On 18 October 2025, I launched the National Framework for the management of Endometriosis. The Framework sets out for the first time in Ireland a defined clinical pathway for women with endometriosis, which spans primary to secondary care to specialist complex care in tertiary settings.
Central to the Model of Care is the principle of presumed diagnosis, proposing that a woman presenting with symptoms should be treated on the presumption that she has endometriosis.
This model acknowledges that women are the most reliable narrators of their own symptoms and pain and reduces delays in the management of symptoms as well as the overall impact of this disease.
Two supra-regional specialist centres, in Tallaght and Cork, have been established for the management of complex endometriosis cases.
Regional Specialist Centres for moderate cases have been established in the Rotunda, the Coombe, and Limerick, with clinics under further development in Galway and the National Maternity Hospital.
All endometriosis sites are operational and taking referrals. Additional funding was provided in 2025 to expand these services through the recruitment of more personnel to provide multidisciplinary care at both supra-regional and regional level. This includes clinical nurse specialists, dietitians, physiotherapists and psychologists.
Funding of over €5 million has already been invested in endometriosis services between 2021 and 2025.
The HSE has carried out an analysis of the short term and medium-term requirements to build adequate capacity, improve clinical pathways and increase expertise within our endometriosis services. The expansion of endometriosis services in 2026 will be further supported through the National Service Plan.
In addition to the implementation of the Framework, I also mandated several actions to expedite access to care for women impacted by endometriosis. Significant progress has already been made:
• The HSE carried out more than 140 additional surgeries in Q4 2025 for women waiting for surgery.
• An additional colorectal surgeon has been recruited to increase capacity for more complex surgical treatments.
• The HSE Endometriosis Surgery Abroad Interim Scheme was opened on 18 October 2025.
• I have written to all GPs, consultants and other clinicians to further raise awareness of endometriosis.
• A national campaign is in development around menstrual health, including endometriosis.
• An Endometriosis Advisory Group has been established, which includes patient advocates. This group held their first meeting on 30 October 2025 and is meeting on an ongoing basis.
The HSE’s budget for 2026 will be €27.4 billion, an increase of 6.2% on 2025. The National Service Plan 2026 provides for significant expansion and improvement in endometriosis services across our specialist centres in order to implement the pathways of care outlined in the framework.
