Women's Health Seanad Éireann — 2026-02-04 ============================================================ Patricia Stephenson (SD), Labour Panel I thank the Minister for coming in. I really appreciate her spending the time on this issue. I know it is an issue she cares about. I am raising it today because I have received significant feedback from many women suffering from endometriosis about the continued challenges they face. I know we have the endometriosis framework and that the endometriosis surgery abroad interim scheme is temporary. However, I fear that, given the state of endometriosis care in Ireland, it is likely to be in place for several years. Patient advocates have expressed specific concerns about the operation of the scheme. I heard from one woman who was refused surgery in Cork due to fear of poor surgery outcome as the clinicians could not sufficiently answer her questions about follow-up care. She was then considered ineligible for the surgery abroad scheme. Women report being scared to go abroad and cannot afford the upfront payments. The administrative burden of filling out the forms is a barrier for many women. I spoke to a woman named Helen who spent €8,700 on surgery in Germany and is still waiting for her reimbursement. Referral for treatment abroad remains a serious concern. Under the scheme, only consultants can refer but, as the Minister is well aware, gynaecologists have huge waiting lists and diagnostic laparoscopies cannot always be fulfilled due to the long lists. There is uncertainty for clinicians about what is required under the scheme. For example, are scans required for referrals? Do clinicians need confirmation of stage 3 or stage 4 endometriosis before referring? I recognise there may be concerns about GPs referring due to a lack of expertise, but can GP referrals be considered in the short-term with targeted training to upskill them? This would greatly reduce waiting times for women suffering from debilitating pain who must often wait years to see consultants. I was deeply disheartened to find out that obstetrics and gynaecology are optional training for GP's despite the fact that women make up 50% of the population. This training should, of course, be mandatory. Women are being forced to go private and pay thousands of euro to travel overseas simply to get a diagnosis. It can take many months to get a scan while they are living with unbearable pain. That is after years of waiting to see a consultant in the first place. It has been reported to me that the locations of the hospitals for the surgery abroad interim scheme seem to have been randomly selected. There is no detail on whether the hospitals selected for the scheme are fit for treating stage 4 endometriosis, for example. Patient advocates have been asking for the inclusion of countries like Greece, which is known for its high-quality endometriosis treatment. Why has Greece been omitted from the list? Patients are frustrated by the lack of understanding around endometriosis. It is still being treated like a gynaecological issue when we know it is a whole-body disease affecting the bladder, bowel and pelvis. Paracetamol and ibuprofen are still being suggested for use as pain management. I recently heard from one woman who went to the emergency room with a burst cyst and who was given paracetamol by means of a drip. I also have serious concerns about fertility options for endometriosis patients. Under HSE guidelines, only cancer patients qualify for egg freezing. While endometriosis patients can get IVF, they have to immediately get pregnant, and this is despite the fact that endometriosis is the most common reason for infertility. I have met patients as young as 15 who are being recommended chemical menopause and women in their late teens and early 20s who have had hysterectomies. Unless they are ready to have a baby immediately, they cannot have their eggs frozen. This is devastating for them. They have to choose between living with excruciating pain and being a mother. For the women who get surgery abroad and finally get some relief from the agony, there is the impossible cost of medicine to keep them pain free. Ryeqo is prescribed to women who have had endometriosis treatment to reduce the growth of internal lesions. It is expensive. It costs about €140 per month and is not available on the drugs repayment scheme. There is a similar drug that is used in the treatment of prostate cancer; it is available. It is really hard for women to trust the system when similar drugs for a particular condition are refundable but those relating to endometriosis involve a significant cost. The optics of the disparity in this regard are incredibly jarring. Will the Minister commit to expanding referral options to include GP's under the treatment abroad interim scheme? Will endometriosis patients be allowed to freeze their eggs through the HSE? Will the Minister include Greece in the approved list of countries under the scheme? Will she make obstetrics and gynaecology training mandatory for all GPs? Will she consider the inclusion of Ryeqo to the drugs payment scheme? --- Source: Houses of the Oireachtas. Licensed under CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). The Official Report is revised after first publication; the fetch timestamp below identifies the version quoted. Record URI: https://data.oireachtas.ie/akn/ie/debateRecord/seanad/2026-02-04/debate/main Retrieved: 2026-08-14T04:54:35+00:00 Sitting date: 2026-02-04