Robert Troy (Longford-Westmeath, Fianna Fail)

The multidisciplinary teams will include specialist consultant roles in colorectal care, urology and radiology, along with women's health physiotherapists, dieticians, psychologists, specialist nurses and healthcare assistants. Recruitment for these funded posts is actively ongoing to further expand specialist capacity.

The Minister for Health and the Government are committed to promoting and improving women's health outcomes, including the expansion of specialist services in endometriosis. Our commitment is spelled out very clearly in the programme for Government. I accept some people wish for the five-year programme to be implemented in five or six months but that is not possible.

The HSE's national women and infants health programme has led on the development of the national endometriosis framework and on the expansion of existing endometriosis services. The HSE has advised that it shared an agreed framework with the Irish Medical Organisation, IMO, on 7 July. Alongside the development of specialist treatment centres, work is continuing in education and training, in reducing the threshold for investigations for suspected endometriosis and in raising the index of suspicion, all of which will go towards reducing the time for diagnosis and treatment.

The diagnostic criteria for endometriosis are determined by clinical experts in the field. The clinical guidelines and the framework emphasise individualised woman-centred care rather than a rigid staging approach to determine the extent of disease. GPs are encouraged to initiate treatment for suspected endometriosis and then to refer to secondary care for laparoscopy if symptoms are severe. This referral pathway is the same for all specialist health services in Ireland.

While the national framework for endometriosis is still being finalised before publication, it is important to note that specialist services in the regional hubs and supra-regional sites are operational and taking referrals. The defined clinics in Galway and at the National Maternity Hospital, while accepting referrals, are not yet fully developed to the same level as other hubs. Services are expanding as recruitment progresses for the outstanding posts.

I am advised that most women referred to specialist endometriosis services and gynaecology services are seen within six months. I accept what previous speakers said about this not being the case. The Minister has taken on board the views that were expressed this evening and will look into them further. The services are being continuously expanded as recruitment continues with the funding provided this year. I acknowledge that many of the posts that have been funded are not yet filled. Most of these unfilled posts relate to new funding allocations in 2024 and 2025 to expand our existing endometriosis services. The HSE recruitment process is in progress for those 18.6 recently funded whole-time equivalent posts.

A total of 47% of women impacted by endometriosis will have fertility issues related to the condition. Fertility care has really benefited from targeted investment by the Government. There are now six regional public fertility hubs across Ireland accepting referrals from GPs directly and from consultants. The system ensures early access for women with suspected or confirmed endometriosis, who are exempt from the standard referral criteria. This integrated model allows for streamlined cross-referrals between fertility and endometriosis services, thereby ensuring women receive timely and appropriate care based on individual needs.

The HSE has identified a holistic care package for women suffering from endometriosis. Multidisciplinary teams, including clinical nurse specialists, dietitians, physiotherapists and psychologists, are being funded to provide a holistic service. Other developments in the provision in gynaecology service will support healthcare provisions. Eighteen gynaecology see-and-treat clinics are already operational, with more in development.

Six specialist menopause clinics are currently operational for those women who require complex specialist care in menopause. A total of six regional fertility hubs will provide support to the estimated 47% of women with endometriosis who will also experience related fertility issues.

To support the implementation of the national framework, the HSE has established an endometriosis professional network to help drive a standardised approach to endometriosis service delivery and care. The HSE national clinical guideline for management of endometriosis was also published in March 2025. Training of medical specialists in the management and diagnosis of endometriosis forms an integral part of the specialist medical training programme provided by the Institute of Obstetricians and Gynaecologists.

The Irish College of General Practitioners also provides education regarding endometriosis to its members, including delivering a blended modular course in community gynaecology in which endometriosis is included as a mandatory topic. Endometriosis is also listed as a core component of the women’s health portion of the postgraduate GP training curriculum.

The HSE is planning an awareness campaign following the publication of the framework. This campaign will focus on highlighting the wide range of signs and symptoms of disease and promote the services available and the associated care pathways. The HSE is also developing a comprehensive patient information resource that will be made publicly available online.

As the Minister for Health, Deputy Carroll MacNeill, advised, the programme for Government is committed to continue to expand specialist service in this area. There has been investment of more than €5 million in the provision of these specialised services to build up a national framework and model of care for endometriosis. This is very much the beginning but it is clear from listening to the contributions tonight that more work needs to be done to continue to broaden the support for women suffering from the impact of this life-changing condition.

The Government is committed to promoting and improving women's health outcomes. In recent years, there has been significant investment to improve, reform and stratify our gynaecology services. This process is ongoing and includes the development of gynaecology clinics, specialist menopause clinics, regional fertility hubs and endometriosis clinics. Through the continued implementation and establishment of these services, our model of gynaecological care and the focus on women’s health is being changed for the better to meet the needs of women accessing these services.

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