Endometriosis affects approximately 10% of women globally, equating conservatively to about 155,000 women in Ireland. Its impact transcends physical pain, often leading to mental health struggles and social isolation.
As we know, Ireland has a lack of Endometriosis medical specialism, with the current Minister for Health publicly conceding recently that we need to do better for Endometriosis patients and further up-skill our surgeons.

As a result of this lack of specialism, Irish women and girls suffering from Endometriosis often face inadequate treatment options in Ireland, resulting in them seeking out consultations and surgeries with Endometriosis specialists abroad. Irish women endure chronic pain and diminished quality of life if they are unable to access the comprehensive care that global leaders in Endometriosis treatment can provide.

The ESAIS (Endometriosis Surgery Abroad Interim Scheme) was designed specifically for Endometriosis and had been welcomed conceptually as the hopes were this would be an improvement on existing schemes. However, many aspects of the scheme put additional roadblocks in place for women travelling abroad for care vs. existing schemes. The main issues with the 1st draft of the scheme are:

It slows down care: Slows down access to care for women
The ESAIS seems like it’s trying to solve for speed of access to services for women but actually potentially slows treatment down further; see more details below

Takes away the patient and GP voices:

The patient’s voice and right to self-advocate, as well as a G.P.’s ability to use their longer-standing partnership with a patient to advocate on their behalf, is eradicated in the scheme

The ESAIS focuses on speed (albeit imperfectly, as above) and reducing some of the financial burdens of patients having to pay for treatment upfront and then get it reimbursed

However, it doesn’t adequately address that a patient might want to seek out treatment abroad for quality reasoning, due to the fact that the care, specialism and multi-disciplinary surgical teams don't exist to the same standard in Ireland

Below are the requested changes that we want made to the ESAIS

Expand the referral criteria:

Requested change:
Patients should be able to be referred using any one of the following pathways:
A G.P. referral letter to the relevant Consultant abroad
A Public Consultant referral letter to the relevant Consultant abroad
A Private Consultant referral letter to the relevant Consultant abroad

Ultimately our request is that the ESAIS will also allow G.P. referrals for consultations and/or treatment abroad, for the reasons outlined above

Current Referral Criteria: “It's for patients who are on a public or private waiting list for endometriosis surgery that a consultant gynaecologist in Ireland recommends for them.”

Add additional x 3 frequently attended/Recommended centres to the Schemes approved list:

Requested Change:
Patients should be able to access a wider range of specialist centres vs. the currently-limited list.

Currently, the scheme has omitted Dr. Konstantinos Kyriakopoulos from the Athens Centre for Endometriosis, Dr. Gabriel Mitroi from the Bucharest Endometriosis Centre, and Dr. Peter Barton-Smith from The Wellington Clinic in the U.K.

We urge the Irish government and HSE to amend the current scheme immediately to include these well-known centres that specialise in Endometriosis

Our Rationale for the change #2:

They (the non-UK centres) are already accessible on other HSE schemes
They are renowned expert Endometriosis centres that hundreds of Irish women have been successfully receiving surgeries in for many years now. Excluding these esteemed centres not only limits the treatment options but prolongs the suffering of patients who already battle long waiting lists and minimal relief from their symptoms.

By integrating these centres into the scheme, the Irish government and HSE can provide a comprehensive, patient-centred approach that acknowledges and nurtures individual needs.

Remove the Criteria That Patients With An Approved Surgery Date Can’t Apply:

Requested Change: Remove the criteria “You cannot apply if you have a date for your surgery in Ireland”

Our Rationale For Requested Change #3: 

Even if patients have a surgery date in the future:
It may be still quite some time away
Surgeries often get cancelled and rescheduled regularly, keeping patients in limbo
As per earlier points, patients might want to seek surgery abroad to have better quality, specialist care i.e. not solely to have a surgery faster than the date they might be able to have a surgery in Ireland