Dáil Éireann Debate, Tuesday - 15 February 2022
629. Deputy David Cullinane asked the Minister for Health the recommendations of the Women's Health Taskforce for endometriosis patients; his plans for the implementation of those recommendations; the steps being taken to improve the diagnosis, management and treatment of endometriosis; and if he will make a statement on the matter. [7427/22]
View answerImproving women’s health outcomes is a key priority for me and this Government. We made a strong commitment to Promoting Women’s Health in the Programme for Government and are fully committed to the development and improvement of Women’s Health services and to working with women and girls to improve their health across the whole life cycle.
We have made a specific commitment to supporting "the work of the Women’s Health Taskforce, including the development of a Women’s Health Action Plan, to tackle a wide range of issues impacting women’s health outcomes in Ireland". A number of initial priority areas for action were determined by the Taskforce, with the issue of endometriosis recognised and included as part of a priority workstream on improving gynaecological health for women and girls.
The endometriosis workstream identified a number of potential actions in this area, including enhanced services and supports and increased information and awareness. There has been significant work underway to reflect these actions in implementation, including direct investment in services which I will mention in further detail shortly, and a public webinar on endometriosis which was held on November 24th 2021.
Information provided by the HSE indicates that endometriosis is a difficult condition to diagnose and treat because of the variation of presentations, impacting the physical and mental wellbeing of patients at varying levels. Treatment may include pain medications, hormone treatment and surgical interventions. The time to diagnose endometriosis varies by patient due to its varying and ambiguous symptom presentation. The HSE's National Women & Infants Health Programme has advised that the best way to help the majority of patients with endometriosis is to improve access to gynaecology services.
In relation to the treatment of endometriosis, I am advised that a GP referral to a gynaecologist is the standard pathway of care for the management of endometriosis in Ireland. This is similar to the pathway in place for the management of other gynaecological conditions.
The HSE’s National Women & Infants Health Programme has developed a plan to increase capacity and reduce waiting times for women awaiting general gynaecology, which includes patients with endometriosis. The plan aims to re-orient general gynaecology services to an ambulatory, or see and treat, model, rather than the traditional outpatient referral model. An ambulatory care model is a more efficient and effective use of resources. It is also better for the patient as it reduces the requirement for multiple outpatient appointments.
As such, the Programme has developed an Ambulatory Gynaecology Model of Care which centres on the establishment of one-stop “see and treat” ambulatory gynaecology clinics. An ambulatory care model is a more efficient and effective use of resources than the traditional outpatient model and it is also better for the patient as it reduces the requirement for multiple outpatient appointments.
Building on progress made in rolling out these ambulatory gynaecology clinics in 2020 and 2021, funding has been provided under Budget 2022 which will facilitate the establishment of additional ambulatory gynaecology clinics, thereby completing the implementation of the Ambulatory Gynaecology Model of Care. This will bring the total number of these clinics to 20 nationally.
As part of the work of the Women’s Health Taskforce, in April 2021, I announced the expansion of the endometriosis service at Tallaght University Hospital (TUH) to deliver a specialist endometriosis centre for the management and treatment of all forms of endometriosis, with particular focus on advanced and complex cases for which there is no ready access in Ireland.
Further to the above, funding provided under Budget 2022 will enable the expansion of the endometriosis service at TUH as well as the establishment of a new service for more complex endometriosis cases at Cork University Maternity Hospital
The issue of endometriosis has also been highlighted through the nationwide “Radical Listening” exercise carried out by the Women’s Health Taskforce. This exercise enabled women across the country to share their views and experiences of the health sector and health services. This was a large-scale consultation process intended to maximise the participation of women across all life stages from 18 years upwards, including minority and disadvantaged women. 278 women participated in open interviews and workshops. A report on the findings of the ‘Radical listening’ exercise on September 14th can be found here:
www.gov.ie/en/publication/ebe3e-significant-milestone-as-minister-donnelly-publishes-a-report-of-womens-voices-on-womens-health-following-a-radical-listening-exercise-this-year/
