COMMITTEE OF PUBLIC ACCOUNTS debate -
Thursday, 17 Sep 2009

Special Report No. 64 of Comptroller and Auditor General: Drug Addiction Treatment and Rehabilitation (Resumed).

Mr. John Buckley (An tArd Reachtaire Cúntas agus Ciste) called and examined.

Mr. Seán Aylward (Secretary General, Department of Justice, Equality and Law Reform) called and examined.

Chairman

Today we will examine special report No. 64 of the Comptroller and Auditor General on drug addiction treatment and rehabilitation. We have already examined the Department of Community, Rural and Gaeltacht Affairs and the Health Service Executive on issues related to the delivery of services to drug addicts, mainly methadone maintenance. Today's session relates to the justice element of service delivery covered in the report of the Comptroller and Auditor General. We will be returning to the issue when we look at the effectiveness of treatment and when we have available the study of the prevalence of opiates in the State. At that meeting the Department of Community, Rural and Gaeltacht Affairs, the HSE and the Health Research Board will be examined on the issues raised. We will also look at the new proposals emanating from the new drugs strategy published last week.

I draw attention to the fact that while members of the committee enjoy absolute privilege, the same privilege does not apply to witnesses appearing before the committee which cannot guarantee any level of privilege to witnesses appearing before it. Furthermore, I remind members of the long-standing parliamentary practice to the effect that they should not comment on, criticise or make charges against a person outside the House or an official, by name or in such a way as to make him or her identifiable. They are also reminded of the provisions within Standing Order 158 that the committee shall refrain from inquiring into the merits of a policy or policies of the Government or a Minister of the Government or the merits of the objectives of such policy or policies.

I welcome Mr. Seán Aylward, Secretary General of the Department of Justice, Equality and Law Reform, and ask him to introduce his officials.

Mr. Seán Aylward

I am accompanied by the following: Mr. Tom Ward, chief clerk of the Dublin Circuit Court; Ms Caroline Murphy, assistant principal officer in the Department's courts policy division, and Mr. Niall Cullen, assistant principal officer in the Department's crime division who spends a day and a half each week with the team in the Department of Community, Rural and Gaeltacht Affairs which deals with drugs issues; Ms Mary Burke, principal officer in our prison and probation policy division; my friend and colleague, Mr. Brian Purcell, Director General of the Irish Prison Service; Ms Frances Nangle-Connor, co-ordinator of prison nursing services; Mr. Michael Donnellan, director of the probation service; and Mr. Gerry McNally, assistant director of the probation service.

Chairman

I now ask Mr. Buckley to introduce special report No. 64.

Mr. John Buckley

As the Chairman said in his introduction, the focus of special report No. 64 is on drug addiction treatment and rehabilitation. A previous meeting in July considered the role of the HSE and the co-ordinating role of the Department of Community, Rural and Gaeltacht Affairs. This session examines drug treatment and how drug treatment and rehabilitation is handled in the criminal justice system.

Within the criminal justice system there are three main institutions which have an input into addiction treatment and rehabilitation: the Irish Prison Service which provides addiction counselling, methadone maintenance treatment, detoxification and rehabilitation for persons in custody; the probation service which assists the courts at sentencing stage in those cases where community based sanctions incorporating drug treatment are contemplated and, in instances where they are actually imposed, monitors their implementation; and the drug treatment court which operates for offenders resident in two Dublin postal districts in the north inner city who have committed non-violent offences. The aim of the court is to maintain offenders in the community on condition that they manage their addiction.

The key findings of the audit were as follows. In the case of the Prison Service, methadone maintenance facilities are available in eight prisons that accommodate three quarters of the prison population. Around 12% to 15% of the persons committed to prison between 2003 and 2007 were placed on methadone programmes. Only Mountjoy Prison provides a rehabilitation facility which is capable of treating around 72 prisoners each year. During the years participation and completion rates in the programme have varied, perhaps influenced by the availability of methadone maintenance programmes. However, after 2006, the completion rate of the programme began to rise.

All prisons offered addiction counselling services, with the exception of Arbour Hill Prison. Since September 2008, most counselling services in prisons have been outsourced and will now be provided by Merchants Quay Ireland. The audit concluded that more information needed to be captured and shared about those treated in prisons, as well as the outcome of the treatment provided. Full utilisation of the computer-based medical record system and integrating prison treatment information into the national drug treatment recording system appeared to be the solution to this. In addition, more continuity of care was desirable as prisoners moved from and back into the community.

The second arm in the criminal justice system is the Probation Service and it was involved in the planning and funding of drug treatment services for individuals. In 2007, it provided €2.7 million for voluntary and community bodies for these kinds of programmes. However, it is reviewing these arrangements in light of the improved general access to addiction services in the community generally and has found there is scope for improvement in the information captured by the Probation Service, especially that pertaining to access to treatment places for those offenders where community-based sanction is being considered. It is also reviewing them in light of the outcomes in court ordered treatments that it supervises.

The Dublin Drug Treatment Court, which was put on a permanent footing in 2006, has a low participation and completion rate. The examination found that just over half of the cases referred to the drug treatment court were found to be eligible and suitable for inclusion on the programme. It also found the throughput of cases was low. Between 2002 and 2008, some 22 offenders a year were admitted to the programme, which is approximately one fifth of the target envisaged at its inception. Only 17% of programme participants completed the programme to the satisfaction of the court. The remit of the drug treatment court was to be expanded to include the entire city of Dublin, but this has not yet happened. The Courts Service has stated the expansion has not happened because other agencies, in particular the HSE, have not been in a position to provide the necessary support services.

Overall, there is a need to evaluate the effectiveness of the Drug Treatment Court in comparison with community-based sanctions that provide for treatment. This would preferably be done by making a comparison with areas of similar socioeconomic profile.

Chairman

I now invite Mr. Seán Aylward to make his opening statement.

Mr. Seán Aylward

Looking at the notes we sent to the committee, I realise I have repeated some of the material used in the presentation by the Comptroller and Auditor General. I propose, therefore, to curtail my remarks to afford more time to the committee to ask questions and probe issues with us. I will keep my presentation terse and hope the committee understands the reason for this. The Chairman may, if he wishes, include my submission in the record, but I will just extract a few brief points now.

We recognise our primary responsibility in this area in the Department of Justice, Equality and Law Reform is to ensure drug supply reduction is effected in the State and that drug law enforcement remains a key priority and is delivered by the services and agencies we support, in particular the Garda Síochána. We recognise we must take a holistic approach to drug treatment and rehabilitation. The agencies represented here today try to respond to the holistic needs in this area. We support preventative and research initiatives in this area and are very much in favour of a co-ordinated, balanced and pillar-based approach. We do not believe any one agency of the State can solve this pernicious problem but that we must all play a collegiate part in achieving a solution.

With regard to the Irish Prison Service, I spent nine years working in various levels of prison management and was involved in a number of initiatives, including trying to create drug-free wings in prisons and battling with various people to introduce methadone treatment, which faced significant resistance to this treatment at management level. There has been significant progress in this regard under the leadership of my successor, Brian Purcell, and he will address that area in more detail later.

The Probation Service has strong leadership currently under Mr. Michael Donnellan who has personally driven many of the projects done. The Comptroller and Auditor General referred to the fact the service supports 19 addiction centres. The service works hard with motivators and the factors underpinning offending behaviour. I will allow Mr. Donnellan address those issues or what the Comptroller and Auditor General feels he should be doing.

I was involved with the launch and inception of the Drug Treatment Court. However, I am disappointed with its low output and am not convinced any longer that is the way we should go. An evaluation is under way and we hope it will be completed by the end of the year. Consultation is also taking place with the Judiciary and we will see where that goes. People here from the Courts Service may wish to speak further on the issue, but while it was started with the best of intentions, the production level of the court does not justify extending the model elsewhere. It is not working and we must go back to the drawing board. There is nothing wrong with the State trying something and then acknowledging it is not working and deciding to go another route. I do not question the bona fides of anyone involved in the project but sometimes we must look at things afresh.

I will conclude with that and hope the Chairman understands that no disrespect is intended.

Chairman

I thank Mr. Aylward. It is a nice change to have a short, concise and accurate report. Sometimes we deal with reports and opening statements that go on for 15 or 20 minutes. We appreciate Mr. Aylward's approach.

Deputy Darragh O’Brien

I welcome all of the witnesses here today. I have read the opening statements in detail and have also seen the Comptroller and Auditor General's report. Mr. Aylward mentioned a holistic approach to the drug problem and this committee has previously examined other aspects. We all agree that people are working very hard in a difficult situation to address the problems and the social scourge of drug abuse, both for individuals and society.

My first question concerns the practical interaction between the various Departments and agencies involved. There are probably seven of them dealing with this issue, which seems an unwieldy number. The Government strategy announced last week by the Taoiseach and the Minister of State, Deputy John Curran, is examining how we can bring it all together. The fact that so many different Departments and agencies are involved is probably one of the main problems in combating the problem. Can Mr. Aylward tell the committee how often the various agencies sit down together and assess policy and strategy and examine failures or successes within the system?

Mr. Seán Aylward

They come together a lot. When I introduced Mr. Niall Cullen, I mentioned that in recent years they have taken an approach under the leadership of the Department of Community, Rural and Gaeltacht Affairs whereby a team and task force work together side by side. I will ask Mr. Cullen to speak on that matter.

The problem of substance abuse permeates our entire society and affects the operation of almost every institution in national life. Therefore, it is not really practical to put all the responsibility in the hands of one person. On a recent visit to the United States I met the drug czar and his people. These officials admit the same thing. We cannot pin a problem as pervasive as this and with so many societal impacts down to a single agency or committee. No doubt about it, the issue must be on everyone's radar as one that underpins many other problems. In recent years there has been an effort to get our act together. The latest product of that approach is the report launched by the Taoiseach last week.

With the permission of the Chairman, I would like Mr. Cullen to give further detail on the issue of co-ordination and co-operation between agencies.

Mr. Niall Cullen

There is more co-operation in the area of drugs policy between Departments and agencies than in any other area. Co-operation goes beyond policy as it is a principle that underlies our whole approach to drugs across all the pillars — supply, treatment, rehabilitation, prevention and research. The principle underpinning everything we do with regard to drugs involves co-operation between all Departments and agencies and with the community and voluntary sector. All the structures reflect this.

In practical terms, under the new structure we have a newly established office for the Minister with responsibility for drugs. The representation in that office reflects that partnership of the relevant Departments and agencies with representatives seconded on a half-time basis for two and a half days of their working week and also representatives from the community and voluntary sector. This partnership is also reflected at a more local level, as well as regional level. Our local and regional drug task forces also have representatives from the various Departments, agencies and sectors involved. At the more senior level, under the new drugs strategy launched by the Taoiseach last week, there will be an oversight forum which will report to the Minister of State, Deputy Curran. It will include representatives of all Departments who will sit down with the representatives of the community and voluntary sector to examine the progress made. In answer to the Deputy, in this area more than any other there is ongoing practical co-operation between the Government agencies involved.

Deputy Darragh O’Brien

The Comptroller and Auditor General referred to the interaction with the Health Service Executive on rehabilitation programmes for persons who have left prison. He refers to a total of 384 programme places and 19 addiction centres nationally. I assume this is the maximum provision for former prisoners with continuing addiction issues. How sufficient is this number and where are the centres in question placed around the country? I will direct a question at Mr. Purcell and his team. I acknowledge they have a difficult job with regard to prisons but I am certain that 384 places is not sufficient to cater for the numbers leaving prison with addiction issues. How far short is the number of places?

Mr. Seán Aylward

Before I pass the baton to the representatives of the Irish Prison Service, I wish to make two brief points about co-ordination which perhaps were not reached by Mr. Cullen. First, the local task forces are excellent and bring together many people, including from the local law enforcement agencies — there is usually high level Garda Síochána representation, at superintendent level. This is something that does not happen in most countries. It is a very good system. This co-ordination of services at local level is very important and the feedback is very good. The other information I picked up when in the United States is that we are well ahead of what is a very rich society when it comes to prison-based treatment. There is virtually no methadone treatment available in the United States; therefore, whatever our weaknesses are, we are not doing too badly by international standards. However, Deputy O'Brien has raised a very substantial and specific point on placements and continuity of care, on which I would like to pass to the representatives of the Irish Prison Service.

Mr. Brian Purcell

The issue of placement is primarily one for the probation service and my colleague, Mr. Donnellan, will speak on it. In recent times we have made significant progress in the treatment of drug abuse among prisoners who come into the system. We have adopted a holistic approach. I will not detain the committee on the subject because it wishes to hear about placements. We have regular meetings with all the other agencies involved, including the lead people in the HSE. We also have regular meetings with the senior consultants dealing with drug treatment within the prisons. We established an independent oversight group to take an independent view of the progress made by the Irish Prison Service in dealing with the aspects of the national drugs strategy relating to the service. We have made significant progress, particularly in the past three years, both on the drug treatment side and in dealing with the issue of supply reduction. The Deputy is correct that prisoners come into the system and that they inevitably return to the community upon completion of their sentence; therefore, we must ensure in so far as it is possible to do so that anything we do in a prison context will allow the treatment of the problem to continue when they move back to the community, in particular mathadone treatment.

Deputy Darragh O’Brien

That is what I am trying to ascertain.

Mr. Brian Purcell

One cannot put a person on a methadone programme when in prison unless there will be a placement in the community for them upon release. We always ensure, through liaison with the probation service and treatment centres on the outside, that there are places available for prisoners who have been released from the prison system into the community who have been on methadone. However, this is not easy and it requires a considerable amount of time and resources to arrange it but in the past three years we have become quite successful.

Deputy Darragh O’Brien

I thank Mr. Purcell for that reply as it deals with methadone treatment but there are many other drug users who are not on methadone programmes. There are 384 programme places but there are substantially more than 384 people who require places. How far short are we of the number required? I am not focusing solely on methadone treatment. While this is very necessary, there is an argument that it prolongs the problem of drug abuse rather than solving it for an individual. What steps are taken with someone who has a serious drug addiction problem prior to his or her release from prison? I presume the Irish Prison Service liaises with the HSE but how far short are we of the required number in providing places in rehabilitation centres?

Mr. Brian Purcell

My colleague, Mr. Donnellan, will be able to give specific details about places outside the prison system. There is considerable engagement with groups outside the system on the treatment being provided inside prison and also on the care elements as prisoners pass from custody into the community. Mr. Donnellan will cover the specific point raised by the Deputy.

Mr. Michael Donnellan

The places to which the Deputy refers are additional and complement those provided in the HSE system. They are funded through the Department of Justice, Equality and Law Reform and the probation service with an allocation of just under €2 million a year. There is a total of 19 centres. It is a non-medical intervention, meaning non-methadone treatment.

Deputy Darragh O’Brien

Therefore, is it the case that anyone who has been on a drug treatment programme in the prison system will be able to access a place in a rehabilitation or treatment centre when he or she leaves prison? I do not mean a residential place but rather a place on a programme. Can we confidently state that anyone with an addiction problem leaving the prison system and who is willing to do so can access a place?

Mr. Michael Donnellan

The Probation Service is confident that those who come within our remit will access sufficient placements through the projects which we fund. Equally, some clients have to take a place within HSE-funded programmes.

Deputy Darragh O’Brien

Is that a person who is on probation? A prisoner who has served his or her full term is not on probation.

Mr. Michael Donnellan

There is a huge return to the community in terms of interventions and the multidisciplinary approach within the local and regional drug task forces; all of the facilities available that can be accessed through these means. There are many complementary services working for people not on probation.

Deputy Darragh O’Brien

I wish to deal briefly with the drug treatment court. I was interested in Mr. Aylward's statement. The court has been on a permanent footing since 2006. As stated by both Mr. Aylward and the Comptroller and Auditor General, the throughput has been very low, disappointingly so. This may be a question for Mr. Ward. For how long has the evaluation process been ongoing? I note it has been stated it might be completed by the end of the year. From anecdotal evidence and the statement made, it seems the court is not working, even though it has the best of intentions. When will the evaluation process be completed?

Mr. Seán Aylward

I am going to ask my colleague in the courts policy division, Ms Murphy, to answer that. I pressed her on the way in here to give me a deliverable on this and she said to me that the dialogue and consultation would be completed by the end of this year. I will ask her for more information on when the dialogue and analysis began and whether she can be more concrete.

Ms Caroline Murphy

It is intended that the review will be completed by the end of this year at the latest. For some time, we have been looking at the systems used abroad and have been consulting the various people involved in the drug court here. Those discussions are continuing. We are looking at how the court is operating and trying to see whether there are cost-effective measures that could be taken that would improve the court as it is currently constituted. I do not want to pre-empt the outcome of the——

Deputy Darragh O’Brien

When did the Department start that process?

Ms Caroline Murphy

We have been looking at it in some detail for about 18 months. It is being done within the Department in conjunction with dealing with many other issues. It will be concluded in the next couple of months.

Deputy Darragh O’Brien

I thank Ms Murphy. Eighteen months have been spent on evaluation. How many people actually accessed or went through the drug treatment court last year? A number applied and over 40% were refused access to it.

Ms Caroline Murphy

Yes, over 40%. There are currently 31 people being assessed. There are about 41 participants at the moment with a further 31 under assessment. The graduation levels have increased. At the end of August, 26 people graduated. That figure is for the entire period.

It is quite clear from the assessments carried out——

Deputy Darragh O’Brien

Is the entire period from 2006?

Ms Caroline Murphy

Yes.

Deputy Darragh O’Brien

It was set up in 2001. Is Ms Murphy saying 26 graduated from 2001?

Ms Caroline Murphy

Yes.

Deputy Darragh O’Brien

The court is set up on a permanent footing.

Ms Caroline Murphy

It is.

Deputy Darragh O’Brien

How many people are in the service?

Ms Caroline Murphy

It sits one day a week.

Deputy Darragh O’Brien

How many staff?

Ms Caroline Murphy

There are a number of staff working part-time but they were taken from existing resources when the court was established.

Chairman

Are there only three or four people on average coming through the system a year?

Ms Caroline Murphy

Finally graduating, but many more participants make it through phase 1 and phase 2 of the programme. However, very few actually complete the entire programme. Part of the assessment involves looking at the criteria being used to consider those being selected into the programme and how they progress through it.

Deputy Darragh O’Brien

For the period from 2001, approximately how many people have applied to participate on the programme? I do not seek the number that were accepted, bearing in mind that there is a refusal rate of over 40%.

Ms Caroline Murphy

Some 373 people have been referred to the court.

Deputy Darragh O’Brien

How many have been accepted?

Ms Caroline Murphy

Of those, 150 were found to be unsuitable.

Deputy Darragh O’Brien

It is down to 223.

Ms Caroline Murphy

Yes.

Deputy Darragh O’Brien

Of that number, 26 people have graduated, which amounts to approximately 10%.

Ms Caroline Murphy

Yes.

Deputy Darragh O’Brien

Does that not show the Department that the scheme has been an abject failure? This casts doubt on the need to have been evaluating the programme for 18 months and focusing resources on the area, bearing in mind that the process is not to be completed until the end of this year. Only 26 people graduated in eight years, which is approximately three per year. I am not an expert but, having looked at the figures in the cold light of day——

Ms Caroline Murphy

I do not think one can strictly look at graduation figures when assessing the success of a particular court. There are a lot of other factors involved. To be fair to the people who have put a lot of effort into running the drug treatment court, it is not suitable simply to assess the numbers starkly without considering whether there is some way in which the number of people being referred could be increased and whether the court could be used in a better way. It is essential to consider all the factors.

Deputy Darragh O’Brien

I agree. I do not want to labour the point but believe it is very important. It does not detract in any way from the bona fides of the people who are involved in the project and working in the drugs area. All members of this committee agree that the work is invaluable. Only two to three, or 10%, of the people referred — there have been 373 in total — graduate per annum. How far does this figure fall below the original targets that were set?

Mr. Seán Aylward

It would have fallen well below what one would have envisaged. We are on slightly delicate ground in that there is a separation of powers. We must approach any initiative of the kind in question in the courts very delicately because we require the consent of people who are constitutionally independent of us.

I was involved in some of the discussions on the court before its inception. The model was taken from the United States, especially from the Florida area where there are flourishing drug courts. In retrospect, I believe the drug courts that were successful in the United States were very much dealing with middle class offenders, such as those with a cocaine habit, for example, who actually had affluent enough lifestyles. There was a high recovery rate under court encouragement and supervision. In our system, the types of offenders appearing before the courts and who make manifest that they have a drug problem are not in the same category as those who have been managed successfully by the US drug court system. Many of them have been involved repeatedly in crime and have tended to lapse into addiction very quickly over their offending lifetimes.

We were trying to apply a US model in Ireland that does not quite fit the offending population among our population. That is not to say for a second that there are not middle class people with substantial substance abuse problems.

Deputy Darragh O’Brien

There certainly are.

Mr. Seán Aylward

However, they are just not appearing before the courts in the numbers that would obtain in the United States, which is a much bigger jurisdiction.

Deputy Darragh O’Brien

That is accepted. I agree that the last place I would want drug addicts who perpetrate non-violent offences to go is through our prison service or the normal courts. Mr. Aylward stated the system in Florida is flourishing but there must be reasons ours is not. In addition to mentioning the social demographic in this country, he made the important point that those with what is referred to as a middle-class background who are guilty of drug related offences are not going through the courts system by comparison with those in another demographic category. That is an issue for the Courts Service and the Department of Justice, Equality and Law Reform. When focusing our resources on the drugs issue, we must acknowledge the disappointing graduation rate within the drug court. The delegates and the Comptroller and Auditor General mentioned this. The court has failed to meet its targets.

One should bear in mind the resources allocated to the Drug Treatment Court which could well be allocated elsewhere. I suggest tweaking will not work because there is a fundamental issue at stake. Where are we going with this? Ms Murphy stated the evaluation will be completed by the end of this year. Will it and how quickly can we focus on another area if the current model is deemed not to work? I agree it is no harm for the Department to hold up its hand, admit a strategy is not working and try something else. I wish many other agencies would do so more often. When will the evaluation be presented to the Minister and how quickly can we move towards winding this up?

Mr. Seán Aylward

We are on track to complete it by the end of the year. The only reason we are being coy about the completion date is we are dealing with an independent constitutional organ of the State, the Judiciary. Out of respect for it, we must ask if it has anything further to state about the findings we propose to publish. I cannot set a deadline for the President of the District Court; I must respect her independence. Subject only to that constraint, we are firmly on track to draw our conclusions in the current calendar year. I can go no further than that without showing gross disrespect to the Judiciary.

I will be looking at the acknowledgement that every District Court judge is dealing with people who are appearing because they come from a background of substance abuse, be it alcohol or illegal drugs. In their own way, they take this into account in their sentencing and disposition towards those concerned. If I see an avenue for the future, it is in further supporting the District Court, a hardworking jurisdiction, by making sure every judge in every courtroom has all the tools available in terms of information on the options and resources available for those before him or her. In many ways, that would be a more pragmatic approach. The specialisation attempted in this court which only sits one day a week — this is not a reflection on those behind the approach — could be better approached by equipping every court with information on substance abuse and addiction and the options available locally. The Judiciary is very IT aware; judges have laptops and are constantly receiving emails. We should go down a different track and make this part of the DNA of every court in the land.

Deputy Darragh O’Brien

Mr. Aylward mentioned that every District Court should have this information on non-violent offenders who have a drug addiction problem and how the court should deal with it. Should the court not have that information at this stage?

Mr. Tom Ward

On the treatment of offenders who come before the Drug Treatment Court, they are normally processed through the District Court in Chancery Place. There is good liaison with the Probation Service to identify those who would be suitable candidates for this process. The Drug Treatment Court is only for offenders living in the Dublin 1 and Dublin 7 areas. In fairness, District Court judges in other districts are well aware of what is happening on the ground and the options available from the point of view of sentencing and of people representing offenders who are not shy about proposing alternatives to sentencing. In the courts we would welcome the establishment of a more formal basis for that process. Any assistance we could receive from the Department would be hugely welcome but the experience on the ground is that District Court judges know what is going on and the treatment programmes available from their day-to-day experience.

Deputy Darragh O’Brien

Therefore, it happens on an ad hoc basis, varying from court to court based on the information available to a judge.

Mr. Tom Ward

That would be fair, although "ad hoc ” is possibly the wrong expression. It varies.

Deputy Deirdre Clune

In the opening statement there was a reference to the strategy to keep drugs out of prison published in May 2006. What measures have been put in place? Consultation prior to the strategy produced last week showed high levels of drug use in prisons, with individuals injecting in prison.

Mr. Seán Aylward

I was head of prison operations for four years and director of the Irish Prison Service for five and was always interested in the level of this activity in the prisons. At first blush, one would say that surely people could not be using drugs in prison but a prison system that would completely eliminate any prospect of anyone abusing any drug at any time would be a very cruel system. It would be an impractical system where prisoners would be held in complete isolation with no contact with visitors at all. It would also be one where the prison yard would have a roof instead of a net. Complete elimination is not possible in a humane prison system. The ways of searching people to completely eliminate any prospect of drug abuse or there being drug paraphernalia are difficult. Some of the technology deployed is helping to do this in a less intrusive way than in the past, which, to put it crudely, involved the probing of body orifices. A difficulty with drug abuse in prison or wider society is that we are talking about covert behaviour with minute quantities of the substance involved and people willingly colluding in supply and use. Studies we commissioned in my time when prisoners were informally and anonymously polled on the subject provided interesting data that contradicted the more lurid reportage of what goes on in prison. The studies, carried out by the Health Research Board in 2001, showed that prisoners used less drugs in prison, that contrary to what is said drugs were harder to get in prison, that supply was intermittent and unpredictable and that the quantities available were much less than could be got on the outside.

Deputy Deirdre Clune

What has happened since the introduction of the strategy in May 2006? What additional measures have been put in place and what success rates have been achieved?

Mr. Brian Purcell

We have put a significant effort and resources into rolling out the policy announced in 2006, primarily in the two pillars of drug treatment and supply reduction. In that context, on the treatment side, we have brought services up to speed to the point where 2,014 prisoners underwent treatment in 2008.

Deputy Deirdre Clune

Was the strategy not to keep drugs out of prison?

Mr. Brian Purcell

On supply reduction, we have introduced operation support units, with 170 members spread across the system, with perimeter security screening similar to that in place at airports. We have also introduced a dog handler unit; there are 19 dog handler teams and dogs at present. By mid-2010 we will have completed that and will have 26 dog handler units. The canine units are particularly effective in dealing with people bringing drugs into prison. In each prison the operational support unit has a team that is called the operational support group, which specialises in conducting searches, gathering and collating intelligence on contraband of all types, not solely drugs, but given the problem there is a concentration on drugs. That has proven to be very successful. We started to operate the teams in 2008 which have been remarkably successful.

Deputy Deirdre Clune

Has Mr. Purcell figures that point to——

Mr. Brian Purcell

We have evidence of the number of drug seizures. To date in 2009 we have 700 drug seizures in the prison.

Deputy Deirdre Clune

How does that figure compare with the number of seizures in 2007? Is there a measurable difference?

Mr. Brian Purcell

Yes, there is a measurable difference and it is acknowledged right across the system, and importantly by the prisoners, who will tell one anecdotally that it is very difficult to get drugs in the prison. Obviously, it is not impossible and the day there are no drugs in the community is when we can safely say we do not have drugs in prisons. I do not wish to exaggerate but the measures have been effective and successful in keeping contraband out of prisons.

As Deputy Clune stated, supply reduction of drugs is not sufficient to deal with the problem, one must also see a reduction in demand and significant resources have been allocated both in terms of staff dedicated to drug treatment and the related activities of therapeutic interventions and counselling and education. We entered into a contract with Merchants Quay which provides 23 counsellors and 1,000 hours of counselling each week.

Deputy Deirdre Clune

If an individual is committed to prison, will he or she be obliged to undergo mandatory drug testing and be tracked through the prison term? Will a file be prepared with all this information and will he or she undergo a mandatory drugs test on release? Does Mr. Purcell have statistics for that type of information?

Mr. Brian Purcell

As part of the initial committal assessment that is done on the health care side, if a prisoner is presenting with a history of drug use, he or she is tested in order to ascertain the particular drugs he or she has been taking.

Deputy Deirdre Clune

Is such testing mandatory for everybody?

Mr. Brian Purcell

I should make it clear that there are ethical issues on mandatory testing as part of a health care committal process. Mandatory testing has to be viewed separately from health care related testing, that would be testing people on methadone treatment and people who present with problems associated with drug taking. Mandatory testing must be conducted in terms of the overall operational requirements of the prison. There are two separate elements to drug testing in a prison setting. That divide is there because of the ethical issues for people who provide health care. Mandatory testing is used in a number of prisons and we are continuing to roll that out. Mandatory testing is subdivided into two further elements, namely, random testing and mandatory testing which is profiled and targeted where it is believed that particular prisoners are taking drugs and would target them for testing.

Deputy Deirdre Clune

Is mandatory testing used in every prison?

Mr. Brian Purcell

We have testing in every prison——

Deputy Deirdre Clune

But not mandatory testing. Is it being rolled out in every prison? Will Mr. Purcell give members an indication of the level of mandatory testing and where it is being conducted?

Mr. Brian Purcell

We have mandatory testing in five prisons. We conduct testing in all prisons. We hope that mandatory testing will be rolled out across the system by the end of this year or early next year. We have identified the staffing required to push that out. I think well before the end of this year, the mandatory testing element will be rolled out throughout all prisons.

I should point out that mandatory drug testing is not a silver bullet. Identifying people who are taking drugs is only part of the problem, the health care screening process does that to a large extent and prison officers and people who have experience of working within the system will know who is taking drugs. Professionals and community workers who deal with drug problems will identify the person taking drugs and in most cases a test is not needed to identify who is taking drugs. A holistic approach is taken and mandatory testing is only one element of it. It is not a silver bullet to identify everyone on drugs and then deal with them.

Deputy Deirdre Clune

I read chapter 6 of the Comptroller and Auditor General's report and there were few hard facts and figures on the numbers committed to prison who are coming in with a drug habit, tracking them and then the follow through right to the community. It is very hard to measure it, even though——

Chairman

A question springs to mind. If an individual is appearing before a court on an armed robbery charge and is sentenced, does the Irish Prison Service look for a file from the HSE to see if the individual has a drug record? When the individual has gone through the prison system and is released, does a file go back to the HSE with an update of his or her medical records and history of drug addiction?

Mr. Brian Purcell

In short, we get the medical records from the central treatment services provided by the HSE. When the person is released, his or her medical records for the period of custody would be sent to the HSE.

On the issue of the prevalence of the problem in prison, Dr. Harry Kennedy in a report in 2004 indicated that 80% of all prisoners within the system would have a lifetime prevalence of substance problems, be that drugs or alcohol. A significant number of the prison population would have issues, which can be readily identified through the information we receive through the health care assessments on committal. The prison staff and the health care staff in the prison will also be aware of prisoners who have problems with substance abuse as they will regularly present to the health care personnel in the prison with problems associated with drug use. They are also identified in that way. The trick after identifying them is to get them into the treatment that is required.

Deputy Deirdre Clune

On treatment, I see from table 6.1 the services that are available in various prisons. Is methadone maintenance the only treatment available?

Mr. Brian Purcell

We have a detox treatment as well.

Deputy Deirdre Clune

Rehabilitation treatment is only available in Mountjoy Prison?

Mr. Brian Purcell

It is not intentional but I think the table does not present the total picture. Where we state that rehabilitation is available only in Mountjoy Prison, we are talking about the therapeutic aspect of the rehabilitation spectrum and those programmes are concentrated in Mountjoy Prison, which is the committal prison where the bulk of prisoners with these problems would come. Rehabilitation obviously goes across a much wider spectrum and one is talking about work training, education, counselling and so on for prisoners. Rehabilitation, which is available not just to drug-using prisoners but to all prisoners, is available in all prisons. A significant element of our resources goes into providing rehabilitative services to prisoners. Where we state that rehabilitation is only available in Mountjoy Prison, we are referring to specifically targeted therapeutic services. Rehabilitation is available in all prisons to all prisoners, not just for drug users.

Deputy Deirdre Clune

On the issue of methadone maintenance, Cork and Castlerea prisons do not have a methadone maintenance service. We know the level of heroin abuse outside Dublin has increased considerably and the committee has heard figures on this issue. There must be a huge need for this service in those two prisons. Why is the service not in place?

Mr. Brian Purcell

The Deputy is correct. It might best be described as a growing need. I hesitate to use the word "huge" in the context of Cork Prison or Castlerea Prison. In general terms, the services we provide in regard to the methadone maintenance treatment programme would generally reflect the treatment available on the outside in the HSE areas which the prisons would cover. In regard to Cork, it is only in the last couple of years that the services the HSE is providing in that area have developed to the point that we are now in liaison with the HSE. We expect to have methadone treatment programmes available in Cork by the end of this year, which is a reflection on the situation on the outside in that HSE area.

The same would broadly apply to Castlerea. In the past, the committal areas served by Castlerea Prison would not have had a huge requirement for a methadone treatment programme but, as the Deputy said, there is now a growing need and, by the end of October this year, we will have a methadone treatment programme available in Castlerea. The structures are——

Deputy Deirdre Clune

The figures suggest there is at least a 12-month waiting list for methadone treatment in the community in Cork. It must be the same for the prison service. Treatment is just not available. What is happening currently with regard to prisoners in Cork or Castlerea who do not have this treatment available to them? Do they have access to——

Mr. Brian Purcell

The Deputy has hit on an issue for the prison system because it reflects what is happening in the community. One cannot put prisoners on methadone treatment in prison unless one can be certain they can then move out of the prison. If there is a shortage of treatment places in the community, that creates an issue in the prison.

It is not always an issue of a shortage of places. One does not necessarily need a fully fledged system in place until such time as it is developed on the outside. We are now at that point in Cork, where the services have developed, we believe, to the extent that we can put a treatment programme in place in Cork Prison. The same applies to Castlerea Prison, where the services in the community have developed——

Deputy Deirdre Clune

There is no service for prisoners at present.

Mr. Brian Purcell

If a prisoner was committed to Cork Prison or Castlerea Prison and was put on a treatment programme in the community, until recently we would have had to transfer that prisoner to another prison where the treatment was available. While from that perspective, it is the best option, it is a disadvantage from the perspective of moving a prisoner away from his or her neighbourhood or locality. This is why we have programmes in place in all prisons where the link with the outside services and the so-called through care element can be adequately covered. By the end of 2009, we will have that service in Cork Prison and by the end of next month, we will have it in Castlerea Prison.

Deputy Deirdre Clune

How can one guarantee the link with the services in Cork when people are already waiting more than 12 months for community services? There is no priority treatment and it is a case of first come, first served.

Mr. Brian Purcell

It is due to sheer hard work by those involved in the programme in the prison and to liaison with the agencies on the outside. While it is a difficult task, we are satisfied that, so far, particularly in the other prisons where the system is in place, we have been hugely successful. The Deputy is correct that this is a problem that will not be solved without a fairly significant level of resources and effort by the staff engaged in the programme.

Deputy Deirdre Clune

I also want to deal with the issue of polydrug use. Methadone is only one strand. We know from reports that there has been a change in drug use in the community and this is obviously reflected in the prisons. Is the Prison Service dealing with treatment for the use of other drugs? I accept the issue is complicated.

Mr. Brian Purcell

It is complicated. We would always say that what happens in the prisons is a reflection of what happens on the outside. Where polydrug use is a problem in the community, it will also be a problem in the prisons. This is especially the case when, because of the shortage of drugs available in the prisons, prisoners are less fussy about what drugs they will use. If they want to take drugs, they will effectively take anything they can get their hands on. While it is a problem, it is one we deal with. We have detox programmes and also the addiction counselling service which we provide through Merchants Quay. This does not just cover heroin use but also other drug use.

Deputy Deirdre Clune

On the co-ordination of services for individuals being treated, do we have an update on the capture of data and the following of the treatment of individual prisoners right through the system? Is that information in place?

Mr. Brian Purcell

It is in place. Our primary vehicle for storage of information relating to health care is the prison medical records system. We have upgraded that system to capture and process all of our health care data. In the last 18 months we have achieved 100% compliance with the prison medical records system. With that, we also have a link to the national drug treatment reporting system, NDTRS. We now have virtually full compliance with the input of information onto the NDTRS with only two prisons yet to be covered by the system, and these will be covered by the end of 2009.

We must then link the two systems. We are in the final stages of an upgrade of the medical records system so we will be able to accommodate and link all the data that are put onto the NDTRS. We have made a good deal of progress on this since the report was completed. I would hope that by the end of 2009, certainly by the end of the first quarter of 2010, we will have hit 100%. We have put a considerable amount of resources into having a system in place whereby we would get reliable data——

Deputy Deirdre Clune

What came across in chapter 6 was that there are no reliable data.

Mr. Brian Purcell

It is flagged that the provision of data is not as good as it could be. However, since that report was compiled and as a result of the recommendations made, we have put a significant element of resources into an effort to ensure we will have this completed by the first quarter of 2010. None the less it is already largely completed, which is a significant improvement.

Deputy Deirdre Clune

I have a final point to which Mr. Aylward might respond. I refer to drug treatment courts and acknowledge that Deputy O'Brien went through this issue in detail. An expansion was supposed to take place in early 2006. Did that happen? I am sure it did not and seek clarity in this regard.

Mr. Seán Aylward

It did not happen because it became increasingly apparent to those who were surveying it that while enormous effort was going into it, relatively speaking there was low output. Before extending it any further, I believe the decision was reached simply to evaluate it. I believe that was correct. While a measure may be a good idea philosophically, that does not mean it always works out in practice. We must have the honesty to admit to ourselves that it is not working and is not the best way to go about this issue and that we must consider it in a different way. This is the point we have reached. No one should construe anything I have said about the drug court as being a reflection on the integrity or sincerity of those who have either worked in the court or who have co-operated with it as offenders who came before it. Their bona fides are unquestioned but it simply is that this is not the most effective use of a scarce and valuable judicial resource, namely, the fine judges that we have.

Deputy Deirdre Clune

I thank the Secretary General.

Chairman

Following the questioning by Deputy Clune, I have one or two outstanding questions. In respect of the rehabilitation programme in place in some prisons, is a prisoner who comes out having successfully undertaken the rehabilitation programme technically drug-free?

Mr. Brian Purcell

Yes. This is a clinical issue. I refer to someone who has undertaken the rehabilitation programme by means of maintenance on the methadone maintenance programme that stabilises his or her situation or by means of detoxification, whereby a person comes out completely drug-free, which includes coming off methadone. Someone who emerges while on methadone and who is not taking anything else is regarded as being drug-free because methadone obviously is a legal substance. Some prisoners detoxify completely via a step-down on methadone or in a fairly straightforward manner or a combination of both. Consequently, those who go through the system and receive the treatment are deemed to be drug-free at that point. The question is whether they remain drug-free, given the chaotic nature of the lifestyles of many of those who have substance abuse problems. Many people rise and fall on the system. They get drug-free but then take drugs again. Given the chaotic nature of the lifestyles of some people, in respect of their lives both on the outside and while in prison, one encounters many falls.

Some people do remarkably well, given the difficulties in this regard and other people have more difficulties. Consequently, people encounter many falls before they can say they are drug-free on an ongoing basis. For many people with problems, to an extent the easiest part is staying on the treatment programmes in prison because the supports are available on an almost 24-hour basis. The treatment and the addiction counsellors are available whereas sometimes, when such people are released, it may be a challenge for them to sustain that drug-free status when they go outside. Obviously they then have a freer lifestyle and like most people who take drugs, regardless of whether they enter prison, much depends on their environment. It is much more difficult for someone who becomes drug-free in prison and this is the reason it is so important to have as many supports as possible on the outside.

Chairman

Arising from Deputy Clune's questions, I revert to figure 6.1 of the report, which sets out the position regarding addiction counselling, methadone maintenance, detoxification and rehabilitation. I note that Castlerea and Cork prisons only have addiction counselling. Is Mr. Purcell telling members that the other three programmes will be in situ in these prisons by the end of the year?

Mr. Brian Purcell

Yes, they will have methadone. We hope the methadone maintenance programme will be in place in Castlerea and in Cork by the end of October and the end of the year, respectively. As I noted, rehabilitation is available throughout the system in all prisons. We can also access the therapeutic rehabilitation that is available in Mountjoy Prison. Prisoners from other prisons can go there to engage with it. However, the other services will be available in the aforementioned two prisons by the end of 2009.

I make the point that rehabilitation in respect of drug users, as in other prisoners, is not solely about the therapeutic elements of the programme. There are also the practical elements of rehabilitation, such as work training and education. However, this is important and is the reason we take a holistic approach in this regard. One needs an element of stability for the prisoners who are involved in such rehabilitative programmes to benefit in so far as they can from the other services that are available. It is not simply about one element but is about the entirety of the available treatment and rehabilitative services.

Moreover, this is not simply about the physical elements of drug abuse as mental issues are also involved. As members are aware, research into the prisoner population has shown that a significantly higher proportion of people within the prison system have mental health issues than is the case in the community at large. Some of these are directly related to problems they have had throughout their lives with substance abuse. Consequently, when considering the treatment and services available, it is important that it does not simply pertain to the physical element and is not just about the mental element but is about everything. We endeavour to provide a level of service that covers the entire spectrum of the needs of people inside.

I do not suggest that we are entirely successful in this regard. Ultimately, whether someone takes drugs is not solely about the provision of all the services required to support them if they desire to come off them. There is an element of free choice there which is not always taken into consideration. Some people, regardless of the fact that they know the harm it does and the chaotic effect it is having on their lifestyle, simply want to take drugs or, in the case of alcohol, want to take alcohol to an excessive degree. While I may be rattling on a little at this stage, these are problems that do not simply apply to prisoners as they apply to people throughout the community. It simply is an issue that becomes more focused and more concentrated, given the nature of the type of people who unfortunately find themselves within the prison system.

Chairman

I thank Mr. Purcell for his detailed presentation. Arising from his comments and his statement about people's mental attitude coming out of prison having undertaken a rehabilitation programme, what follow-up is in place for those prisoners who have been released? For example, I represent inner city Cork and the north side of Cork city. Every week I meet fellows in my clinic who have been released from prison. Some of them are shunned by their families and if they try to get onto a housing list, a Garda check is done on them and they are excluded. Where can such people go? Some of them are living in hovels and they are barred from the housing list because of their records. Where does Mr. Purcell envisage prisoners going after their rehabilitation programme given that when they go into the community, they meet such obstacles?

Mr. Brian Purcell

I will let my colleague, Michael Donnellan, deal with the resettlement issues, namely, the housing issues and so on. I believe the Chairman was referring to mental health issues as well as to the practical elements of housing. We have well developed links with the community services in this regard. We have inreach services coming into the prison from the local health service area. The Central Mental Hospital, CMH, provides a significant level of inreach services. It also provides beds for prisoners with problems so acute that they cannot be addressed within the confines of prison. In that excellent inreach service, consultant psychiatrists from the CMH do sessions in every prison.

We have links with external psychiatric services for when people transfer into the community. Given the particular nature of the problem, as members well know, it can be a difficult situation. Links can be put in place, but whether they are maintained depends on the people's lifestyles to some extent. For this reason and as the Deputy pointed out, the physical element of resettlement and so on is important. I will leave my colleague, Mr. Donnellan, to address that matter.

Mr. Michael Donnellan

There is no doubt that the resettlement issues are challenging. Through the Department, the probation and welfare service spends €18 million per year, some 35% of our budget, on community supports for offenders. People who are in a vulnerable state after leaving prison have been given extra support in this way. When people leave prison, they are citizens and should be able to access general practitioner, HSE, housing and other services in the same way as any other citizen. With our funding, we provide additional support in Cork and other cities, but this is a challenge.

Chairman

Could Mr. Donnellan give an example of the supports?

Mr. Michael Donnellan

They are either specific accommodation supports or rehabilitation through workshops and training. For example, one of our largest programmes is the Linkage programme. Costing approximately €1.5 million, it helps people to return to the work ladder by acquiring skills. The programme, which is nationwide, helps people to get employment and settle into areas. The PACE programme in Dublin is an accommodation, training and rehabilitation programme.

Chairman

Who administers the Linkage programme?

Mr. Michael Donnellan

It is administered through and is a partnership between business and the community. Its board of management, which we fund, runs the national programme.

Deputy Thomas P. Broughan

I welcome the delegation. How many citizens were prisoners in 2008 and how many were in jail yesterday?

Mr. Brian Purcell

I will get the precise figure for the number in custody for the Deputy, but there has been an increase of approximately 8%.

Deputy Thomas P. Broughan

I want to know the number of people. The prison, probation and courts services are in a unique position in respect of drug abuse and addiction which fuel much crime. To some extent, it is in the cockpit of the ongoing serious crime ravaging parts of my constituency, this city and other cities. The reports provided by the delegation had a consistent factor. I missed some of the meeting because I was listening to the NAMA debate but what I heard is that our guests do not have statistics and cannot tell us how many people had major addiction problems yesterday or even last year. They do not have the facts.

According to the Comptroller and Auditor General's report, we do not know the success rate of the detoxification systems at the training unit in Mountjoy Prison. There are no data, which seems to be the characteristic of our guests' administration of this area. This is not acceptable to the committee. How many prisoners were there yesterday and last year?

Mr. Brian Purcell

Does the Deputy mean in the entire system?

Deputy Thomas P. Broughan

Yes.

Mr. Brian Purcell

Yesterday, 3,900 prisoners were in the system, representing an increase of approximately 8% on the number at this time last year.

Deputy Thomas P. Broughan

At this time last year, how many of the 3,500 or so had addiction problems?

Mr. Brian Purcell

We would generally accept the figures of Dr. Harry Kennedy who conducted research in 2004.

Deputy Thomas P. Broughan

That is not acceptable. I am asking about how many people have addiction problems now. Mandatory testing was mentioned and——

Chairman

Hold on one second. Mr. Purcell is trying to answer the question. The Deputy should allow him to answer, then——

Deputy Thomas P. Broughan

I have listened to the debate but he has not answered.

Chairman

Deputy Broughan should not interrupt. Let Mr. Purcell speak.

Mr. Brian Purcell

Our figures show that, of the annual number of committals in the system, just less than 25% have substantial substance abuse problems. I do not know how many——

Deputy Thomas P. Broughan

Does Mr. Purcell know how many have diabetes, cancer or cardiac conditions?

Mr. Brian Purcell

Yes.

Deputy Thomas P. Broughan

Precisely.

Mr. Brian Purcell

Yes. If the Deputy wishes, I can give him a precise breakdown of those figures. The prison medical record system that I mentioned covers the full run of medical assessment of prisoners. I may as well say it straight — I do not accept what the Deputy is stating. We have the figures and data.

Deputy Thomas P. Broughan

I will not ask about yesterday, as I know the system requirements from my visits to the prisons, but can Mr. Purcell tell me how many prisoners had addiction problems this day last year?

Mr. Brian Purcell

We can probably——

Deputy Thomas P. Broughan

Not 25% or guesses. Real figures.

Mr. Brian Purcell

Sorry, but——

Chairman

I try to be fair to members, but I must also be fair to witnesses.

Mr. Brian Purcell

This is not a guess. I am not just plucking the figure out of my head. When I stated that the level of prisoners with a history of drug use was just less than 25%, I based my comment on a figure for 2009 to date of 3,886 prisoners. If the Deputy could ask particular questions, I would only be too happy to give him precise figures.

Deputy Thomas P. Broughan

We are evaluating the amount of money the State spends. I commend the Comptroller and Auditor General on a wide-ranging report regarding a fundamental problem. We discuss other addictions and mental health issues, but this is in the cockpit of an horrendous problem. We are discussing one issue but the other issue exercises many Deputies and has to do with the drugs situation. People are involuntarily in the care of the State, yet mandatory testing is only now being extended. How could Mr. Purcell give precise figures?

Mr. Brian Purcell

I touched on one point.

Deputy Thomas P. Broughan

Mr. Purcell stated there were five prisons.

Mr. Brian Purcell

In terms of mandatory testing, which we will roll out, we have identified the staff resources required. Through the fault of no one in particular, the perception seems to be that mandatory drug testing will see every prisoner tested regularly. This is wrong. As I stated in response to Deputy Clune, mandatory drug testing has two elements, those being, the random selection of prisoners for mandatory testing and targeted and profile testing where staff believe prisoners are using drugs.

There is mandatory testing in some situations. For example, prisoners on the methadone maintenance programme must be tested for drugs as part of the programme's clinical element. The Deputy knows what the programme involves. Mandatory testing is carried out in certain prisons, such as the open centres and the training unit which should be drug free. Targeted testing is part of what is known as mandatory drug testing. This is based on observation and anonymous reports. A person experienced in dealing with prisoners or people who take drugs knows by looking at someone. When a person presents to the health care staff with a range of ailments, the staff are aware that the prevalence of a range of illnesses and ailments are closely linked. By examination of the prisoner when he or she comes into contact with the health care services, staff can identify this. Following this, we can undertake targeted testing. I can provide this information to members.

Deputy Thomas P. Broughan

For us to make a judgment on whether we are receiving value for money in this area, we need to know precisely. Most lay people think that we should have these details to hand as part of the health monitoring of the prison population. Regarding some of the resources, there are nine places in the rehabilitation programme in Mountjoy Prison. This is an overcrowded prison with a population of 500 to 600 prisoners per day and apparently some 72 people can be rehabilitated per year. This is not a sufficiently strong outcome if we are to make serious inroads and enable people to leave prison addiction free so that they can resume a normal role in society.

Mr. Brian Purcell

One cannot look in isolation at the figure of nine people at any one time and a maximum of 72. One must consider this in the context of the other services available. A more accurate figure is 770 prisoners, on an annual basis, who pass through all the drug treatment services, including detox, methadone maintenance and other programmes. We provide a range of services attached to this, including counselling and other therapeutic interventions. It is a mistake to think that the total sum of the services available in a prison like Mountjoy is the 72 places available on that specific detox programme.

Deputy Thomas P. Broughan

The report refers to rehabilitation and one imagines this is a fundamental objective of caring for these prisoners. Mr. Purcell could not tell the Comptroller and Auditor General about the training unit. There was always a demand to go to the training unit because this seems to be the place where prisoners are safe from drug-fuelled issues. Outcomes from the training unit do not seem to be available. Mr. Purcell could not tell the Comptroller and Auditor General the success rate of prisoners who had passed through it going back to society.

Mr. Brian Purcell

Maybe that criticism is a little unfair. There are many reasons prisoners want to get into the training unit. Perhaps the most significant reason is that the training unit is used as a service or as part of the prison system that is effectively pre-release. If the prisoners get into the training unit it means that the prisoner is on the road out the door. We accommodate all prisoners who go through the detox programme in the Mountjoy training unit. People go to the training unit when they graduate from the detox programme. We can quantify the number of people who go into the unit from detox but the training unit does not deal solely with people who are on drugs and become free of drugs. The training unit provides a pre-release setting that is closely linked to services on the outside. A significant number of prisoners from the training unit are out on a daily basis, either on educational courses, employment courses or in employment. They only return to the training unit at night. Members are aware of this. Some of Deputy Broughan's criticism is unfair.

Deputy Thomas P. Broughan

I am conscious of a population passing through the prisons, a significant number of whom return to society. In this city, people tend to return to family homes. It is not as big a problem on the homeless side. These people are allegedly involved in very serious criminal events. The point is to try to cope with this at the point where we can, through the Irish Prison Service, the probation and welfare service and the Courts Service. This seems an obvious and important role for the State. In a number of these areas, the report of the Comptroller and Auditor General does not seem to have the facts.

Mr. Brian Purcell

I hear what Deputy Broughan is saying. That is what we try to do. The efforts in the system fall into two areas, namely, safe and secure custody and providing services that help prisoners' reintegration into society. Everything else we do falls into support of one of these strategic targets. We have statistics available on the type of treatment that people engage in when in prison. At the time of the report of the Comptroller and Auditor General, the PMRS system and its link to the NDTRS data was not fully operational. In response to Deputy Clune's questions, that will be fully functional by the first quarter of next year and will give all the data that is required. We have made great progress. In fairness to the Comptroller and Auditor General, when his staff looked at this system there were issues that were appropriately reported on.

Deputy Thomas P. Broughan

Was the prisoner medical record system a paper-based system?

Mr. Brian Purcell

It was before it became computerised. After the rollout, we are implementing an upgrade of the computerised system that will enable us to link to the NDTRS data. This will be fully implemented by March 2010. I understand that, while reading the report of the Comptroller and Auditor General, one might be tempted to make criticisms of the system but, in fairness to the people involved in it, significant progress has been made since the report was produced, particularly in the realm of data collection.

Deputy Thomas P. Broughan

There do not seem to be outputs on detoxification,——

Mr. Brian Purcell

We have these.

Deputy Thomas P. Broughan

——rehabilitation and the training unit.

Mr. Brian Purcell

We have these.

Mr. Seán Aylward

I do not want the meeting to become ping-pong with Deputy Broughan. We can submit a report to the committee on our data and the medical information we have about prisoners. This will address the points that are brought up repeatedly by Deputy Broughan.

We have moved from a paper-based system. I first got involved in prisons in 1993 and prison medical services were like an island within the system. They would not communicate with anyone and patient confidentiality was a god. We could not get anyone to share data, even in respect of those who had hepatitis, and this raised management and operational problems. There has been a great meeting of minds and people such as the director of nursing services, Ms Frances Nangle-Connor, have broken down the communication barriers. Data entry has followed, which was not there before. We are not challenging anything that was in the report of the Comptroller and Auditor General. The situation has moved on and the report of the Comptroller and Auditor General was a snapshot in time.

Deputy Thomas P. Broughan

How have things moved on? The witnesses could not provide details this morning.

Mr. Seán Aylward

I am offering, within the next week, whatever data we can get captured about prisoners, including those who declare themselves to have addiction problems and those we identify with addiction problems. It is not the case that it is a tiny minority in the prison; it is a majority of prisoners who have substance abuse problems. In prisons, the ethos is to help prisoners forge a new law-abiding lifestyle. Everything in the prison, including education, work training and recreation pushes the message that one can lead a clean life. It would be a gross misunderstanding to suggest there are only nine spaces available at any time for rehabilitation. I acknowledge fully to Deputy Broughan that a prison is a rehabilitation opportunity, including for those with an addiction problem. We will provide the committee with the information we have on our computerised system, which is nearly completed, within the next week.

Deputy Thomas P. Broughan

Will Mr. Aylward include information on linkages to the community which my colleague, Deputy Clune, dealt with to some extent? There seems to be a huge lacuna in this. When we dealt with the other side of this, namely, community-based services, the key point which the Comptroller and Auditor General and Chairman tried to follow up was that people would have individual care management plans and individual carers. The evidence from this report is that the Department of Justice, Equality and Law Reform and the Irish Prison Service are not delivering such a care plan through an individual carer in the community. It is simply not happening.

Mr. Seán Aylward

At the part of the meeting at which the Deputy was not present we went into that and we described what we do. There is rather more done than is represented by that comment. We will address it——

Deputy Thomas P. Broughan

We are looking at the outcomes every day of the week on the streets.

Mr. Seán Aylward

I do not want to repeat it but we did go into it. We described how, for example, we do not put anyone on a methadone programme unless we are certain——

Deputy Thomas P. Broughan

I read that.

Mr. Seán Aylward

——we will get them to continue and how contacts are made by medical people in the prison and the Probation Service. We went into that. We will repeat it but I do not want to go over it again or ask people to testify as they did earlier at this meeting when Deputy Broughan was not present.

Deputy Thomas P. Broughan

Neither the Department nor the HSE delivered——

Mr. Seán Aylward

We will cover that——

Deputy Thomas P. Broughan

——a comprehensive service for many years.

Chairman

Mr. Aylward has made a point. He will provide us with the data that Deputy Broughan is seeking. We will await that data and take it from there.

Deputy Thomas P. Broughan

I recommend that we return to this report. It is vital for our society.

Chairman

We plan to return to this report. We discussed that earlier also and I stated it at the outset of the meeting.

Mr. Brian Purcell

I am sure it is not intended but I must defend the people involved in the system who deal with what is a hugely difficult area. I must also comment that a report from 2008 carried out by two experts in drug treatment, Dr. Mike Farrell and Dr. John Marsden, indicated the level of progress that had been made and hard evidence of that progress in drug treatment in the system. We will make a copy of that report available to the committee. One comment they made was that there is often a lack of understanding and recognition from other elements of the community about the difficulties involved in providing this type of treatment in a prison setting given the nature of the people in there. Not only did the report identify the difficulties, it also stated that there was a lack of appreciation of what was being achieved. We will make that report available as part of the information we will provide to the committee so that members can see what these experts had to say about the provision of the service.

It would be remiss of me not to state that there has been a massive injection of resources and a huge commitment on behalf of the professionals in the system, namely, the consultants, doctors, nurses and medical orderlies, and those on the outside with whom we have links. It may not be what was intended but I would not like the committee to go away from this hearing with a view that we were not providing adequate responses or the relevant data. We will provide all the data Deputy Broughan is seeking and we will provide any additional information he wishes to receive. I am not stating — neither is anyone in the prison system — that what we have is perfect. However, we are doing a very good job in very difficult circumstances. I will stand over and defend that record to anyone.

Chairman

I thank Mr. Purcell. I now ask Mr. Buckley to respond to what he has heard.

Mr. John Buckley

One of the deficiencies, since the formulation of the strategy, is the lack of information and a central point in the report we made was on the need to capture and analyse the information on offenders with drug addiction where they are subject to either custodial or community-based sanctions and then integrate that information into national databases. The movement signalled by the Accounting Officer in his opening statement is to be welcomed. I am glad to see it will be finalised by March 2010.

One could ask why we keep harping on about this and the reason is that accurate information, duly protected, is key to proper service planning and evaluation and is necessary for the formulation of interventions and their later evaluation. In that sense it is very important that we move on and ensure we have the necessary information for service planning and evaluation. The provision of data to judges is also very important so we get a more joined-up approach to the management of this problem. With regard to evaluation and the use of the information, we need to accept it is not just a numbers game.

With regard to the drug court, perhaps it could be used in a different manner. Perhaps it would be more useful in a different socio-economic niche or would work better in the case of non-opiates. As it progresses, the key issue is whether there are sustainable levels of throughput of cases to justify the resources devoted to it. Those are my reflections on what I have heard.

Chairman

I thank Mr. Buckley. I also thank the witnesses for their attendance today. We cannot dispose of special report No. 64 because we want to recall the HSE, the Department of Community, Rural and Gaeltacht Affairs and the Health Research Board. We are also awaiting a report on the prevalence of opiates and it is important the committee has this information prior to making a final report on this matter. The agenda for our meeting on Thursday, 24 September is the Comptroller and Auditor General's special report No. 66 on FÁS promotion and advertising.

The witnesses withdrew.

The committee adjourned at 1.40 p.m. until 10 a.m. on Thursday, 24 September 2009.