Vol. 1082 No. 4
1. Deputy David Cullinane asked the Minister for Health her current policy on the colocation of the Rotunda Hospital; the amount spent to date on colocation planning, including any preliminary stages; and if she will make a statement on the matter. [17627/26]
My first question is on the Rotunda Hospital. Since the question was tabled, however, a memo was brought to Cabinet and the Minister has decided to abandon the plans to colocate the Rotunda Hospital with Connolly. If I am right that this is her position, she might outline that. Now the key thing has to be what happens with the critical care unit. I welcome that, as part of an enhanced planning application and the critical care unit, the sexual assault unit will also be enhanced. The Minister might take the opportunity to update the House on those two very important projects.
I thank the Deputy. Just to clarify and for accuracy, I did not bring a memo to Government. That is only a technical point. The Deputy is quite right. What we have decided to do is reflect on the judgment and on the needs of women going forward. The needs of women going forward are for critical care capacity for neonates. I am sure the Deputy has been in the unit in the Rotunda Hospital. They do exceptionally good work but it is not in a suitable place for neonatal intensive care. The idea is to go back in with a new application. All of our options were considered in relation to whether to take a judicial review. That would mean going through an extensive legal process, potentially for two years, to go back into the same body. I am not sure that really meets the needs in any event.
What we have decided to do is enhance the application, to go bigger. We need critical care capacity onsite. From the perspective of patient safety, that enables me to say I am satisfied that the patient safety needs of women on that site are being yet better met. Already, of course, the Rotunda is practically beside the Mater and there are very good bluelight channels, as the Mater has said. No woman has died in the Rotunda in 20 years. It is a safe pathway already but it does need enhancement. That is why that critical care capacity for women as well as for neonates will form part of the new application.
That enables us to delineate the Rotunda from the otherwise important colocation policy of having that critical care capacity for women closer, the case being Holles Street and the National Maternity Hospital. It enables us to remove that from the equation of a new planning application. The colocation question cannot be in the minds of anyone because it is delineated from that in that way. We are intending to go back with a bigger application directly to An Coimisiún Pleanála with critical care capacity for women and an enhanced sexual assault treatment unit. I want everybody here, which I know they will do, to make a statement that the Rotunda is for women in the city centre in every possible way. The Ministers, Deputies O'Callaghan and Chambers and myself will be backing that application and I am sure the Deputy will too.
The colocation plan unfortunately was an anchor around the hospital for far too long so I welcome the fact that anchor has now been removed. It is policy since 2015 but very little money has been spent on it and there was no real timeframe. An Coimisiún Pleanála's decision did mention colocation not as the main reason but certainly as one of the factors it took into account, so removing that obviously helps.
It is possible and necessary that we protect the built environment that is Parnell Street. Nobody, including the master of the hospital, disputes that the architectural heritage of that building is important. However, it is possible to have a planning application that can address some of those concerns but also provide world-class, first-class buildings and capacity for the staff who, as the Minister said, do a wonderful job in the Rotunda Hospital. I am satisfied that this can be achieved. It will require funding and support at every step of the way from Government.
I agree. Of course, the heritage consideration was the dominant one in that third round for the decision-making. It still remains of importance to that area. However, balancing the public interest is something we do all the time. Dublin City Council and the inspector took the view that in the previous application, the public interest was overwhelmingly served by progressing with it. The deciding body in the end decided in the opposite direction. In many ways, what we say here informs the public interest. We are the representatives of the public in what we say in relation to the importance of the care of women. Successfully and correctly delineating the Rotunda from the colocation policy, which is important for other hospitals, is a significant step in that. I do expect the application to be well supported in the broader public interest.
The Deputy is correct that very little money was spent on the colocation of the Rotunda. However, an enormous amount of money has been spent on colocation policy generally in respect of Holles Street. That reflects the hierarchy of need. The need to move Holles Street was much greater because the patient safety need was much greater, the distance being greater between Holles Street and St. Vincent's than between the Rotunda and the Mater. That speaks to the priority placed on it.
The decision for the Rotunda in relation to colocation has raised issues around other colocation proposals as well. The Minister mentioned Holles Street, which is moving to Elm Park and which is much more advanced. There is a plan for Limerick and for the Coombe. Now questions are being asked about where they stand, particularly the Coombe, which is to move to the site adjacent to the new children's hospital, which is yet to open. Are there timeframes for that? What is the policy of the Government? Is there any fresh thinking on the Coombe given the decision that was made for the Rotunda Hospital? It is really important that certainty is given to all of those hospitals. I refer to one of the lessons we have to learn if the certainty is not there, if the pathway is not there and if there are no timeframes for colocation while these hospitals are trying to expand and provide the services they need to provide in the here and now as well as for five, ten or 20 years' down the road. Being tied to colocation can be problematic when there are no real timeframes or movement. The Minister might be able to give her insight into the Coombe and Limerick as well.
The Deputy is exactly right. Holles Street and Elm Park is settled. The question on Limerick forms part of what we are trying to do generally in Limerick and I would be happy to update the Deputy but our policy is very much the same in respect of colocation there. The Deputy is right to identify the Coombe, which is quite close to St. James's Hospital, where we are investing significant additional capacity at present. It is something I am now going to reflect on. I do not want to separate that yet but it is important that we do a detailed analysis of the needs of the Coombe, the adjacency of St. James's and what we have learned in relation to that. Back in 2013, 2014 and 2015, there were discussions about the necessity for trilocation and all those different efforts to try to put those pieces together. Of course, we are learning more and more. We are seeing the different pathways now. The Deputy is right to identify that and I cannot answer that today. It needs more reflection. We can do that collectively over time. There is not the same imperative because we are driving ahead with investment in the Coombe as it is.
It would be a good issue for the Oireachtas health committee to examine in the next number of months, namely the whole colocation strategy.
2. Deputy Charles Ward asked the Minister for Health whether she will commission a study on the health impacts of prolonged exposure to mould and damp in homes impacted by defective concrete; and if she will make a statement on the matter. [18050/26]
I would be grateful if the Minister of State would let me know whether she will commission a study on the health impacts of prolonged exposure to damp and mould in homes impacted by defective concrete.
I thank the Deputy for raising this. We know that living with mould and damp can have a profound impact on people’s health and well-being. They are known to cause respiratory illnesses and can also affect mental health. Children and other vulnerable people often feel these effects more than most.
The Government recognises the difficult and painful situation that many families are in and is working to address the root cause through the defective concrete blocks grant scheme. We are very mindful of that. This scheme provides financial support to those in designated counties whose homes have been damaged by the use of defective concrete blocks during construction. We understand that families can face financial hardship and in some cases may have to leave their homes. We are very much aware of this and can see that there is a huge level of stress and anxiety.
To support those affected, enhanced mental health supports have been introduced. I do not know if the Deputy is aware of these but they are really important. They have been introduced through the enhanced defective concrete blocks grant scheme, and through our mental health services. It is called MyMind, which provided free counselling, psychotherapy, and psychological support. At the moment approximately 450 appointments are offered each year, along with group sessions and workshops.
Children’s Health Ireland’s respiratory, cystic fibrosis and sleep teams continue to provide essential care for children affected by respiratory conditions. Given the well-established health impacts of mould and damp, a further study is not going to be needed. Our priority is to deliver direct, practical support to those living with the consequences of defective concrete blocks.
I want to highlight some urgent cases in Donegal involving individuals with serious conditions living in unsafe, defective homes. I have written to the Minister of State previously regarding these. Their health, dignity and daily lives are at constant risk. These are real families, not statistics.
Unfortunately the only response from the housing Department was a generic letter offering practically no support. I commend the Minister's leadership particularly with regard to the Letterkenny hub. These cases are an opportunity for the Government and the Department of Health to lead again. We need help. Urgent cases needs to be fast-tracked. People are stuck in homes, their health is failing and they are ageing. They need to be prioritised. At the moment there are no steps to do that. Will the Department take anything from this and help them? They are running out of time in their lives. They need all the help they can get and there is no priory list for them.
Working with my colleague, the Minister of State, Deputy Butler, we will come back to the Deputy on that and see what we can do. Working with the Minister for Health, as a public health approach, this issue has to address the underlying cause of ill health. The best way for us to help those affected by mould and damp in their homes with defective concrete is to address the housing directly. That is a priority. I have been speaking to the Minister for housing, Deputy Browne, about this too. We need to move on this urgently. As the Deputy will probably be aware, the scheme was recently extended in other counties. The amount available to homeowners was increased by 10%. It is now €462,000. We need to do more; I understand. I know families affected myself. I see the stress and anxiety. I will work with the different Departments so there is priority for what needs to be done.
I have a constituent with a severe reduction in her lung capacity. Her daughters are deeply concerned about the effects of prolonged exposure to damp and mould in a defective home. There is no doubt it has shortened her life. Each day this constituent remains in her home, her health deteriorates. She also suffers from dementia and has a heart condition. I am also aware of a terminally ill mother who is a nurse. She has stage 4 cancer. She wants her house rebuilt for her four kids before she dies. That is serious. I would like the Minister for Health to put something in place for these people to make sure there is priority. We need to make sure we is done for them. The mother who came to me will not be here next Christmas and she has four kids. It is important this is looked at in a humane way and try to get it done. Whatever has to be done, get it done. It is not just her and her husband; there are also four young children. As their representative, I take it seriously. We need to make sure there is urgency.
I understand people living with defective concrete in their homes experience real challenges. You can see it - families are really affected by this. That is why our Departments are working together to get the funding to get this done. The scheme is a major commitment by the State to help impacted homeowners to move on with their lives. We have to make sure the families who need counselling or support get it and that there is a commitment from Government. We know mould and damp can have a huge impact on people's health and well-being. I will work with the Deputy on that to prioritise. I will go back to the Minister of State, Deputy Butler, about what is in her remit and mine. We will talk to the Minister for housing because it involves different Departments. I thank the Deputy for highlighting this important and serious issue today.
3. Deputy David Cullinane asked the Minister for Health her plans to bring forward legislation to enhance the powers of the Dental Council; and if she will make a statement on the matter. [17628/26]
The Dental Council of Ireland does not have sufficient powers to protect the public from unregistered dentists. It has been unable to act in 80% of cases of credible concern of unregistered dentists in the past three years. I have met council representatives on a number of occasions. I assume the Minister has as well. It has been raising this matter for some considerable time. I also know compulsory continuing professional development, CPD, is important and the Minister is working on it and has supported it. Regulation and powers for the Dental Council of Ireland are what is at play. Will she set out her intentions are in this regard?
There is no question but that the regulatory framework requires updating and modernisation. It is closely linked to the wider implementation of the national oral health policy. Ahead of comprehensive reform, several priority interim amendments have been identified particularly to strengthen the powers of the Dental Council of Ireland. The first amendment addresses the lack of a statutory basis for continuing professional development, as the Deputy highlighted. While dentists are currently required to meet ethical CPD standards of course, that is not enough and they must be underpinned by legislation. A policy has been developed to introduce CPD on a statutory footing, which will enhance the Dental Council of Ireland’s ability to ensure dentists undertake adequate and appropriate ongoing professional development. I have received Government approval for that policy along with consent to draft the general scheme of the Bill. My Department is now preparing the heads and associated regulatory assessments. We will deal with that in the Oireachtas in due course.
With regard to unregistered dentists, powers to address the illegal practice of dentistry by unregistered individuals exist under the Dentists Act 1985 and other legislation. Under the Dentists Act it is an offence for unregistered persons to use the title of dentist to provide dental treatment or present themselves as dentists and the council may prosecute such cases. In addition, under the Consumer Protection Act 2007, the council can also seek court orders to stop dental practices from operating if they enable unregistered individuals to practice illegally. All suspected cases of illegal dental practice should be reported to An Garda Síochána. Unregistered individuals who treat patients while masquerading as dentists may also have committed assault under the Non-Fatal Offences Against the Person Act 1997 or have breached the Criminal Justice (Theft and Fraud Offences) Act 2001. Those offences carry significant penalties including imprisonment.
I welcome the wider work but the Dentists Act, an issue I have been over several times, does not provide the Dental Council of Ireland with sufficient powers to deal with unregistered dentists. In fact, it has been saying recently that it has not been able to take action against a total of 37 unregistered dentists over the past eight years, including one who was practising unregistered with a sexual assault conviction. I met a locum dentists recently who spoke to me about some horror stories of him being placed in unregistered dental practices. Some of the stuff would make the hairs stand on the back of your head. He was very concerned. There needs to be a review of that Act. I agree with Minister about the wider issues, a new oral health policy and stronger regulation and so on but if it is a case of right here, right now, the Dental Council of Ireland tells us it does not have sufficient powers. It may have some powers and there are other powers but these dentists are going undetected, are not properly sanctioned and I am hearing of these horror stories. I think this was reported in The Irish Times last week as well. They are serious issues that need urgent intervention.
I agree with the Deputy. While the broad legislative suite is in place and there are existing powers are under the Dentists Act, I have no difficulty with a review and strengthening them where needed. I recognise the suite of legislative powers I outlined so we need to be very specific as to the additional powers necessary. I have no difficulty in strengthening the powers of the Dental Council of Ireland to do just that. We are talking about potentially unremediable assault on a person in their mouth or on their face. It is an appalling thing to happen to any person. We need to make sure the powers are as robust as necessary. There is simply no question on that. I signal a change I want to make to the Act to enable direct access for dental hygienists. That would require an amendment to section 54. Direct access refers to the ability of a dental hygienist to initiate treatment within their scope of practice based on assessments of patients' needs without the specific authorisation of a dentist. That is a change I want to make to enable the workforce but that is for dental hygiene work not necessarily dental work. There is distinction, of course.
I welcome that as well. It will add real value. The Minister spoke about oral health generally. The are issues with screening in schools. Enough simply is not being done. There is a need for more publicly hired dentists. I have made the same argument in relation to GPs. I would like to see a public GP contract but for dentists we need to look at that space. Dentists are not engaging with the dental treatment services scheme. There are rights and wrongs on both sides. I have said to dentists and the representative body that there is an obligation on dentists to ensure the most vulnerable patients have access to services. We need to beef up the public system particularly in terms of screening and orthodontists because of the waiting times.
This is particularly the case in the south east where I live, where children are waiting four, five, six or in some cases even eight years. They are listed as urgent cases and the most urgent cases are when children are in pain. There is a lot of work to be done in this area. I acknowledge what the Minister has said but there are so many issues to be addressed.
I agree with the Deputy. At the moment I am trying to develop a programme with Pat Healy in the HSE, who is doing excellent work on a very targeted programme of intervention to get on top of screening in schools and make sure we can address the backlog, particularly in relation to orthodontic work and specialised orthodontic work. I have given a direction to all of the various regions that I expect our new surgical hubs to have a measure of dental capacity in them, whether it is once a month or whatever it happens to be, so that access to theatres is there equally for dentistry in the community and to ensure we have pathways. I acknowledge there is a considerable work to be done and I will bring forward a plan and proposals on this.
I welcome the Deputy's engagement with the dental associations. We do need to hire more public dentists. They have suggested to me that part of the graduation programme could be that qualifying dentists spend a period of time in the public system, something I would greatly welcome. It would give dentists who do not have an opportunity to train in public practice the opportunity to be in public practice. It is too private, too remote and too disconnected from the public health system. If part of the training was that we got the benefit of a graduate spending a year in the public system, I certainly would be very much in favour of that proposal.
4. Deputy David Cullinane asked the Minister for Health her plans for a new cancer strategy; and if she will make a statement on the matter. [17629/26]
This question is on cancer services and the national cancer strategy. We have had two strategies, the one coming to an end and the previous one, and they have added real value and are among the best success stories in the Irish health service. I am blown away by the work people do in this area, with research, development, new technology, new drugs and new treatments. It is mind blowing and it is of benefit to patients. There has been slippage in some of the key performance indicators, KPIs, and some of the access times and wait times. I will go through them later. We should accept any slippage and we cannot afford any slippage. We really need to keep the focus on what has been a real success story for the health service.
I agree with the Deputy. The two strategies have changed the landscape for people who are diagnosed with cancer. Today nearly 250,000 people in Ireland are living with or beyond cancer, 50% more than a decade ago. The evidence is that the chances of survival for more than five years for someone diagnosed with cancer in the 1990s was considerably less than what it is now. This is on foot of the extraordinary work done by clinicians and researchers, and the way in which cancer services are delivered. This has enabled a very considerable shift. Nevertheless, we know we will have more and more people diagnosed with cancer in the years to come. This is because we are living longer and we are diagnosing better, and we need to make sure that the services are available for them, for all of us and for everybody we represent who will face a cancer challenge at some point in their lives, particularly as we live longer.
The Deputy is right to identify the strengths in some of the KPIs as well as the slippages in them. I certainly want to highlight both of these things. One of the reasons we are changing to this regional funding model is so we can have better regional transparency. It is correct that public representatives have the ability to see this regional variation and that there is a pressure linked to the performance framework in relation to the regions achieving the best performance and matching the best performance around the country.
The cancer strategy had 52 recommendations, 43 of which have been delivered or continue to be in the process of being delivered, as will be the case to the end of the strategy. We want to reflect on and evaluate the strategy and its efficacy as we develop a new strategy. What will be very interesting, and where we are open to every suggestion, is how much the world has changed in terms of research and the role AI can play. Some of the extraordinary research being done in Galway, for example, is where they have learned to manipulate cancer cells against themselves and how this works. Treatment has become so individual and personalised. The next cancer strategy can be genuinely ambitious and different again, and I welcome every suggestion relating to it.
We would all accept that early intervention in healthcare is very important, especially for cancer patients, from the first GP referral to a consultant, diagnostics, treatment and surgery. I acknowledge that in some of the areas we are still doing very well but there are areas where there is slippage. Data from 2025 shows that 15% of chemotherapy patients and 21% of radiotherapy patients did not start their treatment on time. It also shows major delays in surgical care, which is concerning A total of 61% of prostate cancer surgeries were not carried out in the recommended time frame, which is the gold standard we all want and we all accept. A total of 45% of breast cancer surgeries and 39% of lung cancer surgeries did not happen in the recommended time frame in 2024 and 2025. There are also issues in relation to diagnostic equipment and radiotherapy equipment. Much of it is out of date, particularly radiotherapy equipment. I see this and hear about it from local representatives and from hospitals. The key issues are staffing and equipment. If we put these in we can improve the areas where we are not doing as well as we should.
The Deputy is right to highlight the variance. It is very different between hospitals. For example, the time for chemotherapy is within 15 days, which is so important. This information has been provided to him. In Cavan hospital, there were 174 patients and 174 of them were seen within 15 days. It was similar in Connolly hospital with 1,717 patients. Naas hospital is at 98%. I do not want to just highlight the good ones and I will pick at random. Tullamore hospital is at 93%, St. James's Hospital is at 91% and Drogheda hospital is at 83%. Then we get to Waterford hospital, which is at 66%, which is the area the Deputy represents. CUH is at 68%. There is variance. Most of the hospitals are concentrated at way over 85% and then there are hospitals such as Portiuncula hospital in Galway, St. Luke's hospital in Kilkenny, CUH, Waterford hospital and St. Luke's Hospital in Dublin, which are at less than 75% and this is not good enough. This is the sort of visibility and transparency we need, and we need to continue to drive to ensure everybody is at a rate of well over 95%. I recognise the variance in this.
One of the benefits of having health regions is that we can have this type of focus, we can drill into the data and we can have real accountability. There are regional imbalances, county imbalances and very localised imbalances. The cancer strategy is a national strategy. We have specialist centres. I want this to be maintained, of course. It is really important. Where the areas of chemotherapy and radiotherapy are a problem, and where we are slipping, we have to fix the problem. From what I can see, part of this is due to equipment being out of date and not having staff to operate some equipment. I have tabled parliamentary questions on this and gone through it in detail. In some places the problem is that we do not have the staff to operate equipment, and somewhere else equipment is not being used because it is out of date, breaking down and needs to be replaced. We have these issues. Surgery is where I think the Minister's own attention is very important. We are seeing slippage in prostate cancer surgeries and breast cancer surgeries. Again, there may well be regional variations but the focus needs to be on where it is slipping and where we are not doing as well. The health regions can add real value from this perspective.
This is very important. We have 58 seconds to have this conversation but it would be good to have a session at the Oireachtas health committee where we can go through all of the various regions and KPIs and recognise the variance. For example, we spoke in December about Galway, where there was a particular challenge. It reported 86% within the target in December, which was up from 68% in November. Local management is so important. Significant additional resources in terms of people and equipment are included in the annual plan and in the capital plan. Sometimes this is the issue and there is a question later on recruitment and replacement when we can deal with this. It is also about local management. Deputy Charles Ward spoke earlier about access to surgery. This is why I am putting in additional oncology chairs and surgical hubs in Letterkenny hospital to make sure there is better access. It is a combination of various things but as long as we are focused on what is different and why it is different, we are all likely to achieve a better and more consistent outcome.
5. Deputy Martin Daly asked the Minister for Health the number of linear accelerators currently in use for radiotherapy services in the State; their age profile, including the number over 20 years old; the recommended replacement age for such equipment; and whether a rolling procurement and replacement programme is in place. [18169/26]
The number of linear accelerators in use in radiotherapy in the State is 22. Following the discussion we have just had about the cancer strategy, will the Minister make a statement on the procurement and replacement programme by the HSE for new linear accelerators? A number of the accelerators are reaching the age of 18 and the recommended international replacement time is eight to ten years. It costs a lot of money to maintain them.
Under the national plan for radiation oncology, an equipment replacement programme is in place in St. Luke's in Rathgar, St. James's Hospital and Beaumont hospital, along with a phased expansion in Beaumont. The replacement programme is being progressed under the national development plan. It is included in the capital plan and the health sectoral plan. There are 23 linear accelerators, ranging in age from three to 18.
These are located across five public hospitals: Rathgar, Beaumont, St. James's, Galway and Cork. State-of-the-art radiation oncology centres opened in Cork and Galway in 2019 and 2023 respectively, representing a €120 million capital investment. The linear accelerators in Rathgar, Beaumont and St. James's were installed between 2008 and 2016. The HSE advises that the typical lifespan of a linear accelerator is ten to 15 years, although some can be used for longer. An accelerator's lifespan depends on many factors, including the type, how it is used, how it is maintained and the manufacturer support lifespan, which includes software upgrades. There is a degree of variance. The preliminary design process for linear accelerator replacements within St. Luke's is ongoing. In addition, tenders for the main contract for the Beaumont phase 2 expansion and replacement project are due in the coming weeks. We are committed to improving cancer care and to investing in this way.
I am asking this question out of concern rather than as a challenge. We heard a presentation from the Irish Cancer Society and Professor Gerry Hanna last week. From the information the Minister is getting from the HSE and from what we are being told, the international standard is to replace a linear accelerator that is being fully used after eight to ten years. The Minister has raised issues around productivity and management of this infrastructure. It appears the procurement process has been held up for the replacement of those older devices, which have been around for 18 years. I believe there are three of these. They will have been in place for nearly 20 years when they are replaced. With regard to the age profile of our infrastructure, it appears we are an outlier within the European Union. It is important that we have an efficient planned rolling procurement process.
I agree with the Deputy. I would like us to be replacing equipment because we have used it so intensively. Part of this issue relates to the number of radiation therapists. There has been a very considerable expansion in that regard. We have 217 radiation therapists in Ireland, an increase of 21% since 2020. In the last six years, the radiation therapy training programme has grown by 32%, with more than 20 additional specialty training posts established in the last three years. We need the people but we also need organisation to allow these machines to be run hard. I will give an example regarding a performance indicator for radiation oncology, that is, the number completing radical treatment and the percentage commencing treatment within 15 working days in the Deputy's own area of Galway. In January 2025, the percentage was 72%, in October it was 98%, in November it was 98% and in December it was 100%. In Cork, there was a fall-off. The figure was 97% in January 2025 but fell to 91%. That is still reasonably strong but nationally we are just not where we need to be. It is about resources, organisation and consistency.
In talking about management and productivity, the Minister will find an ally in me. She has pointed this out very clearly since she began her tenure as Minister for Health. I agree with her 100%. I acknowledge the investment by the Department and the HSE in the linear accelerators in Galway. That is a hugely welcome development but, as the Minister has quite rightly pointed out, the figures for the time between point of diagnosis and getting to chemotherapy are not meeting the targets in the west of Ireland. We should not have that regional disparity. I am getting off the point but the Minister has acknowledged that, which is very honest of her.
With regard to the linear accelerators, it has been expressed to me that part of the problem is a very slow procurement process, especially for those older machines, which have been in service far longer than internationally recommended. I have been told that, when some of the components break down, not only are the machines taken out of operation for up to three weeks, but the replacement components can cost €300,000 to €400,000. In the context of a machine that costs €2 million to €3 million, that seems inexplicable.
I understand the Deputy's point. We want the machines working hard. There is considerable variance. It should not get to 20 years. We have a programme of replacement. The HSE has a key performance indicator target for 90% of patients to commence treatment within 15 working days. The figure for performance nationally is 79%. The majority are exceeding the target. Unfortunately, St. Luke's is consistently below the key performance indicator target. Is that unfair to say? What are the specific reasons for that? Is it a question of disruption to machines, access to radiation or access to management? As public representatives, the Deputy and I are now able to intelligently interrogate the reasons for that and to challenge or support, as appropriate. Because we have the capacity to tell that story rather than speaking in generalised ways, which unfortunately was our wont some years ago, we are able to have a much more detailed conversation and reflect fairly and honestly on the varying reasons for those things.
