I thank the Taoiseach. His time is up. We must proceed to Deputy Joan Collins on behalf of the Independent Group.

There is an ongoing crisis in our mental health service for children and young adults. There are 3,900 young people on waiting lists, up 40% in the past year. One would imagine that for the HSE, this would require an urgent response to increase services but, quite incredibly, the HSE has announced a national cut in services, with the closure of almost half the beds in the Linn Dara facility in Cherry Orchard. Linn Dara is a key facility for child and adolescent mental health services, CAMHS, nationally, and for the greater Dublin area and counties Wicklow, Kildare and Louth, in particular. The HSE has stated these bed closures, a reduction of 11 beds, from 24 to 13, is a consequence of shortages of qualified staff. The CAMHS unit in Cherry Orchard should have 51 nurses. It has only 24. There is an ongoing problem with recruitment and retention in the health service as a whole. We have heard this from the medical scientists. The Psychiatric Nurses Association, PNA, has described the bed closures at Linn Dara as a consequence of poor planning by the HSE. The PNA has pointed out that similar closures took place five years ago in 2017, but it seems nothing has been learned since then.

Mental Health Reform, a national coalition of groups concerned with mental health issues and services, has called for the reinstatement of a national director on mental health to report directly to Mr. Paul Reid, the CEO of the HSE. It has stated this post is essential to ensure proper oversight and leadership in the improvement of mental health services nationally.

In 2006, A Vision for Change was adopted as a Government policy to transform these services. A Vision for Change called for 100 beds to be available. We now have just 56 beds nationally following the closure of the Cherry Orchard facility. Mental Health Reform has also pointed out that these reductions in beds could mean that children may end up being admitted to adult mental health treatment units, which would be in contravention of their human rights. The reductions will mean young people will face increasing difficulties in accessing care in a situation where long delays can have a devastating effect on families and children in need of early intervention.

What has happened makes a mockery of the Sharing the Vision policy, which followed A Vision for Change. There is a need for urgent action. The reduction in beds and overall service at the time of an escalating crisis is simply unacceptable. What action does the Taoiseach propose to take? It is not good enough to say that there is a problem with recruitment and retention. The situation requires urgent action.

I thank the Deputy for raising this most important issue. The issue of CAMHS and bed capacity is a serious one, particularly the decision in relation to Linn Dara and the reduction of beds there, due to a range of issues, as the Deputy has said. In the first instance, the Minister of State, Deputy Butler, is working with the HSE intensively to ensure this is a temporary situation and to get it reversed. As the Deputy has said, a number of beds are now not in operation in Linn Dara. The same applies to Merlin Park University Hospital for different reasons. Ten out of 12 beds are operational in St. Joseph's Hospital, and all of the 16 beds in Eist Linn are fully operational.

The regrettable situation in Linn Dara has come about because a number of nursing posts have become vacant simultaneously for various reasons. It is not a resources or a funding issue but a staffing recruitment issue. The nursing complement available through the use of permanent and agency staff is no longer sufficient to continue to provide a full 24-bed inpatient service to a safe standard. That was the basis and the rationale for the decision taken. There are still seven beds available at Linn Dara specifically for the treatment of eating disorders. No young person was discharged early from the unit as a result of the reduced bed numbers.

The reduction in beds at Merlin Park is due to the reconfiguration of two shared bedrooms to single rooms because of Covid, nursing staff vacancies and physical risks associated with some rooms. The two-bedroom reductions in St. Joseph's are due to staff vacancies and physical limitations of the unit, as advised by consultant psychiatrists.

The HSE explored all options prior to making the decision. For example, it looked at redeploying staff from other CAMHS units or teams. It was not in a position to do that, and it did not want to impact negatively on CAMHS community care and the CAMHS community teams, which are a key part of the broader CAMHS programme.

All four CAMHS units nationally will work collaboratively to maximise the use of national CAMHS bed capacity over the coming while. The Minister of State and the HSE will work to intensify efforts to recruit the specialist skills and people for the vacancies that currently exist. To the end of March 2022, there have not been any admissions of under-18s to adult facilities. In 2021, there were 25 such admissions, down from 50 in 2019. That is something that we do not want to see happening within our mental health services, particularly in respect of young people.

Some 91% of urgent CAMHS referrals are now seen within 48 hours. Record funding of €1.149 billion is being provided for CAMHS, which again is up significantly on last year, but it is an issue of recruiting the specialist nursing staff.

I repeat that there are 3,900 young people on waiting lists, which is up by 40% on last year. Covid-19 has had an impact on the mental health of many young people and adults over the past two years. To see the HSE cutting beds rather than maintaining them is completely incredible.

The Taoiseach said the HSE has been looking to bring in teams from other areas. The issue that arises is that where any child is brought to an adult care facility, it will be breaking their human rights. They should be cared for within CAMHS. It is not good enough for the Taoiseach to stand up and say what he has just said there. This should have been well planned for. The Minister of State with responsibility for mental health and older people launched the implementation of the Sharing the Vision policy and it should have been well flagged if there was a problem. It should have been addressed a long time ago if we were having staffing problems in the area six or eight months ago. This happened in 2017 and it has to be resolved immediately.

It has to be resolved but the level of service is also expanding all of the time. The level of referrals is also going up exponentially. Covid-19 without question had an impact on the number of young people contacting their primary care services and their community teams in respect of mental health issues arising out of the pandemic. This has been a feature across the health service in the past six months as we emerge from the emergency phase of the pandemic where there has been an exponential growth in activity and in referrals, which is exacerbating the problems and issues we have. The funding has been provided to recruit as many people as we possibly can in all of the different disciplines, and that will continue. In the meantime, the Minister of State will work with the HSE to see what we can do, especially in respect of the Linn Dara facility. There is an urgency attached to that and I thank the Deputy for having raised it.