Shane McEntee (Meath East, Fine Gael)

Before I read a reply on behalf of the Minister of State, Deputy Kathleen Lynch, who cannot be here, I would like to say I am delighted that this issue has been raised by Senator Power. I sincerely hope she does not let it drop. I am aware of the work being done by Ms Teresa Moorhead at the premises mentioned by the Senator. I appreciate that this is a massive issue in Ireland. I have been dealing with it through Ms Joan Barry and her parent support group. I am familiar with girls and young men who have had this problem. Along with my friends, I was able to support such people on a small scale in my former life.

Senator Power was right to say this massive and serious issue is not being dealt with properly. It was raised at our conference last week. I have discussed it with the Minister of State and her predecessor over the past two years. As we prepared to go into government, I worked with the previous Minister of State on this issue. I have no problem with saying the manner in which we treat this issue is totally outdated - it is 100 years behind the times. I expect that the statement I am about to read will not satisfy Senator Power. It sets out where we are today. I know from what the senior Minister, Deputy Fitzgerald, said at last week's conference that we will be tackling it.

I appreciate what the Senator said about the Lois Bridges centre, which is a short-term place. The way forward does not involve putting young girls into psychiatric units like St. Patrick's University Hospital. We need to use outpatient facilities and treat people in hospitals for short periods of time. I know several girls who have gone through Marino and into Lois Bridges. They have come out and gone on to get qualifications. The earlier the intervention takes place, the better. I know of cases involving girls as young as nine, ten, 12 or 13. There is no parish in Ireland that does not have a person with an eating disorder. Deaths have taken place. I have dealt with a family in which one girl has already died and a second girl is in trouble. This issue has to be dealt with and it will be dealt with by people like the Minister of State and Deputy Neville.

I cannot say too much about the funding because I do not have the finer details. We cannot afford to wait before we provide assistance to centres like Lois Bridges. I know Ms Teresa Moorhead is away this week. We told her we would have good news of some shape for her. I am pleased that this matter has been raised by Senator Power today. She should take it from here and not let it go. I have spent years working on these services to get them to where they are today. It is ironic that this matter was handed to me this evening. I assure Senator Power that I will work with her day and night. She knows what it is like for the girls who are dealing with this problem.

I am pleased to be here today and to have an opportunity to speak about eating disorders. The national mental health policy document, A Vision for Change, sets out the framework for the development of mental health services generally. The HSE's services for people with eating disorders are embedded in community mental health teams and primary care. The HSE, with Dublin City University, has developed a mental health in primary care accredited training programme for primary care practitioners. The skills included in this programme are designed to enhance the capacity of primary care to recognise, assess and treat a range of mental illnesses within the primary care setting. As individuals with eating disorders frequently present themselves to primary care practitioners with complications of their condition, early intervention at this level greatly improves outcomes.

Community-based adult mental health services receive referrals from primary care and provide assessment and treatment to individuals with eating disorders. Child and adolescent mental health teams provide a similar role for their cohort of referrals. If the individual's psychiatric or medical needs are more acute, inpatient admission is offered within the local psychiatric services or acute medical care where necessary. Following the recommendation of the consultant psychiatrist, the HSE can and has worked with service providers in the independent sector. I know that has happened in some cases, but it does not happen often enough. The HSE and the independent providers have made specialised care available on an inpatient or outpatient basis. The Senator is familiar with centres like that in Marino.

In a limited number of cases, referrals to specialised eating disorder services in Dublin or the UK can be clinically recommended, and supported in appropriate circumstances, subject to the necessary resources being available. In a case in which a person was at death's door, the former Minister, Mary Harney, provided funding for that person to go to the UK. I would like to remember her on that note. HSE child and adolescent acute inpatient units provide evidence-based treatment to young people who require a period of admission by providing multidisciplinary care with dietetic input. Liaison child and adolescent mental health services in paediatric hospitals provide a specialist input during the young person's admission and co-ordinate a treatment programme that may involve admission to a child and adolescent inpatient unit, or interventions provided by the community child and adolescent mental health services.

The HSE also provides funding to Bodywhys, which is the main voluntary organisation that offers services to people with eating disorders. Bodywhys provides a range of supports to health promotion departments throughout the HSE. This interface provides welcome expertise from the user perspective. The situation with regard to services that are covered by private health insurance is that each private health insurance provider in the Irish market has the right to determine which health care providers they will cover for the benefit of their customers. Health insurers operating in a commercial market must choose the providers they cover. It is a matter for each insurer to determine how much capacity in any particular area is purchased by it to deliver the services required by its members.

I assure Senator Power that despite the economic downturn, she and this House can be assured of the Government's ongoing commitment to the development of mental health services in line with A Vision for Change. I reiterate the thanks I have expressed to the Senator for raising this issue, which is on the Government's agenda and is being dealt with by many people in various Departments. The Senator and I are aware that centres like Lois Bridges could be closed by Christmas. I have no problem saying that such a move would be a death sentence. I do not care who argues with me. The manner in which we are treating this problem at the moment is totally unacceptable, is not the way forward and has to change.