Brian Stanley (Laois, Independent)

I welcome our guests in the Public Gallery. I have heard similar stories to the testimonies from the last two Deputies, and particularly the testimony Deputy Whitmore read out from a woman who wrote to her. It might not have been as long, but snippets. As a man, constituents have told me similar stories about this problem over the years and particularly in recent years. We have to stop exporting our health issues and people for treatment, particularly women in the case of this chronic condition. Not nearly enough attention has been given to it. Proper resources have not been given for the proper treatment of it. People have said this disease is pain like one could not describe in words that affects women’s bodies. It causes severe pelvic pain, affects fertility and can cause scarring. It is very stressful and it has been explained to me very clearly how it exacerbates the monthly cycles. It is unbearable, several women have told me. They have described their own situations and that of their daughters to me. It also causes damage to other parts of the body. It is well documented that it does not just affect the womb and pelvic areas, but other parts of the body as well, including the bowel and the kidneys.

This is a disease that affects 10% of women in Ireland. Surely if something is affecting 10% of women we have to stand up and take notice. It is unbelievable that the average waiting time is eight to nine years and how this has been let run for so many years. Think of all the women of previous generations who have suffered this silently. As the previous Deputy said, this is 2025. This has to stop. We have to try to bring forward proper, expert treatment for this debilitating condition.

Endometriosis can cause infertility. For women and couples trying to have a child, this presents a terrible problem and the woman, unfortunately and wrongly, will often feel under pressure and blame herself because of the condition. Many gynaecologists strive to improve services but there are issues around resourcing.

There is also an issue around theatre time for surgery and specialised treatments. Expert-led surgery is a necessity. We must deal with this area and improve the quality of that service for women. HSE guidelines acknowledge that this is a superior treatment for managing the condition and providing an improved quality of life. While there is no known cure, many women who get proper treatment go on to live a good life when the condition is managed properly and they get the proper care.

Women with this condition have been failed for years in Ireland. I know the Minister mentioned the five hubs but the level of expertise, staffing and timely access are issues. Nine, eight or five years is not good enough. This needs to be done in a matter of months so that women can have treatment once it is properly diagnosed. We have to shorten the time from diagnosis to treatment because nine years is appalling. We need more surgeons in the area. Only 25 out of 50 posts have been filled. Recruitment and retention of surgeons and clinical nurses in the field has to be stepped up and has to be stepped up at pace.

Women often feel they are dismissed when they suffer this disease due to not being able to go to work or social events or just participate in normal family life. This is very distressing for them and some of them have described that to me. The situation regarding fertility creates a problem. We have fertility clinics but waiting times for these clinics and costs are factors. While very welcome changes were brought in in September 2023, not all couples are able to access IVF due to age, weight issues or other circumstances and this needs to be re-examined.

The motion is calling on the Government to establish a state-of-the-art centre of excellence for endometriosis care, to establish specialised imaging protocols to assist gynaecologists in identifying, mapping and getting the information on endometriosis; to develop and fund a dedicated training and incentive programme; and to launch a nationwide public health campaign to raise awareness. Doctors and specialists need to start believing women when they present with this condition because of its chronic nature and the sheer number of women who endure it throughout their lives.

We are talking about women's health and we cannot forget about those women who suffer due to the menopause, which can be an extreme condition for some women. This is often overlooked, particularly for those women who are working and who for many reasons have to take time off or who struggle with mental health during that period. It can be a very emotional time for them and we need to do better for them. I acknowledge and welcome the roll-out of free HRT. I raised the issue with the Minister and her predecessors on a number of occasions. I acknowledge that the Government has introduced it. It is very welcome, particularly for low- and middle-income families and women who might not be able to access it otherwise.

We need a step change and improvements with regard to endometriosis. There is a clear action plan and I urge the Minister and Government to get behind this, so women do not have to go to Romania or anywhere else for treatment.

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