Oireachtas Joint and Select Committees
Wednesday, 6 November 2024
Joint Oireachtas Committee on Health
Local Drug and Alcohol Task Forces: Discussion
9:30 am
Seán Crowe (Dublin South West, Sinn Fein)
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No apologies have been received. Before we go to the main item on today's agenda, the minutes of the committee meetings of 22 and 23 October 2024 have been circulated to members for consideration. Are they agreed? Agreed.
The purpose of today's meeting is for the joint committee to consider issues currently facing local drug and alcohol task forces. The meeting will be divided into two sessions. The joint committee will first meet with the Local Drugs and Alcohol Task Force Chairpersons Network, and later meet the Minister of State with responsibility for public health, well-being and the national drugs strategy, Deputy Colm Burke.
Before we commence this consideration, a letter was received by the committee from Mr. Joe O'Neill of the Western Region Drug and Alcohol Task Force, who made a point regarding the ten regional drug and alcohol task forces covering all areas of the State outside of Dublin and Cork and that some of the issues and challenges facing regional task forces are quite distinct from those facing local task forces. It is a fair point and maybe a future health committee can invite representatives back in to revisit this area. This morning's meeting will focus on local drug and alcohol task forces and the submission of the LDATFCN.
I will read a note on privilege. Witnesses are reminded of the long-standing parliamentary practice that they should not criticise or make charges against any person or entity by name or in such a way as to make him, her or it identifiable or otherwise engage in speech that might be regarded as damaging to the good name of the person or entity. Therefore, if their statements are potentially defamatory in relation to an identifiable person or entity, they will be directed to discontinue their remarks and it is imperative they comply with any such direction.
Members are also reminded of the long-standing parliamentary practice to the effect that they should not comment on, criticise or make charges against a person outside the Houses or an official either by name or in such a way to make him or her identifiable. I remind members of the constitutional requirement that they must be physically present within the confines of the Leinster House complex to participate in public meetings. I will not permit a member to participate where they are not adhering to the constitutional requirement. Therefore, any member who attempts to participate from outside the precincts will be asked to leave the meeting.
In this regard, I ask any member participating via MS Teams that, prior to making their contribution, they confirm that they are on the grounds of the Leinster House campus.
I welcome, from the Local Drugs and Alcohol Task Force Chairpersons Network, Mr. Martin Hoey, Ms Aoife Bairéad and Mr. Doherty. We will now hear the opening remarks.
Ms Aoife Bairéad:
I thank the Chair and members of the Oireachtas committee for inviting us. I am the Chair of the Canal Communities Drug and Alcohol Task Force. I represent the LDATFCN here today. Chairpersons are voluntary and independent. Our purpose is to be a representative voice for the task forces. We have a strong collaborative relationship with the local drug and alcohol task force co-ordinators' network, and I am joined by Jim Doherty, one of our co-ordinator representatives.
The local drugs task forces were a mechanism created more than 25 years ago to facilitate the involvement of local communities in the development of the services they needed to deal with the problems created by drugs use. Since then, task forces have been at the forefront of innovation and development of these services, often leading the statutory services because of their more flexible and responsive nature and their connections to the communities in which they are situated. We believe this remains our core strength today, and if the recommendations of the citizens' assembly are to be pursued, task forces are central to their success.
Successive Governments have seen the task forces as key delivery agents and have enshrined their role in the national drugs strategies. The citizens' assembly undertook extraordinary work and commitment to offer the Government a comprehensive plan to address the needs of individuals and communities impacted by drugs. We commend the committee members colleagues on the Oireachtas Joint Committee on Drugs Use on their recent interim report, which further strengthens this plan. The Government acknowledges that a health-led approach to the issue is paramount. Further to this, we welcome the finding of the assembly that the Government should apply a "health in all policies" approach to policy development. Task forces and their funded services are ready to work closely with statutory services to implement the assembly's recommendations. The current funding framework whereby most funding for task forces is distributed through health funding means there is no structural barrier to this. However, it will require a change in focus, leadership and a long-term commitment to the communities we serve, both through collaborative work and, most importantly, adequate resources.
During the period from 2010 to date, health expenditure increased by 56% while drugs task forces have seen their funding decrease by 4.5% and have seen their resources steadily reduced over the past ten years. This is incompatible with a continued leading role for task forces, and with task forces being able to implement either their obligations under the national drugs strategy or the recommendations of the citizens' assembly.
Local drug and alcohol task forces operate in the most disadvantaged communities in the country that have endured the long-term systemic impact of drug use and the wider implications of poverty, disadvantage and exclusion, often over generations. We are abundantly clear on the evidence of the impact of adverse childhood experiences on people's health and well-being. More recently, we have also had to acknowledge the impact of adverse community experiences. Poverty, violence and discrimination, lack of opportunity, economic mobility or social capital, and poor or inadequate housing all create conditions where moving out of drug use, and other challenges such as mental health, poly-victimisation, violence and criminality, is difficult. By continuing to under resource and underfund communities, we not only limit the chances of individual recovery, but also limit the potential for these communities to find the resources and resilience available within them. The future of drug policy in Ireland must be with the goal to not just reduce the harmful impact of drug use, but also to ensure that communities thrive and flourish, lessening the factors that lead to this problematic use.
Task forces are committed to Sláintecare and equality of access and opportunity for all our communities. Ireland's population is growing and becoming more diverse, which is presenting new challenges for task force services. Of particular concern is the lack of a coherent strategy for engagement with drugs and alcohol use among refugees and international protection-seekers, many of whom are fleeing violent conflict, and bring with them much trauma and a desire to self-medicate. There needs to be urgent additional support for task forces, who are being asked to provide services to this population.
The current model of channelling funding through statutory agencies presents complications when these agencies apply their own strategic priorities to funding intended for task forces. This sometimes means that new funding tranches do not reach task forces at all. This prevents task forces from achieving what we are most successful at; offering flexible, adaptable services tailored to the communities we serve. We fill a gap that national strategies and services simply cannot.
We call on the Government to acknowledge the implications of its own commitments and to link the funding levels of task forces to that of the broader health services. This will allow us to serve our communities with confidence and commit to increasing their resilience to difficulties caused by drug use, drugs sales and drug distribution.
Further to this, we ask that the committee ensure that the HSE recognises task forces within the forthcoming changes to its new regional structures. This can be done by funding, providing a clear organisational chart, which shows how representatives on task forces report into the new structures, and at what level, and ensuring that task forces are not overlooked in the new push towards population-based planning. This is necessary considering the clear evidence for an ongoing prioritised approach, as shown in the Health Research Board treatment figures. Task forces were established because it was recognised that not all populations are the same or should be treated the same, and it is essential that our role is clearly defined and properly funded so we can continue to succeed.
If the Government is to be successful in meeting the goals of the national drug strategy, the recommendations of the citizens' assembly and the more recent recommendations of the Oireachtas Joint Committee on Drugs Use, a substantial change in approach and engagement will need to be introduced. It is important that the agenda of Government is not frustrated by the strategies of individual agencies and we need to be seen as meaningful partners in this work. Given this, we propose the following: the role of junior Minister for drugs within the Department of Health to be established; the establishment of a cross-departmental committee on drugs, committed to progressing the recommendations of the citizens' assembly and the Oireachtas committee on drugs fully and in a timely manner; quarterly meetings with the Department and the chairpersons' network to be convened, and that these are planned annually - these should be offered with immediate effect; biannual meeting with the Department, the Minister and the chairpersons' network to be convened, and should be scheduled for 2025 without delay; and a gaps analysis commissioned to look at the structural disadvantages that local drug task force areas face. We welcome the recent confirmation from the Minister that all community workers will be included in pay restoration. Further to this, we require funding to allow organisations to offer competitive salaries, increments and pension contributions, in line with public sector workers. This is absolutely necessary if we are to address the chronic challenges of recruitment and retention in task force services. We also call for funding systems that prioritise the strategic goal of task forces with regards to their own budgets. The unique quality of drug and alcohol task forces is their ability to recruit the time, talents and commitment of volunteers such as board members, chairpersons, and committee members. To safeguard this quality, the autonomy and integrity of task forces must be protected.
I thank committee members for their time.
Seán Crowe (Dublin South West, Sinn Fein)
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I thank Ms Bairéad. Deputy Durkan is leading off.
Bernard Durkan (Kildare North, Fine Gael)
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I welcome the delegation this morning. I thank them for coming along and thank them for the important work that they do in providing a important linkage between Government the people who are affected by addictions.
We all have in our respective constituencies various rehabilitation centres, etc. It is important at this stage to recognise that we are coming from a long way back. We have a lot of ground to cover and this is accentuated to a huge extent by virtue of the population increase in the country, increased demand in the country and increased addictions of all sorts.
I was a member of one of these ministerial task forces a long time ago. It was useful but even though we had been active for a couple of years, we had not got to the stage where we had found the ultimate answer. We still have not the ultimate answer, that is, the strengthening of the link to bring to the centre of Government the necessities and acute demand on the ground and how best to make it happen.
To my mind, two things need to happen. We have to deal with on the treatment level, including methadone treatment, and set up as many treatment centres as possible with the clear intention of reducing dependence on whatever the addiction is. Otherwise, we are not making a gain at all.
There is a debate that I have had previously with some of the treatment centres that it goes on forever.
We need to show some degree of progress. We need to be able to tell patients, for a start, that we are winning the war and they are less dependent than they were or that they do not depend to the extent that they did. That is progress.
We must also deal with supply. The rate of supply is appalling at the moment. It affects all schools, for instance, at primary and secondary level throughout the country. It affects children in a big way. What is happening is that the drug warlords are creating a dependency in advance of their market so they have a steady and guaranteed market based on the misery they create among people who are very often vulnerable. I note the points that have been made about the establishment of new structures and so on. How quickly do the witnesses anticipate the need to set up? What are the primary needs now? What is the most important thing that could be done now to deal with the problem in a meaningful way that is likely to have an effect without having to wait for three, four or five years to see the result?
Mr. Jim Doherty:
I will take that question. The primary things that need to be done now include the re-establishment of regular meetings with the Department. Those are cost free and it is about time they were re-established. Also required is the prioritisation of the task force's local drug strategy. The task force takes the national drug strategy and creates a version of that for the local area in which it acts. We need that to be prioritised, recognised and respected by all the agencies that are involved.
We also need the Minister to have a much stronger focus on trying to bring in the other Departments. Education is a critical player in drugs task forces. We are charged with working with young people and we try so much to do prevention work with them. Justice is also a key player. The environment, in the sense of the local councils, is a key player. The Garda is a key player, as is the Department of Health. Unfortunately, the move to a health-led response has sometimes de-emphasised the need for the whole community of agencies to respond. That work needs to be prioritised and strengthened.
Another thing that will do much to guarantee our future and our ability to implement the citizens' assembly recommendations is the linkage between our funding and the broader health budget. It is incompatible for us to say there is a health-led agency delivering health-led responses but its funding is going to go down by 5% over ten years while the health budget increases by 50%. If there is a strategic focus on what we are doing as part of the panoply of health responses, we have to be treated as part of the panoply of health responses. That has caused all sorts of difficulties and problems. We are not asking for a penny more than other health services get. We are just asking for the respect of being treated like that. We need the community of agencies to be brought together.
The Department of Education decided not to attend drug task forces many years ago and engagement with education is at a low point. That is a critical point because if you are not at the table, you cannot continually express your policy and that has created all sorts of difficulties and problems for task forces over the years. When people think about drugs task forces, they think we are going to work for the young people and be involved. Of course, that is a critical part of what we do and we still do work with young people. However, we generally work in the absence of high-level influence within the Department of Education.
Bernard Durkan (Kildare North, Fine Gael)
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Mr. Doherty makes an important point. Co-ordination is hugely important. Constant monitoring is required. We need to know where we are going and how fast we are going in a particular direction. Whether the situation is good or bad, we in the community at large need to be alerted. Mr. Doherty mentioned the various entities that are part and parcel of this and need to be at the table.
To get the kind of co-ordination we are talking about with the Department of Education and everybody else involved, who should be the driving force? The organisations involved include the Garda, the Department of Education and the health services. Drug and alcohol addiction experts also need to be involved. We must reduce the burden and show hope to the people who are affected, as opposed to imprisoning them for a start, which is not going to help at all. What is needed more urgently is treatment to reduce the dependency on whatever drug they are dealing with. As Oireachtas Members with constituency offices, we all know that there are various ways of dealing with them. The important thing is that we hold out some hope to the people. It is no good telling them that they are chronic addicts and the addiction will last forever while at the same time telling them we will put them in jail because that is the only way to solve the problem. That does not solve the problem. In actual fact, it makes it a whole lot worse. Who should be the co-ordinating body?
Ms Aoife Bairéad:
Given that most of our funding comes through the Department of Health, it should be that organisation. We must also remember that the task forces are set up to have statutory, voluntary and community agencies working together. That framework is in place. Departments need to prioritise us and send that message down through the various organisations they fund and represent. We may have a HSE member or somebody from Dublin City Council but we may not have somebody from, for example, mental health. Given the emphasis on dual diagnosis, the local mental health care team or local primary care centre ought to be represented. We may not have a representative of education or Tusla. That is a top-down message. It has to be an expectation that organisations engage with these services. Drug and alcohol use affect every Government service that I can think of in one way or another. The idea that there is not that top-down expectation surprises me. I have been in the job for more than a year now. I worked in communities for 20 years. It surprises me that the top-down message is not there, given that task forces are set up to allow for that and with the expectation of that. Given where the funding comes from, what we already know and what was emphasised by the citizens' assembly, it should be led by the Department of Health, but the other Departments should see themselves as critical players and make sure that happens.
The Deputy is right in what he has said about treatment. We need those treatment facilities. Many people need residential treatment. We know that particularly for communities where people have had struggles and difficulties, trauma being the most obvious one but other issues as well, their chances of remaining in recovery are less than those who have lived an easier life. That means that those community counselling and therapeutic options must remain. The Deputy said rightly that addiction does not have to affect people for the rest of their lives. However, some people may need support for the rest of their lives for that to be the case. The way funding is given now means that we do not have the resources we would need to ensure that free and readily available counselling is available to everybody who needs it. Funding is often given year on year. This is my voluntary role but my job is as a social worker and I do therapeutic work. There is an ethical issue with offering people therapy that might have to stop in six months and will not be there for those people. That is against any ethical framework I can think of but task forces are forced to do that every year. They must scrimp and save to pull in whatever funding is given, with €20,000 here and €10,000 there. They are told they will have the funding next year but may never have it again. It is unsustainable, unhelpful and unfair. We must have that availability. I agree with the regional task force that what different communities in different parts of the country face is different. Those communities need their own individual responses and task forces are the best people to do that.
Róisín Shortall (Dublin North West, Social Democrats)
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The witnesses are welcome and I thank them for their presentations. The overarching point has been made well. Concentrated and problematic drug use does not happen in isolation. It happens, in the main, in areas of severe disadvantage, which is where the task forces are located. We can talk about the importance of co-ordination and all of that but it is budgetary decisions that influence the level of poverty in the country. I will make the following point very quickly.
What we have seen in recent budgets is a widening of the gap between rich and poor, and that is the approach that has been taken. It is entirely political, and its solutions are political in terms of effective measures to tackle disadvantage, exclusion and poverty. Regrettably, we have not seen many of those in the last ten years.
The witnesses' requests for new structures are very reasonable. The original idea when the task forces were set up in 1997 was that there was a national co-ordinating committee with very senior people on it, probably close to the most senior people in the relevant Departments, and that was operating within the Department of the Taoiseach. We also had senior people at local level as well. I have been a member of the drugs task force in Ballymun for a long time. I was also, for a period, on Mr. Hoey's task force in Finglas-Cabra. What happened very quickly is that those other agencies withdrew from the whole process and, basically, they did not want to know. The Chairman will be aware of this from his own experience; they really did not want to know. The concept of a health-led response is fine in theory, but it does give people in other Departments an out, as the witnesses have stated. I know from dealing with people at a senior level in government that most of them do not have a clue about how to address poverty and exclusion, or they do not want to know, and no effort is made. At various task force meetings, I often used to think that the thinking used to be that senior people will influence things, but actually the education was going the other way. The task forces were educating senior officials from different Departments regarding what the issues were and their solutions. In the main, they did not want to know.
What Ms Bairéad proposed regarding the establishment of a cross-departmental committee on drugs is very important. She said she thought it would sit under the Department of Health. In many ways, I think it should be in the Department of the Taoiseach, because the teeth of the Department of the Taoiseach are needed to get people to do their jobs, to perform and stop this tendency of just leaving it to the Department of Health. I also completely agree with the idea of having senior people locally. Apart from withdrawing from the local structures, what happened was that agencies sent along junior people who did not have any decision-making powers, and that has been the problem. What the witnesses are looking for in terms of the structures seems very reasonable - maybe overly reasonable. Can the witnesses talk to us about the engagement they have with the Department of Health and the Minister at the moment? Is there any functioning body that involves other agencies?
Mr. Jim Doherty:
For a little bit of background, I was co-ordinator in Dún Laoghaire in 2004 and I have been in Blanchardstown since 2012. I have 20 years of experience of this. I think I am right in saying that the contact we have with the Department is at a fairly low ebb. One of the reasons we are asking for things to be scheduled and planned ahead is that it is very difficult to pursue an agenda when there is uncertainty about when the meetings are going to happen. It is probably the lowest level of contact that I have ever had in the 20 years I have been a drugs task force co-ordinator. That is a situation that needs to be addressed immediately.
I am old enough to remember the national drugs strategy team, which was a very good and very effective multi-agency team of senior representatives from different Departments who looked at issues that were common to different task forces across different areas and addressed the policy difficulties that created them. I am also old enough to also remember the national co-ordinating committee for drug and alcohol task forces, which did not do an effective job. The national oversight committee, which as I understand still exists, does not seem to produce effective, useful decisions and policy recommendations for us either. We are saying the structures that are in place are definitely not working. Regular engagement and contact would be a good way for us to start reviving those structures or building new, more effective structures. That would be the priority for us right now. It would be better for us to have a better relationship - this is not a comment on the present Minister's attitude to us - in terms of more frequent meetings and more easy conversations, because if the Minister has responsibility for us, we need access to him in order to articulate our concerns.
Róisín Shortall (Dublin North West, Social Democrats)
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Can Mr. Doherty tell us a little bit about the current drugs unit within the Department? Does it have many staff members?
Mr. Jim Doherty:
It has a broadly administrative function. I have no comment about the performance of individual civil servants or anything like that. It is not about that. It is about the fact that we need the structure in order to plan ahead and say we will have three meetings next year. We recently tried to restart housekeeping meetings to deal with administrative issues which have been arising. Deputy Shortall will remember the national drugs strategy team. Issues could be brought there and could be addressed there and people had decision-making capacity. What we find now is that it has become a lot more difficult to get people who are decision-makers to come into in a room with us in order for them to commit to a decision. I am sure it is a common problem across government.
In defence of the current of the group of people in the Department, they also have the added responsibility for refugees, inclusion and homelessness. These are all critical issues that feed into the drugs issue, as we mentioned in our statement. However, as the Deputy said, we were in the Department of the Taoiseach and had a Minister solely concerned with drugs, and now we are in the Department of Health and have a Minister who also has lots of other jobs. An inescapable conclusion of this is that the drugs issue is not being prioritised the way it used to be.
Róisín Shortall (Dublin North West, Social Democrats)
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It is certainly not being prioritised with funding either.
Róisín Shortall (Dublin North West, Social Democrats)
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There is also a need for commitment from people who may be in the next Government to multi-annual funding because that is certainly a factor in the recruitment of staff, especially if people cannot be offered more than a 12-month contract.
Róisín Shortall (Dublin North West, Social Democrats)
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Mr. Doherty referred to the national oversight committee. Does it still exist?
Róisín Shortall (Dublin North West, Social Democrats)
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Does Mr. Doherty know whether it meets on a regular basis?
Mr. Martin Hoey:
I will answer on behalf of Mr. Doherty. The national oversight committee does meet. One co-ordinator and one chair attend it at the moment. The big issue with it at the moment is that because the local and regional task forces are slightly different, the committee does not have one from each region, which it needs to be viable because there are differences in the areas. I do not know the frequency of meetings, because we do not hear much information coming back to us. It is operating. I know that.
Róisín Shortall (Dublin North West, Social Democrats)
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My final question is on the subject of drug treatment and methadone, which came up earlier. That is one area and there are certainly questions about the length of time people are stuck in methadone maintenance and the lack of counselling services and so on. Again, it is an underfunding issue. Presumably, the majority of problematic drug users are not heroin users; they are cocaine users. What are the services like at the moment for people in that category?
Ms Aoife Bairéad:
I suppose they are in a lot of parts of the country. That again speaks to why having local funding is important, because the profile of what people use and why they use it differs across different communities. It can also change remarkably quickly, often with what is available. Therefore, having a very flexible approach that tailors the services to the community and being able to adapt as they need to is very important. For example, over however many years I have been working, there are these surges of certain drugs, and they change very quickly.
We need services that can adapt to that. The fundamental difficulty with people who continue to use drugs or cannot stop using drugs and on whose lives that has significant problematic impacts is that there are other huge issues in their lives. It cannot solely be about focusing on one treatment or another. We have so many decades of research now that we know why people start using drugs, cannot stop using drugs and then return to drugs. Many people in many communities start using drugs. The other two are factored very much in deprivation, poverty and trauma. We also see the impact now of how, as was referred to earlier, gangs will tailor drug availability and drug use to bring in new people. That is absolutely true but if we do not have this co-ordinated approach to addressing it, those people will continue, as somebody said, to fall through the cracks or, as another person responded, to fall through the canyons. That is how it feels.
Returning to the point about the Department of the Taoiseach, and not in any way to disagree with it, while a health-led approach seems to be the best approach and is the one that is recommended by most experts in the area, and where it has worked in other countries, that seems to be why it works, I am concerned that if we take that approach, there has to be an acknowledgement or commitment from the heads of all Departments about responsibility. Maybe that needs to be in the Department of the Taoiseach. The Deputy would be much better able to decide how these political pieces work. As somebody on the ground, what I find difficult within that is why another Department would not hold that grave responsibility. Why does it have to be siloed? Why is it if it is your responsibility, it is not mine? That seems extraordinary to me, given what communities face. The idea that if one Department has it, nobody else needs to touch it is remarkable. I have been coming to this building for, I think, 15 years in various forums. It has been said in so many forums before that it may be about children, education, drugs or poverty. It has been repeatedly said that one Department-----
Róisín Shortall (Dublin North West, Social Democrats)
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We need a point where there is accountability and-----
Seán Crowe (Dublin South West, Sinn Fein)
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I am trying to keep the interaction to ten minutes. There may be an opportunity for people to come back in and follow up on points.
Neasa Hourigan (Dublin Central, Green Party)
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I will start with what Ms Bairéad just talked about, namely, the interaction between the witnesses and some of the decision-makers. I will talk about recommendation No. 8 of the citizens’ assembly in terms of the national drugs strategy. The witnesses described their interaction as they would like it to be. Is that what recommendation No. 8 would encompass - that there would be regular interaction from multiple agencies overseen by one Minister and the buck would stop there, effectively? I note the answer is "Yes". I suppose recommendation No. 25 and that local partnership is the other side of it. What would the witnesses expect to see? Is that a mirrored version of it except with local gardaí-----
Mr. Jim Doherty:
Yes, a mirrored version of it. When I started in Blanchardstown drugs task force in 2012, we had the person who is currently the CEO of Fingal Council County attending the meetings. I mean no disrespect to her, but we now have someone who is a community development officer. It is stark. I mean no disrespect to the woman in question but in terms of decision-making capability and the ability to influence the decisions of her colleagues in other departments in the council, she has less power to do that.
Neasa Hourigan (Dublin Central, Green Party)
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As a general principle, when it comes to the Garda, is the task force dealing with more senior members or is it more community gardaí?
Neasa Hourigan (Dublin Central, Green Party)
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When was the past? Can we put a year on it?
Neasa Hourigan (Dublin Central, Green Party)
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Is it ten years?
Neasa Hourigan (Dublin Central, Green Party)
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Perhaps 2016 and before.
Neasa Hourigan (Dublin Central, Green Party)
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I am interested in some of these interactions between all the different agencies. We talked a little about the funding coming through the HSE. We are in a time where everything is changing. Regarding the task force operations, we talked a little about local versus regional. Is there concern or are there challenges around the new regional health authorities, RHAs, for example, as regards their size, access to them and whether the witnesses believe they will be able to interact with them in terms of the stakeholder-led model? I take the point that every area is different. Dublin is a particular regional health authority and will be different from somewhere in Cork, Sligo or wherever it might be. How are the witnesses navigating that change? Do they see opportunity there?
Mr. Martin Hoey:
In our area of Finglas and Cabra, our HSE person will also be responsible for the new northern regional health area. She said she will be dealing with regional task forces as well as the local task forces in the area with no extra help or support being provided to her. It will therefore cause a few complications. The task forces have received very little information on how these new areas will work compared with the old HSE areas.
Neasa Hourigan (Dublin Central, Green Party)
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Has anyone from the HSE ever sat down with Mr. Hoey and explained the structure?
Neasa Hourigan (Dublin Central, Green Party)
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Was it requested of the HSE or the Department of Health?
Neasa Hourigan (Dublin Central, Green Party)
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It is not set in stone. The RHAs are pretty progressed to be not set in stone.
Neasa Hourigan (Dublin Central, Green Party)
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How long has the task force been requesting that meeting?
Neasa Hourigan (Dublin Central, Green Party)
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That is quite a while. That is something the committee could perhaps help with.
I seek clarity on Mr. Hoey's point about the lady from the HSE, which he used as an example. That is somebody who is dealing with the local area task force in the normal way but will now also have the regional task force added to her workload. It seems she does not have any information as to how that will work or any additional resources.
Neasa Hourigan (Dublin Central, Green Party)
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One of the issues that has come up, and it came up a lot in the drugs committee as well, is around how we can improve reactions to drug-related intimidation. The citizens’ assembly kind of heralded that the drugs and alcohol task forces can be involved in those DRIVE-type schemes. What is the witnesses’ reaction to that and where do they see their role there? What kind of resources would they require to do more work in that area?
Mr. Jim Doherty:
As part of the response, we have taken over and become the local agency for the DRIVE programme. To those who are not familiar with it, DRIVE is a national policy approach to drug-related intimidation. One thing that we do locally and that many task forces are doing is building it within the nexus of family support. Since the previous iteration of the drugs strategy, family support has become a recognised service offering for drugs task forces for a number of reasons. One is that family members are often permanent people in the lives of drug users and are well placed. If we can train them a little bit, they will be well placed to offer continuing and forever support to that person. In addition, families are the ones who are targeted by drug-related intimidation and its victims. The approach many task forces have taken is to try to offer family support services and then have a close relationship with the local gardaí. Local relationships with all of these agencies tend to be great because you know the person and it is good. If I can make a slight criticism, although I know it is not something the Garda can necessarily do anything about, the turnover of people in Garda positions can cause difficulties, simply because so much of it is based on personal relationships.
Neasa Hourigan (Dublin Central, Green Party)
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Is Mr. Doherty speaking specifically about the community gardaí?
Neasa Hourigan (Dublin Central, Green Party)
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I find that myself with community garda posts. Often, I spend a minute getting to know people and then they are gone.
Neasa Hourigan (Dublin Central, Green Party)
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And the task force has the connections on the ground.
Mr. Jim Doherty:
-----to deal with that. Yes, we have volunteers and local representatives. We are in a very good position to do the best we can on the issue of drug-related intimidation but our communities are also the location of the drugs industry. We all know that drug use has spread right across the island of Ireland and in the most affluent areas, you can find cocaine on the toilet cisterns and so on. There is only a small number of areas, however, where you can find the importation, supply, distribution and battles for control of the drug industry. They are in the areas that we serve.
Ms Aoife Bairéad:
Very quickly on that point, we are doing research into violence in our area. We got some funding to do that, which obviously will be localised but we hope it can offer evidence that can be offered further from there. On the turnover of staff, that is the same for DCC housing complexes, in that they often have very good relationships with the representatives there but again, because of a turnover of staff those relationships have to start again and again.
It is very frustrating for people who are really challenged in those communities where certain individuals are able to and are supported to live, despite continuing threats and intimidation to others. Of course, we are again back to the interdisciplinary issue which is that there are laws in place to protect people's housing rights, which is absolutely right, but other people in those housing complexes have rights too and that intimidation and fear is extraordinary in some areas. It seems to be incredibly difficult to move the dial at all in those conversations.
Neasa Hourigan (Dublin Central, Green Party)
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I have less than a minute but I want to finish on a question I often ask. Have the witnesses received, in any meaningful way, extra resources or supports in respect of the emergence of nitazenes and increases in overdose relating to that substance?
Mr. Jim Doherty:
We have only received information from the HSE. We get timely bulletins and information sent out to us whenever nitazenes present but we have not received any additional resources specifically for that.
Neasa Hourigan (Dublin Central, Green Party)
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Has there been any expanded access to testing?
Gino Kenny (Dublin Mid West, People Before Profit Alliance)
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Good morning, everybody. I want to start off with one of the central themes of this particular issue for the past 50 years, which has been political will to really address issues around drug dependency and so forth. The citizens' assembly and the special committee on drug use issued recommendations and they were largely progressive in terms of looking at different policies and approaches to drug use.
How confident are the witnesses regarding the implementation of those recommendations, specifically the drug task force and the wider recommendations of the two bodies that made them?
Ms Aoife Bairéad:
The interim report from the Oireachtas committee on drugs helped, in that we feel the issues is at least being spoken about. It seems to be recognised and those issues are reinforced. We are back to and are always in that precarious position of somebody having to decide to do it and who that will be and when will it happen. Obviously, there will be changes but the strength of the arguments in both was there.
One of the recommendations was that the Oireachtas committee be established and it was. There is hope in that the dial has moved somewhat but really, again, I am not sure how that grave responsibility each Department should feel it holds is held by Departments. To me, it is extraordinary that it is not and that it does not feel like a grave responsibility to respond to these issues or to do it in a timely and effective way. As the Deputy said, however, that has not always felt like the case. We have had bursts of change and moves forward but then it stagnates for ten years in respect of funding. It really is about how this issue translates into that sense of responsibility and Government. I am not sure.
Gino Kenny (Dublin Mid West, People Before Profit Alliance)
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Obviously, we have had the status quo and what would be termed as a health-led approach. We have had this health-led approach for the past six or seven years and it has largely been lip service in terms of really getting down to the nitty-gritty of trying to save lives. Ireland has the highest rate of drug-related deaths in Europe. Some of those deaths could have been prevented. There are people who should be alive today who are dead because of policy. You cannot get any more serious than that.
Ms Aoife Bairéad:
When I say "grave responsibility", I am using my words with care for that very reason. In the most recent report of the Child Law Project, 20% of the children in care came from families where drug and alcohol abuse is an issue. That is extraordinary because if those treatment centres were there - we should not be taking children into care unless it is absolutely necessary - but I am not sure, having worked in Tusla for a very long time that those services were readily available. I do not work there any more but I did and they certainly were not when I worked there. They are not there with the parents I now work with. When I say "grave responsibility", I mean that in the gravest way possible. I am not sure that sense of responsibility is there all of the time. As I said, on the ground we work with some extraordinarily dedicated people who have spent most of their lives working in the Department of Health and other places to make change happen but it must be from the top and it must be across different Departments. The health-led approach is the most evidence-based but it cannot work alone. That is why the citizens' assembly help in all policies. It named clearly a need to go across different Departments and it has to be seen as such.
Gino Kenny (Dublin Mid West, People Before Profit Alliance)
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We have to be bold and radical in how we look at this issue. We need to look at the underlying issues of dependency and at different forms of how different countries have tackled drug dependency. Portugal has been cited. It is not perfect by any means but it is better than what we have at present. The elephant in the room that many people do not want to talk about, however, is the regulation where the black market essentially controls all drugs. This is the irony at the end of the day. Controlled drugs, which are on the statutory books in this country, are not controlled by the State. They are controlled by the black market. Once you have that situation all the time, you will have deaths and the chaos that comes with unregulated systems.
We have a chance with the two reports to look at things very differently but I do not believe the current Government or successive Governments have the stomach to go after this. It is not going to be absolutely perfect. It is not a panacea by any means but it will certainly save lives and stop stigmatising and criminalising people. We have had 50 years of this and it simply has not worked. We need something different. I have cited this again but public opinion has moved on in this but certain elements of the Government and Departments have not. In fact, they are happy enough with the status quo where working-class communities destroy themselves and are allowed to cannibalise the black market as well as the horrible thing that go on with drug dependency and the drug trade. You have to tackle down-the-line issues and take control of certain drugs that are unregulated. That is my view on things and I think with that different form of policy, you can save lives and stop bringing people through the criminal system.
Gino Kenny (Dublin Mid West, People Before Profit Alliance)
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That is an observation. I do not know if the witnesses want to comment on that.
Gino Kenny (Dublin Mid West, People Before Profit Alliance)
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That is perfectly legal.
Mr. Martin Hoey:
That is an example of where there is one legal drug in the country. Alcohol is a big one. The State has tried to do some things with it but for us as task forces, we have not seen much come down from the Departments in either financing or in help to push against alcohol. For us to continue our work, we would need a lot more help to deal with that problem.
It was added to our remit approximately two years ago.
Gino Kenny (Dublin Mid West, People Before Profit Alliance)
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I always find strange the juxtaposition between drugs and alcohol. Alcohol is a perfectly legal substance to buy, while drugs are completely illegal. I find that parallel a bit of a contradiction in terms of our policy.
Ms Aoife Bairéad:
We have to remember, because sometimes drugs can be talked about as if they are the baddie in the room, that most people who use drugs do not engage in problematic drug use or have negative outcomes. The people who have difficulties with drugs and alcohol have similar experiences and live in similar communities, not just in Ireland but across the world. Terms like “self-medication” hold true. People are medicating against things that have happened. There is excellent evidence that people use certain drugs and alcohol when they have experienced certain trauma. We know these things to be true. We can, therefore, either address the problem at that level, and know that is what we are addressing, or we can keep on pinpointing the problem drug, labelling it cocaine this year, heroin three years ago and benzodiazepines five years ago. We can keep on treating the problem in this manner but that is to treat the problem incorrectly. I am sure the regional task forces will speak to that effect.
In other areas, it is very much about alcohol. I undertake assessments of children and families throughout the country and can say that alcohol has destroyed families in the same extraordinary ways as drugs have destroyed other families where people have died, are incapacitated or where their children are lost to care. It is about treating the harm being done to those people from the experiences in their lives and because of the areas in which they live. Those two things go together. One of the quickest ways people seem to move out of those traumatic response behaviours is to move out of poverty. That is the evidence. We can either take an evidence-led approach or we keep on trying to silo the problems as being about this drug or that drug or whether a drug is legal or illegal. The problem is about the hurt, trauma and harm being done to people.
Mr. Jim Doherty:
If I was asked to characterise our whole approach to this issue over the last 20 years in two lines, I would say that we have had a psychological approach where we look at the individual. While in later years we have been better at looking at the things around the individual, we were reluctant to take a sociological approach where we look much more at the community in which the individual lives. Ms Bairéad referred to a health approach. We need to add to the idea of adverse childhood the idea of adverse community experiences, because we work in unhealthy communities, not just with unhealthy people.
Gino Kenny (Dublin Mid West, People Before Profit Alliance)
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That is a good point.
Frances Black (Independent)
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I thank the witnesses for coming before the committee and for the time and resources they have dedicated to engaging with us today. I also particularly thank them for the presentation they give in September in the audiovisual room. It is important both to raise these issues and put them on the record and to give the wider public an opportunity to understand the valuable work the witnesses undertake. The work they do is unbelievable and I give them great credit for it.
Some important points were raised in the opening statement about adverse community experience, how substance use intersects with poverty, which has been just mentioned again, social inclusion and intergenerational trauma. It is not possible to achieve a truly health-led approach without acknowledging the root causes and addressing the impact that long-term austerity policies and under-resourcing has had on individuals and communities. Deputy Kenny touched on a similar point as the one I wish to make. Why is there a lack of political will in this particular area? There is no doubt but that this issue is at the end of the ladder of priorities. I find it frustrating in the work I do with The RISE Foundation. What are the thoughts of the witnesses on the lack of political will in this regard?
Mr. Jim Doherty:
In the context of the kinds of approaches I previously mentioned, psychological approaches are more likely to yield shorter-term results. Measurable improvements to individuals, therefore, can potentially be achieved within the lifespan of a Government. The broader sociological approaches where you are trying to create better communities and better environments for people to grow and flourish tend to be much longer term.
To use an example from my own work, I have undertaken a lot of research which shows that one of the strongest protective factors against drug and alcohol use for children is staying in school longer. School is often a great source of stability, safety, warmth and, sometimes, nutrition for children in the areas we move in. Keeping children in school longer protects them more than a lot of other things we do. We work locally to try to facilitate children with learning difficulties to stay in school. That is not work, however, of which I may ever see the fruit. If we make an intervention with a six- or seven-year-old, it is extraordinarily difficult for me to measure the impact it might have on that person when he or she is 21. It is almost impossible and very hard for everyone in this room. It is, therefore, difficult to make strong cases for allocation of scarce Government resources towards such interventions. Despite this, those interventions are likely to be the ones that ultimately will have the greatest impact of all because if we keep one person out of Mountjoy Prison, we save the State multiples of everything that we spend on six- and seven-year-olds.
When taking into account people’s political perspectives, the limited time of governments, policies and Ministers, etc., it is difficult to make those arguments. Even as a task force co-ordinator, it is difficult to make those arguments to funders. It is, however, the area where we effect long-lasting change by improving people's lives and keeping them in education. When they stay and do better in education, they will have more job opportunities and broader horizons for their own lives, which will lead them to function better within their families and all these kinds of things. It all feds in but I am not sure it is something that can be measured on an Excel spreadsheet in the next 18 months.
We need a deeper, more analytical and more strategic view about what it is we are trying to achieve for individuals and what success looks like for that individual. For a child who was refusing to go to school but is now going to school again, we need to look at the impact that might have down the line on that child's life chances. There is plenty of sociological research in this regard. It should not be impossible for us to calculate that and weight our efforts towards work like that. As Ms Bairéad said, there will be another drug next year to which we will react. There will be another type of addiction and we will react to that also. Ultimately, however, we have to try to stop the conveyor belt of children needing those drugs.
Ms Aoife Bairéad:
I have worked with communities in the south inner city for most of my adult life and I am always taken aback by how little the positive resources and strengths of those communities seem to be recognised or even whether people are interested in them. There is an extraordinary lack of curiosity as to why so many people in those communities continue to do well, survive and keep their families as healthy as possible. They are seen as problems, which are then individualised into drugs, poverty, housing or education. The fact that they all culminate in the same area is recognised but there is nothing beyond that. Not only is there a lack of recognition but there is also a lack of respect for how extraordinary the people we work with are. Most of the people who work in drug task force services are from those communities and are dedicated to strengthening those communities. While some of them end up in places like here to represent those communities elsewhere, they are on the ground doing work all day every day to make their communities better. As for how this is not given a curiosity, it should not simply be a curiosity as to how you get into the problematic areas; it should be about how do you get to be you and how do you get to be that strong and capable.
I have always struggled with that top-down approach when national strategies are brought in or even city-led strategies. There never seems to be somebody checking to see whether it will work in the community and asking how to can be made better. Portugal has been cited. My fear is that we would take lock, stock and barrel any approach without going to the communities we work in and asking them to tell us how it will work there, because they are the experts. The idea we do not see communities as experts in themselves is one of the fundamental problems as to why those changes have not been made.
Mr. Martin Hoey:
I would look at it as news stories. We always see where big drug seizures are caught that they will always make good news, but people will never hear of somebody who has gone through a full treatment programme, has recovered, has come out the other side and is grand. You never hear that story. The Government will always look at it and say it put in the resources and stopped a certain amount of drugs getting into the country. We never hear the Government saying it put the money into task forces and 100 or 1,000 people recovered and no longer have an issue with drugs. We will not hear that part but we always hear the negative side. That is why it is more down the bottom of the ladder.
Frances Black (Independent)
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Do the witnesses believe there is a kind of unconscious moral model? Is that still there?
Ms Aoife Bairéad:
The problems faced by the communities we work with are the ones that people are most fearful of in our society. It does not mean that they do not affect other families or other places but they are concentrated in those communities in ways they are not in other places. People want to look away. They are hard to watch. They are really painful to watch sometimes.
Frances Black (Independent)
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Earlier the witnesses spoke of the need for a shift in focus and leadership. For many of us here our political careers begin with advocacy, for example, within our own communities. There is always the worry of us becoming disillusioned or detached the more we have to engage with the system. It is almost like a little bubble in here sometimes. That is why we need and why it is so important that civil society and local communities participate in that arena in politics. We share the same vision but the approach taken is shaped by the expertise and experience of those in the driving seat. Engagement is simply not enough. We need innovative ways of sharing our expertise and working as a collective. What is the consensus among local drug and alcohol task forces in this regard? When working with statutory bodies or funded services, do they feel they are influencing the direction of a programme or shaping it? What changes can we make to bridge the gap between different organisations that share a common goal? Will the witnesses say a little bit more about that. I know they have touched on it but perhaps they will just say a little bit more on it.
Mr. Jim Doherty:
At the moment, particularly with regard to health, there is a huge policy shift taking place within the Government. As chair of the co-ordinators' network and, personally, as a co-ordinator, we feel we are very much going to be policy takers, at least in the short term, rather than policy makers. That speaks to some of the organisational deficits and interactional deficits we have with various Departments and senior officials in various Departments we mentioned earlier. As a key delivery agency that will very much be part of implementing some parts of Sláintecare, our voice is not necessarily being expressed loudly enough within the direction of how that will be implemented locally. That speaks again to the weighting conversation and the recognition that the complexity of the communities we deal with and the complexity of the problem are really an order of magnitude different from many other health services. I am aware that all the health services have their challenges. My wife works in St. James's Hospital so I am acutely aware of the challenges of standard health services. Because our area has that overarching reach into justice, education, family support and other issues that cannot easily be captured on a health metric, there is a complicating layer for us. That conversation feels lacking and feels more lacking now than it has felt for 20 years. It feels like that conversation is not sufficiently expressed and sufficiently heard. As people have said, we have a lot of experience of our communities and we know them very well. It is not a question of saying we are not going to do this but of saying here is how we could do this better. It is because we lack those organisational structures that we are not able to express that very well.
Seán Crowe (Dublin South West, Sinn Fein)
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I have some questions. A question was asked about the make up of the drugs task force and the pillars that make up drug rehabilitation, education, health, justice, social protection, and child and family. We all accept it has been a fault line or a weakness in the system that those key players or people of influence are not around the table. If members agree, this is certainly one of the issues we can raise with the Minister. It should be a recommendation. It will be agreed by most people familiar with this situation that we are moving back instead of moving forward. I do not believe I was even elected as a public representative when former Deputy Chris Flood, the Minister of State in health at the time, asked political parties' representatives to get involved in drugs task forces. It goes back that far.
We had a meeting last week with the Joint Committee on Drugs Use. A number of groups came in and the common theme from the people who spoke was that they have never seen it as bad in their communities. There is no sense of that within the Oireachtas. I do not think there is a sense of that as part of debates or at meetings and so on. What does it mean when we say it has never been as bad? One of the things it means is that the age profile of those involved is getting younger and younger. We hear of kids of seven years of age partaking in illegal drugs, including nitrous oxide. People used to talk about cannabis as the gateway drug but this is the one that is really frightening out there. It is amazing the number of people that do not know this. They start off with these silver bullets and then it is huge containers. The challenge is that these are legal and illegal. They are illegal to consume but they are legal for bakeries and coffee machines and so on and are needed for such uses. I put forward simple legislation that, much like cigarettes, you could not sell it to kids. Again there seemed to be consensus among everyone on that but we were not able to move the legislation to do that. It seemed a simple thing we could do.
There is a normalisation of drugs in many communities, something we have been talking about for years. The witnesses have spoken about drug intimidation and the impact this has on families and communities. This is another aspect that has changed. We had a centre in my locality that was attacked by the people who were selling drugs outside it. Perhaps a person had gone out and asked them to move and the centre was set on fire. That was a new norm that had never happened before and we had not seen that. It used to be the norm that people would be able to get supports without having to run a gauntlet of drug dealers. This is another barrier that has gone.
The Minister of State will be coming in and he will talk of the amount of money being spent. The witnesses have said that it is 5% less than the past five years-----
Seán Crowe (Dublin South West, Sinn Fein)
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The past ten years. Not only that, people working in the front-line services have had no increase.
Again, that is something that has recently been addressed. Another example would be community healthcare organisation, CHO, 7 where there are ten residential beds. They have run out of funding for that since September. What do they do for the next six months? Again, the balance is that has never been as bad. People are coming forward. The Minister gives all the figures and all the rest. It is going up, yet the funding does not go up. I suppose my question this morning is-----
Seán Crowe (Dublin South West, Sinn Fein)
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Does Mr. Doherty get any sense of why it is the poor relation with regard to the drugs budget? He told the story about contact being at a low ebb and about simple things like meetings with the Minister that are not structured enough. It just does not seem to be that people get that there is a challenge out there.
Mr. Jim Doherty:
I think it is immediacy bias; I really do. The refugee programme, particularly since Russia's invasion of Ukraine, has become such a big thing. People tend to focus on the newest problem without realising the older problems are still there and are, in fact, going to interact with the new problems to make both worse. There is some element of that.
I hate to say it, but we often hear this phrase, and people say this to me a lot, that the drugs issue is not sexy anymore politically. It does not have immediacy and "now" currency. I hate to think that Government policy could be dictated by such things, and I do not believe it is because there are far too many thoughtful analytical people involved.
If, however, we look at the trajectory of our location within the Department of the Taoiseach to where we are now and the trajectory of funding and interaction from the other Departments, it is difficult to draw alternative conclusions. That is why I really welcome the Citizens' Assembly because it is seemed to refresh our idea that this needs to be a national conversation.
The Chairman is absolutely right in everything he said about fast gas, but we have to prioritise our approach in every area. For instance, we still have conversations about whether Naloxone is available. Someone else mentioned drug-related deaths earlier. Naloxone is one way - it is not going to solve all drug-related deaths - we can tackle and reduce some drug-related deaths. Yet, it is not yet freely, totally available in a very clear and totally accessible way to families, drug users, service users or service providers. It is available through restricted access to certain classes of people.
We need to just push past the barriers on things like that, but that is about getting the urgency back into the conversation. Drug-related deaths are an extremely good place to start because our rate of drug-related deaths is really high. It should be given the kind of primacy we once gave when our rate of road deaths was really high. It was actually about the same as what our rate of drug deaths is now. It became a national conversation and we did make great strides in road safety. Therefore, we need to have that conversation.
Seán Crowe (Dublin South West, Sinn Fein)
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Mr. Doherty said that drugs are no longer sexy. I would argue that we have been in denial for decades regarding the challenge of drugs. Many of us thought that with the emergence of crack cocaine in communities, women being turned into prostitutes, people going into houses without a stick of furniture and children going hungry it would be a wake-up call. It is probably only certain communities, however, and we talked about that. Cocaine per se is impacting on all societies on all levels whether someone is a chief executive or otherwise. It is a normal part of life. One cannot go into a pub or social setting in which people are not using. It is normalised in that regard and it has an impact.
I was linked with a project to which the local hospital reached out because people in their 70s were turning up at the local hospital on a regular basis at weekends after cocaine. It was a simple step of giving the hospital information about services that were in the community. A piece of work was carried out on that. A pilot was done, and the money ran out. That seemed to be a simple health solution, yet it was not replicated right across the country in other hospitals in other areas. We do not see people learning from a lot of the simple things that can be done with regard to this.
It will be interesting to hear what the Minister of State has to say. He is very new in the job, and it is a challenge in itself when someone is only new. It is going to take at least six months. However, the multi-annual funding is clearly an issue, and the funding with regard to emerging needs. The one thing that comes up when we talk to all the drug task forces, whether they are regional or the 14 that are based around the cities, is that idea of emerging needs and how we need to be flexible enough for the new drug that is coming down the track.
Ms Aoife Bairéad:
I will add one thing to what the Chairman said. One of the difficulties he mentioned earlier was that because we have such short-term funding and the way funding is done, it is really hard to recruit and retain staff, particularly if people move into, say, the HSE and other places where they will get pensions and permanency and all of that. Because so many of our services are literally in survival mode, the time and energy it would take to share the information we have and give it to Government so that it would know is not always there. Often, when things come up or when new funding comes up, we are scrambling to try to get as many people as possible together to get that funding into place and again, because it is done in short-term small pots here and there, even just that process takes an extraordinary amount of time. Therefore, not having the staff we need means that we cannot collate the information we know we have. Certainly, it is much harder to co-ordinate that nationally. We have the chairpersons' network. They are volunteers; we are all volunteers. Most of us do our very best to do that. However, those things have such huge consequences because we cannot retain and recruit the staff we need to work and function the way we need to. That is such an important part of this moving forward.
Mr. Jim Doherty:
I will just say that because people are the tools of our trade, all our services are human services. We do not use machines or medication or anything like that to deliver our services. We use people. Things that impact on recruitment, selection, retention, training and all those things have a disproportionate impact on the services we deliver.
Seán Crowe (Dublin South West, Sinn Fein)
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In the task force meetings, a disproportionate amount of time is spent every meeting on funding. It is funding, funding, funding. We should be strategising and talking about the issues, not this idea of funding. There will be common agreement on the Criminal Assets Bureau, CAB, money. I read a report that stated the Garda recovered something like €20 million in cash alone. Why is that not being directed straight away into those communities that are so badly affected by it? I am coming to an end, and I know Deputy Shortall is looking to get in.
Róisín Shortall (Dublin North West, Social Democrats)
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I have a really quick question.
Seán Crowe (Dublin South West, Sinn Fein)
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I do not think I have time. We are supposed to be finished by 11 o'clock. Can we perhaps focus on discussing with the Minister of State what has been raised this morning? We really appreciate the witnesses coming in. It was really useful. I apologise if anyone else was trying to get in. I thank the representatives from the local drugs and alcohol task force chairpersons' network for their engagement with the committee and discussion on the important issues they face. Hopefully this conversation can continue. I am conscious that as a committee we have not had them in previously, but hopefully the next committee, whoever that is made up of-----
Bernard Durkan (Kildare North, Fine Gael)
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We should make it our recommendation that it be a priority for the next committee, whoever is in it.
Seán Crowe (Dublin South West, Sinn Fein)
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We can do that, yes.
Seán Crowe (Dublin South West, Sinn Fein)
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Okay. The meeting is now suspended. We will resume very shortly with the Minister of State.
Seán Crowe (Dublin South West, Sinn Fein)
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The committee will now resume its consideration of issues facing local drug and alcohol task forces. I have received an apology from Senator Frances Black who has had to leave to introduce a Bill in the Seanad. I am pleased to welcome the Minister of State, Deputy Colm Burke, who has responsibility for public health, well-being and the national drugs strategy. He is accompanied, from the Department of Health, by Ms Siobhán McArdle, assistant secretary, and Mr. Jim Walsh, principal officer, and, from the HSE, by Mr. Joe Doyle, national social inclusion office.
Witnesses are reminded of the long-standing parliamentary practice that they should not criticise or make charges against any person or entity by name or in such a way as to make him, her or it identifiable or otherwise engage in speech that might be regarded to the good name of the person or entity. Therefore, if their statements are potentially defamatory in relation to an identifiable person or entity they will be directed to discontinue their remarks. It is imperative that any such direction is complied with.
Members are also reminded of the long-standing parliamentary practice to the effect that they should not comment on, criticise or make charges against a person outside these Houses or an official by name or in such a way as to make him or her identifiable. I remind members of the constitutional requirement that they need to be physically present within the confines of the Leinster House complex in order to participate in public meetings. I cannot permit a member to participate where he or she is not adhering to the constitutional requirement. Therefore, any member who attempts to participate from outside the Leinster House precincts will be asked to leave the meeting. In this regard, I ask members participating via MS Teams to confirm that they are on the grounds of the Leinster House complex prior to making their contribution to the meeting. I now invite the Minister of State to make his opening remarks.
Colm Burke (Cork North Central, Fine Gael)
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I thank the committee for the opportunity to discuss the important public health topic of drug and alcohol use and the issues facing local drug and alcohol task forces. I am accompanied, from the Department of Health, by Ms Siobhán McArdle, assistant secretary, and Mr. Jim Walsh, principal officer. I am also joined by a colleague from the HSE national social inclusion office, Mr. Joe Doyle.
Drug use is a serious health issue with long-term implications not just for the person who uses illicit drugs, but for their family and the community around them. I am strongly committed to a health-led response which treats drug addiction first and foremost as a public health issue and which also diverts people from the criminal justice system towards effective programmes that support rehabilitation and recovery.
The Government’s policy on drug use is set out in the national drugs strategy, Reducing Harm, Supporting Recovery 2017-2025. The central tenet of the strategy is that drug use should be dealt with as a public health issue. It advocates for a compassionate response to individuals who use drugs. The programme for Government reiterates the health-led approach to drug use and the shift to this approach to drug use continues to evolve. Drug use is a dynamic situation to which policy must adapt in a flexible manner.
Our strategic priorities include prevention of drug use among children and young people; access to, and delivery of, drug services in the community and harm reduction responses and integrated care pathways for high-risk drug users; the social determinants and consequences of drugs use; alternatives to coercive sanctions for drug offences; and evidence-informed and outcomes-focused policy and implementation.
In 2024, the Department of Health provided funding of more that €160 million for the provision of drug services. Approximately €65 million or 40% of this funding is allocated by the HSE to community-based organisations. Drug and alcohol task forces play an important role in supporting the implementation of the national drugs strategy in communities by co-ordinating the response to drugs at local and regional level. There are ten regional and 14 local drug and alcohol task forces in operation across Ireland. They are responsible for supporting the implementation of the national strategy, Reducing Harm, Supporting Recovery 2017-2025, in the context of local population needs.
It is important to acknowledge the contribution of the independent chairpersons and the members of the task forces to addressing drug issues. The independent chairpersons play a key role in bringing together the various stakeholders to work together in a collaborative manner. The work of the task forces is supported by the HSE, which employs a co-ordinator for each task force and provides the channel of funding for the services overseen by the task force. In total, the Department of Health provides more than €28 million in recurring funding for drug services and related initiatives overseen by the task forces. Of this, €18 million goes to the 14 local task forces, with annual funding ranging from €1 million to €2 million. The €18 million represents 11% of the funding allocated by the Department of Health every year for drug services, and 28% of that allocated for community-based services.
Since 2020, the Department has allocated a total of €13.1 million in additional recurring funding to support existing community-based services and develop new services. This additional funding has been allocated on the basis of population across the nine community healthcare organisations which have recently been amalgamated as six health regions. While not ring-fenced by individual task forces, the additional funding has benefited drug services across all task force areas.
The drug and alcohol task forces contribute to the priorities in the national drugs strategy and are represented on the oversight structures for the strategy, including the strategic implementation groups. These groups are responsible for implementing a range of actions in the strategic action plan for 2023 and 2024. One strategic priority to which the task forces contribute in a major way is to enhance access to, and delivery of, drug services in the community. Drug treatment demand has greatly increased since 2017. In this period, the number of new cases treated for problematic drug use has grown from 8,922 to 13,104, an increase in new cases of 4,000, or 47%. From 2022 to 2023, the number of cases increased by more than 1,000. The local task force areas account for just under half of the total number of new cases in 2023. The remaining 53% fall within the geographical remit of the regional task forces.
There is geographical variation in the number of people accessing treatment for the first time, with some areas recording a higher demand for services than others. This increase in treatment cases reflects growing demand, as well as the additional investment under the national drugs strategy over the past few years in expanding access to, and availability of, treatment, for those who are seeking help with addiction issues. As Minister of State with responsibility in this area, I have prioritised investment in drug services to ensure these are available to all those who need them and in all locations where they are needed. This is in line with the Sláintecare objective of ensuring equity of access to healthcare services.
To better inform the planning and funding of drug services across the new health regions, the Department of Health is undertaking an audit of drug services. The first output of the audit is an interactive map of 442 publicly funded services across the country. This map suggests an uneven distribution of services, as well as a fragmentation of services across the country. The next step is to audit current service provision, based on treatment demand and population need, to inform the planning of drug services in the new HSE health regions.
Another strategic priority which the task forces support is addressing the social determinants and consequences of drug uses in disadvantaged communities. I recognise the additional challenges arising from drug use in communities where there are high levels of poverty and deprivation. Poverty and deprivation are government-wide issues which affect employment, education, housing, health, policing and community safety.
The Department of Health and the local task force chairpersons network jointly convened a conference in May 2023 to examine local responses to problematic drug use. The conference highlighted the importance of a joined-up approach involving Government Departments and local stakeholders, including the drug and alcohol task forces and the Sláintecare healthy communities programme. One aspect of drug use that has a corrosive impact on families and local communities is drug-related intimidation and violence, DRIVE. A recent initiative developed by the task forces and supported by the Department of Health is the DRIVE project to address this violence.
DRIVE is an interagency project set up to develop systems and structures across the country, facilitated by the local and regional drug and alcohol task forces, to support people who experience drug-related violence.
The Department of Health is the lead sponsor and funder of the DRIVE project and provides annual funding of €250,000 to support the work of the project. The Department of Justice, An Garda Síochána and the Probation Service are also key partners in the project. An Garda Síochána has appointed 30 inspectors who are totally focused on this issue.
I recently met the chair and co-ordinator of the DRIVE project to discuss plans for a national awareness campaign on drug-related intimidation. This campaign aims to address issues of stigma and fear, to deliver a message of hope and to advise people of how to access help. I acknowledge the positive, collaborative working relationship between the Department of Health and the chairs of the drug and alcohol task forces. In August, I met the chairpersons network to outline to them the additional funding being provided to sustain community-based drug services, covering both operational and staffing costs and I understand a further meeting has been arranged for 11 November. Funding of €2.3 million was allocated to sustain community-based drug services and support people in recovery. In addition, Department officials meet the chairpersons network on an ongoing basis to address operational and governance issues and to provide updates on new funding opportunities.
I will turn now to the report of the Citizens' Assembly on Drugs Use and the plans for drawing up a new national drugs strategy, which I know are of major interest to the task forces. I acknowledge that the implementation of the recommendations of the citizens' assembly will require a major step-change to develop a comprehensive health-led approach to drugs use. The deliberations of the Joint Committee on Drugs Use, which recently published an interim report, are also relevant to strengthening this approach. The vehicle to implement the recommendations of the citizens' assembly is the new national drugs strategy. It is proposed to prepare a draft of the next national drugs strategy in early 2025 informed by an evaluation of the current strategy, the Government response to the recommendations of the citizens' assembly and the Joint Committee on Drugs Use and the 800 submissions made to the citizens' assembly.
Task forces will play an important role in the design and implementation of the new national drugs strategy. I look forward to continuing the positive working relationship between myself as Minister, officials in the Department of Health and the chairpersons network and to having regular engagements on issues of common concern. As Minister with responsibility for the national drugs strategy, I am fully committed to ensuring we move forward with a health-led approach that reduces the harms of drug use, supports recovery and provides measurable benefits to the lives of everyone affected by the use of drugs.
Bernard Durkan (Kildare North, Fine Gael)
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I welcome the Minister of State. I know he is not familiar with this territory, but it is not so long since he left so he will have a certain familiarity with the problem which will be useful and it is likewise for his officials.
What we learned about the task forces from the last group that appeared before the committee - and it was not for the first time - is that the money does not seem to be the problem, although more money will be required because the problem is getting bigger. The problem appears to be co-ordination of the efforts of all concerned throughout the community and throughout the regions and local areas. It would be of huge benefit if someone had overall responsibility, as Deputy Shortall mentioned. I am not sure that one overall person is the right way to go about it, but we have an opportunity now to make recommendations to the next committee, whoever may be on it, and the next ministerial task force as to how to proceed. What appears to have happened is that the thinking is good. Everyone has the right intention, but it comes to a halt between election times and different things that seem to divert attention to other areas of equal importance. It is now necessary to give an informed opinion to the next incumbents of the position of this committee and of the task forces and to pick out the most salient parts of the fight against drugs, including the medical part, rehabilitation and dealing with the drug problem in general. We heard earlier that liberalisation of drugs is the answer. It is not. We see more and more instances of school kids, including primary school kids, being taken over by the drugs problem and then their whole lives are affected.
From the Minister of State's perspective and that of the Department and the HSE, how does he see the most dramatic impact of a beneficial nature being made now with the knowledge we have, recognising that we have to go further because the task is getting bigger?
Colm Burke (Cork North Central, Fine Gael)
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I outlined that we had the citizens' assembly and the Oireachtas Joint Committee on Drugs Use. We are now talking about preparing a new report in 2025 and the task forces will play an important part in contributing to that. The existing policies were from 2017 to 2025. Therefore the new one will have to cover a five year programme and we have to hold a consultation to develop that new programme and policy, taking into account the issues that have occurred under the existing programme, making sure they can be remedied.
Ms Siobhán McArdle:
As the Minister of State said, it is important we evaluate what we have learned from the implementation of the national drugs strategy, which is now about to conclude and then take the inputs and learning from those who contributed in such a great way to the citizens' assembly. We have a greater level of evidence, including data, information as well as personal and staff experience, which will inform what goes into and what continues to be part of the next strategy. What we will see in the new strategy will be a refresh and reframing, rather than saying that the strategy we have is not working.
We need to continue to focus on prevention and early intervention, ensuring we have access to services, as the Minister of State said, and understanding across the health regions how, with the new integrated areas, we can ensure people in those regions have accessible services that talk to one another, including addiction services, mental health services, community services and GPs. We must ensure they are all joined up and people understand what is available in that ecosystem of health services and community and voluntary services. What we have seen in Sláintecare as we have implemented it is the importance of evidence to good outcomes, understanding what is working and ensuring we have better data to understand more about the reasons people come forward and the factors that are having an impact on their lives. We are beginning to do more about the social determinants of health, as the Minister of State said. There is quite a focus under the broad strategy.
Bernard Durkan (Kildare North, Fine Gael)
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The ravages of crack cocaine throughout the community were mentioned. Mention was made of deprived communities, not necessarily unemployment, but if there is a serious drug problem in a community, it has an economic impact as well and tends to make the individuals living and attempting to work and survive in such areas do so under a cloud. That is not healthy. We all have to deal with the severe, acute and chronic cases and I think we all agree that there has to be an end in sight.
We have to have an objective or a goal. To what extent are we setting these goals? Are we setting them now for the next members of this committee and the next drug task forces as well, with a view to starting off from the point at which we are finishing now, as opposed to starting all over again given the knowledge we have gleaned in the meantime?
Colm Burke (Cork North Central, Fine Gael)
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If you take the way we responded to crack cocaine, for instance, take the south inner city drug and alcohol task force and its cocaine and crack cocaine research. There was a HSE-led initiative in order to reduce health-related hard from cocaine and crack cocaine in the south inner city area here in Dublin. Therefore, there was a response. This is the challenge now we have regarding heroin. As the Deputy knows, we will have a supervised injection facility opened in Merchants Quay. The target is to have it opened by mid December. That project has taken up to five years because of various planning issues. I have been down there where the building work is going on and that is the response there. The issue now is that while the challenge still is in relation to heroin, there is also a huge challenge related to the use of cocaine, particularly crack cocaine.
Bernard Durkan (Kildare North, Fine Gael)
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If I might come in for a second again, there is a feeling as well that we have not succeeded so far. We have not succeeded in stopping the problem; there is no doubt about that. The challenges continue. We need to intervene in some way to intercept the flow of drugs towards the community in a way that entices the people away. That means a task force needs to be funded with the right to implement the means of lifting the siege on such areas or in other words, to give more of a feeling of well-being. There are serious situations throughout the country where drugs and alcohol have taken a hold to an extent that is fearsome. It frightens everybody.
Colm Burke (Cork North Central, Fine Gael)
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I gave the example of the south inner city area but there was also Tallaght. The Tallaght project is open seven days per week with 68 presentations per week. This deals with crack cocaine. This was the result of the Tallaght drug and alcohol task force working with the HSE to provide a response.
Ms Siobhán McArdle:
I might just add to that. From a health perspective, we are very much focused on the importance of a health-led approach. That came across in the citizens' assembly as well Our national drug strategy focuses on that. One of the important things that needs to be embedded in that and that has been part of it is not just about prevention but reducing stigma. By addressing stigma, this encourages people to come forward. We can invest in increasing the number of services available but we also need people to feel safe to come forward and feel that it is a good thing to do. We know from the research carried out by the Health Research Board that there has been a significant increase in the numbers of people coming forward. We have to give credit to our services on the ground, be they HSE statutory services or the drugs and alcohol task forces, for their involvement at community level in addressing things like stigma and prevention and information that encourages people to come forward.
Bernard Durkan (Kildare North, Fine Gael)
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I will conclude with this. There is a tendency to believe we should almost legalise the administration of drugs generally. I was a member of the task force previously. I visited the Zurich experiment once upon a time in the company of the late Tony Gregory. I visited the Amsterdam experience and incidentally reference was made earlier on to Portugal. None of those things worked. They have not worked yet.
Neasa Hourigan (Dublin Central, Green Party)
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They all worked.
Bernard Durkan (Kildare North, Fine Gael)
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They do not, actually.
Neasa Hourigan (Dublin Central, Green Party)
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They did.
Bernard Durkan (Kildare North, Fine Gael)
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They do not. They just continue-----
Seán Crowe (Dublin South West, Sinn Fein)
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Deputy, can we-----
Bernard Durkan (Kildare North, Fine Gael)
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Wait a second. I did not interrupt anybody else.
Seán Crowe (Dublin South West, Sinn Fein)
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I know you did not because no one has spoken. Can we finish up?
Bernard Durkan (Kildare North, Fine Gael)
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If we embark on a plan to continue and support drug addiction, we are going to give the people the wrong impression.
Seán Crowe (Dublin South West, Sinn Fein)
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Okay. Thank you. I am just conscious if we want to let everyone in, people will have to stick to the ten minutes.
Róisín Shortall (Dublin North West, Social Democrats)
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A lot of people might have a question about the performance of the Government regarding this issue. There is a lot of talk about data and evidence and all of that. That all shows that what is being done at the moment is not working. I do not know why we continue just fooling ourselves that the approach is effective. I make that comment.
I want to get onto the issue of funding for local drugs task forces, which is the purpose of this meeting. We were presented earlier with figures showing that over the last 12 years there has been a welcome increase in overall Government expenditure, there has been a very substantial increase in overall health expenditure but when it comes to funding of the drugs task forces, we are actually devoting less funding to them now than we did in 2012. I think it is about 4.5% less and that is not even adjusted for inflation, which is about 28%. How does the Minister of State defend the fact that the local structures responding to the drugs issue are being underfunded relative to 12 years ago?
Colm Burke (Cork North Central, Fine Gael)
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The actual funding for drug-related health expenditure has gone from 2020-----
Róisín Shortall (Dublin North West, Social Democrats)
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No, I am talking about the funding of the drugs task forces.
Colm Burke (Cork North Central, Fine Gael)
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I will give the Deputy the figures-----
Róisín Shortall (Dublin North West, Social Democrats)
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I know what those figures are-----
Colm Burke (Cork North Central, Fine Gael)
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Let me give the Deputy the response. The response shows funding has increased from €134.9 million up to €161.7 million in 2023. That is a 28% increase in funding.
Róisín Shortall (Dublin North West, Social Democrats)
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For what?
Colm Burke (Cork North Central, Fine Gael)
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The Deputy is looking at the core funding for the task forces but there are different initiatives-----
Róisín Shortall (Dublin North West, Social Democrats)
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I am asking you a question about the local drugs task forces-----
Colm Burke (Cork North Central, Fine Gael)
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I am giving you a response.
Róisín Shortall (Dublin North West, Social Democrats)
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-----so stop telling me about other services. Tell me about the drugs task forces.
Colm Burke (Cork North Central, Fine Gael)
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Let me give you the response. In addition to the core funding the task forces are getting, they are also getting funding for additional projects they take on. It is not a case that they are getting less funding. It depends. For instance, taking the example I gave regarding Tallaght and the south inner city, there was additional funding for those projects to those task forces. It is not a case that there is no increase in funding for task forces. Perhaps Ms McArdle may-----
Róisín Shortall (Dublin North West, Social Democrats)
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I am talking about the core funding for local drugs task forces.
Ms Siobhán McArdle:
While the Minister of State is speaking about that increase, what we are seeing at the HSE level is that the drugs and alcohol task forces are very much core to accessing the services and delivering on the initiatives.
Róisín Shortall (Dublin North West, Social Democrats)
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I am just looking for figures. Has the core funding decreased for local drugs task forces every year for the last 12 years?
Colm Burke (Cork North Central, Fine Gael)
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When you take into account-----
Róisín Shortall (Dublin North West, Social Democrats)
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I am asking the Minister of State a straight question. I am talking about core services.
Colm Burke (Cork North Central, Fine Gael)
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When you take into account the additional projects they take on, for instance I gave the Deputy the example of south inner city and Tallaght, where they took on additional projects additional funding was provided for them. That is part of the whole thing. This is co-ordinated by the HSE.
Róisín Shortall (Dublin North West, Social Democrats)
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I am asking the Minister of State a straightforward question about the core funding for local drugs task forces over the last 12 years. The information we have been given this morning from the group who were in earlier is that this funding has reduced by 4.5% over the last 12 years, not adjusted for inflation. Is that true?
Róisín Shortall (Dublin North West, Social Democrats)
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What does Ms McArdle mean by a significant increase?
Róisín Shortall (Dublin North West, Social Democrats)
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I am asking the Department to provide a note for us here in the committee on the core funding provided to local drugs tasks forces since 2012.
Róisín Shortall (Dublin North West, Social Democrats)
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I would appreciate that and we might get a straight answer that way.
Colm Burke (Cork North Central, Fine Gael)
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The Deputy will also have to take into account-----
Róisín Shortall (Dublin North West, Social Democrats)
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I want to move on.
Colm Burke (Cork North Central, Fine Gael)
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-----that additional funding is provided through the HSE to each of these task forces as well.
Róisín Shortall (Dublin North West, Social Democrats)
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I know what the Minister of State is talking about but I am asking about the core funding. The next question I want to move on to-----
Colm Burke (Cork North Central, Fine Gael)
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Did Mr. Walsh want to come in there?
Róisín Shortall (Dublin North West, Social Democrats)
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Okay. We will see that with the figures which will be provided by the Department, I hope.
I want to move on. Reference was made to the factors that were taken into consideration when pursuing a strategy, one being the social determinants of health. The point was made that Government-wide issues impact on the causes of people developing drug issues. Will the Minister of State outline the national structures that involve the local drugs task forces and provide for that input from the relevant Departments?
Colm Burke (Cork North Central, Fine Gael)
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I will ask Ms McArdle to address that question.
Róisín Shortall (Dublin North West, Social Democrats)
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Will Ms McArdle outline those, please?
Róisín Shortall (Dublin North West, Social Democrats)
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On what?
Róisín Shortall (Dublin North West, Social Democrats)
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I am sorry. I am asking for the structures, please. Will Ms McArdle outline those?
Ms Siobhán McArdle:
The national oversight committee of the national drugs strategy is the structure. It has a cross-governmental membership as well as representation from the community, voluntary and statutory sectors, so there is a broad range of members. We can provide information on the membership to the Deputy.
Róisín Shortall (Dublin North West, Social Democrats)
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Please do, just so we can see who the representatives are. How often does that body meet?
Ms Siobhán McArdle:
It meets in an oversight capacity on a quarterly basis and the minutes of those meetings are published. In between those meetings, and as part of the purpose of the oversight structure, there is feedback from the six special interest groups that are focused on addressing six key strategic priorities, including prevention, children and young people, and access to services.
Róisín Shortall (Dublin North West, Social Democrats)
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What is the opportunity for the local drugs task forces to make an input into policy development?
Mr. Jim Walsh:
We adopted as a strategic priority addressing the social determinants and consequences of drug and alcohol use in disadvantaged communities. We prioritised that in 2021. We set up a structure to focus specifically on that within the national oversight committee. In that structure are two representatives from task forces. It is chaired independently by Mr. Ciarán Reid, who works with Louth Local Development, and we have a range of other stakeholders.
Róisín Shortall (Dublin North West, Social Democrats)
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That is a subgroup of the national oversight committee.
Róisín Shortall (Dublin North West, Social Democrats)
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Are the task forces represented on the national oversight body?
Róisín Shortall (Dublin North West, Social Democrats)
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How are they represented?
Róisín Shortall (Dublin North West, Social Democrats)
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How many representatives?
Róisín Shortall (Dublin North West, Social Democrats)
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At what level are the other agencies and Departments represented?
Róisín Shortall (Dublin North West, Social Democrats)
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Is there good attendance?
Róisín Shortall (Dublin North West, Social Democrats)
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The quarterly meetings are minuted and those minutes are available.
Róisín Shortall (Dublin North West, Social Democrats)
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Previously, the DPU dealt with the drugs issue and had direct contacts with drugs task forces. The problem now is that many other responsibilities are being placed on staff who previously had been solely concerned with the drugs issue. Is it the case that people within the HSE and the Department of Health are overstretched because additional responsibilities have been loaded onto them?
Colm Burke (Cork North Central, Fine Gael)
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I have been in the Department since April and my staff are focused on dealing with the policy area of drugs and alcohol addiction, providing support to the various agencies and liaising with the HSE. They are not-----
Róisín Shortall (Dublin North West, Social Democrats)
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Is there responsibility for other policy areas, for example, asylum seekers and social exclusion, under their remit?
Ms Siobhán McArdle:
The unit is actually called the drugs policy, refugee and social inclusion unit. To respond to the increase in remit, there has been an increase in staffing, so we still have dedicated staff whose responsibility is to ensure implementation, and work with those who are working on the implementation, of the drug strategy.
Róisín Shortall (Dublin North West, Social Democrats)
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Does the Minister of State believe the strategy is working?
Colm Burke (Cork North Central, Fine Gael)
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The number of people receiving treatment increased by 1,000 last year. It is up to 13,000 for drug addiction and 8,000 for alcohol addiction.
Róisín Shortall (Dublin North West, Social Democrats)
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So, there are more people looking for treatment now.
Colm Burke (Cork North Central, Fine Gael)
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Absolutely. I have given the figures-----
Róisín Shortall (Dublin North West, Social Democrats)
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That is why I asked whether the Minister of State thinks the strategy is working.
Colm Burke (Cork North Central, Fine Gael)
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Which particular aspect of the strategy? Regarding task forces, it is about working in the community. This is where the review arises. We are talking about a new policy from 2025 onwards. All of the parties involved – we already have the citizens’ assembly, the Oireachtas committee-----
Róisín Shortall (Dublin North West, Social Democrats)
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I am talking about the structures within the Department.
Seán Crowe (Dublin South West, Sinn Fein)
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I have to bring an end to the Deputy’s questions. I will let the witnesses respond to one point, but I need to move on.
Ms Siobhán McArdle:
Part of what we are doing is a formal evaluation of the strategy. The outcome of that will inform the new strategy. We can measure some things, but one of the things that we can see and we hear from the citizens’ assembly is the greater public discussion of the importance of a health-led approach as opposed to a punitive approach, addressing stigma and the importance-----
Róisín Shortall (Dublin North West, Social Democrats)
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And not letting other Departments off the hook, too.
Seán Crowe (Dublin South West, Sinn Fein)
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I call Deputy Hourigan.
Neasa Hourigan (Dublin Central, Green Party)
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Using the metric of more people in addiction and seeking treatment is not a great metric of outcomes in a health-led approach.
I would like some clarity about when we will see the new national drugs strategy.
Colm Burke (Cork North Central, Fine Gael)
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My understanding is that we will be working on that and it will be quarter 1 of 2025.
Neasa Hourigan (Dublin Central, Green Party)
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That is what the replies to parliamentary questions have stated to date. Is that still the case?
Ms Siobhán McArdle:
Yes. As the Minister of State said, we are reviewing the number of submissions to the citizens’ assembly. I think there were more than 800 submissions. That is a breadth of information. We are also reviewing the assembly’s findings and recommendations and will review the findings of the evaluation, which will be very broad in terms of stakeholder engagement. It is important that we hear all of that to know what works and what needs to be continued or added to in the new strategy.
Neasa Hourigan (Dublin Central, Green Party)
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I am just trying to get a bit of clarity on that. During the drugs committee’s sessions, we were under the impression that the drafting of the strategy had already begun.
Colm Burke (Cork North Central, Fine Gael)
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In any new policy, we have to take into account the citizens’ assembly, the Oireachtas committee and the views expressed in the 800 submissions that Ms McArdle outlined. The Government has the final decision over what the final policy will be, but all of those factors have to be taken into account in finalising the policy document. It is a-----
Neasa Hourigan (Dublin Central, Green Party)
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I am sorry for cutting across the Minister of State, but language has been used today to the effect that the new drugs strategy will be a “refresh”, to use Ms Ardle’s word, of the existing strategy. I notice that we are steering very-----
Colm Burke (Cork North Central, Fine Gael)
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No, I did not say that.
Neasa Hourigan (Dublin Central, Green Party)
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It was said on that side of the room. We are steering very far away from the idea that we failed. We needed to hold a citizens’ assembly on the matter and the drugs committee sat for many sessions, yet we cannot sit here and say we have failed people in addiction.
My next comment is not really aimed at the Minister of State, but more at the Department. When the citizens’ assembly’s recommendations were published, the Minister said that there would be a speedy response to them. However, it now sounds like the only response we are going to see is the new national drugs strategy, which will effectively be a rehash, refresh-----
Colm Burke (Cork North Central, Fine Gael)
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No.
Neasa Hourigan (Dublin Central, Green Party)
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-----and a reframing of the existing drugs strategy. For the removal of doubt, the drugs strategy has failed.
Colm Burke (Cork North Central, Fine Gael)
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Just-----
Neasa Hourigan (Dublin Central, Green Party)
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It has failed and failed. We needed to have a citizens’ assembly to prove how much it has failed.
Colm Burke (Cork North Central, Fine Gael)
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The final decision on any new strategy has to be taken by the Government. No matter who is in government, it will have to take into account the citizens’ assembly and what came from that, and also what came from the Oireachtas committee, which has produced an interim report. It is on that basis that the next Government will have to sign off on what the new policy will be. We have to remember that this will be a five-year policy.
Neasa Hourigan (Dublin Central, Green Party)
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That is reasonable but, from that framing of it, do I take it that the only response the Department will provide to the drugs committee and those of us on the citizens’ assembly who engage with that process will be in the form of the new national drugs strategy? It will not be done recommendation by recommendation or as a direct response; it will be in the shape of a new strategy.
Colm Burke (Cork North Central, Fine Gael)
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That is what the Department is doing. This is about drafting policy and about what we have learned from the past. We are doing an evaluation of the existing policy. Therefore, it is about learning from that evaluation and then seeing what is the best way forward in dealing with it.
Neasa Hourigan (Dublin Central, Green Party)
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I understand that. The Minister of State sounds very reasonable when he says that but major legislative questions were raised by the citizens’ assembly and the drugs committee that will not fit within the framework of the drugs strategy nationally. Moreover, if the drugs strategy is a refresh of an existing policy, that also will not serve the citizens’ assembly's findings.
Colm Burke (Cork North Central, Fine Gael)
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I never said it would be a rewrite. I am saying that the evaluation has to take place and the Government has to look at the report from the citizens’ assembly and also the interim report from the Oireachtas committee. The Department then has to work with whoever is in this portfolio but also with the new Government regarding the best way forward. Mr. Walsh may wish to add to that.
Neasa Hourigan (Dublin Central, Green Party)
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I want to move on to other questions. I understand the Minister of State’s point that some of it is policy. However, some of it is not policy and is very practical stuff around the regulation of drugs in a particular way, and I am not just talking about cannabis but about naloxone and products like that.
Neasa Hourigan (Dublin Central, Green Party)
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In what format will that be?
Neasa Hourigan (Dublin Central, Green Party)
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What will be the role of the Department in contributing to that work?
Neasa Hourigan (Dublin Central, Green Party)
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Is the Department doing work on that right now?
Neasa Hourigan (Dublin Central, Green Party)
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When will we see that?
Mr. Jim Walsh:
We need to take into account the interim report of the Oireachtas committee because it needs to be part of this. We are making those preparations and the Minister of State referred to that in his contribution. The Government response will be done. The Minister of State also said that in order to implement the recommendations, we require a step change in our response. That is how we are approaching this. It is a step change, not business as usual.
Neasa Hourigan (Dublin Central, Green Party)
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In our earlier session, the drugs task force said it felt that relationships between it and the Department were at the lowest ebb they have ever been. Will Mr. Walsh respond to that?
Mr. Jim Walsh:
That is not my experience. We are meeting the members of the task force next week, the Minister of State met them recently and we met them earlier in the year. We have engagement with the task force through all of our strategic implementation groups, of which there are six. Last year, we held a big conference in the Department with the local task forces, which was a joint conference addressed by the Minister and the senior official from the Department of the Taoiseach. I do not know what the experience was before but, as the Minister of State said, we have massive respect for the chairpersons, who are voluntary and independent, and we work with them in a collective manner. We are completely committed to that.
In my own background, I have done a lot of work with non-governmental organisations and we have our own structures in the Department whereby we work with NGOs. We are committed to that kind of engagement with civil society organisations. I would be disappointed if we were not delivering on that.
Neasa Hourigan (Dublin Central, Green Party)
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In the next iteration, we can perhaps work on that so the feeling is mutual.
Colm Burke (Cork North Central, Fine Gael)
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Since I came in as Minister of State, I have visited many of the treatment centres around the country, from Bray to Waterford, Cork and Limerick - I think I have visited seven different places in Limerick alone - as well as the centres in Dublin. I am at a meeting once a month at the Merchant’s Quay project because I think it is an extremely important project. In that area, it is also about liaising with the local community. For example, yesterday, I was at a primary school in that area which is concerned about having something like this very close to it. It is about everyone working together in that area. The Government also has a responsibility to give support to groups and organisations, like that primary school, to make sure they are getting the additional support they require.
Neasa Hourigan (Dublin Central, Green Party)
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My time is ticking down so I will finish with two questions. A recent parliamentary question response states that the Department intends to commission an independent evaluation of the existing drugs strategy in quarter 4 of 2024, to be completed in 2025, and the witnesses have mentioned this a number of times. Is that commissioned and who has the Department commissioned to do it? Second, in the course of the drugs committee there was a discussion around the fact we do not currently inspect drug treatment facilities in the same way that HIQA would inspect other health service providers. Is the Department doing any work on that?
Neasa Hourigan (Dublin Central, Green Party)
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The tender is out at the moment but is not commissioned yet.
Neasa Hourigan (Dublin Central, Green Party)
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Will that push out the quarter 1 target?
Mr. Jim Walsh:
No. We have a few balls in the air here. We have to wrap up our current plan, we have to do the Government response and we have to do the evaluation. We will start the preparation for that and we also want to do a bit more consultation. One of the consultations that we want to do is with the task forces. We envisage an event in early January where we would bring in the task forces to discuss the new strategy, and that will be a specific session with them. There is a lot happening at the moment but we are trying to keep everything moving.
Neasa Hourigan (Dublin Central, Green Party)
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The inspection piece came up a number of times.
Ms Siobhán McArdle:
The role of regulators is to come in and inspect when there are regulations applying to services. However, there are only a very small number of services in the State for which there are regulations, and they are the approved inpatient centres and nursing homes for older persons. However, there are standards, called the Safer Better Healthcare standards, which apply across the board to healthcare facilities where health and social care services are provided. HIQA has set out those standards, and the services that provide healthcare services are obliged to ensure they are complying with them, along with things like their health and safety standards.
Neasa Hourigan (Dublin Central, Green Party)
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Is Ms McArdle saying there are inspections?
Colm Burke (Cork North Central, Fine Gael)
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The centres that I visited have a large and dedicated staff. They are all doing the programmes of care in a different way and they seem to have a different approach in each of the individual areas. One of the things that comes across is the dedication and commitment of staff in each of the centres that I visited, whether it is a day centre or a residential centre.
Gino Kenny (Dublin Mid West, People Before Profit Alliance)
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I want to drill down into the figures around the problematic use of drugs and those who are seeking treatment, although I am not sure the Department can give a breakdown of this. The figures are startling and they have increased by nearly 50% since 2017. Can the Department give a breakdown of the substances that people are seeking treatment for, in particular with regard to problematic substance use?
Mr. Jim Walsh:
We have a detailed breakdown in the report and it breaks it down by each individual drug. I will share a summary with the committee.
The headline is that we see a change in the main drug for which treatment is required. We see heroin use declining, which probably reflects a population that is growing older, and an increase in cocaine use. That is one trend. That includes cocaine use among women as well, which is another trend we have identified.
The second issue is polydrug use. We are seeing people presenting with problematic drug use across a range of drugs, including what might be called prescribable drugs or benzodiazepines. That would be a second trend. It is an evolving situation. We have been trying to respond to that as best we can. In 2022 and in 2023 we provided an extra €1 million specifically for cocaine treatment and crack cocaine treatment. The Minister of State mentioned some of the examples earlier on about Tallaght in south Dublin. It is evolving and of course we have not yet captured the more recent issues to do with synthetic opioids. Thankfully, that has been quite isolated but it is something we need to be ready for.
Gino Kenny (Dublin Mid West, People Before Profit Alliance)
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There is a definite trend since 2017 in the context of those presenting with an addiction to cocaine and the decline in heroin use.
Gino Kenny (Dublin Mid West, People Before Profit Alliance)
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There appears to be roughly a 50% increase. Mr. Walsh spoke about prescribed drugs and polydrug use, could he identify a percentage out of that 50%?
Gino Kenny (Dublin Mid West, People Before Profit Alliance)
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Would it represent a higher percentage of that 50%?
Gino Kenny (Dublin Mid West, People Before Profit Alliance)
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Does the polydrug use involve prescribed drugs?
Gino Kenny (Dublin Mid West, People Before Profit Alliance)
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I think "leakage" is the term used.
Gino Kenny (Dublin Mid West, People Before Profit Alliance)
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I ask Mr. Walsh to send those figures on when he gets a chance.
The Department is compiling the new national drugs strategy. Given the citizens' assembly's recommendations and the special committee on drug use, how effective will that strategy be in the context of the provision of amending legislation? The soundings thus far from Government are that it will not go near the misuse of drugs legislation with a barge pole. The soundings are that if decriminalisation has to be introduced it must be done in an Irish context and will not go near the existing legislation. It would be a major mistake if that happens. We could be in a cycle talking about the same thing in ten or 20 years' time. One of the recommendations from the special committee on drug use involves repealing section 3 of the Misuse of Drugs Act and looking at regulation in respect of cannabis, which could free up a considerable amount of police time and so forth.
Colm Burke (Cork North Central, Fine Gael)
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The question of repealing that section or anything to do with legislation will be a matter for the new government. The decision to bring forward amending legislation will have to be an overall Government decision and will not be a decision within the Department. Obviously, we will not know that until the next government is formed. There is no point going into what will or will not happen. I do not have a say in that at this stage. That is basically the way I would look at it.
Gino Kenny (Dublin Mid West, People Before Profit Alliance)
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There is definitely a shift in public opinion, as reflected in the citizens' assembly and the special committee, to the effect that we need to do something very different from what we have been doing for the past four or five years.
Colm Burke (Cork North Central, Fine Gael)
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No matter what we do, we need to ensure that we continue on with the supports that are there for people who are addicted. An important point about alcohol addiction was made by one of the speakers before I came in. We also have the issue of dual diagnosis involving mental health issues and drug addiction. We need to put in place a range of measures to ensure we can adequately deal with the current trend. For instance, we talked about crack cocaine in two areas. We are also taking an initiative with the supervised injection facility. I know it has taken five years, but that was not the Department's fault. A combination of issues delayed the project, but it is going to be delivered. As with any new initiative, even if it involves amending legislation, we need to make sure we have the supports in place.
Gino Kenny (Dublin Mid West, People Before Profit Alliance)
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Yes.
Colm Burke (Cork North Central, Fine Gael)
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One of the criticisms I have heard was that while Canada changed its legislation, it did not put adequate supports in place. There will be an increase in use if we change the legislation. The illegal drugs market will still remain in place. Many people think that any change in legislation will get rid of the illegal drugs market; it will not.
Gino Kenny (Dublin Mid West, People Before Profit Alliance)
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Nobody has ever said that. That needs to be debunked here and now. Nobody has ever said if we regulate a certain amount of drugs that the black market will suddenly disappear.
Colm Burke (Cork North Central, Fine Gael)
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All I am saying is that this is an issue for the next government to deal with. I cannot deal with it in the interim.
Gino Kenny (Dublin Mid West, People Before Profit Alliance)
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We can see that by being very wary, successive governments have completely failed on this issue. They do not have the stomach to really challenge the issues of social deprivation. Social circumstances determine why people take drugs in the first place and it is a very complex issue. Continuing to criminalise people for personal drug use simply does not work. The Government needs to look at something very different.
Colm Burke (Cork North Central, Fine Gael)
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In fairness, the supervised injection facility-----
Gino Kenny (Dublin Mid West, People Before Profit Alliance)
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That is a progressive thing. It has taken forever to do it.
Colm Burke (Cork North Central, Fine Gael)
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It is a positive step for people who are heroin users who will now have a facility where they have access to a range of services. I am trying to set up a day centre in Cork where many people are staying in facilities at night and find themselves on the street during the day with no place to go. We need to create a day centre. We also need to provide a range of supports in that day centre. Many of those supports are spread throughout the city at the moment and it would be better if they were in one spot. People who are unfortunately homeless are ending up the Simon Community or other facilities at night. If they have some place to go during the day they can also get access to services. The important issue about people who have addiction problems is getting access to services.
Gino Kenny (Dublin Mid West, People Before Profit Alliance)
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We all agree with that. We all agree that we need to put mechanisms in place to save people's lives.
Colm Burke (Cork North Central, Fine Gael)
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Can I just point out-----
Gino Kenny (Dublin Mid West, People Before Profit Alliance)
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In the previous session, it was pointed out that Ireland has the highest rate of drug-related deaths.
Colm Burke (Cork North Central, Fine Gael)
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That figure is actually not correct.
Gino Kenny (Dublin Mid West, People Before Profit Alliance)
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Well, contradict me then.
Colm Burke (Cork North Central, Fine Gael)
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One death is one death too many. The figures for this year have come down.
Gino Kenny (Dublin Mid West, People Before Profit Alliance)
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We have the highest-----
Colm Burke (Cork North Central, Fine Gael)
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We are not comparing like with like. Other European countries do not have the same mechanism for determining the cause of death. For instance, Scotland was not covered in that report. Even though that report covered 29 countries, only 21 countries actually had figures. One country that was not included was Scotland, where the number of deaths was over 1,200. I am not saying that we should accept what is happening; we should not. One death is one death too many. We need to work on reducing the numbers. It came down by 19% between 2021 and 2022. We do not have the 2023 figures yet.
Hopefully, the reduction to which I refer will have continued. There are other medications such as naloxone that are so important in this area. Ms McArdle might wish to come in on this.
Seán Crowe (Dublin South West, Sinn Fein)
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I am over time. I am conscious that several members want to contribute.
Martin Conway (Fine Gael)
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The Cathaoirleach can use some of my time.
Seán Crowe (Dublin South West, Sinn Fein)
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I thank Senator Conway.
Gino Kenny (Dublin Mid West, People Before Profit Alliance)
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Is that with decriminalisation?
Gino Kenny (Dublin Mid West, People Before Profit Alliance)
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This is what I am concerned about. We need to go much further than that.
Seán Crowe (Dublin South West, Sinn Fein)
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I cannot allow Deputy Kenny any more time.
Martin Conway (Fine Gael)
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The Deputy can have a minute of my time to ask the question.
Gino Kenny (Dublin Mid West, People Before Profit Alliance)
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With regard to health diversion, is it possible that the existing legislation which underpins all of this can be amended? It is the elephant in the room. If we do not amend the Misuse of Drugs Act we will continue to have this merry-go-round of criminalising people for simple drug use.
Colm Burke (Cork North Central, Fine Gael)
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With regard to Merchant's Quay, the target is to have the project opened by mid-December. It will then be under review for 18 months. There will be lessons from the review. It is important this is done to make sure people who are using the facility have access to the service to see what further work can be done with them with regard to helping them with the challenges they have health-wise.
Martin Conway (Fine Gael)
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I welcome the Minister of State and the officials. He has only been in the role since 10 April but, to be fair, he has an excellent handle on the portfolio. The granular detail he has at his fingertips is quite impressive. We all know that on Saturday nights in our cities and towns throughout the country cocaine is freely available. An audit has been done on the six new regional health areas. The Minister of State said that in the mapping work that has been done there are discrepancies with regard to supports. Will the Minister of State elaborate on this and tell us where the discrepancies are and what is being done to address them?
Colm Burke (Cork North Central, Fine Gael)
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The information with regard to the location of the 422 facilities is on a map. With regard to where the shortfall is, I am not sure we have the answer.
Ms Siobhán McArdle:
What the map shows is that some areas have more services or a wider range of services than others. We want to ensure that people in various parts of the country have the same access. Some of the initiatives, for example those happening in the Cork area, are a hub and spoke model. This provides outreach from areas that might have greater levels of experience or specialist services to more rural or dispersed communities. It is a work in progress. It provides a good information basis in terms of looking at what is effective, where it is and ensuring that as we begin to grow and expand services we know where to put these new services.
Martin Conway (Fine Gael)
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I am particularly interested in the first strategy priority because it is a big problem. This is the prevention of drug use among children and young people. We all know that young people go out on Saturday nights and take cocaine in huge numbers. Is the strategy working? I suggest it probably is not. What is the Department doing to try to counter it? How does it audit how successful the strategy is in terms of prevention among children and young people?
Colm Burke (Cork North Central, Fine Gael)
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The issue now is the evaluation process and this is what we need to do next. Everyone accepts that drugs are available on every street in every area throughout the country, whether rural or urban. This is a challenge. Some people experiment with drugs, not realising they can get easily addicted. We come across people of all age groups becoming addicted, as Senator Conway has in his area. It is a big challenge.
Martin Conway (Fine Gael)
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The Department was represented at Electric Picnic. Having a stand at Electric Picnic is nearly too late. We really need to infiltrate their thinking and come up with prevention mechanisms before people go to events like Electric Picnic. What is the Department doing to get to them before they go to these concerts?
Colm Burke (Cork North Central, Fine Gael)
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The process at Electric Picnic is about dealing with the issue where people have acquired drugs that may be dangerous. The idea is that we have a box where a person can drop in a sample that is analysed. If it is identified as being dangerous, the message is sent out through social media about a particular drug that may be circulating. The idea is to save lives and make sure somebody does not take the drug. In the past two years, more than 100 different samples were dropped in. Dangerous substances were identified and the message went out. We must remember a large number of people attend Electric Picnic. We could have anything up to 100 people having access to a dangerous drug that is circulating, which could cause large problems in itself.
Martin Conway (Fine Gael)
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I fully endorse the strategy. I am curious to know what happens if a drug is identified as not being dangerous.
Colm Burke (Cork North Central, Fine Gael)
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The samples are given anonymously. The whole idea is to make sure that if there is any dangerous substance being sold or made available, it is identified and the information gets out there for people not to take it. With regard to anything else, there is nothing more we can do at that stage.
Martin Conway (Fine Gael)
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I accept that. What is the school programme? Is there a specific type of school programme whereby all schools are visited? What is the process for evaluating it?
Colm Burke (Cork North Central, Fine Gael)
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This comes under the Department of Education.
Martin Conway (Fine Gael)
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It should come under the Department of Health.
Mr. Jim Walsh:
The issue of prevention is something we have tried to get a grip on in recent years because it has been the Cinderella of the policy response to drugs. The task forces have done some good work locally but they did not have a national framework or structure to support it. Last year we rolled out funding of €500,000 per annum to support drug prevention initiatives. One of these is to do an evaluation of Know the Score, which is a school-based programme developed by the HSE with input from the Department of Education. It will be evaluated to see how effective it is.
Martin Conway (Fine Gael)
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Did the officials ever come across programme in Blanchardstown called Think Before You Buy? When I was a member of the justice committee in the previous term it was deemed very effective. The Garda Commissioner was very much on board. Has Mr. Walsh come across it?
Martin Conway (Fine Gael)
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The Department should look at rolling it out on a national basis.
Seán Kyne (Fine Gael)
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I welcome the Minister of State and the team from the Department. On the relationship between local and regional drugs and alcohol task forces, has analysis been done recently on the number of task forces, whether there is a need for additional task forces or whether there is demand? Has this come up in recent years?
Ms Siobhán McArdle:
Under our national drugs strategy and the strategic action plan, there is a focus in strategic implementation group 6 on policies and strategic development and governance. It is to look at how well functioning our governance and how well connected and integrated each of the different elements is, whether the statutory or the community and voluntary sector at local level. We want to have combined, good, integrated services at community level. We are committed to developing it and ensuring that is as strong as it can be.
Mr. Jim Walsh:
We have 24 task forces at the moment, with national coverage across those. It is quite uneven. While there is national coverage, some of the regions have a very large geographic remit, while some local groups are focused on very small communities. With the new health regions the HSE is rolling out, there might be an opportunity to look at whether there is a more rational way to allocate those resources and efforts and to ensure that they are better integrated with the new structures of the health regions, because the health regions will become the planning structures for the delivery of drug services. We need everyone to be part of and co-operating in those new regional drug plans.
Seán Kyne (Fine Gael)
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Do the witnesses envisage those discussions will form parts of the drugs task force review or the new drugs task force?
Seán Kyne (Fine Gael)
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I ask about the drug-related intimidation and violence engagement, DRIVE, campaign, which is an interagency campaign to stem drug-related violence. How is that operating and where is it operating? Is it across the country?
Colm Burke (Cork North Central, Fine Gael)
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One issue is intimidation. I am sure the Senator has come across it in his constituency. People are being intimidated and money is being paid because a member of the family owes money to a dealer. This is about a co-ordinated approach. As I said, 30 Garda inspectors have been appointed around the country to co-ordinate within each individual region of the Garda force. The idea is to make sure that we can provide assistance to anyone who is feeling intimidated. People do not have to go to the gardaí. They can work with the different groups locally too. Over time, they will maybe get the confidence to report the matter to the gardaí. It is about trying to support them where they are intimidated. I have had to deal with at least four or five of those cases. They are all difficult. The idea with the DRIVE programme is to provide information about where people can get assistance.
Ms Siobhán McArdle:
As the Minister of State said in his opening speech, work is ongoing to develop a national awareness campaign, so people are aware that help is available, where it is available, and that there is signposting. Work is ongoing to develop that because it is an important topic. It supports that feeling of addressing stigma, so people know this is okay to talk about, that help is available and where to get that help.
Seán Kyne (Fine Gael)
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On a practical basis, where elderly parents are approached by an individual, for example where their son owes the individual money, what is the first port of call for those parents?
Colm Burke (Cork North Central, Fine Gael)
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If they know anyone in their local community, we are talking about training people in that area. We have talked to the gardaí about this. The gardaí are prepared to meet people, not necessarily in their own home but in a place where it is not obvious they are meeting the gardaí, because their biggest challenge is that they are afraid of being seen going into a Garda station and they are afraid of the gardai calling to their house. It can be established at a neutral venue so they can sit down and talk to people. The gardaí have become involved in an amazing number of cases over time after people did not go to the gardaí on the first day but went to one of the other State agencies for help. Then the State agency worked with them and eventually gave them the confidence to meet the gardaí privately and to move on from there. It is important that people who feel intimidated and that they are on their own know that they are not on their own and that support will be provided. It is important that we spread the message that support will be provided in the community and also by the gardaí. People who are intimidating others are taking advantage of the situation. In some cases I have come across, they are alleging that money is owed, when in fact no money is owed at all, but they have realised that the person is vulnerable and are taking advantage of the situation.
Ms Siobhán McArdle:
Part of the DRIVE programme will be to provide training for all the staff who work in the more than 400 publicly-funded drugs services. Approximately 130 of those services are particularly targeted at family supports. Part of the awareness campaign will be to provide a signpost for people to those services. The staff they meet will understand how to manage and support families who are struggling with drug-related intimidation and how to have those links with An Garda Síochána.
Seán Kyne (Fine Gael)
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Are the witnesses confident that there is sufficient capacity in facilities for rehabilitation and drying out? Are there regional imbalances?
Colm Burke (Cork North Central, Fine Gael)
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The issue of dual diagnosis of mental health issues and drug addiction issues is one area where there is a challenge. We need to fast-track it. While some people in mental health services might say this is a drug addiction issue and nothing to do with them, drug addiction services might then say this is a mental health issue and they are getting no support. It is important that we have a co-ordinated approach in that area. Regarding the step-by-step approach, I have come across self-employed people who have become addicted to drugs and ended up losing the entire business and their family home. It is then a matter of trying to deal with the addiction issue and then come back to live a normal life again. It is a slow process with a step-by-step approach. It is important, where someone is in a treatment or residential facility, that we have somewhere for them to go once they are finished in that treatment facility. Likewise, we need to make sure that when people end up in prison, they have somewhere to go when they are released from prison and they are not back out on the street where they have no place to go. It is important that we do a lot more work in that area.
Seán Kyne (Fine Gael)
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I absolutely agree. We hear of cases where people leave rehabilitation facilities and are lost in the system for a period. They may be on a social housing list. They may or may not have a relationship with their families. It is an area that has to be included in strategies.
Colm Burke (Cork North Central, Fine Gael)
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Housing bodies such as Depaul, whose representatives I have met, are doing a lot of work on that. People have come through rehabilitation and the bodies have provided housing for them. I was in Usher's Island in the past two weeks, where the Simon Community has opened a brand new facility. It has 100 separate rooms with en suite bathroom facilities. When I was there, 51 people were moving in on the day. This is about helping them to come off the street into a treatment programme. The next step after that is more permanent housing. It is an amazing facility, in fairness to everyone involved in it, including Dublin City Council, the Department and the Department of housing. My Department and Dublin City Council are giving funding to run that facility. The facility is well worth visiting to see what can be done. This is just the first step of getting people into a more stable structure and being able to take the next step after they go through the treatment programme.
Seán Crowe (Dublin South West, Sinn Fein)
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The last group that was in here talked about drug task forces and the importance of decision-makers being around the table. This is an old chestnut. It goes back years. We are talking about the pillars of drug rehabilitation. Those that need to be there are education, health, justice, social protection, child and family, and probably others. At some stage, however, a decision was made that the Department would pull out of those structures. The Minister of State says it is on the oversight body and so on, but if we do not have those key elements and those key people around the table, it is very frustrating for any of the task forces operating. None of us know where we will be in the coming weeks but we certainly need a champion of change in that area.
Colm Burke (Cork North Central, Fine Gael)
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Visiting the centres throughout the country certainly has helped me because every place you go you learn something new. You learn about the challenges they are facing and the new changes that have occurred as regards drug use. It is one of the things that is well worth doing. In fairness to the Department officials, they have a direct link not only in getting in information but also in making sure they respond appropriately to that information.
Seán Crowe (Dublin South West, Sinn Fein)
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As regards the other areas, you speak about "a dynamic situation to which policy must adapt in a flexible manner". Respectfully, that does not happen. You mentioned the funding that came for the likes of the cocaine project in Tallaght, which was welcome. They are waiting now. They do not know whether there will be funding for next year; no one has told them. I mentioned the ten residential beds in the CHO 7 area earlier. That funding ran out in September. People are arriving for treatment or feel they are ready for treatment, the projects are saying they are ready for treatment, and the funding is not there. One of our members said funding is not an issue. Funding is an issue because it takes up so much time at every Dublin task force meeting I have ever attended, and that is right across the different drug task forces.
There is a big challenge ahead of the Minister of State if he is in the job the next time around. I wish him well.
Colm Burke (Cork North Central, Fine Gael)
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Thank you.
Seán Crowe (Dublin South West, Sinn Fein)
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We talked earlier about the challenges that exist. People are saying they have never seen things as bad in communities. We need an injection of hope and reality. The idea we will have another report will probably garner a collective groan from many of us, but that is part of what needs to be done in this regard.
Colm Burke (Cork North Central, Fine Gael)
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The Merchants Quay project, the target date for which is 15 September, and the Usher's Island project for the Simon Community in Dublin are two very good projects. There are also the day facilities. In fairness to the HSE and Cork City Council, my Department had a meeting with them and the Department of housing. Everyone was working together to try to get that project to the next stage. It is important to recognise, however, the projects that have been delivered already and, likewise, in Limerick-----
Seán Crowe (Dublin South West, Sinn Fein)
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Yes. There is a huge amount of work there, and we send our commendations to all those task forces that are operating, under difficult circumstances in a lot of cases. If I had the time, we would go into a lot more.
I thank the Minister of State and his officials for meeting this morning with the committee on the issue of the local drug and alcohol task forces. This is probably the last meeting we will have, so I thank the staff for all the support they have given us over the years and the members, who have co-operated with me. It has been an honour being in the Chair, and I wish everyone well in the coming weeks.
Martin Conway (Fine Gael)
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The same to you, Chair.
Seán Crowe (Dublin South West, Sinn Fein)
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Thank you. I hope we will all be back here safe and well in a couple of weeks' time, but if not, thank you again for everything. The meeting is now adjourned until Tuesday-----
Colm Burke (Cork North Central, Fine Gael)
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If I may, it is important that I thank you as well, but also the staff of the committee, who have worked very hard in making sure all the people the committee needs to bring in for its meetings are brought in. It is not an easy thing to do at times. I thank the staff for all their work over the years I was on the committee. I was on the committee from 2011 before I became a Minister of State. I certainly learned an awful lot from this committee. I thank you, Chair, and all the staff who work on it.
Seán Crowe (Dublin South West, Sinn Fein)
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Thank you. The meeting is now adjourned until, possibly, 4 p.m. on Tuesday, 12 November, when the committee will meet in private session.