Edward Timmins (Wicklow, Fine Gael)
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84. To ask the Minister for Health the number of operations completed for complex laparoscopy for severe endometriosis to date; and if she will make a statement on the matter. [64607/25]

Edward Timmins (Wicklow, Fine Gael)
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One in ten women in this country are affected by endometriosis, a condition that inflicts immense pain and suffering and is often unspoken about and misunderstood. Can the Minister advise how many operations have been completed for complex laparoscopy for severe endometriosis to date?

Jennifer Carroll MacNeill (Dún Laoghaire, Fine Gael)
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I thank Deputy Timmins. I think it may be closer to one in seven - possibly one in six - women who are affected by endometriosis, rather than one in ten. We are learning more about it together. Our specialist endometriosis services are monitored by the HSE's national women and infants health programme.

At the end of September 2025, 719 specialist endometriosis surgeries had been carried out. The most complex endometriosis surgeries are performed by multidisciplinary teams. Some 263 of the reported 719 surgeries took place in our complex centres in Tallaght and Cork. Surgeries for less complex endometriosis may also be performed in our acute gynaecology services.

I am committed to expanding the scope and standard of our endometriosis services and improving supports for women. In recent weeks, I approved a plan to expedite access to care for women with endometriosis. The HSE will, as a consequence, carry out more than 100 additional surgeries by the end of this year. We expected 1,200 but will instead have 1,300 by the end of this year, an important addition. I have provided an additional €0.5 million directly for this purpose. By way of progress update, in October, 34 additional surgeries had been completed against a target of 33. The majority of these were excision surgeries. Complex and severe cases were prioritised. An additional colorectal surgeon is also being actively recruited to try to facilitate more complex surgical treatments.

On 18 October, I launched the national framework for the management of endometriosis. It is a necessary expansion of services. The HSE’s budget will help to enable expansion and improve all of our services, including endometriosis. We have to increase awareness. I have written directly to all GPs to try to drive awareness where it is not already there and try to drive a better opportunity for women to have referral pathways much more quickly and a presumptive diagnosis, recognising that women are, of course, the most reliable narrators of their own experience and pain.

Edward Timmins (Wicklow, Fine Gael)
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I thank the Minister for the information. I welcome the launch of the first national endometriosis framework and the recognition of the women and girls who have suffered for many years from this condition. I recently met a constituent in my office who has suffered for over 20 years. She has experienced bottlenecks regarding diagnostics. It is very clear that we must acknowledge the pain and impact this condition has brought to the lives of so many women and girls. We need to ensure the framework is actioned without delay. I understand Cork and Tallaght are super hubs. Is this correct? Do all of the surgeries take place in those hospitals? When is it expected that the additional colorectal surgeon will be in place?

Jennifer Carroll MacNeill (Dún Laoghaire, Fine Gael)
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Not all of the surgeries take place in Cork and Tallaght but the most complex ones do. I have expanded a scheme to treat women who require complex surgery abroad. It was the case that they would go abroad and get the funding back via the cross-border directive. We very quickly put in place a scheme whereby people could get funding upfront for such surgery in many clinics in the UK and Europe. I have actively asked clinicians in the HSE to visit two clinics in Athens and Bucharest that women report to me as being very good but which did not meet the criteria in the first instance. We are trying to expand services.

On 1 September this year, I held a patient voice forum in the Department of Health. The Chief Medical Officer, the CEO of the HSE and the chief nursing officer listened to the voices of 60 or 70 women with very complex and painful endometriosis. On 5 September, I put in place a new action plan, drawn up based on the needs of the women at that forum. From 1 October, we had a new plan for additional surgeries in Ireland to be carried out over three months. On 18 October, I launched a framework and plan to support women who are not able to get the scale of intervention they need here, so that they can get that help internationally while we collectively scale up our complexity on imaging and surgeries in Ireland.

Edward Timmins (Wicklow, Fine Gael)
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I thank the Minister. It is obvious that she is making great progress and is giving this the priority it deserves. We must commit to increasing capacity and implementing the visiting consultant model. Bringing internationally recognised experts to operate alongside Irish surgeons would rapidly and affordably expand skills and capacity, which would be far more effective than relying on an overstretched endometriosis surgery abroad interim scheme, ESAIS. This is especially important if the quote of over 100 extra complex surgeries per month is to be met. Over 30,000 women are on waiting lists for complex endo surgeries. To send each abroad at an approximate cost of €20,000 would result in a total cost in the order of €600 million. For operations and treatment to be provided in Ireland under the visiting consultant model would be more cost-effective and have more long-term benefits. This would demonstrate real commitment to the care of women.

Jennifer Carroll MacNeill (Dún Laoghaire, Fine Gael)
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There are not 35,000 people with endometriosis on outpatient gynaecology lists. Approximately 700 are waiting for endometriosis surgeries. An additional colorectal post has been prioritised and advertised for recruitment in Cork University Hospital. The time it will take will depend on the interest generated but I very much hope it will be done as soon as possible.

The Deputy is correct. I do not necessarily want women to be travelling abroad. I would much rather they get surgery here but it is not an either-or situation. I want them to be able to get the right surgery as soon as possible. As we scale up, we must also facilitate women to be able to get the surgery they need. There will be a major conference in January, which will be driven by the Royal College of Physicians and the college of obstetrics regarding endometriosis and the skills available here.

One surgeon, who will remain nameless, offered to travel with her patient to a clinic in the UK to shadow the surgery and better inform herself in order to learn how to provide a better service to her patients. It is that sort of leaning in that I have seen from consultants in recent months who want to provide a service to women, many of whom have advocated for this and want to do more and better for their patients. I was heartened to hear that story from a patient about her surgeon.