Lisa Chambers (Fianna Fail) | Oireachtas source

The Minister is welcome to the House. It is fantastic to hear him going through all of the delivery that has happened for women's health over the past two years. It sounds like he has been doing this for much longer. There has been a huge amount of delivery despite the fact that he was dealing with a pandemic for most of his term of office.

The Minister hit the nail on the head when he spoke about women's experience of feeling not listened to. We often hear the term "gaslighting" whereby women are told something is not wrong with them when they know that is not the case. It is welcome to reiterate our position that we will listen to women and shape our services around what they need.

The work that has been done around menopause clinics, see-and-treat gynaecology clinics, free contraception and trying to reduce waiting lists is all very positive. Waiting lists are probably the number one issue women are raising with us, in terms of the length of time it takes to be seen. I agree with the Minister that the clinicians and doctors working in this space are the best trained in the world. Getting in the door and being seen is the problem. I know the Minister is doing significant work to reduce waiting times. When something is termed an elective procedure, very often people think it may not be necessary. However, the women behind the statistics are often living with chronic and rehabilitating pain and have no quality of life while waiting for much-needed procedures.

I would like to focus on the areas that would be a priority for me. One is an issue I have spoken about for many years, namely, endometriosis. It is an issue close to my heart and Senators in the House will have heard me mention it numerous times. I welcome that we have additional endometriosis clinics, which is great, but there needs to be a greater focus on those at the severe end of the spectrum, namely, those with stage 3 or stage 4 endometriosis who require complex surgery which often involves more than one surgeon operating at the same time. We know for a fact that women are still travelling to the UK, Poland and Romania for such surgery because there is a view among the community that access to the specialist surgery required, namely, excision surgery which, rather than ablation, is the gold standard, is quite limited here. We are doing a good job in treating and providing access to services for women at the milder end of the spectrum with stage 1 or 2 endometriosis. However, those with more severe cases often require surgery on their bowels, reproductive organs, including the uterus, and, perhaps, the rectum, diaphragm and lungs. Such surgery can be lengthy and extensive. It requires theatre time, which can be difficult to secure because three C-sections could be performed within the time it would take a surgeon to perform complex endometriosis surgery. Competition for theatre time has proven to be a challenge in terms of booking surgeries.

In the next phase of dealing with this disease, which affects one in ten women, I ask the Minister to put a particular focus on those at the more severe end of the spectrum and those requiring complex surgery. Ultimately, I would love for no woman to feel she has to travel to another country to get that surgery. We should be the best place, not just in Europe but in the world, to get that surgery. We should have the top surgeons and doctors and provide that treatment here in Ireland. Currently, the view of the people with the condition is that is not the case today. It is something we need to work on.

The Minister has committed to funding IVF for couples and women. I have no doubt he will make the case to the Ministers for Public Expenditure and Reform and Finance in the upcoming budget talks which will kick off this summer. Many of us will have had contact with couples and women who are waiting for this much-needed financial assistance. Without it, they simply will not be able to have a chance of having a family. I ask the Minister, when he enters into budget negotiations, to make it a priority to secure much-needed funding for IVF cycles.

We can do better than three cycles; we should be able to do four or five. We have to ask ourselves whether we should limit the number of cycles. Infertility is considered a disease. Do we limit treatment for other diseases? It depends on what we think is reasonable. Cost will always be a factor. Perhaps the doctors working in this space will have a better idea of what will be a reasonable level of assistance. As it stands, we are an outlier and one of the only EU countries that provides no financial assistance whatsoever to couples facing infertility. Infertility is classed by the WHO as a disease. We can do better on that front. The Minister is committed to delivering for the women and couples who require much-needed fertility treatment.

As I have said, I welcome that the new national maternity hospital has got the go-ahead. I sincerely thank all of the consultants, doctors, midwives, nurses and others working in healthcare who have been involved. Many of them came out in their droves to support the project. They are not public people and did not want to have a public profile, but they knew the project was on the line and because of that, they staked their reputations on defending the project. That is why it is going ahead. I thank them for doing so and articulating the point so well on behalf of women and girls in this country. We could have been waiting another decade to get the hospital started otherwise.