I thank the Leas-Cheann Comhairle and from the outset I congratulate him on his recent election to Leas-Cheann Comhairle. It is great to see him in the Chair. I thank the Deputy for her forbearance. Last Thursday I was not in a position to take the question. I thank her for agreeing to have the debate tonight. I thank the Deputy for raising this important matter in the House this evening. While I cannot discuss the details of an individual case here, I acknowledge what the Deputy has told me and am sorry to hear about this experience. As Deputies will be aware, eating disorders occur in approximately 5% of the population and have long been recognised as one of the most severe of the mental health conditions. We also know that it disproportionately affects adolescents and women. While some people benefit from more intensive treatment through day programmes or inpatient care, research shows the most effective treatment setting is in the community, and this has been the area of focus for recent new investment in eating disorder services. Some 90% of people with an eating disorder are being treated in the community. Enhancements for specialist mental health services such as the national clinical programme for eating disorders is a key priority for myself as Minister of State, the Government as a whole and the HSE. Dedicated investment in eating disorders continues. Last year, the HSE spent over €9 million on eating disorder services under the clinical programmes. It is factually incorrect to say that money is not being spent. The previous year the spend was €8 million. It is ring-fenced funding that has been built on, year on year. Approximately 100 posts are funded under the programme including ten consultant psychiatrists now treating people with eating disorders across the country. The national clinical programme is being implemented by multidisciplinary teams on a phased basis. There are now 11 teams in place, as the Deputy said, six adult teams and five child and adolescent mental health services, CAMHS, teams. Funding was secured for an additional two teams under budget 2025. I also secured the funding for the 14th team last year when there was an announcement of €10 million last February. This means that 14 of the 16 teams envisaged under the model of care are now funded. It takes about a year and a half to stand up a multidisciplinary team. I am delighted to say that one of them, a CAMHS team, is on the way to the mid-west, in Limerick. These are very specialised services. To stand up the team takes some time. It has to be led by a consultant psychiatrist. That means we will have a new CAMHS eating disorder team for the mid-west, bringing the total number of eating disorder teams nationally to 14 out the 16 teams under the model of care. In addition, HSE data indicates that, as the national clinical programme is rolled out, fewer people are needing to access eating disorder services abroad via the treatment abroad scheme. For example, I understand from the HSE that no child under 18 has had to be sent to the UK for treatment of an eating disorder since 2019. We have four different inpatient facilities for eating disorders for those under 18, namely, Eist Linn in Cork, Merlin Park in Galway and Linn Dara and St. Vincent's in Dublin. I am also aware the HSE funds patients in private facilities based on individual clinical need, as assessed by the local mental health team, and the prioritisation of available funding. I will address the beds in my supplementary reply.

Sentiment score: 0.10

The new CAMHS eating disorder team will transform the experiences of adolescents with eating disorders in the mid-west, giving them earlier and enhanced supports and reducing the need for hospital admissions. As I said, there are currently 20 dedicated eating disorder beds across the four CAMHS inpatient units. The Deputy is right to say there are only three adult beds in St. Vincent's hospital. We have done a full bed capacity review of all mental health beds across the whole country. I have asked the HSE to conduct a full review of the national clinical programme. When it was established in 2018, at the time there was an indication that there may be 60 people who might need access to eating disorder extensive supports. I am meeting the lead on eating disorders this week. Last year, the figures show there were 894 referrals. We have seen the issue regarding eating disorders grow exponentially over the past four to five years, especially among young girls aged 15 and 16 with anorexia nervosa. When the model was put in place in 2018, it was envisaged that the best care for young people like that is in the community. A decision was taken at the time to try and put supports across every single community. When I became a Minister of State in 2020, we had one eating disorder team in place. We will have 14 by the end of this year. I have built on it year on year, securing the funding and getting the multidisciplinary teams in place. We will do the next two teams next year, and that is the 16 under the model of care. Notwithstanding that, our focus has to turn to the beds. I would like to see a geographical spread of the beds, not just in the large cities. I met with my HSE officials last week to discuss it.

Sentiment score: 0.13

I congratulate Deputies Sheehan and Quaide on their recent election to the Dáil and I thank them for their interest in all health matters. The Minister for Health has asked me to thank Deputy Sheehan for raising this important matter and for the opportunity to update the Dáil on it. Primary care therapy services, such as speech and language therapy, play a central role in providing care and treatment to children and adults in the community. There have been persistent challenges in recruiting certain grades of health and social care professionals to meet the demands for primary care therapy services and other community-based services, in part due to the lack of availability of suitably qualified candidates. In July 2024 we saw the lifting of the HSE recruitment pause. Each of the six health regions and each national service has been provided with a specified number of whole-time equivalents and can replace, recruit and prioritise staff within that approved number. This has given the health regions further control to focus resources where there is the greatest need and it informs decision-making at local level on the filling of available posts. Specifically, to address the Deputy’s question, primary care speech and language therapy services are provided for the community of King’s Island and the surrounding areas in Limerick from King’s Island primary care centre. I note the Deputy's comments around the area being disadvantaged and the challenges in the local national school. The HSE has advised that the staff grade paediatric speech and language therapist post in King’s Island primary care centre has been vacant since January 2024 due to the resignation of the post holder. Since this post became vacant last year, all new referrals have been and will continue to be triaged by senior speech and language therapists within the north Limerick city network. However, I do have some good news that I am happy to report. Approval has been given for the permanent backfilling of the vacant speech and language therapist post in King’s Island Primary Care Centre. The HSE has advised that this post has been recently accepted from the national staff grade speech and language therapist panel. The HSE has further advised that it will be a number of weeks before the speech and language therapist is in post. However, as an interim measure, it has been agreed that a new graduate grade paediatric speech and language therapist employed through an agency will provide a level of cover at King's Island Primary Care Centre until the post is filled permanently. The Minister fully acknowledges the frustration of those who are impacted by the vacancies in primary care therapy services and agrees that much more needs to be done to address the gaps in staffing and the waiting lists for these services, including speech and language therapy. In that context, it is welcome news that progress has been made to fill this specific post in King’s Island Primary Care Centre. We are all very much aware that early intervention is crucial and I am glad to see that there is a pathway here with both a long-term solution and a short-term solution.

Sentiment score: 0.49

I thank the Deputy. We have had the change from the nine community healthcare organisations, CHOs, to six individual health regions. Each of the six health regions and each national service has been provided with a specified number of whole-time equivalent staff members that they can hire. They can replace, recruit and prioritise staff within the approved numbers they have. By the end of this year, there will be 133,000 whole-time equivalent staff members working across the HSE. That is an increase of over 20,000 staff in the past four years. The health regions have further control to focus resources where there is the greatest need and this informs decisions made at local level on the filling of available posts. They have informed us, which is very good news, that they have given approval for getting the permanent backfilling of the vacant speech and language therapist post. When a post becomes available and the post of the person moving into that post is not backfilled, nothing happens. It is really good news that that post is being backfilled and, in the short term, an interim measure has been agreed that a new graduate grade paediatric speech and language therapist employed through an agency will provide a level of cover at King's Island Primary Care Centre until the post is filled permanently. It is really important that I reiterate that recruitment and retention of these very specialised, dedicated staff has become very difficult. Retention is also an issue. It is a full-time post and it is very welcome that the other post is being backfilled. The HSE is confident that the new person will be in place in a number of weeks. That is very positive and we will keep a close eye on this matter for Deputy Sheehan because it is very important that those children have those vital interventions.

Sentiment score: 0.37