irish embassies and consulates must promote the scheme once established. In addition, the Irish LGBTQI+ community abroad should be funded to promote the scheme within their own communities. At home, community groups across the island should be supported and funded to participate in the scheme and encourage local communities to take part.”
“There are various accounts of how people were targeted by these laws. People were targeted by public order, vagrancy and lodging laws and other police operations. There may be the need for future work as to how the laws impacted on women and trans people, particularly in the context of their treatment through the family courts. We must not forget them. It is important we make this scheme as inclusive as possible for the wide breadth of the LGBTQI+ community. It is important that any effort made by the Government must ensure people are encouraged to participate in this scheme. There are a number of ways in which participation in the scheme can be encouraged. First, it must be acknowledged that many people will be hard to reach.”
“They remained in place until they were repealed by the Criminal Law (Sexual Offences) Act 1993. That is within most of our lifetimes. These leave a long legacy of structural and systemic homophobia. I shudder to think about the number of people who suffered under these laws over 400 years. In 2018, on the 25th anniversary of decriminalisation, the Taoiseach at the time, Leo Varadkar, issued an apology to the LGBT community on behalf of the State. Subsequently, a process was commenced to right the wrongs of the past. It is great to see we are moving forward in that regard with both this Bill and the Minister’s commitments. This disregard scheme should be open to anyone who believes the law was used unfairly to police, arrest, charge or convict them because of their sexual orientation.”
“This 1829 Act was subsequently repealed by the Offences Against the Person Act 1861, which removed the punishment of death upon conviction and instead classified buggery as an offence by penal servitude for life. It also introduced the offence of attempted buggery, which was punishable by a sentence of penal servitude of up to ten years. The Criminal Law Amendment Act 1885 criminalised gross indecency between adult men with a maximum penalty of two years imprisonment with or without hard labour. The 1885 Act subsequently extended criminalisation to all sexual acts between men. The 1861 and 1885 offences dealing with buggery and gross indecency applied to both consensual and non-consensual acts. These laws remained in place following the foundation of this State and, in many ways, the new Irish Government doubled down on them.”
“The State must right the wrongs of the past and we are running out of time for some of these men. The Government must act urgently to disregard these historical convictions and deliver true equality for LGBT people in Ireland. I welcome the remarks of the Minister that the Government will make progress on this because we have delayed far too long. As others have mentioned, there is a very long history when it comes to these laws in Ireland - almost 400 years of history. The Act of the Punishment of the Vice of Buggery Ireland 1634 was the first Act of an Irish parliament to punish the sexual act between adult men. Under that Act, sex between men was a capital offence punishable by death. This act was repealed by the Offences against the Person (Ireland) Act 1829, which retained the death penalty on conviction of buggery.”
“I begin by thanking Sinn Féin and Deputy Ó Snodaigh for all of their work on this. I was delighted to cosign the Bill on behalf of the Social Democrats. It is now 33 years since homosexuality was decriminalised, but some men are still living with the negative impacts of criminalisation. Let us be clear. The prosecution and conviction of gay and bi men for consensual sex was a gross violation of their human rights and did immeasurable damage. These arrests and convictions destroyed lives. These laws also had a negative impact on those who were not convicted because the mere threat of prosecution was used to harass people in the community. The archaic laws also had a major impact on the provision of public services, including HIV and AIDS prevention.”
“Over one third, almost 2,500, have been waiting for over a year. This is indefensible. Decent healthcare services for children should not be too much to ask for. Families are under enough pressure. They should not have to watch their children fall behind, denied the opportunity to reach their full potential. What is the Government going to do to address this crisis in our primary healthcare service?”
“Right across the country, people are being pushed to the pin of their collars. They are struggling to pay for basics, such as food and fuel. They are also struggling because of the Government's inability to provide basic health services. This is most evident in the dire state of primary care services for children. Figures released to me show that in just 11 months, the number of children waiting more than two years for an initial speech and language therapy assessment rose by an alarming 149%. Some 1,200 children have now been languishing on the waiting list for over two years. Even once assessed, these children just move straight from one waiting list to another, this time for their first speech and language session. At the end of February, nearly 7,000 children were waiting for their first speech and language therapy session.”
“We call for that in our motion and I call on the Government and the Minister for Health especially to support the nurses who are under particular pressure, as well as other essential workers, with the increased cost. The overall message is I want to see a change of direction here. We have to move to a green economy. We need green energy production here at home and we need to support people in the here and now who are massively struggling with the huge cost of living.”
“It is not just farmers and agri contractors as there are people right across society who need support. As health spokesperson for the Social Democrats, I support the call from the Irish Nurses and Midwives Organisation for supports for nurses and midwives working in the community who are using their own cars to travel across communities to support people. These nurses and midwives support people from cradle to grave. I am thinking of public health nurses, community midwives and palliative care nurses who are driving around in their own cars. Some are covering up to 400 km a week to support people and we need to support them with an increased mileage allowance.”
“The Government needs to look at that and make the supports the Minister of State says are there more accessible and more available for people. The key point is we need a green energy revolution. We need to stop burning imported oil, gas and fracked gas and to move to domestic solar and wind energy. We need to make this as accessible for people as possible, which is why we have put forward solar for all proposals. We have to do this to avoid a climate catastrophe but I do not get a sense of urgency from Government on this. The Minister of State talks about identifying sites by 2027. We are not seeing the urgency that is needed to have the huge transition to a green system of energy produced domestically. While we have these failures we have to support people in the here and now.”
“I wish to make three points on this. I hope the events of the past week have been a wake-up call for the Government because people across the country are under huge pressure with the rising costs of living. The Social Democrats have put forward real solutions to that, including a targeted €400 energy credit. I urge the Government to implement that as soon as possible. I hope the Government understands that we have to have better energy security, energy independence and move away from imported fossil fuels. The Minister of State talked about people being able to access help from the Department of Social Protection but there are huge barriers to people accessing help. There is so much bureaucracy there and people struggle to access some of the supports he mentioned.”
“We need a full investigation of the grounds of Bessborough. This should be followed by sensitive excavation of the site, which should then be subject to a CPO to establish a memorial for all those who suffered. The Minister mentioned the museum in Dublin but survivors elsewhere across the country, including in Cork, also need a space, not just an apartment complex. Every attempt to reckon with this period of our history has been deeply flawed. Time and again successive Governments have failed survivors. This cycle must end. That starts with the Minister intervening to stop this planning application at Bessborough. Abuse cannot, and must not, be cemented over.”
“Some of those in power think that this is an issue of the past. They could not be more wrong. The survivors of Bessborough have never received justice. Families are still looking for information and answers. This is not just about Bessborough. If the planning permission goes through here, it sets a precedent for the use of other grounds and other institutions such as those in Sean Ross Abbey and Castlepollard where burials also remain unaccounted for. These children matter, the survivors matter and our history matters. The Government cannot treat this like a normal planning application and sit idly by as concrete is poured over graves. Despite what the Government might say, our reckoning with this dark period of our history is not over. It is crucially important that future generations understand what happened here and elsewhere.”
“Afterwards I took time to look at the death records from the institution: 923 children died in the care of the nuns in Bessborough. The scale of the suffering cannot be overstated, yet only 64 burials are accounted for. The commission of investigation into mother and baby homes found that it is very likely the remains of infants are buried on this site. During the 1940s in Ireland, the infant mortality rate was 6.5%. In Bessborough, it was nearly 61%, which is ten times higher. The State knew this and it turned a blind eye. Officials in the Department of Local Government and Public Health at the time recognised that should Bessborough deaths be leaked to the public it would result in a "public scandal". All these years later all we have is a decision to grant permission to build apartments on the site that saw so much tragedy.”
“Today's statements on Bessborough are welcome and very important but they will be meaningless unless the Government takes action on foot of the debate today. I urge the Minister to listen to the contributions from across the House, including by Members from her own party, who are calling on the Government to intervene. The bottom line is that apartments should not be built on what is very likely a mass grave. It would not be accepted anywhere else and we cannot accept it here. Níl sé ceart. Last week I spoke at a protest outside the gates of Leinster House. I want to say directly to the Minister what I said to the survivors and their supporters at that gathering. Recently I attended a vigil organised at the Bessborough site in Cork.”
“The only way this project will be completed on time is if BAM provides enough workers on site to do the work but it has repeatedly reneged on its commitment to do this. Why is the Government not in the High Court today to seek an urgent undertaking from BAM that it will deliver on its own promise? This would not be a lengthy court action. It would be quick and on that net issue to ensure that the hospital can open as soon as possible in order that children across the country who desperately need it can be treated there.”
“After more than €2 billion of public funds and a decade of construction, we still have no idea when the national children's hospital will open. When we were told yesterday at the Oireachtas health committee that the 18th completion deadline will be missed, it was not a surprise. I am beginning to wonder why we get project deadlines from BAM at all. We would be better off asking Mystic Meg at this point. BAM is giving the run-around to the Government, the hospital development board and ultimately, the Irish people. The Minister for Health was told at a meeting earlier this month that more construction workers would be put on site to get this essential project finished, but this has not happened. The Minister now tells us that she is going to write to BAM again. I am sure it is shaking in its boots. This farce has gone on long enough.”
“We have just seen delay after delay. It is not the only capital project that has been delayed in Cork city. It has now been ten years since the sod was turned on the event centre; and there is still no event centre. It has been five years since the library was announced, and there is no library. No funding has been allocated for the Luas, BusConnects is still delayed, and there is no safe injection facility and no homeless hub. The list goes on. The Government promises capital investment and projects for Cork city and it fails to deliver them time and again. We really need to see progress on a new city library in the heart of Cork city.”
“The Minister of State's Department is responsible for libraries. My point here is that his Department and the Department of public expenditure and reform, the Department of housing and local government, and the city council need to work together to deliver this project, which was promised over five years ago. The real frustration here is the lack of information and the lack of public consultation on this key project. A campaign group has been set up to push for action on this project. It has set out its vision for how public authorities could engage in a public consultation. It has also set out a clear vision of what the library should look like, namely, a world-class library, a cathedral of learning in the heart of the city, and it has shared that with the Department. The lack of progress on this library is really frustrating.”
“For over a year now, Cork City Council has been giving us identical answers and no new information. We resorted to submitting freedom of information, FOI, requests to the council. They have all been refused. I have asked questions to the Taoiseach here and not got an answer. I understand a business case has finally been submitted to the Department of housing and local government. Has that been reviewed? Has the Minister of State's Department looked at that business case? We need a working group, the various Departments and the council to come together to work on this project and deliver the world-class library the people of Cork were promised over five years ago by the Government.”
“We can have the ambition but we need the delivery and it has now been five years since the Taoiseach came to Cork and announced there would be a new city library, and there has been no development. The issue here is that nobody is taking responsibility for the project. The Government says it is the responsibility of the council. The council says it is waiting on the Government. This passing of the buck must stop. I have tried really hard to work with everybody constructively on this. During my time as a councillor, I submitted multiple questions and a motion to the council on it. My party colleague Councillor Niamh O'Connor has done the same. I had multiple meetings with librarians and council staff. We have submitted questions and got identical answers.”
“My question relates to the development of a new library for Cork. In March 2021, the Taoiseach announced that €50 million would be spent transforming Grand Parade by providing a new public library, plaza and boardwalk. Staff at the library do a fantastic job but the building is not fit for purpose. It does not reflect the services and it is not befitting of the second city. We are five years later and we have no new library. Even more concerning is that there is very little information about this project. We urgently need an update because the people of Cork want a new city library.”
“We need to have the same commitment to deliver that was present for the first two cancer strategies but notably absent in the third. I urge the Government to change track on this, to invest in cancer services and to start improving cancer services so we can improve outcomes, improve lives and prevent avoidable deaths.”
“It is time to support and value these tutors not just in words but in actions. Otherwise we will not be able to increase the number of tutors or retain them or provide patients with timely diagnostics. I sincerely hope this debate is a wake-up call and in particular the really harrowing personal stories Members have shared about themselves, people they know, their constituents and family members. We really need to improve cancer services for people right across the country. This next strategy must not be starved of funding and it must not be at the whim of every budget cycle. We must have multi-annual funding. I would like the Minister of State to take that message back to the Minister. The downward trend in cancer care can and must be reversed. We have done it before and we can do it again.”
“If we are to attract and retain more tutors, they must be remunerated and graded appropriately. The cancer strategy is clear on the need to increase the number of student places and I welcome that the Government is implementing this recommendation. Just last week, however, I heard reports of radiography students studying in the library instead of doing clinical hours because of a lack of practice tutors to support their placements. One tutor described this to me as being akin to learning to drive by simulator. Hospitals must be funded to deliver these extra placements and there needs to be more joined-up thinking. What good is having college places if the tutors are not there in the hospitals? This escalating crisis requires an urgent intervention by the Minister for Health.”
“In CUH, a radiation therapist told me that patients are being outsourced to private providers because the public system does not have enough staff. Outsourcing creates more business for private centres which, in turn, hire more staff. This means that even more consultants and radiation therapists leave the public system for the private system, which is booming on the taxpayers' dime. Another issue I want to raise relates to radiography practice tutors. Radiographer tutors play a vital role in clinical education and training of students within our hospitals but their value is not recognised, not least in their current terms and conditions. We know that experienced radiography practice tutors are stepping down because the pay does not reflect the level of responsibility.”
“Luke’s network but why do machines have to reach breaking point before action is taken? Not one machine in Dublin is under ten years old and, as I said, four are approaching 20 years old. The need to replace machines is entirely predictable yet there is no rolling national radiotherapy equipment replacement programme in place. The machines in Galway will need to be replaced by 2032 and the machines in Cork will need to be replaced by 2029, just four years from now, yet no planning is under way. We need a rolling replacement programme and not an ad hoc system of replacement. This would also save the State money by buying equipment in bulk. There are similar issues in relation to staffing. We now have a radiation therapy staffing shortage of between 15% and 22%. The increased reliance on outsourcing is creating a vicious cycle.”
“Since 2020 over €113 million has been spent outsourcing radiotherapy for public patients to private providers. In 2020, €12 million was spent on outsourcing radiation therapy. Since then it more than doubled to €28 million in 2025. One of the biggest reasons for this shocking spend on outsourcing is the failure to plan. Radiation therapy machines have a ten-year lifespan yet 50% of public machines are over 15 years old with four of these over 18 years old. After the ten-year mark, machines break down, maintenance costs increase and the standard of care decreases. St. Luke's Hospital in Rathgar, for example, is limited to using just three of its machines at any one time to mitigate frequent breakdowns. This means it is losing a quarter of its capacity on any given day. I accept a replacement programme is finally under way in the St.”
“Three in ten women did not get their breast cancer surgery within the recommended 20 working days. In 2024, which is the year for which the latest data are available, three in five men did not get prostate cancer surgery in the recommended 30 working days. The bottom line is that these delays caused avoidable deaths. Research published by the British Medical Journal found that every four-week delay in starting cancer treatment can increase mortality by 10%. This is precisely why we have targets in the national cancer strategy. We know that a person’s chances of surviving cancer are up to four times higher when treated at stage 1 rather than stage 4. One of the biggest issues in cancer care is the hollowing out of public radiotherapy services.”