I thank the Deputy for raising the important issue of endometriosis. It is something that for too long we have not spoken about. There still is not enough awareness of what it is and the challenges and difficulties that women across Ireland face when they have this condition. There are women across Ireland living in severe pain because of endometriosis. There are woman across Ireland who experience heavy bleeding. There are women who have to undertake serious surgery to treat endometriosis, which is very painful and has a long recovery time. There are couples right across Ireland who, because of endometriosis, are facing incredible challenges with reproduction. These are all things that for far too long we have not spoken enough about publicly. We have not raised enough awareness about it. I am really heartened that Deputy Burke has raised the issue here today and that women right across Ireland are speaking out about it and about the necessity to treat it and, more important, to get access for women to treat this condition. That is the most important point. I commend the Minister, Deputy Carroll MacNeill, on tackling this issue head-on and putting it front and centre as something she wants to address. I just wanted to say that at the outset. In 2025 and earlier this year, the Minister engaged directly with women on a one-to-one basis through the patient voice forum and listened to their personal experiences of endometriosis. The national framework for the management of endometriosis in Ireland was published in October 2025. This marks a milestone in the evolution of women's healthcare in Ireland. The framework establishes, for the first time, a defined clinical care pathway for women and girls living with endometriosis. In conjunction with this framework, the Minister has written to all GPs, consultants and other clinicians to raise awareness of endometriosis in their clinical assessments. Moreover, the expansion of endometriosis services provided in Ireland is supported through the HSE's national service plan. Regarding Ryeqo, I will provide some background for our colleagues and then address Deputy Burke's question. Relugolix, estradiol and norethisterone acetate, marketed under the trade name Ryeqo, is a medicine used for the symptomatic treatment of endometriosis in women of reproductive age with a history of medical or surgical treatment for their endometriosis. The European Medicines Agency, EMA, granted marketing authorisation for this product in July 2021. The company marketing this medicine made an application for addition to the HSE's reimbursement list in May 2024. The HSE has statutory responsibility for medicine pricing and reimbursement decisions. HSE decisions on which medicines are reimbursed are made on objective, scientific and economic grounds on the advice of the National Centre for Pharmacoeconomics, NCPE. Formal processes govern applications for the pricing and reimbursement of medicines, and new uses of existing medicines, to be funded or reimbursed. The HSE commissioned a health technology assessment, HTA, in July 2024. Just under a year later, in July 2025, the applicant submitted a full HTA dossier to the NCPE. Further engagement between the NCPE and the applicant has taken place in the interim, and the application remains under consideration. The HSE cannot make any comment on possible outcomes from the ongoing process. The Deputy can see from those milestones that it took considerable time for the State to receive the necessary dossier. We cannot progress reimbursement applications without timely engagement. We strongly encourage all pharmaceutical companies to apply for reimbursement here in Ireland and to submit fully prepared HTA dossiers in a timely fashion.

Sentiment score: 0.09

As I said, the HSE cannot comment on the outcome of this application. That is fair enough. There is a process to go through. I can probably comment more freely. I agree with Deputy Burke. There are obviously different levels of endometriosis but the surgery is costly and painful and there is a long recovery time. I am not a doctor, but the surgery does greatly increase the success rate for reproduction. Nevertheless, endometriosis can come back. If there is a treatment that can prevent that, it should be looked at and it should be accessible. I agree with Deputy Burke in that regard. In fairness, the statement says this is under consideration. The HSE probably cannot comment any further on the outcome, but I agree with the Deputy's request that the result of this application should be made known as soon as possible so that women like his constituent and women right across Ireland know where they stand, and so that we can address this hidden condition, which for too long has meant women have lived in severe pain with excessive bleeding and reproductive challenges, and address it head-on. I again thank Deputy Burke for raising this issue.

Sentiment score: 0.15

I thank Deputy Cooney for representing the people of his constituency in Clare who have been affected by this issue. I appreciate the issue of defective concrete blocks is particularly emotive for households and sympathise with all who are caught up in this distressing situation. The establishment of the appeals board was an important step in offering those affected by decisions made by the Housing Agency and local authorities an opportunity to have their cases assessed by an independent group of industry experts. The chair of the panel and the rest of the panel members have undertaken to examine each case thoroughly. It should be noted that the appeals panel is statutorily independent in the performance of its functions of the senior Minister, Deputy Browne, the Department of housing and the Housing Agency. The Department of Housing, Local Government and Heritage provides administrative support during the initial stage of the process, in that appeals submitted by homeowners are forwarded to the panel. Recently, in recognition of the challenges facing the panel, the Department provided additional funding for the engagement of a direct staffing resource to work directly with the appeals panel chair. I understand this is now beginning to pay dividends, as evidenced by the recent issue of determinations by the panel. The powers granted to the appeals panel are outlined in legislation under section 39(10) of the Act. The appeals panel may either affirm the decision that is the subject of the appeal, or annul it. In the case of an annulment, if the appeals board considers the Housing Agency has made a serious error in law or fact that amounts to a serious or significant error, it can direct the Housing Agency to reconsider its decision in accordance with such directions as the appeals board may consider appropriate, or replace the decision with such other decisions as it considers it appropriate to make in accordance with the Act. Like in any appeals process, there is a continued focus on the further roll-out of determinations. Importantly, in line with statutory commitments, the panel operates within the legislation. The chair and panel must be allowed to continue their work. There is no role under statute for the Minister, Deputy Browne, or me as Minister of State in this regard. We hope that continued engagement with appellants will take place with a view to properly assessing appeals so those who still suffer the awful weight of their experiences can be satisfied. We are aware of the urgency of this work and I recognise the vulnerability of a particular group of homeowners. It is an absolute priority for the Department. It is my understanding that in recent weeks a number of determinations have been issued to homeowners and I expect this process to continue to accelerate as the appeals panel continues its work. The main point is that we have to, at all points, respect the independence of the appeals board. It cannot be under any influence in any way, shape or form from the senior Minister or the Department. However, I take the Deputy's point. He is seeking pretty important and basic information in the specific details he has asked for. I will go back from this discussion to find out if we can get access to any of that information, as long as it does not unduly influence any of the decisions. I do not see why we cannot make that request and get some of the specific answers the Deputy looked for in his opening contribution.

Sentiment score: 0.11

It is my understanding that the appeals panel is aware of the understandable desire of applicants to have their cases dealt with in as expeditious a manner as possible. The time taken to assess appeals has in many cases been longer than originally envisaged. We have to accept that. However, I understand some of the time taken to consider applications and issue decisions has been taken up by requests for further information, either from appellants or other stakeholders. I am informed the panel has taken this approach to allow appellants to have the full facts of their situations properly assessed. A corollary of this inclusive and holistic approach is that it has added time to the overall process. The programme for Government commits to undertaking the planned review of the defective concrete blocks scheme. This refers to the fact that the legislation mandates the Minister to review the scheme within three years of the Act's commencement and the appeals process will form part of this review. The Deputy asked for the specific time it will be published and I will get that information for him. Key here is that we have to keep that independence but time and the access to information are the major issues the Deputy is addressing. We have already given the panel additional resources to get appeals decisions out in a more timely manner. Requests for further information can sometimes take a bit of time with the back and forth. I am sure the people the Deputy represents are so anxious to get their decisions that they will get information to the appeals board as quickly as possible. I do not think there is an issue with that. If it is the case we need to resource the board further, we will look at that. I assure the Deputy I will come back to him on his specific question about the technical review with a specific time. There will be officials listening to this response and they will issue him with information about when it might be expected.

Sentiment score: 0.04