2026-05-20

There is a deeply concerning and worrying direction of travel here. We have around 50% of the recommended beds nationally for CAMHS. That recommendation is contained in the Department's own mental health strategy. We know that CAMHS is already operating at half the capacity that experts said was needed almost 20 years ago. Against that backdrop, the proposed closure of the CAMHS unit in St. Vincent's Hospital in Fairview makes absolutely no sense. Quite frankly, it is alarming. That the CAMHS unit in Linn Dara is due to reopen after four years being closed due to staff shortages is of course welcome. The problem, however, is that the proposed closure of the function of CAMHS in St. Vincent's Hospital in Fairview is being done to staff Linn Dara. Instead of genuinely expanding services, the Department is effectively robbing Peter to pay Paul. I know the Minister of State will tell me about the new children's hospital but there is no timeframe for that, and nor have the 20 beds been budgeted for. The Fairview unit is operational, staffed and delivering care. The families know it and they trust the service there. Yet, there seems to be an intention to redeploy staff from Fairview to Linn Dara. I am informed that so far only two members of staff have agreed to this. We must also remember that St Vincent's Hospital is a section 38 hospital, while Linn Dara is directly managed by the HSE, and those workers cannot be compelled to move. At a time when recruitment and retention is already at crisis point, this approach is reckless.

Linn Dara closed in 2022 for what was supposed to be four months. It has still not reopened with the beds that are due to open again. That was a crisis at the time and it has been a crisis since. It is welcome that the facility is to reopen but will it reopen with a full complement of staff? When Linn Dara opened, the problem from day 1 was that there was never a full complement of staff. Then there were staff changes because of the pressures that were put on staff. The unit eventually closed because it was no longer safe as there was not a full complement of staff. Linn Dara is needed, St. Vincent's Hospital is needed and the children's hospital, which is also in the area, is needed. Nobody is saying that they should not all be open. We know we have a crisis in this country and in this city. We need all of those services. The fact that one service is closing to facilitate the opening of another is absolutely ridiculous. We need to know about the planning and where the funding for the CAMHS services in the children's hospital is going to come from because in two years' time we do not want Linn Dara to close again to facilitate the children's hospital.

This decision is inconceivable. As a long-time member of the Psychiatric Nurses Association - I stopped nursing at the last election - I am well aware of the shortages on the ground and of the crisis management we are forced to do - dissipating some of the therapeutics and trying to keep patients safe. It is inexplicable that it has been decided to shut the section 38 and to transfer everybody to Linn Dara and that it will be happy days. That is not going to happen and it will not be as smooth as people think it will be. From talking to nurses on the ground, who are my colleagues, two are in favour moving while the other 20 fear they will be lost to the adult services because they are desperate. We are short 6,000 nurses across the Twenty-six Counties. They will be lost to the adult services as will their expertise with young people. There is also the waiting list. We know we have failed in terms of CAMHS. We also know we have failed our children in the past. Look at Kerry and at lots of issues. Linn Dara closed in 2018. I was on the Joint Committee on the Future of Mental Health Care with former Senator, Joan Freeman, and we visited it. It opened again and then it closed again. I would like clarification.

I thank all three Deputies for raising this really important issue. First, I want to make absolutely clear that neither my Department nor the HSE is closing any beds. In fact, this year, in budget 2026, I have provided over €4 million to open 18 HSE CAMHS beds. I have allocated €2.7 million to open the first phase of the new acute CAMHS wing of the national children's hospital and I have also allocated over €1.3 million to hire the staff to reopen 11 CAMHS beds in the state-of-the-art Linn Dara campus. As a result of this funding, the HSE has made the sensible decision to discontinue the purchase of ten CAMHS beds from a voluntary provider, St. Vincent’s Hospital, Fairview. These are not HSE beds but these are beds within the HSE that the HSE has been buying as additional capacity while the Linn Dara beds have been out of operation due to safe staffing. In 2025, the HSE child and youth mental health office completed a national review of HSE-funded CAMHS inpatient services focused on referrals, admissions, diagnoses, staffing and bed capacity. The review recommended the development of a national commissioning model and service specification in line with, and complementary to, the new CAMHS operational guidelines to ensure consistent access, service delivery and care standards across all inpatient units. The report made specific findings, which none of the Deputies referred to, regarding the current inpatient unit at St. Vincent’s Hospital, Fairview: first, the unit's restricted age cohort as it only accepts 15 to 17-year olds for admissions; second, the lack of an appropriate eating disorder pathway and no out-of-hours or weekend admissions; third, concerns raised by the Mental Health Commission regarding governance; fourth, staffing constraints, including reliance on a single full-time consultant dedicated to the unit; and, very importantly, unsuitable physical infrastructure where the current building is no longer fit for purpose. I understand the two floors above the CAMHS unit in St. Vincent’s Hospital, Fairview, are derelict or uninhabited. As these limitations result in inequitable access and service inconsistency when compared to other CAMHS inpatient units nationally, the HSE decided to discontinue the use of the beds at St. Vincent’s Hospital, Fairview, and to streamline the provision of HSE CAMHS inpatient beds across the Dublin region in line with the recommendations from the review report. Consequently, CAMHS inpatient beds will be provided through an expanded service at Linn Dara in Cherry Orchard and the newly commissioned beds in the Children's Hospital Ireland, CHI, campus to best meet the future needs of the HSE Dublin North East, HSE Dublin Midlands and HSE Dublin South East health regions. The HSE aims to reopen the 11 beds in Linn Dara by the end of September and has therefore advised St. Vincent’s Hospital, Fairview, it will no longer need the ten beds from the date it was paying for privately. There will be, of course, flexibility on both sides in relation to this timeline to ensure no reductions in overall capacity. Importantly, this approach will place all CAMHS inpatient units under a single, standardised HSE clinical governance framework and address current service limitations. There will be no staff redundancies arising from this decision. The HSE expects the transition to create opportunities for the experienced and dedicated staff working in St. Vincent’s within the newly commissioned CAMHS inpatient services at Linn Dara and CHI. I want to acknowledge the work done by the Psychiatric Nurses Association working in St. Vincent’s. It is of course a personal decision for staff whether or not they wish to transfer to either the new hospital or to Linn Dara. I was surprised to find the reconfiguration of beds was the main theme at this year's PNA annual conference. We face many challenges in our public mental health services and I did not expect keeping ten voluntary non-HSE CAMHS beds with the limitations I have described to be the key concern of the body for a profession for which I have the upmost admiration and respect.

I have read some statements on this issue which are quite frankly very concerning such as "It will reopen if staff can be recruited". That is literally the job of the Minister of State and her senior Minister. I do not think it is reasonable to expect anybody whose child needs a CAMHS bed to accept that the Ministers may have woken up and suddenly realised they are in government. This is actually their job. Families across the State have endured scandal after scandal when it comes to CAMHS. The Psychiatric Nurses Association described the proposal as inconceivable and I agree. I ask the Minister of State to please to look at this. There is something fundamentally wrong when the State is reliant on beds in a hospital that is not even completed.

As a TD in Dublin South-Central where Linn Dara is based I welcome the fact it is going to open but it is not additionality. This is something that was closed in 2018 and 2022. It was supposed to be for three or four months. Here we are how many years later? It is four years later and the Minister of State says it is an expanded service. It is not expanded - it is a reinstatement of service. If it was expanded, the Minister of State would be announcing 20 extra beds in Linn Dara or she would announce the capacity would increase based on St. Vincent’s. That is not the case.

Respectfully, this is not a sensible decision being made by the HSE. The Minister of State's response will be used in the WRC. The PNA is to meet and to discuss this with the HSE on 24 or 25 May to try to get a resolution. Keep the ten Fairview beds open and keep Linn Dara and the 20 beds in the National Children's Hospital. She should engage. There has been no engagement with the PNA or its members who are the experts on the ground.

There has been.

There has been very minimal engagement. The section 38 thing is bit muddying the waters a little bit. We are looking at the number of beds and services available in totality.

My team spoke to the PNA in advance of the conference and indeed spoke to some of the nurses in St. Vincent’s about this change. If anything the nurses' main concern was the way in which the decision was communicated to the staff at St. Vincent's by their CEO, by email on a Friday evening with no detail about the opportunities to transfer. That was completely wrong. This is no way to treat hard-working and dedicated staff who deserve our respect and to be communicated with properly about such a significant change. By way of background context, CAMHS inpatient bed capacity is 72 beds nationally but due to a range of issues, there are 45 beds in operation. As of 12 May 2026, the waiting list nationally to access CAMHS inpatient units was one. Of the available 45 inpatient beds, 36 were occupied on 12 May, leaving nine beds available to accommodate an admission. It is important to stress that there has not been an occasion since the reduction in operational beds nationally to 45 when all available beds have been occupied. I am really concerned, especially about Deputy Clarke’s narrative. There is a reason this has been looked at and she did not refer to that at all, that is, the unit's restricted age cohort of 15 to 17 years; the fact a child can only be referred to the unit on a Monday to Friday, 9 a.m. to 5 p.m.; the lack of an appropriate eating disorder pathway; the concerns raised by the Mental Health Commission; staffing constraints, including reliance on a single full-time consultant; and, most importantly, unsuitable physical infrastructure where the current building is no longer fit for purpose. I am trying to open public beds here. I am trying to stop spending money on private beds. I look forward to staff being hired. I hope some of the staff will move across to the excellent Linn Dara site. Please God, we will get the beds open as soon as possible.