Sorca Clarke (Longford-Westmeath, Sinn Fein)
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116. To ask the Minister for Health the current waiting times for inpatient admission for eating disorder services; her plan to increase the number of inpatient eating disorder beds and to fully resource the model of care; and if she will make a statement on the matter. [24476/25]

Conor McGuinness (Waterford, Sinn Fein)
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This question relates to the waiting times for inpatient admission for eating disorders and plans that are in place, or not in place as the case may be, to increase the number of inpatient eating disorder beds and to properly resource the model of care. We know from the HSE's estimates that there are 1,700 new presentations of people with eating disorders every year. Between 2018 and 2022, those figures show us that of 700 people who presented to the HSE with an eating disorder, only 46 received inpatient treatment. Something is not tallying. What is the plan?

Mary Butler (Waterford, Fianna Fail)
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I thank the Deputy for the question. I was expecting Deputy Clarke.

Eating disorders are complex and individual and can be one of the most serious mental health issues. The national clinical programme on eating disorders is progressing well with 14 of the 16 teams envisaged by the model of care now funded and approximately 100 dedicated eating disorder clinicians working in teams across the country. Approximately 90% of people with eating disorders are treated in the community. Enhancement of eating disorder services is a key priority for me and I have stated my intention to secure funding for the remaining teams in the next budget.

In response to the Deputy's question on inpatient admissions, eating disorders affect a relatively young section of the population and younger people can access 20 dedicated eating disorder beds across the four CAMHS inpatient units.

As of the most recent update available, the waiting list nationally to access beds in CAMHS units, for those aged 18 and under, due to eating disorders was two as of 6 May. For adults, the HSE currently works to meet people’s needs through the provision of general adult mental health beds, by procuring private capacity on a case-by-case basis and through the three specialist eating disorder beds at St. Vincent’s Hospital. As of yesterday evening, no one was waiting to access the beds at St. Vincent's.

A review of adult bed capacity for specialist eating disorder beds is currently under way and the national clinical programme is developing a plan with a geographic spread based on this review. I met with the HSE about eight weeks ago regarding a plan to increase bed numbers organically. We are keen to have a geographical spread of these beds. I expect to receive this plan from the HSE next month. It was promised that I would have it by the end of June.

Conor McGuinness (Waterford, Sinn Fein)
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I thank the Minister of State for the reply. As she outlined, the fact is that there are only three specialist beds and they are in St. Vincent's Hospital. When the current Tánaiste was the Minister for Health, he promised to deliver 20 beds by 2023. He did not promise to deliver them for no good reason. It was understood at that time that there was an urgent need for additional capacity in the system. We must also be realistic here. There might not have been anybody waiting as of yesterday precisely because the HSE is spending €12.5 million annually to send people abroad for treatment. Something we have done far too often in this country is to send women and girls, in particular, abroad for treatment. The statistics bear this out and show it is predominantly an issue affecting women and girls. The question remains as to what the plan is to increase this capacity. While it is appropriate and positive that many people are treated in the community, this is not suitable for everybody. What is the plan to increase capacity?

Mary Butler (Waterford, Fianna Fail)
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To be clear, since this model of care came in, no child under 18 has had to go abroad for treatment. Since 2019, 14 people have gone abroad for treatment under the auspices of the HSE. Other people may have gone under the cover of private healthcare, but we know that 14 people went abroad for very specialised treatment.

Turning back to the Deputy's initial question, there were two phases to the clinical model of care when it was launched in 2019. I suppose the plan was centred on the fact that the HSE and best practice showed the majority of people with an eating disorder are best served in the community. The emphasis was put on the teams being displaced all over the country. As I said, 14 of the 16 teams are funded, with 11 now operational. We will have the 14 teams up and running by the end of the year. Phase 2 concerns the eating disorder beds for adults. We have 20 for children and this capacity is sufficient. We monitor it weekly. I will speak to this aspect in my next contribution.

Conor McGuinness (Waterford, Sinn Fein)
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The other issue, and the Minister of State touched on it, is the number of people opting to go private. Often, parents are putting their hands in their pockets or borrowing money to access care for their children or young adults. It is important for the HSE to do work on this aspect. I understand the Minister of State does not have these figures and that they are not readily available. Whatever means are available and at the HSE's disposal in terms of surveying must be used to find out what percentage of these 1,700 new cases emerging every year are being forced to make the decision to go private because of the lack of capacity in the public system. This is an element that really needs to be looked at. Not only is it perhaps delaying and impacting treatment and creating divisions between the private treatment they are paying for and the other community supports they could return to, it is also putting families under real hardship at a time when people need to get access to urgent care.

David Cullinane (Waterford, Sinn Fein)
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Hear, hear.

Mary Butler (Waterford, Fianna Fail)
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I thank the Deputy for his question. We saw eating disorders grow exponentially during Covid, for example. This was especially the case among younger girls aged 14, 15 and 16. Last year, for example, the eating disorder clinical team worked with approximately 520 young people. Many of those were transferred back to a GP for further support. It is possible to recover from an eating disorder but it is a very difficult process and happens on a case-by-case basis. For some people, it can take up to seven years to recover. One of the challenges we encounter a lot is the transition of a young person who has been receiving the support of a dedicated team while aged under 18 to the adult services. This is an area we are really putting a focus on. It is the reason I am waiting on the plan from the HSE to develop eating disorder beds for adults across the country and to try to increase them organically. We have 64 approved centres round the country and there is absolutely no reason why there cannot be one or two beds with the correct wraparound supports. The support of a dietician here is extremely important.