Alan Kelly (Tipperary, Labour)
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385. To ask the Minister for Health the status of the steering committee to develop an integrated service for those with gender identity issues; the number of times it has met; the recommendations it has made; if it was informed of the loss of 109 referrals to the national gender service; and if he will make a statement on the matter. [47335/19]

Simon Harris (Wicklow, Fine Gael)
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In line with international trends, the demand for transgender services in Ireland has increased exponentially over the last number of years.

The development of trans-gender services in Ireland has happened on an ad hoc basis over the last number of years with adult services based in St. Columcille’s Hospital (SCH), Loughlinstown (part of Ireland East Hospital Group – IEHG) and children’s services are located in Our Lady’s Hospital for Sick Children (OLHSC) – part of Children’s Health Ireland (CHI) – in Crumlin. Endocrinology and psychological support services are delivered on both sites.

Given the number of agencies involved in the delivery of care to this group, it was decided to establish a steering committee to develop and enhance governance arrangements across these agencies. Dr. Siobhán Ní Bhriain, National Clinical Advisor and Group Lead for Mental Health in the HSE, chairs this committee. The overarching aim of the committee is to ensure a seamless and integrated service for those presenting with transgender issues, and ensuring the needs of the patient and their families are placed at the centre of service delivery.

The Steering Committee have met on two occasions to date – Thursday July 4th 2019 and Thursday October 16th 2019. The inaugural meeting focused on scoping out the remit of the Steering Committee, developing a Terms of Reference to reflect that responsibility, and developing two workstreams with the following remits:

1. Develop the draft job description for the Child and Adolescent Consultant Psychiatry post, to be located in CHO 7 but with a defined role in OLHSC.

2. Work on developing seamless interfaces between the agencies involved in care delivery.

The work of the Steering Committee remains a work in progress and, to date, a number of potential recommendations have been identified:

1. Move from the current system of psychological support for those under 18 years old to ensure services are provided and delivered by the Irish Health Services;

2. Develop operational and governance arrangements between Child and Adult Mental Health services (CAMHS/AMHS), to be formalised with Standard Operating Procedures and Terms of Reference;

3. Develop local expertise in gender assessment in CAMHS/AMHS nationally in order to support the Hub & Spoke Model outlined in the Model of Care.

The committee aims to have its final meeting in December 2019, after which it will issue a final report and recommendations.

In relation to your query about the loss of 109 referrals I have referred this to the HSE for direct reply.