Seanad debates

Monday, 8 March 2021

Nithe i dtosach suíonna - Commencement Matters

Disease Management

10:30 am

Photo of Anne RabbitteAnne Rabbitte (Galway East, Fianna Fail) | Oireachtas source

I thank the Senators for bringing this issue to the floor of the Seanad and giving me an opportunity to address it. My speech is on behalf of the Minister, Deputy Donnelly, but both he and I are acutely aware that the Senators have long been advocates on this issue. I wish to begin by emphasising that the Government is committed to promoting and improving women's health outcomes. That commitment is spelled out very clearly in the programme for Government and has been underpinned by a provision of €12 million in budget 2021 for new developments in maternity and gynaecology services.

As Senator Chambers stated with regard to the current treatment of endometriosis, a general practitioner referral to a gynaecologist is the standard pathway of care for the management of this condition. This is similar to the pathway in place for the management of other gynaecological conditions. I am advised that all obstetricians and gynaecologists are trained in the diagnosis and treatment of endometriosis.

The HSE national women and infants health programme has advised that the best way to help the majority of patients with endometriosis is to improve access to gynaecology services generally. I think all present would agree on that. The programme has developed a plan to increase capacity and reduce waiting times for women for gynaecology appointments. The plan aims to reorient general gynaecology services to an ambulatory or see-and-treat model, rather than the traditional outpatients referral model. The new model of care involves the establishment of one-stop ambulatory gynaecology clinics. These clinics will help to ensure that gynaecology patients receive safe and appropriate treatment, reduce the need for multiple appointments, ensure a more effective use of public funds and, ultimately, improve clinical outcomes. The roll-out of phase 1 of the new model of care commenced last year and I am delighted to confirm that the ambulatory gynaecology clinics in Cork and Galway are now providing services, while it is anticipated that the clinics in the Rotunda Hospital and Waterford will be operational this year. It is important to state that although I have mentioned four hospitals, that is not nearly enough by any manner or means. With the new funding provided in budget 2021, the roll-out of the model of care will be accelerated and additional ambulatory gynaecology clinics will be established this year.

Last year, the women's health task force identified several priority areas for action. In that context, the need to improve services for women with endometriosis was recognised and included as part of a priority work stream to improve gynaecological health for women and girls.The endometriosis work stream identified a number of potential actions in this area, including enhanced services and supports, and the potential establishment of a centre of excellence for endometriosis surgery.

Budget 2021 has also provided a dedicated €5 million health fund to progress a programme of actions arising from the work of the health task force. The Department of Health has engaged with the HSE to identify proposals which could be implemented in 2021 and funded through the women's health fund. A number of proposals are being finalised with stakeholders and it is anticipated that announcements will be made in the coming weeks on the actions which will be supported by the fund. The developments I have outlined underscore this Government's commitment to improving services for endometriosis and gynaecology more broadly.

However, as Senator Chambers says, one in ten is the figure, there are 30,000 on a waiting list, two hospitals are providing the service and two more are due to come on stream in 2021. That is clearly not good enough. It is about education and providing support to our GPs as well. We must get rid of the idea that it is in one's head. There is an issue with that. We need to be able to call that out and give people their lives back.


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