Mary Butler
Waterford · Fianna Fáil · Ireland
“Major improvements are happening across services: enhanced access to proactive and preventive healthcare to support a better quality of life; the embedding and upscaling of women's health initiatives put in place through the implementation of the previous women's health action plans, including, as the Senator knows, free contraception, sp…”
“In relation to any proposal, a proposal for a new location requires a detailed business case, a premises, support from the regional HSE management, and the necessary funding to resource the staffing of the service. That is where I come into it and what I will be trying to do.”
“We are currently working closely with it to support the expansion of Jigsaw services to Waterford and the south east, as well as to County Clare. The location of Waterford was picked because we have no services in the south east at all. It is great that we will have the hub and spoke model the Senator spoke about.”
“That is where I do not agree with the Senator. I believe €180 million of funding ring-fenced for women's health, when we have come from a low base, is absolutely unbelievable.”
“The plan will build on our knowledge of women's health through research and innovation and will spotlight important areas such as endometriosis and cardiovascular health. Recently, the Minister announced €2 million in funding for women's health research.”
“This plan will continue to focus on how we can improve access to specialist endometriosis care and treatment. As the Senator knows, we have established two super-regional specialist centres, one in Tallaght University Hospital and another in Cork, alongside the development of five regional endometriosis hubs.”
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“The question relates to the mental health intellectual disability teams, which are different from other teams because they are very small. There may be nine or ten people on an eating disorder or CAMHS multidisciplinary team, for example, but mental health intellectual disability teams can normally, believe it or not, be made up of just one person and some staff to support them. I am disappointed to hear that the person referred to by the Deputy left after a week. This is part of the clinical programmes under CAMHS. There are several clinical programmes. CAMHS received approximately €160 million in dedicated funding in 2024, an increase on €137 million in 2023. We also provided funding of €110 million to various NGOs, with a significant proportion dedicated to supporting young people.”
“That is the whole purpose of the review and the report on it, which I await. The spread of the beds will be geographical; they will not just be located in Dublin.”
“I expect to receive a plan from the HSE regarding future eating disorder bed provision very shortly. Yesterday, I met Dr. Michelle Clifford, clinical lead, and Dr. Amir Niazi, national clinical adviser and, on Monday, I met Bernard Gloster, the CEO of the HSE, to discuss this specific issue. I have had four priorities since I was reappointed. I thank the Minister for my delegated functions this week. These priorities include the CAMHS waiting list, the adult beds and the Mental Health Bill 2024, which I hope to bring to Committee Stage in the Dáil next month. In relation to the eating disorder beds and the Deputy's earlier comments, what I said was that the review was specifically looking at the fact that 90% of all eating disorders are treated in the community and we may not need the 20 beds.”
“Please let me answer. We now have the nasogastric tube feeding, which is available in the Eist Linn centre in Cork, in the Linn Dara unit and in Merlin Park. Unfortunately, this is a feature associated with an eating disorder, but we do have this provision. For the past six years, we have spent €1 million annually treating some very complex cases abroad. We also spend money every year on supporting adults with eating disorders in private facilities in Ireland. This is a fact. In relation to the beds issue, I had a review undertaken of all mental health bed capacity. It has taken place and is currently under consideration by the HSE. This includes a review of data on eating disorder bed use in the HSE, in the approved centres, and in private placements and treatment abroad.”
“Some of the Deputy's information is inaccurate. I have put a major focus on eating disorders. Just to be clear, no child under 18 has had to have treatment abroad since 2019. This is because we now have-----”
“I say this because this has been lost in translation as well. There are 20 dedicated eating disorder beds across four CAMHS inpatient units. Coupled with this, the majority of people presenting with eating disorders are, unfortunately, aged 14, 15, 16 and 17. I will respond during my next contribution concerning the adult beds.”
“Eleven of them are in place and one of them actually moved into a new premises last Friday, while three of them are currently in the process of recruitment. Most teams, as I said, are fully operational and seeing people with eating disorders every day. It is also extremely important to point out that there are 100 dedicated clinicians working across all the eating disorder teams in the country, with ten psychiatric consultants. The progress being made is not being acknowledged at all. There was recurring funding of €9 million this year alone for eating disorder teams under this clinical programme. We have two more teams to fund and I hope to do that in next year's budget, with the support of the Minister. Under-18s can access 20 eating disorder beds across the four CAMHS inpatient units. This is very clear.”
“As the Deputy will be aware, eating disorders are complex, individualised and are and can be one of the most serious mental health illnesses anybody can go through. As Minister of State, I am firmly committed to improving services for eating disorders in Ireland. The national clinical programme was set up in 2018, and when it was set up it was envisaged there would be approximately 60 people who would require the supports of clinical eating disorder teams. The figure now stands at approximately 600 in the space of seven years. The programme has progressed very well. Some 90% of all people with an eating disorder are treated in the community. Quite rightly, therefore, a decision was made to focus the supports as much as possible in the community. We now have 14 of the 16 teams envisaged by the model of care funded.”
“I met the head of estates for Dublin south east which covers our particular area during the week on all things related to estates in that area. We discussed three primary care centres and Gorey was one, as well as another in Lismore in my area. It is going out to tender in the first quarter of this year. The Deputy is right about the model that is being used to do this. With the previous tender that was in place, the developer withdrew from it and therefore progress was lost, but it is going out to tender in the first quarter and we hope to make progress very quickly.”
“In allocating funding to any organisation under a service level agreement, boxes must be ticked in regard to previous accounts and in respect of clinical and other governance on the part of the organisation. The HSE is not satisfied at the moment that this governance is in place in the case of SOSAD Ireland. However, it is working with the organisation to put that governance in place and to try to secure a service level agreement. I receive updates on a weekly basis.”
“As Minister of State with responsibility for mental health, I will respond. I met with members of SOSAD Ireland before the election, when they expressed their concerns about keeping the doors open. I acknowledged that the organisation does a huge amount of very good counselling work in the different regions Deputies represent. There has been constant engagement with SOSAD Ireland following the election and since I have been back in my role. I was disappointed initially that it took quite a while for the HSE to engage with the organisation but that has now been resolved. The main issue I have to raise in regard to funding for any section 39 organisation is that there is a spending code in respect of taxpayers' money.”
“and shall in any event be taken on the conclusion of the Statements on International Women’s Day; and (ii) the Dáil shall adjourn on the conclusion of topical issues until 2 p.m. on Wednesday 19th March, 2025; and 2. the Statements on International Women’s Day shall not exceed 2 hours and 25 minutes and the order of speaking and allocation of time shall be as follows: (i) the arrangements for the statements, not including the Ministerial response, shall be in accordance with the arrangements contained in the table immediately below (to be read across, not down); (ii) following the statements, a Minister or Minister of State shall be called upon to make a statement in reply which shall not exceed 10 minutes; and (iii) members may share time.”
“the proceedings on Committee and remaining Stages of the Financial Services and Pensions Ombudsman (Amendment) Bill 2023 shall be taken either at 5 p.m. or on the conclusion of the Statements on the Irish Language to mark Seachtain na Gaeilge, whichever is the later, and shall, if not previously concluded, be interrupted and stand adjourned either at 8.31 p.m. or after 2 hours and 30 minutes, whichever is the later. In relation to Thursday's business, it is proposed that: 1. (i) the ordinary routine of business as contained in Schedule 3 to Standing Orders shall be modified to the following extent: (I) no motion for a Committee report pursuant to Standing Order 111 or private member's Bill pursuant to Standing Order 169 shall be taken; and (II) topical issues may be taken earlier than 7.24 p.m.”
“or on the conclusion of the Statements on Policing and Community Safety, whichever is the later, and shall not exceed 2 hours and 25 minutes, and the order of speaking and allocation of time shall be as follows: (i) the arrangements for the statements, not including the Ministerial response, shall be in accordance with the arrangements contained in the table immediately below (to be read across, not down); (ii) following the statements, a Minister or Minister of State shall be called upon to make a statement in reply which shall not exceed 10 minutes; and (iii) members may share time; and Gov SF Lab Gov SF Mins 25 15 10 10 3 SD Gov SF IPTG Gov Mins 10 10 3 9 10 SF ITG Gov SF NP/G Mins 3 9 10 3 5 4.”
“the resumed Statements on Policing and Community Safety shall not exceed 1 hour and 32 minutes and the order of speaking and allocation of time shall be as follows: (i) the speaking slots from Tuesday’s arrangements for the statements shall be continued from the point at which they were adjourned; (ii) following the statements, a Minister or Minister of State shall be called upon to make a statement in reply which shall not exceed 10 minutes; and (iii) members may share time; 3. the proceedings on the Statements on the Irish Language to mark Seachtain na Gaeilge shall be taken either at 3.45 p.m.”
“the ordinary routine of business as contained in Schedule 3 to Standing Orders shall be modified to the following extent: (i) Parliamentary Questions to the Taoiseach pursuant to Standing Order 47(1) shall not be taken, and the SOS pursuant to Standing Order 25(1) shall commence at the time when Parliamentary Questions to the Taoiseach would normally be taken, with consequential effect on the commencement time for Government business; and (ii) the weekly division time may be taken earlier than 8.45 p.m., and shall in any event be taken on the adjournment of proceedings on the Financial Services and Pensions Ombudsman (Amendment) Bill 2023, or where those proceedings conclude within the allotted time, on the conclusion thereof, with consequential effect on the time for the adjournment of the Dáil; 2.”
“the proceedings on the Statements on Policing and Community Safety shall be interrupted and stand adjourned after 2 hours and the order of speaking and allocation of time shall be as follows: (i) the arrangements for the statements shall be in accordance with those contained in the table immediately below (to be read across, not down); (ii) any speaking slots which are not reached may be taken on Wednesday in accordance with the agreed sequence; and (iii) members may share time. Gov SF Lab Gov SF Mins 35 25 15 15 5 SD Gov SF IPTG Gov Mins 15 15 5 12 15 SF ITG Gov SF NP/G Mins 5 12 15 5 8 In relation to Wednesday's business, it is proposed that: 1.”
“and shall, in any event be taken on the adjournment of the Statements on Policing and Community Safety, or where those statements conclude within the available time, on the conclusion thereof, with consequential effect on the commencement times for the items following in the ordinary routine of business, namely, oral Parliamentary Questions to the Minister for Transport, and topical issues, and on the time for the adjournment of the Dáil; and 2.”
“or after 2 hours and 30 minutes, whichever is the later) Wednesday's private members' business shall be the Motion re Addressing Government Waste and Oversight in Public Expenditure, selected by the Independent Technical Group. Thursday's business shall be Statements on International Women's Day (not to exceed 2 hours and 25 minutes). Proposed Arrangements for this week’s business: In relation to Tuesday’s business, it is proposed that: 1. the ordinary routine of business as contained in Schedule 3 to Standing Orders shall be modified to the extent that private members’ business may be taken earlier than 6.12 p.m.”
“I move: Tuesday's business shall be Statements on Policing and Community Safety (to adjourn after 2 hours). Tuesday's private members' business shall be the Motion re Guaranteeing Right to Education in Irish to All, selected by Sinn Féin. Wednesday's business shall be: - Statements on Policing and Community Safety (resumed) (not to exceed 1 hour and 32 minutes) - Statements on the Irish Language to mark Seachtain na Gaeilge (to be taken no earlier than 3.45 p.m. and to conclude within 2 hours and 25 minutes) - Financial Services and Pensions Ombudsman (Amendment) Bill 2023 (Committee and remaining Stages) (to be taken no earlier than 5 p.m. and to adjourn at 8.31 p.m.”
“With the help of the Ceann Comhairle and the House, I hope we can take Committee Stage on the floor of the Dáil in a couple of weeks, given that we currently do not have the option to do it in committee.”
“One would assume pre-legislative scrutiny will take place in committee, when we get the committees up and running. I am very anxious to progress the Mental Health (Amendment) Bill. A lot of work has been done on it in the past six months.”
“The Bill will amend the Defence Acts to reform the existing provision concerning the dispatch of members of the Defence Forces for services outside the State. I reiterate that it is a priority for publication and drafting of the general scheme is ongoing at the moment.”
“I thank the Deputies very much. The Government, and me as Chief Whip, believe the best way to address changes to Standing Orders is within the Committee on Standing Orders and Dáil Reform. This process should be respected. A meeting of the committee will take place this evening. It is imperative that the Dáil can function and that Oireachtas committees can be established as soon as possible. I am sure we will have a robust session later. In response to Deputy Boyd Barrett's question, the Department of Defence has prioritised one Bill for publication and one Bill for drafting. The Defence (Amendment) (No. 2) Bill is prioritised for publication and drafting of the general scheme is ongoing.”
“The Department of the Taoiseach will continue to play a central role in supporting effective co-ordination and prioritisation of policy and legislation across government through Government meetings, the Cabinet committee structures and the Government legislation committee. Currently, some Bills are held up because the committee structure is not yet in place and, as a result, pre-legislative scrutiny of certain Bills will be pushed back.”
“This aims to advance important legislation around updating employment and equality Acts, the national cybersecurity Bill, licensing of professional home support providers and legislation on housing. All Government Departments were consulted on the preparation of the spring legislative programme. The Government Legislation Committee, which I chair and is attended by the Attorney General, met on Thursday 13 February 2025 to finalise the programme. The committee will meet on a regular basis throughout the session to ensure that the key legislative priorities are progressed.”
“The Government's legislation programme, which was published on 18 February 2025, sets out the Government's legislative priorities for the current parliamentary session. We all understand that it is a shorter session than usual, but we will have a new programme again just after Easter. This is the first legislative programme of the new Government, which includes 50 Bills for priority publication and drafting during this Dáil session. There are 14 Bills at various Stages across both Houses of the Oireachtas. These include legislation that will amend the Mental Health Acts, amend the law on defamation and provide for sufficient and effective access to cash. I will work with all Members to progress legislation through both Houses of the Oireachtas.”
“Much of the country was closed between 2020 and 2022 during the time of Covid. The figure of 740 SME closures in 2021 is preliminary. The statistics also show that as many new businesses started up at the same time.”
“The reason information is not available is that European business statistics regulation requires data to be transmitted with a two-year time lag. For example, 2022 data were transmitted in June 2024. The CSO is always trying to enhance the timelines of its publications. It is examining new products relating to signs of life for businesses, which it is hoped will provide a timelier picture of enterprise activity. There is some good news for County Mayo in terms of information on new enterprises that have been created there. County Mayo ranked eighth out of 26 in 2019 for SME births. This is the first time I ever heard that term. It refers to the birth of small and medium enterprises. It was ranked 25th out of 26 in 2020. It was second out of 26 in 2021 and 24th out of 26 in 2022. However, we must put it into context.”
“The number of SMEs that closed in 2017 was 687. In 2018, it was 718. The preliminary figure for SME closures in 2021 is 740. I will come back with more detail after the question.”
“The Central Statistics Office, CSO, has responsibility for collating information on the number of enterprises that close each year as part of its work in developing and maintaining the CSO's central business register, CBR. The CBR is developed using data provided by the Companies Registration Office, CRO, and the Revenue Commissioners. The most recent data available on enterprise closures from the central business register, published as part of Business in Ireland - Insights on the Lifecycle of Businesses 2022, is for 2021, for preliminary enterprise closures. This is due to the CSO's approach whereby an enterprise is recorded as having ceased trading where no tax returns have been filed for two successive years, with one year of no returns being recorded. There are a lot of complicated details on the number of SMEs involved.”
“I understand we are covering a total area in that regard. Clermont Screen Hub officially opened on 26 October 2023. Currently, we have full employment, and there are often unintended consequences. I take on board the point the Deputy makes about parents having a long commute and family time being affected by that.”
“The local enterprise office, LEO, supports the creation of many jobs in County Meath. The 2024 annual employment survey of LEO clients once again shows positive job creation across most LEOs. In 2024, the local enterprise office in County Meath provided grant assistance to 259 small businesses, thereby helping them to support 1,455 jobs and to create 255 new jobs. The plan the Deputy mentioned has five clear strategies to balance regional development. Highlights from the mid-east region include the Boyne Valley food hub having opened in May 2023 and Meath County Council participating in a pan-European programme to determine circular economy best practices for small businesses. Funding of €5.2 million was awarded under rural regeneration development for the development of the Athy Food, Drink & Skills Innovation Hub.”
“I will not go through all the figures because the Deputy will get them in writing. In 2014, there were 284,200 persons in employment. In 2024, there were 405,600 people in employment. While this region covers the counties of Kildare, Louth, Meath and Wicklow, it does not give a specific breakdown. The Deputy can have a copy of this information. These figures and further data relating to the Irish labour market, with a regional breakdown, can be accessed on the CSO website.”
“The exact information requested by the Deputy is not available. The labour force survey, LFS, carried out by the CSO, is the official source of estimates of employment in the State. The most recent figures available are for the fourth quarter of 2024. The figures for this response use the second quarter as the reference period for the year. Due to the methodology and sample size of the survey, it is not possible to produce reliable county estimates from the LFS. Regional estimates of employment are produced at the NUTS 3 level. NUTS are the geocode standard developed and regulated by Eurostat. The NUTS 3 mid-east region includes counties Kildare, Louth, Meath and Wicklow. I will give a sample of the number of persons aged 15 to 89 in employment in the mid-east between the second quarter of 2014 and the second quarter of 2024.”
“It is a full-time post and it is very welcome that the other post is being backfilled. The HSE is confident that the new person will be in place in a number of weeks. That is very positive and we will keep a close eye on this matter for Deputy Sheehan because it is very important that those children have those vital interventions.”
“They have informed us, which is very good news, that they have given approval for getting the permanent backfilling of the vacant speech and language therapist post. When a post becomes available and the post of the person moving into that post is not backfilled, nothing happens. It is really good news that that post is being backfilled and, in the short term, an interim measure has been agreed that a new graduate grade paediatric speech and language therapist employed through an agency will provide a level of cover at King's Island Primary Care Centre until the post is filled permanently. It is really important that I reiterate that recruitment and retention of these very specialised, dedicated staff has become very difficult. Retention is also an issue.”
“I thank the Deputy. We have had the change from the nine community healthcare organisations, CHOs, to six individual health regions. Each of the six health regions and each national service has been provided with a specified number of whole-time equivalent staff members that they can hire. They can replace, recruit and prioritise staff within the approved numbers they have. By the end of this year, there will be 133,000 whole-time equivalent staff members working across the HSE. That is an increase of over 20,000 staff in the past four years. The health regions have further control to focus resources where there is the greatest need and this informs decisions made at local level on the filling of available posts.”
“However, as an interim measure, it has been agreed that a new graduate grade paediatric speech and language therapist employed through an agency will provide a level of cover at King's Island Primary Care Centre until the post is filled permanently. The Minister fully acknowledges the frustration of those who are impacted by the vacancies in primary care therapy services and agrees that much more needs to be done to address the gaps in staffing and the waiting lists for these services, including speech and language therapy. In that context, it is welcome news that progress has been made to fill this specific post in King’s Island Primary Care Centre. We are all very much aware that early intervention is crucial and I am glad to see that there is a pathway here with both a long-term solution and a short-term solution.”
“The HSE has advised that the staff grade paediatric speech and language therapist post in King’s Island primary care centre has been vacant since January 2024 due to the resignation of the post holder. Since this post became vacant last year, all new referrals have been and will continue to be triaged by senior speech and language therapists within the north Limerick city network. However, I do have some good news that I am happy to report. Approval has been given for the permanent backfilling of the vacant speech and language therapist post in King’s Island Primary Care Centre. The HSE has advised that this post has been recently accepted from the national staff grade speech and language therapist panel. The HSE has further advised that it will be a number of weeks before the speech and language therapist is in post.”
“Each of the six health regions and each national service has been provided with a specified number of whole-time equivalents and can replace, recruit and prioritise staff within that approved number. This has given the health regions further control to focus resources where there is the greatest need and it informs decision-making at local level on the filling of available posts. Specifically, to address the Deputy’s question, primary care speech and language therapy services are provided for the community of King’s Island and the surrounding areas in Limerick from King’s Island primary care centre. I note the Deputy's comments around the area being disadvantaged and the challenges in the local national school.”
“I congratulate Deputies Sheehan and Quaide on their recent election to the Dáil and I thank them for their interest in all health matters. The Minister for Health has asked me to thank Deputy Sheehan for raising this important matter and for the opportunity to update the Dáil on it. Primary care therapy services, such as speech and language therapy, play a central role in providing care and treatment to children and adults in the community. There have been persistent challenges in recruiting certain grades of health and social care professionals to meet the demands for primary care therapy services and other community-based services, in part due to the lack of availability of suitably qualified candidates. In July 2024 we saw the lifting of the HSE recruitment pause.”
“We have seen the issue regarding eating disorders grow exponentially over the past four to five years, especially among young girls aged 15 and 16 with anorexia nervosa. When the model was put in place in 2018, it was envisaged that the best care for young people like that is in the community. A decision was taken at the time to try and put supports across every single community. When I became a Minister of State in 2020, we had one eating disorder team in place. We will have 14 by the end of this year. I have built on it year on year, securing the funding and getting the multidisciplinary teams in place. We will do the next two teams next year, and that is the 16 under the model of care. Notwithstanding that, our focus has to turn to the beds. I would like to see a geographical spread of the beds, not just in the large cities.”
“The new CAMHS eating disorder team will transform the experiences of adolescents with eating disorders in the mid-west, giving them earlier and enhanced supports and reducing the need for hospital admissions. As I said, there are currently 20 dedicated eating disorder beds across the four CAMHS inpatient units. The Deputy is right to say there are only three adult beds in St. Vincent's hospital. We have done a full bed capacity review of all mental health beds across the whole country. I have asked the HSE to conduct a full review of the national clinical programme. When it was established in 2018, at the time there was an indication that there may be 60 people who might need access to eating disorder extensive supports. I am meeting the lead on eating disorders this week. Last year, the figures show there were 894 referrals.”
“We have four different inpatient facilities for eating disorders for those under 18, namely, Eist Linn in Cork, Merlin Park in Galway and Linn Dara and St. Vincent's in Dublin. I am also aware the HSE funds patients in private facilities based on individual clinical need, as assessed by the local mental health team, and the prioritisation of available funding. I will address the beds in my supplementary reply.”
“I am delighted to say that one of them, a CAMHS team, is on the way to the mid-west, in Limerick. These are very specialised services. To stand up the team takes some time. It has to be led by a consultant psychiatrist. That means we will have a new CAMHS eating disorder team for the mid-west, bringing the total number of eating disorder teams nationally to 14 out the 16 teams under the model of care. In addition, HSE data indicates that, as the national clinical programme is rolled out, fewer people are needing to access eating disorder services abroad via the treatment abroad scheme. For example, I understand from the HSE that no child under 18 has had to be sent to the UK for treatment of an eating disorder since 2019.”
“It is ring-fenced funding that has been built on, year on year. Approximately 100 posts are funded under the programme including ten consultant psychiatrists now treating people with eating disorders across the country. The national clinical programme is being implemented by multidisciplinary teams on a phased basis. There are now 11 teams in place, as the Deputy said, six adult teams and five child and adolescent mental health services, CAMHS, teams. Funding was secured for an additional two teams under budget 2025. I also secured the funding for the 14th team last year when there was an announcement of €10 million last February. This means that 14 of the 16 teams envisaged under the model of care are now funded. It takes about a year and a half to stand up a multidisciplinary team.”
“While some people benefit from more intensive treatment through day programmes or inpatient care, research shows the most effective treatment setting is in the community, and this has been the area of focus for recent new investment in eating disorder services. Some 90% of people with an eating disorder are being treated in the community. Enhancements for specialist mental health services such as the national clinical programme for eating disorders is a key priority for myself as Minister of State, the Government as a whole and the HSE. Dedicated investment in eating disorders continues. Last year, the HSE spent over €9 million on eating disorder services under the clinical programmes. It is factually incorrect to say that money is not being spent. The previous year the spend was €8 million.”
“I thank the Leas-Cheann Comhairle and from the outset I congratulate him on his recent election to Leas-Cheann Comhairle. It is great to see him in the Chair. I thank the Deputy for her forbearance. Last Thursday I was not in a position to take the question. I thank her for agreeing to have the debate tonight. I thank the Deputy for raising this important matter in the House this evening. While I cannot discuss the details of an individual case here, I acknowledge what the Deputy has told me and am sorry to hear about this experience. As Deputies will be aware, eating disorders occur in approximately 5% of the population and have long been recognised as one of the most severe of the mental health conditions. We also know that it disproportionately affects adolescents and women.”
“We have 14 teams funded. It takes a year and a half to set up a team. They are multidisciplinary teams. We have 100 clinicians and ten consultant psychiatrists working on eating disorder teams across the country. The Deputy is right in that we have not made progress in relation to the bed capacity, but 90% of those with an eating disorder are treated in the community. That is what we priorities in the first instance. We are reviewing the model of care and looking at all situations in relation to inpatient beds.”