Chris Andrews (Dublin Bay South, Sinn Fein)
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I wish to join with my colleagues in extending my sympathies to the family of Mary O’Rourke. She was a former colleague who was robust and had a big personality.

As for the Topical Issue, after a week in which the budget was announced, when the Government has finished clapping itself on the back for its give-away budget it is important to remember that 70% of prisoners in Irish prisons have addiction issues. In August of this year, ten prisoners were hospitalised due to suspected drug overdoses. In response to a recent parliamentary question I tabled, the Minister made what I find an astonishing admission - the Irish Prison Service has no full-time addiction nurse. That is pretty shocking, given the level of addiction in Irish prisons. To have no addiction nurse in our prison service is absolutely criminal. When I asked whether there were any addiction nurses in the Prison Service, it said that primary care nurses carry out specialist assessments. In its reply, the Prison Service is acknowledging that addiction is a specialist role, yet it does not employ any full-time addiction nurses. Does the Government care so little about those in addiction in our prisons? Based on the Minister’s response to my recent parliamentary question in which it was stated there are zero addiction nurses in the Prison Service, the answer is a resounding “Yes”. That sums up the Government’s view of those who are vulnerable in our society. If people have money, the Government will look after them, but if people are vulnerable in any way, it just does not care.

The Minister of State will probably say there is a nurse lead appointed to the role of addiction and mental health. However, what exactly is that person managing, given that there is not one full-time addiction nurse in the entire estate? Report after report have recommended that each prison should have full-time addiction nurses. That recommendation has been made since 2009. There are simply no drug addiction nurses despite recommendations being made in 2009, 2016 and again in 2022 in various reports. You have to ask yourself why these reports are being carried out if recommendations are not going to be implemented. What is the point in saying we need more addiction nurses when there has not been one since 2009? It is criminal from this Government.

While I know he will not have the figure off the top of his head, will the Minister of State be able to get the figure for the number of drug overdoses in Mountjoy Prison? Approximately two and a half years ago, one of the Minister of State’s colleagues asked for this information and it was not available then. Those figures are vital if the Government is serious about trying to address overdoses and recovery in Irish prisons. Why are these figures not available, given that this was flagged over two years ago? I suggest the Minister of State does not have those figures because there are no addiction nurses working within the Irish Prison Service and, therefore, it cannot provide this information. Surely those figures would be a basic and essential part of determining a strategy and a process to reduce addiction in Irish prisons. These figures, and the subsequent patterns from them, would not be so hard to find out if a process was set up within the Irish Prison Service. This is not rocket science. Why is it not being done?

Colm Burke (Cork North Central, Fine Gael)
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I too wish to send my condolences to the family of Mary O’Rourke. I first met Mary when she was a Minister and I was the Lord Mayor of Cork in 2003. We had an entertaining engagement because, as Lord Mayor of Cork, one of the jobs you have is to visit every school in the city and grant a half-day. Her colleague, Noel Dempsey, withdrew the right to grant the half-day. I remember Mary telling me that if she was Minister, she would have been far more diplomatic in making sure that the power of the Lord Mayor of Cork was not removed. I always remember that conversation. I send my condolences to her family. She made a huge contribution over a long number of years in this House and the Seanad and to the constituency which she served.

I thank Deputy Andrews for raising this issue. I am familiar with the challenges in the Irish Prison Service as I make an open admission that a member of my own family worked in a medical role for a time in the Prison Service. I am very much aware of the challenges in this regard. On the point which the Deputy has raised, it is important I engage with the Department of Justice about this matter because my role is in the whole drugs addiction area. It is an important issue the Deputy has raised.

I apologise on behalf of the Minister, Deputy McEntee, who cannot be here to give this reply. I thank the Deputy for raising this important matter.

The Irish Prison Service is committed to providing the best possible healthcare to all prisoners, including those living with addiction. The Irish Prison Service has partnered with Merchants Quay Ireland to provide an in-reach service to prisoners who require addiction counselling. There are currently 19 addiction counsellors working across 11 prisons, providing an invaluable rehabilitative service to prisoners, and it is hoped that in the coming months this service will be further enhanced and refined to reach more vulnerable prisoners.

The Irish Prison Service recognises that when it comes to treating addiction, one size does not fit all. As such, it is also striving to diversify its approach to the treatment of addiction and has been engaging with numerous organisations, including AA and NA, DCU's Recovery College initiative, and the HSE's dual diagnosis clinical programme to expand the options available and ultimately reach more prisoners. Prison nurses play a pivotal role in the provision of healthcare to inmates and show great care and professionalism across a range of fields, from primary care to mental health and addiction.

The chief nurse officer within each prison is tasked with ensuring the equitable delivery of healthcare resources to cater for the diverse and often complex needs of prisoners. There is currently no dedicated addiction nursing role within the Irish Prison Service because all prison nurses are members of the same primary care team within the prison. As such, their focus is on duties such as, but by no means limited to, medication administration, triaging, wound care and vaccination. In addition, there are a number of primary care nurses who are assigned the function of carrying out specialist addiction assessments when this is feasible, taking account of the operational demands of the prison. However, in light of the prevalence of addiction issues among the Irish prisoner population, and recommendations from the high-level task force on mental health and addiction, Irish Prison Service drug strategy and the health needs assessment, the Irish Prison Service appointed in May of this year a national clinical lead for mental health and addiction whose primary focus will be improving and enhancing clinical protocols, governance and, ultimately, the breadth of services available to prisoners living with addiction. One of the actions that may have commenced is the scoping of an addiction nurse role as part of the prison healthcare team to build the case for the introduction of an addiction nurse to provide crucial care for those most in need in our prisons.

That is the response I have received from the Department of Justice.

Chris Andrews (Dublin Bay South, Sinn Fein)
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I thank the Minister of State and appreciate his coming in but the reality is that 600 prisoners in Mountjoy Prison are in addiction and there is no addiction nurse. Appointing clinical leads is well and good, but who will they work with? There are no addiction nurses for them to work with. How will that operate? It seems extraordinary. There are 180 prisoners in Mountjoy on methadone.

The Minister of State mentioned the chief nurse officer. I understand that on the night shift in Mountjoy Prison, there is just one nurse working. The treatment and neglect of prisoners are shameful.

I understand there used to be three nurses working in Mountjoy Prison, but now there are none. That is just not acceptable in a modern, wealthy country. On the one hand, there are no addiction nurses in Mountjoy Prison for the 600 prisoners in addiction, yet we are giving €9 million for phone pouches for schools. Who thought giving €9 million to schools for phone pouches was a good idea? Who could not see it was a harebrained idea when there are serious issues and deficiencies throughout services?

Today, I am highlighting the lack of addiction nurses in the Irish Prison Service but in every sector one will find the same need for funding and resources. Addiction nurses comprise a crucial element in ensuring the addiction rate in Irish prisons is reduced. This Government has failed miserably.

Colm Burke (Cork North Central, Fine Gael)
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I set out in my reply that there are 19 addiction counsellors working across 11 prisons, providing an invaluable rehabilitative service to prisoners, and it is hoped that in the coming months this service will be further enhanced. I understand the point the Deputy has raised but believe there is now a commitment to further expand the role of the nurses. I hope that will happen over the next 12 months.

The Irish Prison Service recognises the significant prevalence of addiction and drug-related harm in our prisons. This issue affects not only the prisoners involved but also their families, prison staff and the wider community. As such, the service is committed to a multi-pronged approach to tackling the issues of drugs and drug addiction in prisons, including through the provision of education and health promotion materials to prisoners via education partners, the detection and prevention of contraband smuggled into prisons, and the expansion and diversification of the treatment options available to prisoners and addiction.

It has been highlighted that there is likely to be a need for dedicated addiction nurses in some prisons, and the Irish Prison Service is currently scoping where these nurses are most needed, what an addiction nurse role within the Irish Prison Service would look like, and how best to deliver this service with the current staffing.

I referred to Merchants Quay Ireland's role and the work it is doing. Therefore, this is not something that is being ignored. There is a proactive approach on the part of the Irish Prison Service and Department. I hope this will continue and that the appointment of nurses dealing with addiction will expand further over the coming 12 months to two years. There is a scoping exercise under way and I hope the matter will be resolved within the next few months and progressed from there. It is an important issue. I am dealing with drug addiction and will certainly raise within my Department the issue of engaging with the Department of Justice on the matter.