I must now deal with a postponed division relating to the motion regarding endometriosis care in Ireland. On Tuesday, 15 July 2025, on the question, "That the amendment to the motion be agreed to", a division was claimed and in accordance with Standing Order 85(2), that division must be taken now.
Endometriosis Care in Ireland: Motion (Resumed) [Private Members]
The following motion was moved by Deputy Mary Lou McDonald on Tuesday, 15 July 2025:
That Dáil Éireann:
notes that:
— endometriosis is a serious, chronic inflammatory disease that affects the entire body, and it is characterised by severe pelvic pain, infertility, internal scarring (fibrosis), heavy and painful menstruation, and can cause irreversible damage to multiple organs;
— the disease primarily affects organs within the pelvic cavity, including the uterus, fallopian tubes, cervix, bladder, bowel and kidneys, and has also been found in the diaphragm, gallbladder and lungs;
— at least one in ten women in Ireland are affected, with recent global research suggesting that nearly one in six may have symptoms indicative of endometriosis; and
— it takes an average of nine years for patients to receive a formal diagnosis, resulting in prolonged suffering, permanent organ damage, and increased risk of infertility;
further notes that:
— a number of gynaecologists are striving to deliver better care, but are hindered by a lack of critical resources, including access to theatre time, specialist surgical tools and specialised training programmes in the identification and excision of endometriosis;
— for decades, endometriosis care in Ireland has failed thousands of women;
— the management of suspected cases in primary care settings is fundamentally inappropriate and delays essential intervention; and
— international best practice confirms that expert-led excision surgery remains the gold standard for long-term disease management and improved quality of life;
acknowledges that:
— the most recently published Health Service Executive (HSE) guidelines acknowledge that excision is a superior treatment for managing endometriosis;
— the disease's complexity and varied presentation require specialised expertise and training to diagnose and evaluate;
— excision surgery, involving the complete removal of endometrial lesions with clear margins, offers the most effective means of managing the disease, alongside multidisciplinary care; and
— while there is no known cure, expert surgical treatment allows many patients to regain their quality of life and functional health, with the support of multidisciplinary care teams;
recognises that:
— discussion of excision surgery as a superior treatment option in the most recent HSE treatment guidelines is a step forward;
— the HSE's supra-regional endometriosis clinics have less than 25 out of 50 posts filled across both centres;
— the ongoing neglect of endometriosis care in Ireland is emblematic of broader systemic failures in women's healthcare;
— women living with this disease continue to report being dismissed, ignored and traumatised by a health system, which they state, fails to recognise their suffering;
— the current model of care fails to account for the psychological, emotional and social toll of endometriosis, compounding the physical burden of the disease; and
— use of the outdated staging process in HSE guidelines is causing difficulties for patients and clinicians alike, and has recently been abandoned by specialists in the field; and
calls on the Government to:
— establish a state-of-the-art centre of excellence for endometriosis care staffed by multidisciplinary care teams, including specialists in endometriosis imaging, pelvic floor physiotherapy; dietetics, pain management, occupational therapy, endocrinology, fertility management, psychology and surgical specialties, including colorectal, urology and hepatology;
— immediately establish specialised imaging protocols to assist gynaecologists in identifying and mapping deep infiltrating endometriosis;
— provide upfront financial support for diagnosis and excision treatment in designated specialist centres abroad;
— end the current model which places diagnostic responsibility in primary care, and instead implement a fast-track referral system to specialist services, at home or abroad;
— consider replacing the outdated endometriosis staging system with, the Enzian score combined with the Oxford University Innovation Endometriosis Health Profile 30 questionnaire;
— develop and fund a dedicated training and incentive programme to upskill Irish surgeons in identifying the disease during surgery, and in the specialist excision techniques required to remove it; and
— launch a nationwide public health campaign to raise awareness of the diverse symptoms and severe impact of endometriosis, and to challenge the silence and stigma that still surround the disease.
Debate resumed on amendment No. 1:
"recognises that:
— endometriosis is one of the most common gynaecological conditions in Ireland and approximately one in ten women may have endometriosis;
— there is a wide range of symptoms associated with this condition and the burden of disease varies from person to person;
— some women may have endometriosis that goes undetected, while for others endometriosis can have a significant impact on their quality of life; and
— endometriosis is a chronic condition for which there is no definitive cure, many women with endometriosis require long-term care and treatment provided within a multidisciplinary care team;
notes that:
— the Health Service Executive established the National Women and Infants Health Programme (NWIHP) to lead the management, organisation and delivery of gynaecology services in Ireland;
— just over €5 million has been invested in developing endometriosis care and management in Ireland since 2021, and the Programme for Government commits to continue to support specialist endometriosis services;
— new development funding of €543,822 provided in Budget 2024, with full year costs of €2.175 million in 2025 is further expanding and improving these services;
— investment since 2021 has provided for 24.6 whole-time equivalent (WTE) staff;
— services are expanding as recruitment continues for a further 18.6 WTEs with the additional funding provided for this year;
— the recruitment process of these specialised posts will take time to complete;
— Ireland's first National Framework for the Management of Endometriosis, alongside the implementation of structured care pathways is in final development;
— in March 2025, the publication of the National Clinical Practice Guideline: Assessment and Management of Endometriosis, will support the delivery of evidence-based standardised care;
— investment in endometriosis services has provided for the establishment of two supra-regional centres in Tallaght and Cork and five regional hubs, providing specialist services in each maternity network across the country;
— regional endometriosis hubs operate from the Rotunda Hospital Dublin, the Coombe Hospital, the National Maternity Hospital (NMH), University Maternity Hospital Limerick and University Hospital Galway;
— the NWIHP has advised that all regional hub sites are taking referrals and providing treatment pathways for women affected by endometriosis, a specialist endometriosis clinic structure has been formalised in the Coombe Hospital, the Rotunda Hospital, and University Maternity Hospital Limerick;
— women are receiving care through the University Hospital Galway and the NMH regional hubs, while the formal structuring of these defined clinics is in ongoing development;
— endometriosis care is provided through multidisciplinary teams, these include consultant roles in colorectal, urology and radiology, along with women's health physiotherapists, dieticians, psychologists, specialist nurses and healthcare assistants, recruitment for these funded posts is actively ongoing to further expand specialist capacity;
— surgical treatment abroad, under the Treatment abroad scheme, is available when the necessary treatment is not available in Ireland or within the time normally necessary to get this treatment in Ireland;
— women may choose to avail of private treatment abroad; and
— women who opt for treatment abroad will be provided with ongoing care to manage their condition across the public network after they return; and
acknowledges that:
— psychologists play a key role in endometriosis care by helping patients manage chronic pain, emotional distress and the psychological impact of the condition, a psychologist has been appointed to support the supra-regional service at Cork University Maternity Hospital with further expansion of the service under consideration;
— the diagnostic criteria for endometriosis are determined by clinical experts in the field, the clinical guidelines and the framework emphasise individualised woman centred care rather than rigid staging;
— in line with clinical guidelines, general practitioners are encouraged to initiate treatment for suspected endometriosis, where symptoms persist or if symptoms are severe, timely referral to secondary care for laparoscopy is recommended;
— the NWIHP has advised that on average 72 per cent of women waiting on specialist services were seen within six months of referral;
— women affected by endometriosis may also be waiting on general gynaecology waiting lists, as of 26th June, 2025, 79 per cent of women waiting on gynaecology waiting lists are seen within six months and 97 per cent of women are seen within 12 months; and
— improvements in endometriosis care are an integral part of the overall transformation of women's healthcare included in the Programme for Government, 18 ambulatory gynaecology 'see and treat' clinics are currently operational with more in development as part of the Model of Care for Ambulatory Gynaecology, six specialist menopause clinics are currently operational for women who require complex specialist care, six regional fertility hubs will provide support to the estimated 47 per cent of women with endometriosis who will also experience related fertility issues.".
- (Minister for Health)
Amendment put:
The Dáil divided: Tá, 88; Níl, 69; Staon, 0.
Tá
- Aird, William.
- Ardagh, Catherine.
- Boland, Grace.
- Brabazon, Tom.
- Brennan, Brian.
- Brennan, Shay.
- Brophy, Colm.
- Browne, James.
- Burke, Colm.
- Burke, Peter.
- Butler, Mary.
- Butterly, Paula.
- Buttimer, Jerry.
- Byrne, Malcolm.
- Byrne, Thomas.
- Cahill, Michael.
- Callaghan, Catherine.
- Calleary, Dara.
- Canney, Seán.
- Carrigy, Micheál.
- Carroll MacNeill, Jennifer.
- Cleere, Peter 'Chap'.
- Clendennen, John.
- Collins, Niall.
- Connolly, John.
- Cooney, Joe.
- Crowe, Cathal.
- Cummins, John.
- Currie, Emer.
- Daly, Martin.
- Dempsey, Aisling.
- Devlin, Cormac.
- Dillon, Alan.
- Dolan, Albert.
- Dooley, Timmy.
- Feighan, Frankie.
- Fleming, Seán.
- Foley, Norma.
- Gallagher, Pat the Cope.
- Geoghegan, James.
- Grealish, Noel.
- Harkin, Marian.
- Healy-Rae, Danny.
- Healy-Rae, Michael.
- Heneghan, Barry.
- Heydon, Martin.
- Higgins, Emer.
- Keogh, Keira.
- Lahart, John.
- Lowry, Michael.
- Martin, Micheál.
- Maxwell, David.
- McAuliffe, Paul.
- McCarthy, Noel.
- McConalogue, Charlie.
- McCormack, Tony.
- McEntee, Helen.
- McGrath, Séamus.
- McGreehan, Erin.
- Moran, Kevin Boxer.
- Moynihan, Aindrias.
- Moynihan, Michael.
- Moynihan, Shane.
- Murphy, Michael.
- Naughton, Hildegarde.
- Neville, Joe.
- O'Brien, Darragh.
- O'Callaghan, Jim.
- O'Connell, Maeve.
- O'Dea, Willie.
- O'Donnell, Kieran.
- O'Donovan, Patrick.
- O'Meara, Ryan.
- O'Shea, John Paul.
- O'Sullivan, Christopher.
- O'Sullivan, Pádraig.
- Ó Cearúil, Naoise.
- Ó Fearghaíl, Seán.
- Ó Muirí, Naoise.
- Richmond, Neale.
- Roche, Peter.
- Scanlon, Eamon.
- Smith, Brendan.
- Smyth, Niamh.
- Timmins, Edward.
- Toole, Gillian.
- Troy, Robert.
- Ward, Barry.
Níl
- Ahern, Ciarán.
- Bacik, Ivana.
- Bennett, Cathy.
- Buckley, Pat.
- Byrne, Joanna.
- Carthy, Matt.
- Clarke, Sorca.
- Connolly, Catherine.
- Conway-Walsh, Rose.
- Coppinger, Ruth.
- Cronin, Réada.
- Crowe, Seán.
- Cullinane, David.
- Cummins, Jen.
- Daly, Pa.
- Devine, Máire.
- Doherty, Pearse.
- Donnelly, Paul.
- Ellis, Dessie.
- Farrelly, Aidan.
- Farrell, Mairéad.
- Fitzmaurice, Michael.
- Gibney, Sinéad.
- Gogarty, Paul Nicholas.
- Gould, Thomas.
- Graves, Ann.
- Guirke, Johnny.
- Hayes, Eoin.
- Hearne, Rory.
- Kelly, Alan.
- Kenny, Martin.
- Kerrane, Claire.
- Lawless, Paul.
- Lawlor, George.
- Mac Lochlainn, Pádraig.
- McDonald, Mary Lou.
- McGettigan, Donna.
- McGrath, Mattie.
- McGuinness, Conor D.
- Mitchell, Denise.
- Murphy, Paul.
- Mythen, Johnny.
- Nash, Ged.
- Newsome Drennan, Natasha.
- Ní Raghallaigh, Shónagh.
- O'Callaghan, Cian.
- O'Donoghue, Richard.
- O'Donoghue, Robert.
- O'Gorman, Roderic.
- O'Hara, Louis.
- O'Reilly, Louise.
- O'Rourke, Darren.
- Ó Broin, Eoin.
- Ó Laoghaire, Donnchadh.
- Ó Murchú, Ruairí.
- Ó Snodaigh, Aengus.
- Ó Súilleabháin, Fionntán.
- Quaide, Liam.
- Quinlivan, Maurice.
- Rice, Pádraig.
- Sheehan, Conor.
- Sherlock, Marie.
- Smith, Duncan.
- Stanley, Brian.
- Tóibín, Peadar.
- Wall, Mark.
- Ward, Charles.
- Ward, Mark.
- Whitmore, Jennifer.
Staon
Tellers: Tá, Deputies Mary Butler and Emer Currie; Níl, Deputies Pádraig Mac Lochlainn and Denise Mitchell.
Amendment declared carried.
Question put: "That the motion, as amended, be agreed to."
The Dáil divided: Tá, 88; Níl, 69; Staon, 0.
Tá
- Aird, William.
- Ardagh, Catherine.
- Boland, Grace.
- Brabazon, Tom.
- Brennan, Brian.
- Brennan, Shay.
- Brophy, Colm.
- Browne, James.
- Burke, Colm.
- Burke, Peter.
- Butler, Mary.
- Butterly, Paula.
- Buttimer, Jerry.
- Byrne, Malcolm.
- Byrne, Thomas.
- Cahill, Michael.
- Callaghan, Catherine.
- Calleary, Dara.
- Canney, Seán.
- Carrigy, Micheál.
- Carroll MacNeill, Jennifer.
- Cleere, Peter 'Chap'.
- Clendennen, John.
- Collins, Niall.
- Connolly, John.
- Cooney, Joe.
- Crowe, Cathal.
- Cummins, John.
- Currie, Emer.
- Daly, Martin.
- Dempsey, Aisling.
- Devlin, Cormac.
- Dillon, Alan.
- Dolan, Albert.
- Dooley, Timmy.
- Feighan, Frankie.
- Fleming, Seán.
- Foley, Norma.
- Gallagher, Pat the Cope.
- Geoghegan, James.
- Grealish, Noel.
- Harkin, Marian.
- Healy-Rae, Danny.
- Healy-Rae, Michael.
- Heneghan, Barry.
- Heydon, Martin.
- Higgins, Emer.
- Keogh, Keira.
- Lahart, John.
- Lowry, Michael.
- Martin, Micheál.
- Maxwell, David.
- McAuliffe, Paul.
- McCarthy, Noel.
- McConalogue, Charlie.
- McCormack, Tony.
- McEntee, Helen.
- McGrath, Séamus.
- McGreehan, Erin.
- Moran, Kevin Boxer.
- Moynihan, Aindrias.
- Moynihan, Michael.
- Moynihan, Shane.
- Murphy, Michael.
- Naughton, Hildegarde.
- Neville, Joe.
- O'Brien, Darragh.
- O'Callaghan, Jim.
- O'Connell, Maeve.
- O'Dea, Willie.
- O'Donnell, Kieran.
- O'Donovan, Patrick.
- O'Meara, Ryan.
- O'Shea, John Paul.
- O'Sullivan, Christopher.
- O'Sullivan, Pádraig.
- Ó Cearúil, Naoise.
- Ó Fearghaíl, Seán.
- Ó Muirí, Naoise.
- Richmond, Neale.
- Roche, Peter.
- Scanlon, Eamon.
- Smith, Brendan.
- Smyth, Niamh.
- Timmins, Edward.
- Toole, Gillian.
- Troy, Robert.
- Ward, Barry.
Níl
- Ahern, Ciarán.
- Bacik, Ivana.
- Bennett, Cathy.
- Buckley, Pat.
- Byrne, Joanna.
- Carthy, Matt.
- Clarke, Sorca.
- Connolly, Catherine.
- Conway-Walsh, Rose.
- Coppinger, Ruth.
- Cronin, Réada.
- Crowe, Seán.
- Cullinane, David.
- Cummins, Jen.
- Daly, Pa.
- Devine, Máire.
- Doherty, Pearse.
- Donnelly, Paul.
- Ellis, Dessie.
- Farrelly, Aidan.
- Farrell, Mairéad.
- Fitzmaurice, Michael.
- Gibney, Sinéad.
- Gogarty, Paul Nicholas.
- Gould, Thomas.
- Graves, Ann.
- Guirke, Johnny.
- Hayes, Eoin.
- Hearne, Rory.
- Kelly, Alan.
- Kenny, Martin.
- Kerrane, Claire.
- Lawless, Paul.
- Lawlor, George.
- Mac Lochlainn, Pádraig.
- McDonald, Mary Lou.
- McGettigan, Donna.
- McGrath, Mattie.
- McGuinness, Conor D.
- Mitchell, Denise.
- Murphy, Paul.
- Mythen, Johnny.
- Nash, Ged.
- Newsome Drennan, Natasha.
- Ní Raghallaigh, Shónagh.
- O'Callaghan, Cian.
- O'Donoghue, Richard.
- O'Donoghue, Robert.
- O'Gorman, Roderic.
- O'Hara, Louis.
- O'Reilly, Louise.
- O'Rourke, Darren.
- Ó Broin, Eoin.
- Ó Laoghaire, Donnchadh.
- Ó Murchú, Ruairí.
- Ó Snodaigh, Aengus.
- Ó Súilleabháin, Fionntán.
- Quaide, Liam.
- Quinlivan, Maurice.
- Rice, Pádraig.
- Sheehan, Conor.
- Sherlock, Marie.
- Smith, Duncan.
- Stanley, Brian.
- Tóibín, Peadar.
- Wall, Mark.
- Ward, Charles.
- Ward, Mark.
- Whitmore, Jennifer.
Staon
Tellers: Tá, Deputies Mary Butler and Emer Currie; Níl, Deputies Pádraig Mac Lochlainn and Denise Mitchell.
Question declared carried.
Is féidir teacht ar Cheisteanna Scríofa ar www.oireachtas.ie.
Written Answers are published on the Oireachtas website.
Cuireadh an Dáil ar athló ar 10.25 p.m. go dtí 8.47 a.m., Déardaoin, an 17 Iúil 2025.
The Dáil adjourned at 10.25 p.m. until 8.47 a.m. on Thursday, 17 July 2025.