Pádraig Rice (Cork South-Central, Social Democrats)

I, too, thank Sinn Féin for this motion and for putting a spotlight on this important issue. I also commend the campaigners in the Gallery. They should not have to be here, they should not have to share their stories and they should not have to email their TDs and lay out their pain, but I commend them on their work and their advocacy in respect of this matter. I urge the Minister to take action and ensure we are not back here again.

It is estimated, as we know, that one in ten women and girls may suffer from endometriosis. It affects women and girls from eight to 80. Yet, in the words of the Endometriosis Association of Ireland, "endometriosis is a misunderstood, misdiagnosed and mistreated condition". It is no coincidence that it is women who are being misunderstood, misdiagnosed and mistreated. There is a widespread culture of women's concerns being dismissed, minimised and invalidated within the Irish medical system. This is a cultural problem and an attitude problem, and it needs to change. Women's healthcare for far too long has not been a priority for the State. In recent years, two women's health action plans have been published but they consisted largely of repackaged initiatives that had already been announced or were already in train, and there is no implementation plan alongside the 2024-25 action plan. Publishing glossy plans is all well and good, but delivery is key.

The Minister talked about the national endo framework. It is now two years since the development of the framework was announced. It was due to be published within a year, by April 2024. However, 14 months later, we are still being told the framework is nearing completion. This is the line the Department of Health has rolled out time and again. Obviously, the framework is no panacea, but it is an important step in improving the model of care for endo. Even at the most basic level, it would provide us with proper data on disease prevalence because what gets measured gets managed.

Like others, I want to share some of the stories of those who have come to my office in recent times. Last week, I heard from Dr. Rachel Marie O'Connor, a physician who recently underwent lifesaving surgery for endometriosis. Like so many women, she had to go abroad for treatment. For a decade, Rachel endured excruciating pain because of her undiagnosed endometriosis. She was repeatedly prescribed antibiotics for UTIs. However, Rachel never had a UTI; she had bladder endometriosis. When she eventually got an appointment with a consultant gynaecologist in Ireland, she was told her endometriosis was "too advanced for the Irish medical system". The waiting list was one to three years. As a result, Rachel was forced to travel to Poland for treatment. Once she was there, she discovered the true severity of her condition. Due to a decade of misdiagnosis and mistreatment in Ireland, Rachel's endometriosis had spread beyond her reproductive organs. It turned out that she had been living with multi-organ damage for almost a year and that her organs were failing. In Poland, away from family and friends, Rachel had to have major surgery to save her life. Had her endo been diagnosed and treated earlier, this would not have been necessary. As Rachel herself has said, "No woman should have to leave Ireland—or empty her life-savings—to receive the care her own health service should provide." Like so many women before her, the State turned its back on Rachel, exporting the problem. Rachel is now fighting to ensure that no woman has to suffer the same fate. She has sent the Minister a concise proposal outlining the ways in which early diagnosis, early recognition and referral pathways for endo can improve if the political will exists. I ask the Minister to consider the proposals carefully, and it would be great if the Minister could meet her.

I also received another correspondence from a constituent which I would like to briefly share with the Minister. This is a woman who is just 18. She had been suffering from endo since she was 15. Her pain was often chronic, leaving her bedridden and unable to move. She described it as feeling like her insides were being stabbed. She has attended her GP repeatedly over many years. As she herself said, what she got was an eyeroll and some paracetamol. It was not until April of this year that she finally got a referral to a gynaecologist. This is after four years of debilitating pain as a result of which she missed out on countless days of school and college. When she went to the gynaecologist, one of the solutions proposed was to get pregnant to ease her symptoms. This is unacceptable but it is the reality of care in this country.

Ultimately, we need the framework and we need better care. That starts with better understanding and, crucially, better services.

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