Helen McEntee (Meath East, Fine Gael) | Oireachtas source

I thank the Senator for raising this extremely important issue. I know a programme such as the "Dispatches" programme can be very upsetting, particularly for someone with a child with a mental health problem or disability, and even more so for a parent whose child is there. As the Senator said, three young people with mental health problems have been sent over there. I am sure people in Tusla and the disability sector are speaking to the HSE officials who, I know, are over and back quite frequently. They were over in October before the new facility was occupied. They have been over since then and have assured me they have not found any issues with the three young people currently over there. However, it is extremely important we are not complacent and that we ensure the checks and balances we have are up to the highest standard possible.

The HSE is committed to ensuring that all aspects of mental health services are delivered in a consistent and timely fashion. However, on occasion as we know, the presenting clinical need of children is such that current service provision is not in place to address identified need here in Ireland.

Child and adolescent mental health services fall within the secondary and tertiary levels of care provision, based on the increasing severity of the mental health need. Tertiary services provide specialist mental health services for those children and adolescents who have complex and severe mental health problems or who are at high risk of harm. It also includes those with an eating disorder.

The four HSE CAMHS units operate as a national network of inpatient care. Each has a regional remit and co-operates with other units to ensure optimal utilisation of available bed resources. I know we have a difficulty in recruiting staff at the moment which, of course, has a knock-on effect on the ability to use all our beds. We are trying to deal with that.

There is a small group with particularly complex needs who may require a level of specialised intervention not available in Ireland. In such cases, a child or young person may be placed in out-of-State care at a facility abroad, which offers a wider range of treatment options or interventions than those provided in Irish facilities. In such cases, priority is always given to the care of the young person's needs, and placements are made in the best interests of the child.

The HSE operates a treatment abroad scheme for people entitled to treatment, along with associated costs, in another EU state. The scheme is governed by EU regulation, and in accordance with Department of Health guidelines.

The scheme allows a consultant, based in Ireland, to refer a patient normally resident in Ireland for treatment in another EU member state or Switzerland, where the treatment in question meets various relevant criteria as follows. Following clinical assessment, medical evidence must be provided by the referring hospital consultant, giving details of the patient's medical condition, the type of treatment envisaged and the proposed provider of the treatment abroad. The referring consultant, having reviewed the patient in the immediate previous two weeks, must certify that they recommend treatment in another EU or EEA country. The treatment must be medically necessary and meet the patient's needs. The treatment must be a proven form of medical treatment and not be experimental or test treatment. Care must be in a recognised hospital or other institution and under the control of a registered medical practitioner. The treatment must not be available in Ireland or otherwise not available within the timeframe normally necessary for obtaining it in Ireland, taking account of the young person's current state of health and the probable course of the medical condition.

The HSE keeps the needs of young people with mental health issues of greater severity under review, where the treatment abroad is considered necessary and in the young person's interests.

The process of finalising the design brief for the national paediatric hospital is near completion. This will include a 20-bed CAMHS inpatient unit, incorporating an eight-bed specialist eating disorder service. We know the reason that many of our young people are sent abroad is to deal with eating disorders. The provision of a ten-bed adolescent secure unit is part of the planned redevelopment of the national forensic services at Portrane. We hope the contracts will be signed in coming weeks so that we can get moving on that. Such additional service initiatives should assist in providing services not currently available.

Children with difficult life experiences and mental health difficulties require the highest possible standard of multi-agency supports to address specific needs. The HSE is committed to working to ensure this is attained. It is also committed to ensuring that those children who are on the island of Ireland receive the same level of care as those here.