Marie Sherlock (Dublin Central, Labour)
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79. To ask the Minister for Health her plans to deliver on the previous Government commitment from 2018 to increase the number of specialist public eating disorder adult in-patient beds to 23; and if she will make a statement on the matter. [10127/25]

Marie Sherlock (Dublin Central, Labour)
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My question relates to the 2018 commitment regarding inpatient beds for those with an eating disorder. It is important to say there was a significant amount of hurt at some of the previous comments made by the Minister of State about the need for these beds. We met some of those suffering from eating disorders last week. The reality is that while we very much welcome an expansion of community care, there is a desperate need for an increased number of inpatient, specialist beds for those suffering from an eating disorder.

Mary Butler (Waterford, Fianna Fail)
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As the Deputy will be aware, eating disorders are complex, individualised and are and can be one of the most serious mental health illnesses anybody can go through. As Minister of State, I am firmly committed to improving services for eating disorders in Ireland. The national clinical programme was set up in 2018, and when it was set up it was envisaged there would be approximately 60 people who would require the supports of clinical eating disorder teams. The figure now stands at approximately 600 in the space of seven years. The programme has progressed very well. Some 90% of all people with an eating disorder are treated in the community. Quite rightly, therefore, a decision was made to focus the supports as much as possible in the community. We now have 14 of the 16 teams envisaged by the model of care funded. Eleven of them are in place and one of them actually moved into a new premises last Friday, while three of them are currently in the process of recruitment. Most teams, as I said, are fully operational and seeing people with eating disorders every day. It is also extremely important to point out that there are 100 dedicated clinicians working across all the eating disorder teams in the country, with ten psychiatric consultants. The progress being made is not being acknowledged at all. There was recurring funding of €9 million this year alone for eating disorder teams under this clinical programme. We have two more teams to fund and I hope to do that in next year's budget, with the support of the Minister. Under-18s can access 20 eating disorder beds across the four CAMHS inpatient units. This is very clear. I say this because this has been lost in translation as well. There are 20 dedicated eating disorder beds across four CAMHS inpatient units. Coupled with this, the majority of people presenting with eating disorders are, unfortunately, aged 14, 15, 16 and 17. I will respond during my next contribution concerning the adult beds.

Marie Sherlock (Dublin Central, Labour)
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I look forward to that response from the Minister of State concerning the adult beds. What I am hearing from the initial contribution of the Minister of State is that there is no intention to make good that commitment from 2018 regarding the 20 adult beds. The reality is that it is a very complex psychiatric condition. When we look at the data from the Health Research Board, it can be seen that eating disorders require the longest inpatient stays of all psychiatric illnesses. The reality in this country is that we have outsourced care for some of the most severe eating disorder conditions to the private sector and charities. Some 76% of inpatient admissions for eating disorders are to private facilities and private charity providers. Quite a number of people have to go to England. Now, that is shameful in this day and age. We also know the number of those concerned, especially for the under-18s, has increased by about 43% in a short period between 2019 and 2023 in respect of those requiring inpatient stays. I welcome the 20 CAMHS beds, but there need to be an awful lot more. We do not have sufficient provision for people with eating disorders in this country now.

Mary Butler (Waterford, Fianna Fail)
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Some of the Deputy's information is inaccurate. I have put a major focus on eating disorders. Just to be clear, no child under 18 has had to have treatment abroad since 2019. This is because we now have-----

Marie Sherlock (Dublin Central, Labour)
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We now have the-----

Mary Butler (Waterford, Fianna Fail)
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Please let me answer. We now have the nasogastric tube feeding, which is available in the Eist Linn centre in Cork, in the Linn Dara unit and in Merlin Park. Unfortunately, this is a feature associated with an eating disorder, but we do have this provision. For the past six years, we have spent €1 million annually treating some very complex cases abroad. We also spend money every year on supporting adults with eating disorders in private facilities in Ireland. This is a fact. In relation to the beds issue, I had a review undertaken of all mental health bed capacity. It has taken place and is currently under consideration by the HSE. This includes a review of data on eating disorder bed use in the HSE, in the approved centres, and in private placements and treatment abroad.

Marie Sherlock (Dublin Central, Labour)
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When are we going to see that review? We have been waiting for these beds. They were promised quite a number of years ago now, but we have not seen them. It is good that there is a review, but we need urgency on it. The reality is there are too many people in this situation. It is simply unacceptable that the State is spending money on sending people suffering with this condition abroad. We need to be providing for these individuals here. This is particularly the case given the length of inpatient stay required for many of these individuals.

Mary Butler (Waterford, Fianna Fail)
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Many people choose to use the treatment abroad scheme themselves. They actually choose to use it. We have to be fair. People do choose to use the treatment abroad scheme.

Marie Sherlock (Dublin Central, Labour)
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No, they do not.

Mary Butler (Waterford, Fianna Fail)
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I am expecting-----

Marie Sherlock (Dublin Central, Labour)
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All the people I have spoken to did not choose to-----

Mary Butler (Waterford, Fianna Fail)
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Does the Deputy want me to answer her question or does she want to heckle me? It is up to her.

John McGuinness (Carlow-Kilkenny, Fianna Fail)
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The Minister of State without interruption.

Mary Butler (Waterford, Fianna Fail)
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I expect to receive a plan from the HSE regarding future eating disorder bed provision very shortly. Yesterday, I met Dr. Michelle Clifford, clinical lead, and Dr. Amir Niazi, national clinical adviser and, on Monday, I met Bernard Gloster, the CEO of the HSE, to discuss this specific issue. I have had four priorities since I was reappointed. I thank the Minister for my delegated functions this week. These priorities include the CAMHS waiting list, the adult beds and the Mental Health Bill 2024, which I hope to bring to Committee Stage in the Dáil next month.

In relation to the eating disorder beds and the Deputy's earlier comments, what I said was that the review was specifically looking at the fact that 90% of all eating disorders are treated in the community and we may not need the 20 beds.

That is the whole purpose of the review and the report on it, which I await. The spread of the beds will be geographical; they will not just be located in Dublin.