For years now I have been raising the issue of specialist treatment for eating disorders. The news that no new inpatient beds for adults with eating disorders have opened should be surprising but, given all of the broken promises and missed deadlines over the years, how could anyone be surprised? We should be, however. We should be shocked at the lack of urgency, the level of mismanagement and the complete lack of help and hope for so many people who are seriously ill.

In 2018, when the Taoiseach was the Minister for Health, the HSE published a new national model of care for eating disorders. Under that plan, 20 new inpatient beds were promised. They were supposed to be delivered by 2023. To date, zero have been delivered. Not only has there been an abject failure to deliver these beds, but there has not even been an attempt. The Journal has confirmed today that no new funding to open these beds was provided at any stage in the past six years. As it stands, there are just three public beds in the entire country for adults with eating disorders, all of which are located at St. Vincent's hospital. That means that only people who reside within that hospital's catchment area can get treated in those beds. There are three beds for the entire country, and most of the country cannot use them.

I have to say that it does not seem like the Government understands how serious eating disorders are. Over the years, I have spoken to women who have been forced to speak publicly about what they are going through and to set up GoFundMe campaigns to get the care they need. I have spoken to parents who are at their wits' end watching their children quite literally waste away in complete disbelief that there is no support for them. I have spoken to people who work in the NHS who are seeing Irish women who are at death's door and who are going over to the UK because they cannot get the care they need at home. That reality is not represented at all in the Government's response. There has been zero funding to provide more beds at any stage in the past six years.

Anorexia has the highest mortality rate of any mental health condition and incidences are rising. In 2022, admissions were the highest in a decade. Despite this, when people are at death's door, when early intervention is obviously not an option, there is nowhere for them to go because the beds do not exist. The HSE will sometimes pay for private treatment while other times it will not. There is no clarity or transparency as to how decisions in this regard are made. I acknowledge that there has been some progress with regard to care in the community but we know that many people are far past the point of needing that early intervention. It is not an option for some people. They urgently need inpatient care. Twenty new inpatient beds for adults with eating disorders were promised in 2018. When will they be delivered?

I thank Deputy Cairns for raising this issue. I acknowledge that it is an issue she quite rightly raises on a regular basis. I assure her that I wish to show commitment to enhancing specialist services for eating disorders, including improved access and shorter waiting lists. I accept that this is an issue in every community across Ireland. I also agree that there has historically been a lack of publicly funded services for people with eating disorders in Ireland. We are starting from a very low base as regards the record of investment. However, I point to the fact that the new model of care for the national clinical programme for eating disorders in 2018, which the Deputy has referenced, marks a significant milestone and provides clarity as to how we intend to deliver and design our services. It also provides a list for Government as regards initiatives that quite rightly need to be funded.

Research shows that the most effective treatment setting for eating disorders is in the community. I will come back to the point the Deputy has made about treatment outside the community in a moment. It is right to say that a small number of people, mainly those with restrictive eating disorders, will require inpatient care for stabilisation and for other reasons. However, 90% of eating disorder services are delivered within the community. The HSE works hard to meet the needs of people with eating disorders in a setting most appropriate to their needs. This might be through the community eating disorder teams, beds in the public system, specialist beds with private providers that are funded by the HSE, which the Deputy acknowledged, or, on occasion, the treatment abroad scheme, although we definitely need to reach a point at which we can move away from that.

Based on multidisciplinary community teams, the national clinical programme for eating disorders is now being implemented on a phased basis across the country. There are now 11 teams, comprising six adult teams and five child and adolescent mental health service teams. Six of these teams only started last year. I say that to push back slightly on the suggestion of a lack of progress. We started six of these teams in the last year. More than €8 million has been allocated to the national clinical programme since its establishment and approximately 100 posts have been funded through that programme. There are now just over 80 eating disorder clinicians in the country. This number includes ten consultant psychiatrists.

Adults who have an eating disorder diagnosis and require inpatient care can be referred to any of the HSE's acute inpatient mental health approved centres around the country. Eating disorders disproportionately affect a relatively young section of our population. There are currently 20 dedicated eating disorder beds across the four CAMHS inpatient units. As of 23 April, there was nobody waiting for access in that area. Access to services is increasing. Twice as many assessments were conducted last year as were conducted the year before. That is 449 assessments versus 227. As part of additional funding secured under the last budget, a number of new posts will now be available to support youth mental health service provision and development. This includes specific new posts to support eating disorders.

On St. Vincent's specifically, community healthcare organisation, CHO, 6 has three dedicated beds for adults requiring inpatient care and these are based in St. Vincent's. The Deputy is entirely correct that the need for additional inpatient beds has been identified in the model of care and in other policy documents. A recent HSE mental health bed capacity review included eating disorder beds. It is intended that the number of dedicated adult beds will increase in line with the model of care recommendation to get us to 20 adult inpatient beds.

As I have said, I welcome the opening of the 11 treatment hubs. Care in the community and early intervention are obviously of great importance. I acknowledge that. It is not what I asked the Taoiseach about-----

It is linked.

-----but we are missing the target in that area too. Some 16 treatment hubs should have been opened by 2023. Treatment remains a postcode lottery. It is not just adult services that are at breaking point but also those for adolescents. In some areas, 45% of beds are empty. According to the Psychiatric Nurses Association, the HSE's recruitment embargo is the reason for that. There are simply not enough staff for them. Is it the Government's plan to lift that embargo to address this issue?

To go back to what I actually asked the Taoiseach about, more desperate than that situation is the issue with inpatient beds for adults.

The Taoiseach acknowledged that we need them, but no funding has been allocated. Will he tell us when funding will be allocated and when we will see the delivery of those 20 inpatient beds for eating disorders?

I fully acknowledge the need to get from three to 20 beds. That is a statement of fact. It is Government policy. It is in the model of care and other policy documents published by the Government and has been endorsed by the HSE mental health bed capacity review. I outlined that this year the area of priority for additional investment into this area is around some of the youth mental health and CAMHS provision. I can send the Deputy a note on what we intend to get done this year. It was interlinked to make the point that at CAMHS level we have 20 beds across the four areas and as a result we had-----

They are not staffed.

As a result, zero people were waiting for beds yesterday. I needed to say that. The direct answer to the Deputy's question is that we need to get from three to 20 beds. I intend to make more progress on that in the budget.

On recruitment, all of this has to be seen in context. Sometimes, the debate in the House is a little skewed. There is not a ban on recruitment to the health service. Some 2,200 more people net will work in the health service - it will probably be more but 2,200 have been funded - at the end of this year than last year. That is true. That does not include disability services. The figure goes up to more than 3,000, if disability services are included. Within the budget relating to this area, the HSE needs to make decisions as to where to direct that investment on the front line. I will specifically talk to the Minister for Health about the importance of this area.