Thursday, 15 May 2008
Dáil Eireann Debate
6. Deputy Shane McEntee asked the Minister for Community, Rural and Gaeltacht Affairs if the Health Service Executive report of the working group on residential treatment and rehabilitation of substance users on the availability of dedicated drug residential services has been brought to his attention; his views on the report’s recommendations; and if he will make a statement on the matter. [18948/08]
Deputy Éamon Ó Cuív: I am aware of the report of the Health Service Executive working group on residential treatment and rehabilitation. My Department was represented on the working group and I welcome the recommendations therein.
The HSE appointed the group to provide a detailed analysis and overview of known current residential treatment services and to advise on the future residential requirements of those affected by drug and alcohol use. Being focused on residential services, its scope was much narrower than that of the working group on drugs rehabilitation, chaired by my Department. However, it covers all substance abuse, and so includes alcohol which is not part of the current national drugs strategy. The report makes a number of recommendations including the endorsement of the use of the four tier model of care as the framework for the future organisation of alcohol and drug services in Ireland, which involves the need for an appropriate level of service provision to best meet the needs of the individual client, from advice and referral up to specialist expertise to intensive interventions; emphasising the need for protocols to facilitate optimum inter-agency working; recommending the provision of dedicated high quality residential detoxification facilities including the provision of 127 dedicated beds, 50% each for drug and alcohol clients; recognising that detoxification is not an end in itself, a client-centered continuum of care is required to progress people towards recovery; quality assurance of residential services for alcohol and drug users; robust tracking systems to ensure that clients continue to get any support required; and involvement of families, in so far as is feasible in individual cases, in the care plan for recovering drug and alcohol misusers.
These recommendations are in line with those outlined in the report of the working group on drugs rehabilitation. While their implementation is primarily a matter for the HSE, I will support them in any way I can through the co-ordination of the national drugs strategy and I hope that significant progress can be made in that regard.
Deputy Michael Ring: Yesterday we had a report from the Health Research Board regarding the amount of drugs used in this country. There has been a 700% increase in cocaine users and the number of new heroin cases outside Dublin has doubled between 2001 and 2006. There has been a jump of 690% in cocaine users. The HSE issued this report but, on the other hand, it is not providing detox beds. It tells us we need 365 extra beds but at the same time it is cancelling the opening of new clinics. What is going on with the national drugs strategy? What will the Minister do if the HSE will not provide the necessary beds? In rural Ireland there are no detox beds for people with serious alcoholic problems. What will the Minister do if the HSE will not do the job it is empowered to do? We cannot have a major drug problem, with people needing detox and beds, and the HSE not having the will to provide beds. What will the Minister and the Government do?
Deputy Éamon Ó Cuív: We will continue to work with the HSE, which is the health authority with responsibility for this matter. Extra beds are being provided but more are needed. Whereas alcohol is a serious drug and one that is highly abused, it does not come under the drug strategy of my Department. Whether one can separate the problem of alcohol from opiate abuse is an issue we have debated many times in the past. We have an open mind on this and it warrants debate. It is worth noting that 50% of beds are needed for alcohol detoxification as opposed to drug detoxification but we will continue to work with the HSE on this matter.
Deputy Jack Wall: Regarding submissions to the national drug strategy, did the question of linking drugs and alcohol arise in trying to overcome the major problems that exist? Regarding the fragmentation of support groups in the country there does not seem to be any co-ordinated effort to align them to have a main thrust. There is a wonderful woman in Athy called Sister Concilio, who has facilities in Down, Galway, Bruree in Limerick, Cork and Athy. This was undertaken with her own initiative and funding. She has provided some residential services. There is also the St. John of God service. Is there any detailed evidence on amalgamating the two major problems in the submissions received? Regarding the overall picture, why is this so fragmented with so many groups seeking to alleviate the problem of drugs and drink?
Deputy Éamon Ó Cuív: Regarding alcohol misuse, we are having a series of public meetings. I attended the meeting in Sligo for a very short time but I will attend the meeting in Portlaoise. Alcohol and opiates are on a continuum and cannot be separated. We must examine the issue and are not at the conclusion stage because the meetings are still going on. They are being done on a round table basis to encourage people to interact. I am interested in the feedback from the ground.
We have far too many structures. It has taken a long time to get cohesion between partnerships and Leader companies. I hope it will be worthwhile. We must find a balance between dealing with structures all the time, rather than issues, and ensuring we do not have too many structures and duplication and that we keep things tight and focused. There should not be endless consultation and no business. We must undergo the consultation and when we finish we will have a clear strategy to implement.
Deputy Catherine Byrne: It is encouraging to hear of the 50% increase in beds. One of the main problems with residential care or rehabilitation is the fact that there are over 12,000 people on methadone. In order to go into residential care they must be clean. When will a programme be introduced so that people can access the service so that they can be brought down on the drugs? At present they are in no man’s land.
Deputy Éamon Ó Cuív: That is the problem. All we can do is keep working at the problem. I do not know if we have all the answers but we will continue to liaise with the HSE to move the process forward.
Deputy Joan Burton
Minister for Community, Rural and Gaeltacht Affairs
the number of submissions to the National Drugs Strategy 2009 to 2016; the number attending
iithe public consultation meetings to date; and if he will make a statement on the matter. [18813/08]
40. Deputy Joan Burton asked the Minister for Community, Rural and Gaeltacht Affairs the cost involved in advertising the public meetings on the National Drugs Strategy 2009 to 2016; the cost of holding such meetings; and if he will make a statement on the matter. [18814/08]
Officials in my Department, along with members of the steering group established to develop proposals for a new national drugs strategy are currently undertaking an extensive consultation process in regard to the new strategy. This involves 15 public consultation meetings, meetings with the various Departments and Government agencies involved, meetings with key sectoral groups and organisations working in the drugs area, along with focus groups that will include some drug users.
The public consultation meetings are being held in various locations around the country. They commenced in Dún Laoghaire on 23 April and will conclude in Croke Park on 3 June. The meetings to date have been well attended, averaging 70 to 80 people per meeting. Generally those attending have represented a good cross-section of people, from members of the public to people who are involved in drugs issues at community, voluntary, and statutory sector level. Feedback from participants at the meetings in regard to the format used and their level of satisfaction regarding being able to input has been very positive.
The full cost of advertising the public meetings is not available at this stage as only eight have been held to date. Consequently, the advertising campaign is ongoing and the details of the campaign can be subject to some change. The cost of holding the various meetings varies significantly depending on the venue, with Dublin locations generally being more expensive. Overall, the cost per venue to date is averaging at approximately €2,000.
So far, more than 120 submissions have been received from a wide variety of organisations and individuals. My Department is continuing to accept submissions and as such I expect this figure will increase during the coming weeks. I believe the public consultation process is central to the work of formulating a new strategy. It is important we hear the views of as wide a cross-section of the public as possible, young and old, to inform the overall work of developing proposals and making recommendations for an effective national drugs strategy for the period 2009-16.
Perhaps the Minister will say if sporting and recreational organisations such as Comhaltas and so on have attended any of the meetings held thus far. It is important they and not only local groups and concerned parents attend these meetings if the programme is to be a success. If following assessment of the programme the Minister finds that this is not the case will he ensure a national meeting is held with such organisations to get their views on the strategy?
Deputy Éamon Ó Cuív: I could not agree more with the thrust of Deputy Wall’s contribution. The diversion of young people into all types of activities is probably the best way of protecting ourselves against drugs. I cannot say whether the organisations referred to have attended the meetings.
Under the RAPID process, which includes the 46 areas most deprived and engaged in drug abuse, I have been actively engaging with the Football Association of Ireland which has been proactive in terms of funding and so on. I recently met with the chief executive of the FAI to discuss how we could further co-operate with particular reference to the RAPID areas. Also, I requested my officials within the past two days to contact the ard stiúrthóir of an Cumann Lúthcleas Gael to ask if he will meet me to discuss the Irish language, the Gaeltacht and, in particular, RAPID areas. I have discussed this matter with the Leinster Council and now believe we should do so nationwide.
Deputy Michael Ring: Does it make any sense to hold these public meetings when the HSE has decided to scrap plans for the introduction of cocaine clinics in Dublin, Waterford, Cork and Kerry? It is also proposing to close treatment services in Dublin for heroin users and is delaying the introduction of detox beds in hospitals. Does it make sense to seek the views of the general public when we know we will not even get the detox beds we need?
Deputy Éamon Ó Cuív: There is much more to this than detox beds. Deputy Wall put his finger on it when he said the real answer is diversion. We must treat those who have a problem with drugs and examine how we can keep young people away from drugs. The work we are doing is incredibly important. We must reduce demand and divert people away from drugs.
As in other areas of life, we often focus on curing rather than preventing a problem. I believe the only way to reduce drug abuse is by encouraging young people to get involved in activities and away from the scene which encourages drug use. We must continue to reduce supply. However, supply will to a certain extent follow the market. If we can reduce the market for drugs, a reduction in supply will follow.
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