Jennifer Carroll MacNeill (Dún Laoghaire, Fine Gael)

I propose to take Questions Nos. 87, 97 and 101 together.

I thank the Deputy. Endometriosis has been under-considered by all of us, including the Department of Health and the HSE, but a significant body of work has happened in recent months. I am pleased to say that the national framework for endometriosis is now ready for publication. I am conscious that the budget is next week and we are trying to find the appropriate moment to publish the framework. It has developed and changed considerably, with significant additional patient voices now included. On 1 September, a patient voice forum was held in the Department of Health with 60 to 70 patients, comprising girls and women who were in difficulty or who had had difficulties and had successful surgeries abroad. I was also in attendance, as were the CEO of the HSE, the chief medical officer, the chief nursing officer, the head of the national women and infants health programme, NWIHP, and all of the senior clinical team. We were not there to participate but simply to listen to the women. We were there for quite a number of hours listening to their experiences. Their voices have directly influenced changes in the completed framework. I am glad we had that interregnum to enable their voices to come into that space and be heard. They have directly changed the language and some of the direction in the framework, as well as the communication of it. I am glad that opportunity arose and I thank each woman who shared her personal experience. Following the forum, I mandated an immediate action plan.

On 5 September, I received an initial plan from the Department and officials from NWIHP. On 15 September, the HSE CEO advised that a working group had been established to develop the plan. On 18 September, I updated those who attended the patient voice forum. On 22 September, I approved the revised national framework for endometriosis and a letter for GPs to go alongside that framework to help advance awareness.

On the details of the plan, the HSE will, crucially, increase the number of surgeries to be done this year. Some 600 surgeries were done in the first part of this year so you would expect 600 to be done in the second half of the year. I have required that an additional 100 surgeries will be made available in quarter 4 of this year and have provided funding for those surgeries. Nevertheless, I am conscious of the quality and nature of surgery, which is an issue we can discuss again, and the need to increase surgical skill everywhere. This condition is misunderstood or too little understood everywhere. The increase to surgical skill must happen internationally and also in Ireland. I have also provided funding for an additional colorectal surgeon. That position has been advertised. The role will be an important part of facilitating more complex surgical treatments.

The HSE is also providing additional support for women within the treatment abroad scheme. It has in the past been too difficult for women to access funding to get effective surgeries internationally. I have a little more work to do in that regard to look at the different international programmes that can be supported. I will update the House as soon as I can.

The HSE has created a different email address specifically to assist women with that service to try to streamline their experience within the HSE, which is important. An endometriosis group, with patient advocates and women's health task force members, has been set up. International endometriosis experts will now be invited to collaborate and engage with our own clinicians for better learning, diagnostics and surgical expertise. I yesterday approved a letter to all GPs, consultants and other relevant healthcare professionals to go alongside the framework, which is an effort to raise awareness of endometriosis. It is affecting many women, perhaps as many as one in seven. By that, I do not mean one in seven people but one in seven women. It is just as prevalent as other very common conditions, and should be as prominent in GP surgeries and should be understood by GPs. The HSE has also planned a GP practice update and a specific endometriosis awareness campaign.

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