Women's Health Seanad Éireann — 2026-02-04 ============================================================ Jennifer Carroll MacNeill (FG), Dún Laoghaire The Senator raised quite a number of issues. I suspect that she and I have spoken to many women who have many of the same issues. We must recognise that endometriosis is a whole-system condition, but it does in many cases start from a gynaecological position as well. We have to acknowledge both of those things. We are very much trying to move the dial in terms of how it is understood and described. That is why the framework has been advanced beyond where it started out to really try to recognise, as the Senator said, that this is a whole-system condition for many women, although not all, and that it impacts maybe one in six women. It is a very common condition indeed. I launched the national framework for the management of endometriosis on 18 October. It is the first time that we have had such a framework. It gives a presumptive diagnosis background for GPs rather than their having to articulate and advance an argument. It gives a presumptive diagnosis basis, which is an enormous step forward for people on a pathway to get proper specialist care in the regional centres. Let me speak about the endometriosis surgery abroad interim scheme, ESAIS, scheme in particular, because there are a couple of important pieces in respect of that. We created the scheme specifically because we did not want women to have to pay upfront in the way they have done for either the treatment abroad scheme or the cross-border directive where they can be reimbursed. I recognise that, first, the treatment they were looking for was not necessarily available in Ireland and, second, it was too expensive to try to pay for that upfront. It is really important to understand that. The only way we could legally set up a scheme is that it is absolutely essential that it is a temporary scheme to meet a need we cannot meet today while we are on a pathway to meeting that need clinically. Otherwise, the scheme would not survive. It has to be understood that it has to be temporary and time limited. As a result, it is limited to two years. We have an enormous body of work to do in order to try to upskill and advance imaging and surgical options here. I am pleased to say that work in this regard is progressing. For example, there have been a number of different study abroad opportunities. We are creating fellowships for surgeons to do much more detailed work. The Royal College of Physicians of Ireland around the corner is having a dedicated day on endometriosis in March. This is a big step forward for the clinical community, which had not previously recognised endometriosis at that level before. The Royal College of Surgeons in Ireland is also leaning in. There has been a very big change in the clinical community's understanding of endometriosis and their commitment to upskilling, imaging and surgery options. Again, the criteria for this scheme must be tightly set. It is not that we are selecting countries or clinics at random. We are looking for specific accredited lists. The British Society for Gynaecological Endoscopy and the European Endometriosis League both provide specific clinical criteria. The clinic in Greece that the Senator mentioned is not on that list, which is why it is not part of this scheme, but we have asked clinicians to visit the clinic to see whether it meets the standards and the reason is as follows. As before, consultants were reluctant to recommend that women get their treatment abroad because they could not stand over and verify it. We are now saying to them that we have done that for them based on these internationally accredited lists and therefore, this clinic is fine and they do not have the option any more. We are telling them they should be comfortable referring to a clinic because it is against a measurable list. Greece and Romania were not on the list but we have tried to take extra steps to see if they can meet the standards. Some will and some will not but unless we keep within the criteria of the scheme, the scheme itself cannot survive. That is why this is so important. We are trying to do something very different. We have never created a scheme like this. We are creating it to try to meet a need. In many cases, there are women availing of this already and we are trying to do our best to make sure that women are supported in every way but we do operate within certain constraints. I appreciate that I have not answered all of the questions but I have run out of time and will answer if I have another opportunity. --- 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