Cancer care in Ireland, a strategy for political action
An academically robust practical tool to turn evidence into delivery for policymakers & politicians.
I recently moderated the launch of the Cancer Dashboard for Ireland by the Swedish Institute for Health Economics (IHE), and it struck me as the kind of work we need more of. It is academically robust, the evidence is clearly cited, but it is written for the people who actually have to make decisions, ministers, advisers, officials, and parliamentarians. It is not trying to win an academic debate. It is trying to improve delivery.
What I value most is the structure. It helps shift the political conversation from the familiar line, “we need to do better”, to the harder and more useful question, “where exactly do we act, and how do we track progress”.
The Dashboard follows the full patient pathway, from prevention and screening through diagnosis, treatment, and survivorship. It benchmarks Ireland so we can see where we lead, where we fall behind, and where progress is stalling. And it points to practical policy levers, from data and workforce to screening uptake, diagnostics, access, and accountability.
If you are trying to communicate with politicians or policy teams, this is a strong example of how evidence can be shaped into something usable.
In Ireland, we have no shortage of plans. We have strategies, targets, and plenty of capable people working hard in the system. But it’s not too often that we evaluate the delivery of these plans, and even less so when it comes to benchmarking them against our European counterparts.
This is where the recently launched Cancer Dashboard for Ireland is different. This “living document” lays it out how we are doing as a country in a way that is hard to ignore. It benchmarks Ireland across prevention, screening, diagnosis, treatment, and survivorship. It also points to the practical policy actions that would make the biggest difference for patients and families.
This is not about adding another report to a shelf. It is about finishing what we started, fixing what is not working effectively, and building a cancer system that is fair, modern, and accountable.
This is a well-researched piece of work by the Swedish Institute for Health Economics. It is academically robust, with evidence clearly cited, yet it is designed for politicians and policymakers rather than academics.
Below are a few aspects of the Cancer Dashboard which stood out for me.
Finish the current strategy properly, then set a better one
Ireland’s National Cancer Strategy 2017–2026 is coming to the end of its life. The Dashboard is clear that we need a transparent, comprehensive evaluation of the strategy, and we need to use the lessons we have learned to shape the next one. Not vague lessons. Real lessons tied to what was delivered and what was not.
The next strategy should be built with patients, clinicians, researchers, and communities at the table. It should set targets that are ambitious but measurable, and it should align with European goals where that helps drive delivery. Just as important, it must be properly funded on a multiannual basis so that we don’t just lurch from one short budget cycle to the next.
Sort out data and digital systems, so we can manage what we measure
If we cannot see what is happening in real time, we cannot fix problems quickly. The Dashboard calls for accelerating the Governments Digital Healthcare Strategy, Digital for Care and introducing unified national electronic health records. That matters for patients, because it means safer care and fewer repeat tests. It matters for those making decisions because it means proper performance tracking.
There is also a blunt point here about money. Ireland does not have official statistics on how much health spending is devoted to cancer, or how it is split across public and private hospitals. That is not good enough. We need systematic reporting of spending by disease area, so priorities are based on evidence and outcomes, not noise and pressure.
Put prevention back at the centre, with real follow through
Prevention is not the glamorous part of cancer policy, but it is where the biggest long-term gains are.
On tobacco, Ireland has made progress, but daily smoking is still far above the national target. The Dashboard points towards stronger public awareness campaigns, education programmes, and continued taxation measures, using the WHO MPOWER framework as a guide.
On alcohol, the Dashboard highlights the need to intensify awareness campaigns and strengthen enforcement of the Public Health (Alcohol) Act 2018 across its provisions. It also flags the need for targeted action where risk is highest, including clear sex-based patterns in harmful drinking.
On HPV vaccination, Ireland is doing better than the EU average, but we are still short of the 90 percent target for girls by 2030 and we have regional gaps. The actions are practical. Better invitation systems, addressing disparities across regions and groups, and delivering catch-up vaccination commitments.
Make screening work for everyone, not just the easy-to-reach
Screening is one of the clearest routes to earlier diagnosis and better survival. But participation is uneven, and some programmes are not meeting targets.
The Dashboard calls for targeted outreach to groups with persistently low uptake across all screening programmes. It also supports expanding breast and colorectal screening age ranges in line with EU recommendations, to maximise early detection.
There is another important transparency point. The Dashboard recommends publishing annual data on stage at diagnosis by cancer type on the National Cancer Registry Ireland (NCRI) website. That is not just a data exercise. Stage at diagnosis is a real-world signal of whether early detection is working, and it should drive timely policy response.
Fix the bottlenecks in diagnosis and treatment
Patients feel delays most sharply at diagnosis and at the point treatment should start. The Dashboard highlights several concrete areas.
(i) Workforce: Ireland has grown its medical workforce over time, but there are gaps in specialist capacity and regional disparities in consultant availability. The policy direction is clear. Expand specialist training, maintain approvals for consultant posts, speed up recruitment and retention, and reduce over-reliance on non-training hospital physicians.
(ii) Imaging capacity and transparency: Ireland’s diagnostic imaging equipment availability is below the EU average, and national data on the number of scans performed are not publicly available. The Dashboard calls for increased investment in CT, MRI, and PET, supported by annual capital planning. It also calls for national performance indicators on imaging access and public reporting of utilisation and turnaround times. If we want shorter waiting times, we need this kind of basic system discipline.
(iii) Biomarker testing and precision oncology: Modern cancer care is moving fast, and biomarker testing is now central to selecting the right treatment. The Dashboard notes that multi-biomarker testing with next-generation sequencing (NGS) has been limited and uneven, and that gaps in infrastructure can block precision oncology in routine care. The recommended actions are to expand national capacity for NGS, monitor uptake in eligible patients, and embed multidisciplinary tumour boards to make genomic expertise part of normal decision-making.
(iv) Comprehensive cancer centres: Ireland has gained its first Organisation of European Cancer Institutes (OECI)-accredited comprehensive cancer centre in 2025 at St. James Hospital, which is a real milestone. But one centre is not a national solution. The Dashboard calls for a national roadmap to upgrade centres and link hospitals through clear referral pathways so patients across the country can access the same standard of integrated care and research capacity.
(v) Access to new medicines, and the fairness question: This is one of the hardest parts of the picture. The Dashboard reports poor performance on the availability and timeliness of reimbursement for novel cancer medicines, and it points to long timelines within the Irish approval processes, when compared to other EU countries. It also warns about equity risks where private health insurers cover some medicines earlier than public reimbursement, pushing us towards a two-tier system.
The policy actions here should not be controversial. The approval system need to comply with the 180-day legal limit for reimbursement decisions and the 225-day benchmark for patient access. Future cancer strategies should put timeliness and availability of medicines into the targets, not leave it as a side issue.
(vi) Radiotherapy equipment and staffing: Ireland has relatively strong availability of radiotherapy machines compared to peers, but the Dashboard highlights that we still do not meet the international benchmark for linear particle accelerator capacity, and that many machines in public hospitals are now coming near their replacement date within a short timeframe.
Treat survivorship as part of cancer care, not an afterthought
Cancer does not end when treatment ends. The Dashboard focuses on two areas where policy choices can change lives.
First, palliative care. Ireland launched a National Adult Palliative Care Policy in 2024, with funding for rollout and a focus on timely, equitable, person-centred care. The Dashboard says the job now is full implementation, strong integration into oncology services, and adequate workforce capacity so access does not depend on postcode.
Second, financial protection and the Right to be Forgotten. Ireland has had a voluntary code for mortgage protection insurance, and the Dashboard describes the move towards legislation to prevent financial discrimination against cancer survivors. The recommended actions are to enact and implement the law in time, educate survivors on their rights, train healthcare staff on confidentiality after remission, and monitor compliance properly.
The bottom line
Ireland has improved survival over time, and that matters. But patients do not live in averages. They live in waiting times, travel distances, staffing gaps, delayed access to medicines, and the stress that lands on the kitchen table at home.
The policy actions in this Dashboard are not abstract. They are specific levers.
We need to evaluate and fund the next strategy properly. Fix data and digital foundations. Push prevention. Raise screening participation and expand age ranges. Build workforce and imaging capacity. Make biomarker testing routine. Grow comprehensive cancer centres. Deliver timely access to medicines fairly. Replace radiotherapy equipment. Implement palliative care. Protect survivors financially.
If we do those things, we will not just talk about better cancer care. We will deliver it.