About three quarters of radiation machines need to be replaced now or within five years, an analysis by a representative group has found, sparking concerns about “substandard care” for patients.
Last month the Irish Radiation Oncology Advocacy Group submitted a proposal to Government on establishing a national radiotherapy equipment replacement programme, describing the current situation as a “national crisis”.
Radiotherapy is delivered through linear accelerators (LINACs), which have a recommended 10-year lifespan.
There are 23 in the State: five in Cork, four in Galway and 14 across the three Dublin centres (Beaumont Hospital, St Luke’s Hospital in Rathgar and St James’s).
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The advocacy group says 35 per cent (eight machines) are more than 15 years old, with two approaching 17 years old.
Some 40 per cent (nine machines) will require replacement within the next five years, meaning a total of 75 per cent of machines require replacement now or within five years.
This presents “major clinical, operational, and reputational risks”, the group says.
It gave the example of St Luke’s hospital in Rathgar, which in July, had unscheduled downtime on 16 out of 24 working days due to machine breakdowns, and eight of these days had unscheduled downtime of more than one full (nine-hour) working day.
“Machine failures lead to treatment postponements, affecting overall outcome of entire treatment plans, with many studies showing a reduction in cancer cure when there are gaps in treatment,” their submission to Oireachtas members said.
“Equipment suppliers often work on a 10-year technology cycle. Outdated LINACs cannot be upgraded to facilitate modern radiotherapy treatments, therefore patients in Ireland will not be able to access optimum treatment planning. Outdated technology is preventing Irish patients taking part in modern radiotherapy clinical trials.”
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They said it also results in increased costs to the exchequer as well as an eroding trust in the public healthcare system.
“We would not expect patients to accept cancer treatment with the only chemotherapy drugs available being from more than 10 years ago, and likewise patients should receive modern, evidence-based radiation therapy,” the organisation said.
Social Democrats’ health spokesman Pádraig Rice, who raised the issue in the Dáil this week, said machines are “unreliable due to frequent breakdowns”.
“Nationally, a disturbing picture of antiquated unreliable machines, frequent breakdowns and a large proportion of machines reaching the end of their lifespan emerges,” he said.
“The situation in one hospital, St Luke’s in Rathgar, is so bad that it has had to cut its capacity to provide radiation therapy by 25 per cent.”
He said: “This has a serious impact on patient care, which can be delayed, and leads to the State incurring additional and avoidable expense, by having to outsource treatment to private providers.”
In response to a parliamentary question on the topic last week, Minister for Health Jennifer Carroll MacNeill said the roll-out of a replacement programme is expected to be completed “over a five-year-period, and installed by the third quarter of 2030″.
“The scope of the programme includes design, construction works and installation of equipment. The HSE has noted that the linear accelerators will take approximately 22 to 26 weeks each to install,” she said.
“The delivery of this replacement programme is particularly complex, as upgrade works will be required to the buildings and treatment capacity will have to maintained for patients.”
A spokeswoman for the Health Service Executive (HSE) said the design process for the replacement programme is under way.
“It is expected that step one of the procurement process for the works and the equipment supply will commence in quarter one of 2026. Sufficient funding is currently in place to support this project,” she said.
