2026-07-09

99. Deputy Marie Sherlock asked the Minister for Health the reason the national lipoedema working group is proposing to exclude surgical intervention from its guidelines on the management of lipoedema; and if she will make a statement on the matter. [52269/26]

108. Deputy Maeve O'Connell asked the Minister for Health for an update regarding the work her Department has undertaken to improve access to care for people living with lipoedema. [47296/26]

My question concerns lipoedema. It is a condition experienced by an estimated 11% of women in this country. We understand a working group was set up in 2023 and was due to report in the second quarter of this year. We have not seen it yet. When will we see that report? I raise significant concern about the outcome of the report, in that the HSE has indicated it relates only to diagnosis and non-surgical management, when we understand surgery should be an important part of the care of these women.

I propose to take Questions Nos. 98 and 108 together. I recognise that lipoedema is a chronic and often very painful condition, which can significantly affect physical health, mobility, quality of life and psychological well-being. It is frequently under-recognised or misdiagnosed. I am very aware of the distress many women experience in seeking recognition, diagnosis and appropriate support. Diagnosis remains challenging as there is no specific diagnostic test. It is based on clinical history and examination by an experienced clinician, with investigations used to exclude other conditions or contributing factors. There is currently no medication or cure as such that we are aware of. Management that appears to be the approach, requiring a holistic, multidisciplinary and person-centred approach. In relation to surgery, the HSE's chief clinical officer has tasked the national clinical programme for plastic surgery with reviewing the evidence. I understand the clinical programme has provided its advice to the chief clinical officer for consideration. I would like to have the opportunity to discuss this with the chief clinical officer in greater detail. I have not had that opportunity in the context of the parliamentary questions and everything else going on. International research continues to evolve, including the LIPLEG trial in Germany examining whether liposuction can provide greater long-term improvements in pain and symptoms compared with complex decongestive therapy alone. That evidence will be important to inform any future updates to the guidance. A working group was established in 2023 to develop a standardised, evidence-based approach for health services but I really want to discuss the matter with the chief clinical officer, recognising the evolving evidence.

Many in the medical community with expertise in this area are of the view that specialised sparing liposuction surgery - there is big distinction from other types of cosmetic liposuction - is the only intervention that can directly address the pathological adipose tissue issues. Many women have to travel to Cyprus and other countries to access those surgical interventions. Serious consideration has to be given to that surgical intervention in Ireland. Some women who believe they have this condition are seeking liposuction in a setting not specific to lipoedema, which is very worrying. We need to make sure we can provide for these women in this country.

I take this opportunity to raise awareness about lipoedema. As Deputy Sherlock said, one in 11 women or girls has it. That is one member of your camogie or football team or two in your leaving certificate class, at least. That is how significant this is. I know the Minister is a huge advocate for women's healthcare. I joined her yesterday in Tallaght hospital for the national women's strategy. We really need to see a strategy and path forward for how we will raise awareness among the public and medical professionals, specifically for early diagnosis, which is so important for early treatment and in preventing this condition from becoming a more severe chronic disease. There are also psychological issues associated with chronic disease, in particular one like lipoedema, which is a physically debilitating and visual disease that women and young girls in particular are very sensitive to.

I thank both Deputies. It is wonderful that so many other Deputies have joined us to hear that lipoedema affects 11% of women. It is a serious chronic disease and, as with many other conditions for women, we have to think carefully about the research available. Yesterday, we launched the third iteration of the women's health action plan. In that we talk about so many conditions that present differently for women. For example, heart failure in women has different symptoms, has been under-researched and under-diagnosed and treatment outcomes have not been as good because of that. We put €2 million in funding this year specifically into women's health research, precisely to identify areas that have been under-researched. Many colleagues here have talked about endometriosis. Lipoedema is just as important. It affects 10% or 11% of women and the impact on lymphedema - the crossover that can happen - is also a significant risk with serious health implications. Women's health has been under-researched and under-diagnosed and there has been a bias in research against understanding women's health as something distinct, important and separate from health generally. We have seen that consistently in the research. It is important we take the opportunity to consider the most contemporary research on lipoedema and that it has the opportunity to feed in at every level. I will discuss it with the chief clinical officer to make sure we have all the best evidence about this condition. Like the Deputies, I know women with lipoedema. There are many of them. Like the Deputies, I want to advocate loudly for women's health generally. I thank them for joining us at the women's health action plan launch yesterday. We must continue to advocate separately and differently against the bias that has existed against women's health and women's health research for so long. I thank Deputies Sherlock and O'Connell for raising the important issue of lipoedema in front of all Deputies today.