Erin McGreehan (Louth, Fianna Fail)
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87. To ask the Minister for Health for an overview of the recently launched national endometriosis framework; and if she will make a statement on the matter. [63981/25]

Jennifer Carroll MacNeill (Dún Laoghaire, Fine Gael)
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I thank the Deputy for giving me the opportunity to raise this matter again. It is fantastic to see the amplification and awareness of endometriosis in Ireland. That is part of what the framework is trying to do. We launched the framework on 18 October. I will set out the timeline again. This was in gestation for some period but it was becoming very clear that we were not meeting the needs or responding or perhaps hearing the acuity of what women were describing in terms of their pain, suffering and the impact on their lives. I also have to recognise the very many women in Ireland - I have met and discussed it with them - who received treatment that was absolutely satisfactory for them but perhaps they are at a different level of acuity. For the most complex and severe cases of endometriosis, it was not the case that we were meeting that need. We were not recognising it either in our public awareness of the impact on a person's life in terms of sport, attendance at work, opportunity to look for promotion and to participate in life in a normal way and how that impacts women and girls and can do so for a very long period of their lives. It is also not recognised that many women got surgeries that were successful here but at the more complex end were travelling abroad, paying considerable sums. In many respects they got all or much of that back through the cross-border directive or the treatment abroad scheme but after the fact.

It is not satisfactory to me that women should have had to do that and that the surgeries were not available to them here. Part of what we are trying to do is upskill what we are doing here and the complexity of surgeries. We are recruiting additional colorectal surgeons in Tallaght and Cork to try to enable more complex surgeries. We need to improve our understanding of the diagnostics and imaging. Endometriosis is very difficult to see sometimes. Different types can be very difficult to see. We need to do a lot better on that and upskill more broadly our capacity to do complex surgeries. In the meantime, I want to try to provide women with upfront support to those who need to travel abroad.

Erin McGreehan (Louth, Fianna Fail)
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I am an endometriosis sufferer. It is physically, mentally and emotionally draining. Some days I come into this House and I am in absolute agony. I negotiate how I sit down and I am afraid I am not fit to finish the day. As the Minister knows, our job is demanding. It is people-facing. It feels like a knife-fight is going on inside you quite often. Many women and girls have to tolerate that pain and agony day in, day out. It is chronic and absolutely exhausting. I am grateful for the Minister's work and that it is recognised and that we have a national framework. I feel emotional about it because it is so important. I was diagnosed and I was absolutely alone. There was no space. I am grateful to the Government for recognising women's health is specific and deserves specific frameworks.

Jennifer Carroll MacNeill (Dún Laoghaire, Fine Gael)
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I did not know that. I am sorry I did not. I am so glad the Deputy and I have the opportunity to describe the pain women face every day. As she said, it is like a knife fight inside you and yet she comes to the Dáil, working an extraordinarily demanding job, as everybody here knows. It is exceptionally physically and emotionally difficult and that is just the job. That is on top of all the things we bring to work with us. It has not been understood. The Deputy knows that better than me. She does not need me to explain that to her. I am glad we have a different understanding. I attended a fund-raising last night for a local rugby club and a gentleman came up to me to talk about his 28-year-old who had been in precisely the same situation for a very long time. The impact on women's participation in normal life has to be understood. Teenage girls cannot participate in sport and perhaps cannot sit their exams. There are women who have gone through university, doing phenomenal jobs in the workplace, taking significant periods off and are not able to explain or have that understood by their employer. This impacts women's lives. It is important that it be broadly understood and named. It is a series of cells that can move through the body with exceptional pain right through from pelvis, through the diaphragm up to their shoulders, thoracic region and into women's brains and eyes. It is exceptionally painful. The more we try to explain that pain women have been going through, it will be better understood. It helps me to generate urgency around improvement in services.

Erin McGreehan (Louth, Fianna Fail)
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The Minister is absolutely correct. I ask for mental health supports alongside the framework and fertility education and counselling for women who are not ready to have children. I am blessed that I have four children. I bucked the odds. I am eternally grateful my body was able to do that for me. We need that GP training and dedicated research funding. This is an autoimmune disease. In Ireland, we have quite a lot. Women are more inclined to have autoimmune diseases. We probably do not have a test bed because of the island are. We could be doing clinical trials and looking at research funding for endometriosis and autoimmune conditions in women. I cannot tell the House how important it is to move forward - go big or go home. The Minister is improving women's health and families. When a woman is sick in their home, it impacts the family. When we improve their health, we improve families and communities.

Jennifer Carroll MacNeill (Dún Laoghaire, Fine Gael)
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I will do everything I can do try to drive clinical trials and research. I am launching the clinical trials oversight group this evening. This is an obvious space. It is under-researched more broadly though there is an opportunity for us in France that I might to talk to the Deputy about separately. It is really important that she mentioned fertility. Fertility is inextricably linked to the experience of endometriosis. Many women have not been able to have children, have had to postpone fertility to try to receive endometriosis treatment and there are women trying to work out that intersection. This is why awareness is so important. I have met teenage girls who have had it suggested to them by professionals in the medical system that they have a baby because that would release the symptoms of endometriosis. If it was a once-off case, I would not say it in the Dáil. I have listened to women of different ages, including teenagers, who have been told, go and have a baby; that will fix it. Of course, it will not. I have spoken to women who have had children and it does not necessarily fix it-----

Erin McGreehan (Louth, Fianna Fail)
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I have had four. It does not fix it.

Jennifer Carroll MacNeill (Dún Laoghaire, Fine Gael)
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-----or women for whom it has come as a consequence of pregnancy. Can we just put a line under that now that it never happens ever again in an Irish medical facility that a teenage girl is told to go and have a baby and that will sort her endometriosis?