Deirdre Clune (Cork South Central, Fine Gael)
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I thank the Ceann Comhairle for allowing me speak on the important issue of eating disorders. These disorders have become increasingly prevalent, especially among young people. There is a need to provide funding and resources to deal with the problems experienced by individuals and their families who have to face the terrible trauma of anorexia, the more prevalent bulimia and binge eating.

The 2006 report of the expert group on mental health policy, A Vision for Change, estimated that 200,000 persons are affected by eating disorders in Ireland. Each year, a total of 400 new cases emerge and, alarmingly and sadly, these result in approximately 80 deaths. Eating disorders are more prevalent among females in the 15 to 40 years age group. Approximately 4,000 people suffer from anorexia and 15,000 suffer from bulimia. One in ten males suffer from anorexia and bulimia. An estimated 7,000 adolescents currently live with bulimia or anorexia. Approximately 500 of these will die of medical complications or suicide.

Alarmingly and more tragically for these young people and their families, there are no designated public services in Ireland for the management of eating disorders in children or adolescents. The Minister must ensure the provision of appropriate intervention, which is so important, because without the necessary supports, the parents of a young person who has an eating disorder have few options. This is a frustrating situation which makes people angry. Local GPs can do nothing as they have nowhere to which they can refer young people. When a young person deteriorates to a serious extent, he or she is admitted to hospital through the accident and emergency department. We do not want this to happen.

In many cases, eating disorders are caused by low self-esteem and a lack of confidence. Early intervention such as counselling is important, as having someone to talk to can help build up a young person's self-esteem and help prevent full-blown anorexia. Child psychiatrists are non-existent, regardless of whether one is a public health patient or a member of the VHI. Many parents are driven to distraction and have to bombard their GPs and accident and emergency units to get attention for their sons and daughters.

Only three beds are designated in the public health service for persons with eating disorders but they are for patients aged over 18 years. Two eight-bed units operate in the private sector, in St. John of God's Hospital and in St. Patrick's Hospital in Dublin. The turnaround is very slow in this area as it takes a long time to reach recovery and the needs that exist are not being serviced. What is required is a dedicated bed capacity with the establishment of multidisciplinary teams in each Health Service Executive area.

Given that early intervention in this area is so important, we also need significant investment in child and adolescent mental health services. The situation is becoming difficult and alarming. Media reports appear every day about how eating disorders are affecting young people but media images also affect young people. Thankfully, the Madrid fashion council would not accept size zero models but the UK continues to accept them. I shudder to think what size they are.

All these issues have an effect on young people who are bombarded with images by the media, through the Internet and international television. This is a serious issue. There is a sad deficit of public and private services to address the problem of eating disorders. I am delighted the Minister of State with special responsibility for children, Deputy Smith, is present in the House to take on board what I have said and address this issue, but not in terms of A Vision for Change which would take too long to implement. We need services to be provided as a matter of urgency.

Brendan Smith (Cavan-Monaghan, Fianna Fail)
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I thank Deputy Clune for raising this important matter and for the pertinent points she made. I am replying on behalf of the Minister for Health and Children, Deputy Harney.

As Deputy Clune is aware, the report of the expert group on mental health policy, A Vision for Change, was published in January 2006. The report addressed all aspects of mental health services, including services for those with eating disorders. A number of recommendations were made concerning mental health services for people with eating disorders. These include support for health promotion initiatives that encourage greater community and family awareness of eating disorders, the further development of primary and community care services and the provision of full multidisciplinary teams in a national centre for eating disorders for complex cases that cannot be managed by local community mental health teams. Responsibility for implementing these recommendations rests with the Health Service Executive.

The Health Service Executive has established an implementation group to ensure that mental health services develop in a synchronised and consistent manner across the country and to guide and resource service managers and clinicians in making the recommendations a reality. The Government has accepted the report of the expert group as the basis for the future development of mental health services. An additional €26.2 million was allocated for the further development of mental health services in 2006 and a further €25 million was provided in 2007, bringing the total allocation for 2007 to €1 billion.

A total of €7.95 million of the additional 2007 funding has been provided to significantly improve both community and hospital-based child and adolescent services and facilitate the provision of early intervention services. The multidisciplinary nature of existing child and adolescent mental health teams will be enhanced, with eight new teams being developed in 2007. The implementation of A Vision for Change requires the recruitment of 40 additional child and adolescent mental health teams. It is envisaged that these will be provided on a phased basis over a five year period — 16 of which have already been funded.

With regard to specific funding for eating disorders, €750,000 of the additional funding in 2007 was allocated for the development of designated eating disorder services. A total of €500,000 has been allocated to enhance the service in the Elm Mount Unit, St. Vincent's Hospital, Dublin, which will provide a national service to support local mental health services in addressing eating disorders. The balance of €250,000 has been allocated to the Health Service Executive, south area, to commence the development of an eating disorder service. The Health Service Executive also works with the independent sector to provide specialist care on an inpatient or outpatient basis, which can result in referrals to specialised eating disorder services.

An independent monitoring group was established early last year to monitor and assess progress on the implementation of A Vision for Change. The group's first report was published in May 2007. The report acknowledged that 2006 was a year of significant challenge and change for the mental health services. However, in recognising that some positive developments had taken place, the report highlighted a number of issues which would require further attention. These include a systematic approach to implementation of A Vision for Change and clarity in responsibility for implementation in the Health Service Executive.

In acknowledging the need to provide a dedicated and co-ordinated response to A Vision for Change, the Health Service Executive appointed a full-time project manager to progress the prioritised implementation plan. This plan, which will include a timed and prioritised set of short, medium and longer-term goals, is expected to be finalised in the coming weeks.

I assure Deputy Clune the Government is fully committed to the development of services for those suffering from eating disorders and to ensuring that services will continue to be improved and enhanced in the coming years.