I thank Deputy Fleming for raising the issue of Erkina House. We have been here before. The Deputy has been a long-time advocate for and supporter of Erkina House. It is a key priority for me and for the Government that people experiencing mental health difficulties receive the appropriate level of care they require in the most suitable location in the community which best meets their needs. Achieving this involves reform of mental health services and developing fit-for-purpose community services that will meet people's needs into the future. I have just spent the past two and a half hours in the Seanad dealing with Committee Stage of the Mental Health Bill, and I will be back in there again tomorrow. It is important that we have services that are fit for purpose. Erkina House is operated by the HSE as a fully staffed community mental health residence. The HSE has advised the Department that there are three remaining residents supported at the residence. Erkina House has provided much-needed mental health support to many people over two decades. I acknowledge the care and affection and immense mental health supports provided by the staff there. However, it is not the type of mental health facility we would build today. In that regard, there are documented issues with the configuration of the building as a mental health service. In 2018, a report by the Mental Health Commission inspectorate outlined the need for a significant response to multi-occupancy rooms. This was further recommended by the HSE for the purpose of infection prevention and risk control during the Covid-19 pandemic. The HSE has advised the Department and me that Erkina House would be significantly non-compliant with forthcoming Mental Health Commission community residence standards and that a significant level of investment would be required to develop the facility in order to achieve the additional regulatory standards required. An independent review was commissioned by the chief officer of the HSE midlands-Louth-Meath community healthcare organisation in 2022. The review was completed on the basis of a potential move of services to another location in County Offaly. This is no longer an option being considered by the HSE. The review strongly recommended that the views of residents on their future service provision be the focus of decision-making. A person-centred management model has been implemented by the HSE, which has indicated that the remaining residents wish to move to other long-term care facilities elsewhere in the community. The HSE has advised the Department that this property is not suitable for upgrade and adaptation, and, accordingly, no new admissions to Erkina House will be undertaken. The HSE has provided assurances to the Department as to the service provision being made for the existing residents to properly meet their needs. I will not go over these details on the floor of the Dáil because the number of people involved is so small that the individuals involved would be identifiable. I would be happy to engage with the Deputy offline on that matter. It is important to address the situation with the staff. At present, there are 12 staff based in Erkina House, five nurses and seven multitask attendants. Consultation with staff and their union representatives is planned for later this month to collaboratively negotiate and agree transition plans. This will be informed by the expressed will and preference of the remaining residents on their plans to leave Erkina House to go into further long-term residential care. In my concluding remarks, I will discuss the Deputy's concerns about Rathdowney and south County Laois and how we can work with him on investment in the area.
Sentiment score: 0.22
I understand the strength of the Deputy's feelings. As I said, he has been advocating for Erkina House for many years and also for the residents who live there and who called it their forever home. I understand how difficult it is for residents who have lived in a facility that they will have to move away from for several reasons. The Deputy has accepted that the building is no longer fit for purpose in the context of the provision of mental health supports. It no longer aligns with the mental health policy, Sharing the Vision, and HSE policies, including Time to Move on from Congregation Settings and Design for Mental Health Housing 2015 to 2017. However, I hear him loud and clear in relation to the facility. On many occasions, the HSE has moved out of facilities and they have been left unused. I am very much of the view that every option should be explored. I will make contact with the HSE in the region to see that all options are explored on the future use of the premises. I am conscious of the issues the Deputy raised in respect of the health centre. My first priority is to the three residents at the facility in the context of making sure that they are moved on safely and securely and that they get the long-term residential care they need. My next priority is the 12 staff. This is a time of uncertainty for them. I will request that every effort be made to support the staff as they are relocated. Obviously, this can be a disruptive process for many people. I reiterate that I am happy to work with the Deputy to explore all options for the premises.
Sentiment score: 0.20
I thank the Deputy for raising this important matter. He is quite right that people look at Christmas in different ways. It is a really difficult time For some people. He is also quite right about the unique problems for people with an eating disorder and how they may feel more isolated than ever before. We have a national clinical programme on eating disorders, which has progressed well, with 16 teams funded, 14 teams up and running and the national roll-out having substantially advanced across some of those teams. Dedicated investment in eating disorders continues and the HSE has spent over €9 million annually on eating disorder services under the clinical programme. It is an area I have prioritised since I came into the role in June 2020. That was a time we had one eating disorder team in place and two others funded, so we have made a lot of progress in relation to eating disorder teams in the community. We now have over 100 clinicians working on eating disorder teams, with eight consultant psychiatrists doing phenomenal work. We did see a huge peak in demand during the Covid-19 pandemic, especially young girls aged 15, 16 and 17 presenting with anorexia nervosa. The demand is there. The Deputy highlighted how Christmas can be a particularly challenging time for people with an eating disorder and their families for many reasons. For those living with an eating disorder, the festive season often does not bring the same sense of anticipation as it does for others, and it is important that we acknowledge this. The build-up to Christmas, the changes in routine and expectations around socialising and food can contribute to stress, pressure and conflicted thoughts and feelings for people. It is very important that people with an eating disorder who need help reach out to the range of community supports available to them. These include their own care practitioners including their GP and mental health teams and the eating disorder association Bodywhys, which I want to acknowledge. I am very happy to be able to support Bodywhys through the mental health budget. It does a lot of really important work on the interaction between Christmas and eating disorders. The Deputy mentioned Bodywhys Coping at Christmas guide. For anyone currently supported by an eating disorder team, the HSE has confirmed that all teams will make arrangements with service users and families for days when services are closed. In addition, the HSE Self Care app will have additional guidance on how to manage during Christmas. Bodywhys has developed two excellent guides and a detailed podcast, led by a psychotherapist, with key information for people, families and carers on how to manage at this time of year. I encourage everyone to consult these guides on the Bodywhys website and will share this information with Deputies as needed. Bodywhys has also advised the Department of Health that their virtual support groups will meet as normal in December, and that their helpline service remains open over the festive period with the exception of public holidays. If support is needed on these days, yourmentalhealth.ie has full information on emergency and out of hours supports available, including crisis phone and text support. I also direct people, particularly young people, to our new Navigator mental health support, Ireland’s online tool connecting them to personalised mental health information, resources and support.
Sentiment score: 0.14
The Deputy raised a valid point. The priority over the past few years has been community supports because 90% of people with an eating disorder are treated in the community. It is a very difficult mental health disorder and for many people it takes over their entire life. It can sometimes take up to seven years for recovery and some people relapse. It is very challenging, and I am happy to see the roll-out of the supports. The demand is still very high, and we will continue to do that. In relation to young people under 18 years old with an eating disorder, we have 22 dedicated beds in Cherry Orchard, Dublin, Merlin Park, Galway and Eist Linn, County Cork. The story is not a good when it comes to adults. This is my next focus. We currently have three dedicated beds in St. Vincent's Hospital Dublin specifically for that particular area. We conducted the bed capacity review and I was delighted to work with the Minister for Health, Deputy Jennifer Carroll MacNeill, to secure significant capital investment from 2026 to 2030 sitting somewhere around €400 million for mental health. I have never had that kind of funding available to me before for capital investment. As a result, we will invest in 20 adult beds. We will locat them geographically. From memory, there will be approximately eight to ten beds in the Dublin region, six in the Cork region and another approximately six in the Roscommon region. The reason they are located like that is these are three areas we have identified and approved for building new centres with departments of psychiatry where we will include these beds. The most important thing is that a person does not have to be living in that particular area to access a bed. That is a specific problem we have at the moment with St. Vincent's Hospital. I am really pleased we will be able to move this on. It does take time, but we are certainly making progress.
Sentiment score: 0.13
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Sentiment score: 0.00
I thank Deputy Farrelly for the manner in which he has raised the issue. While acknowledging the challenges in Naas General Hospital, he spoke about this issue being no reflection on the staff and that the level of care being provided is exceptional. I want to acknowledge his work in advocating for the people of Kildare. I did not realise 250,000 people live in Kildare. That is huge population growth. Naas General Hospital is a 202 inpatient and 18 day bed acute public hospital, providing healthcare to over 250,000 people in the growing catchment area of Kildare and west Wicklow. Naas General Hospital caters for patient activity through emergency, inpatient, outpatients and day services departments. The hospital is the sole provider of acute care in the integrated health area and serves a significantly larger population than many of its model 3 hospital counterparts. Naas General Hospital continues to experience sustained pressure across all service areas. From January to October 2025, emergency department attendances have risen by 9% compared to the same period in 2024. Emergency department attendances of patients aged 75 and over have also risen by 9% in this timeframe. The average length of stay for patients aged over 75 is more than twice that of patients aged under 75, compounding pressure on bed capacity and overall patient flow. I acknowledge the fact that the Deputy said 255 people were on trolleys through the month of November. The last thing any of us wants to see are people waiting on trolleys, especially elderly people and those aged over 75. We have invested hugely in home care, day care and meals on wheels to provide as much support as possible to support people in living well in their own communities, but there comes a time when people have to present to hospital and be looked after. The emergency department can be very difficult for an elderly person when it is extremely busy. I want to highlight some of the good work being carried out at Naas General Hospital during these challenging circumstances. From January to October 2025, the median waiting time for all emergency department patients was down 18% compared to the same period in 2024. I accept there is more to be done. The HSE capital plan sets out the planned health infrastructure investment within a given year. Capital investment plays a critical role in enabling and enhancing health service provision. Construction is underway to repurpose and refurbish existing HSE accommodation in St. Mary's at Naas General Hospital to provide short-term accommodation for enhanced community care, the integrated care programme for older people, ICPOP, and chronic disease management services. Naas General Hospital is currently at design feasibility stage for multiple projects, including the conversion of an existing operating theatre and ancillary rooms into two endoscopy procedure rooms, increasing the total number of rooms from one to three. Another project involves a 15-cubicle transition unit for patient admissions and discharges to alleviate emergency department admission pressure. In 2020, Naas General Hospital received a €74 million budget. In 2025, the budget allocation for the hospital rose to €130 million. This investment in recent years is fundamental to supporting the ongoing development of services and ensuring that Naas General Hospital will continue to play an invaluable role in the delivery of health services to the local community in the years ahead. Notwithstanding the almost doubling of the budget between 2020 and 2025, I take on board the points the Deputy has raised. I will be very happy to discuss them with the Minister for Health, Deputy Carroll MacNeill.
Sentiment score: 0.09
You are not.
Sentiment score: 0.00
I thank Deputy Farrelly for raising Naas General Hospital and the challenges we are seeing right across the country at the moment in terms of the surge in presentations, in particular older people, relating to flu. I heard Bernard Gloster, the chief executive of the HSE, say quite clearly on Sunday that if people are very unwell, they need to present to hospital. It is especially true for older people in relation to flu. I will also take this opportunity to encourage people to take the flu vaccine as well. That is really important because we are seeing a huge surge of presentations. I could talk about waiting list initiatives and that but that will not help the Deputy out at the moment. Under the 2025 plan, Naas General Hospital has completed works, including an 11-bed acute medical assessment unit and an emergency department admissions discharge lounge. They were some capital projects that have completed. I take on board what Deputy Farrelly is saying. With the size of the population in Kildare, the fact it is the only model three hospital in that area means there is a huge amount of demand. I will give the Deputy a commitment on the floor of the Dáil that I will speak to the Minister, Deputy Carroll MacNeill, to see what more supports can be provided for the hospital. I look forward to seeing the announcement in relation to where some of this national development plan health capital allocation of €1.56 billion for 2026 goes. I will certainly relay the Deputy's concerns to the Minister.
Sentiment score: 0.17
To be helpful while the official is looking up the exact Standing Order in relation to it, I have discussed with all senior Ministers that I expect, as Chief Whip, that somebody from the Department takes a question. That is why I am here myself taking the previous three health questions. I always try to come in if they are about mental health. Sometimes, it is impossible if a Minister or Minister of State is not available. Deputy Mac Lochlainn said he has seen the Minister of State. We then move to Front Bench cover. My expectation of Ministers is that, where possible, it would be fulfilled by the Minister or a Minister from that Department.
Sentiment score: 0.12
To clarify, Topical Issues are on at 9 o'clock tomorrow morning and I am actually taking one. It is my understanding that the list is already full for the morning so I cannot say whether it would revert to tomorrow or further away. That does not come through me. It comes through the Oireachtas. I cannot state for definite that Deputy Mac Lochlainn's will be taken in the morning.
Sentiment score: -0.04