Joe Higgins
Question:10 Mr. Higgins (Dublin West) asked the Taoiseach the number of meetings of the Cabinet Sub-Committee on Social Inclusion and Drugs which have been held in 2001. [16002/01]
Ceisteanna – Questions. - Cabinet Committee on Social Inclusion.
Michael Noonan
Question:11 Mr. Noonan asked the Taoiseach the number of occasions on which the Cabinet Sub-Committee on Social Inclusion and Drugs has met; the number of further meetings planned during 2001; and if he will make a statement on the matter. [16648/01]
Tony Gregory
Question:12 Mr. Gregory asked the Taoiseach the number of meetings of the Cabinet Sub-Committee on Social Inclusion and Drugs which have been held in 2001. [16662/01]
Ruairí Quinn
Question:13 Mr. Quinn asked the Taoiseach the number of occasions on which the Cabinet Sub-Committee on Social Inclusion and Drugs has met since 1 January 2001; when the next meeting is due to be held; and if he will make a statement on the matter. [17892/01]
I propose to take Questions Nos. 10 to 13, inclusive, together.
The Cabinet Sub-Committee on Social Inclusion and Drugs has met five times to date this year and is scheduled to hold its sixth meeting on Thursday, 26 July. A further four meetings – one per month – with the exception of August, are planned before the end of 2001.
The Cabinet committee continues to give political direction to the national drugs strategy, the young people's facilities and services fund and the RAPID programme. The meetings provide an opportunity to review trends, to assess progress in the relevant strategies and programmes and to resolve any policy and organisational problems which may arise.
At its five meetings this year, the Cabinet committee noted the progress made in implementing these initiatives which are aimed at addressing the drugs problem in a targeted manner. In particular, it has approved 11 new local drugs task force action plans and allocated £6.9 million to projects in the task force areas. It has also approved £3.7 million for 19 projects under the special premises initiative for task force areas to meet their accommodation needs, for which £10 million is available over three years – £3 million in 2001.
In April the Cabinet committee also approved the new national drugs strategy, 2001-08, which was launched on 10 May. In addition, the committee has approved more than £46 million under the young people's facilities and services fund since it was established in 1998 which includes funding for 97 facility projects and 168 services projects. The primary focus of the fund is on local drug task force areas and selected urban areas – Galway, Limerick, south Cork city, Waterford and Carlow – where a serious drug problem exists or has the potential to develop.
The new national drugs strategy is the first occasion on which all elements of drugs policy in Ireland have been brought together in a single framework with responsibilities clearly assigned across the four pillars of supply reduction, prevention, treatment and research. In addition, under each of the four pillars, a series of objectives and key performance indicators have been set with specific targets that Departments and agencies are required to meet. A series of 100 individual actions have also been developed which the relevant bodies have to carry out in order to deliver the strategy and meet its objectives.
The interdepartmental group on drugs, which I will chair, will, in conjunction with the national drugs strategy team, establish an evaluation framework against which progress on the strategy will be measured. Furthermore, in consultation with the team, the IDG will report on progress to the Cabinet Sub-Committee on Social Inclusion and Drugs every six months. Each Department and agency will also prepare a critical implementation path for each of the actions relevant to its remit and an annual report will be produced. A mid-term evaluation of the strategy will take place in 2004.
The Cabinet committee agreed to the RAPID programme which is designed to target the 25 designated urban centres with the greatest concentration of disadvantage for special support and prioritisation of the funds available under the national development plan during the first three years of the plan's implementation. The establishment of a framework for the implementation of the programme will be put in place by this Department.
In each of the designated areas, a dedicated co-ordinator, working with an area implementation team, will prepare an area action plan. I am happy to report that all 25 local co-ordinators have been recruited, as has the national co-ordinator. The plans will identify the needs of each area, whether with regard to facilities, services or investment which may be delivered under the national development plan. The plans are scheduled to be completed before the end of this year. Once the plans have been completed and agreed, the front-loading of funding provided under the national development plan will be undertaken during 2002 and 2003 to meet the needs identified in each area. This Department will act as a lead Department in facilitating the cross-departmental agency response required to meet the needs identified in the area plans.
(Dublin West): Does the Minister of State agree that, while quite a number of targets are set in the national drugs strategy, 2001-08, regarding a number of areas, particularly the heroin crisis, there are no targets for the section that deals with minimising the harm caused to those who continue to engage in drug taking activities which put them at risk? Does he agree it is crucial that targets are set regarding those at risk, particularly from heroin addiction?
The rate of transmission of HIV through intravenous drug use continues to rise, yet there is no reduction target. Similarly the rate of hepatitis C continues to rise, yet there is no reduction target. Does the Minister of State agree there should be a target to reduce deaths caused by heroin, particularly from over-dosing, of which there were about 86 last year? Such a target should be promoted actively to reduce this terrible tragedy which struck 86 individuals, families and neighbourhoods last year. This is a dramatic statistic for a small country and these deaths are confined to a relatively small area.
My second question relates to the ongoing problem of waiting lists. Does the Minister of State agree that there is a contradiction in the drugs programme? On the one hand, the Minister of State says the number of places will increase from 6,000 to 6,500 by the end of this year but, on the other, he says that immediate access for drug abusers to professional assessment and counselling by health board services, followed by commencement of treatment as deemed appropriate, is not later than one month after assessment. There is a contradiction there. The Minister of State is saying that everybody should be able to access treatment, not just 100 extra this year. Will he acknowledge that there is still a big problem concerning waiting lists? This is a big problem for those working on the ground and trying to assist heroin addicts, in particular.
The Deputy will appreciate that a number of other Deputies wish to contribute and as we are running out of time, they may not get a chance to ask their supplementary questions.
(Dublin West): I will conclude, a Cheann Comhairle. You will appreciate that we do not get a chance to question the Minister of State often on this crucial issue. To conclude my question, there is a still a big problem about waiting lists. What does the Minister of State say about this? Will he come up with definitive programmes for problem drug users under 18 years of age? All workers on the ground report a big problem in this area.
I agree with the Deputy regarding waiting lists. I meet health board representatives regularly to try to resolve this matter. I met them as recently as last week and they spelt out the new centres that will be opening. There is, therefore, positive news on that front. We have made a number of breakthroughs in locating drug treatment centres in areas which have proven to be particularly difficult during the years. There was a waiting list of approximately 400 when we had 4,000 in treatment, yet the waiting list is similar now with between 5,500 and 6,000 in treatment. As the Deputy and most people will be aware, the problem we have is that local communities have objected to treatment centres in certain areas. That is beginning to change, however, because people are beginning to see that there is a positive aspect to this.
Yes, and their fears are not materialising.
That is becoming very clear. I could cite many examples of this. I took part in a radio discussion recently in Crumlin when the chairman of the local residents association, who had objected strongly to the opening of a drug treatment centre, openly said that he had been wrong about the issue. He said that not alone had the centre not caused problems but it had improved the situation within the community. This morning, I was in another flat complex and the same thing applied – there were huge objections initially but now there is a drug treatment centre within it. People are being treated and there is complete acceptance from the local community which is very positive about it. We have to get local communities on board. As the Deputy is aware, if we try to ram through the introduction of drug treatment centres without agreement, the plan will backfire. If, however, we negotiate slowly with communities, they will see that there can be a positive outcome. We must get backing from everybody, including public representatives. Everyone who has done so is aware it is difficult to stand up and say one is in favour of a drug treatment centre but sometimes we have to show leadership and do it.
(Dublin West): That is not the only reason there are waiting lists.
It is one of the main reasons, believe me. If we could have all the treatment centres open by the end of the year, there would be no waiting lists. There are approximately 13,500 addicts, of whom a certain percentage do not want treatment. Others do, however, and if it is seen to be available, they will come forward. If they see their friends and others going into treatment and can see the advantages, they will come in. At a certain stage we will have enough treatment places when I hope the waiting list will come down a lot.
The Deputy asked about harm reduction. Obviously getting people into treatment is the easiest way of achieving it. That is what we are endeavouring to do but we want to make sure that it becomes more attractive for them to come into treatment. When they are there they should be looked at on a case by case basis and a holistic approach should be taken. They should know their rights and the way in which they should be treated. I am aware that there have been complaints that they are not treated very well. They get angry about this, especially those whom I have met. We are also negotiating with pharmacies to put in place a new needle exchange programme. There is a problem with regard to drugs users under 18 years. We cannot provide medical treatment to such people without their parents' agreement. We are working on a new protocol for under 18 year olds that will attempt to satisfy the legal and ethical problems we may encounter when dealing with that age group. We are all horrified at the number of people under 18 years presenting for treatment but at least they are doing so whereas a few years ago such people were taking heroin but had nowhere to go to access treatment. That is what the people working at the coal face say. The length of time these young people have been taking heroin before presenting for treatment is often much shorter than it was a few years ago. We are very much aware of the problem of under 18 year olds. Unfortunately, the medical professionals have a legal and ethical problem which we are trying to resolve.
The Minister of State referred to the interdepartmental group the detail of which is outlined on page 120 of the national drugs strategy, 2001-08. This seems to be a new body chaired by the Minister of State which reports to the Cabinet sub-committee so it appears it will decide what is prioritised to go before the sub-committee. There is no representative of the community and voluntary sector in the group. The Minister of State will agree that this sector has played a critical role in policy formulation and has, to a large degree, been the driving force behind much of the national strategy. Clearly it should be represented on the interdepartmental group. I ask the Minister of State to consider co-opting a representative of the community voluntary sector onto it.
Is the Minister of State aware of the practice by some doctors in some treatment centres of imposing sanctions on drug users, for example, reducing the amount of methadone given to those who turn up late? This seems to be unethical. Does he disapprove of it and will he take action to ensure that it does not continue? Is it intended to integrate the national strategy on alcoholism with the national drugs strategy in light of the fact that there does not appear to be any structures in place to implement this policy which was developed five years ago and about which we have heard little or nothing? If that is the intention, what progress has been made?
Will the Minister of State indicate whether the substantial capital sums at the disposal of the committee for which he has responsibility can be allocated to specific social needs such as youth clubs or youth activities which would help to distract young people, particularly those under 18 years, from drifting into the drugs culture?
Have there been any success stories in which individuals receiving methadone treatment have got off it and become drugs free? Who are the members of the Cabinet sub-committee and why is no member of the Cabinet here to answer questions on the matter?
The IDG is not a new body. It has always been there. It will work in conjunction with the national drugs strategy team which, as Deputy Gregory will be aware, has community and voluntary representatives on it. The chair of the national drugs strategy team will automatically be on the IDG. The IDG was set up from Departments that worked with the drugs strategy team—
It makes the decisions.
No, it does not. If that were the case, it would be farcical. It decides how to implement decisions that have already been made in conjunction with the national drugs strategy team.
Then the critical people on that team should—
No interruptions, please, because time is just up.
(Dublin West): On a point of order, we were six or seven minutes late starting.
That is right. There are still four minutes left for the Minister of State to make his reply.
When the Minister of State co-opts—
Let him answer the question.
Please allow the Minister of State to reply.
It works in conjunction with the national drugs strategy team.
On the new national drugs strategy team there will be somebody from the alcohol unit. There will also be somebody to deal with the problem of alcohol and under age drinking on every regional task force. The problem of under age drinking came very much to the fore during our nationwide consultations. It was obviously a serious one which people raised with us all the time. It is up to the local drug task forces to identify projects they want to fund, some of which will be for youth facilities. Outside of that, the young peoples' facilities and services fund, which has spent about £45 million, is one of the best things I have seen in the Department. It is simple and effective and goes straight to the heart of the matter. Local communities can apply for the money which can be given out. This excellent fund has contributed to over 300 projects and is something that should not only be continued but expanded.
Deputy Jim Mitchell asked about success stories. An independent assessment shows that 40% of those on methadone are back at work, over 70% of whom are no longer on heroin.
Can they get off methadone?
This morning I was at a project where approximately ten young women and two young men are on the programme. I asked the question the Deputy has just asked and they all said it is without doubt that they would still be on heroin were it not for methadone. Two of them are off methadone and all want to get off it. At a centre I visited in Inchicore – in the Deputy's constituency – a number of people had come off it and had completed a City and Guilds computer course. Their last challenge was to get off methadone.
There is much criticism of methadone but if one asks those participating in the programme, they are very positive about it. What we need to have is a range of options available to those who present for treatment, be it naltrexone, buprenorphine or methadone, or allow them to detoxify completely. The latter is a very difficult course and not very many who take it are successful. It is an option but we have said we are looking for, and are open to, successful international best practice. There is a general view that there will be a number of breakthroughs in the area of drug addiction and medication for drug addicts that will not necessarily be based on the methodology methadone treatment is. There is light at the end of the tunnel in the number of those getting into treatment and new developments in the medical field.
(Dublin West): Does the Minister of State agree that a comprehensive rehabilitation programme is critical in moving people away from addiction to opiates? I have raised this matter with him before. The strategy promises that by the end of 2002 there will be a range of treatment and rehabilitation options for each drug misuser. Can I ask precisely how this is being advanced? It is absolutely critical. Will this target be met and at what stage is it now?
I refer the Minister of State to the question I asked about the practice at treatment centres of imposing sanctions on drug users who turn up just 15 minutes late and have their methadone reduced from 80 millilitres to 20.
That seems absolutely unethical and I cannot understand the motivation behind it. What can the Minister of State do about this?
I am sorry I did not answer Deputy Gregory's question. Obviously this is very disturbing for those on treatment, many of whom have complained to me that if they are late, which can happen for child care reasons—
The bus service.
—or due to work, the amount is cut. That is unacceptable and not right. What we are trying to do with this new strategy is to introduce a more holistic approach and a more case-led programme, where each individual is looked at, in order that they are carried along and that people's methadone is not cut. That only leads to them dabbling in other drugs to try to fend off the problems of withdrawal, which is no good.
FÁS is very much involved in rehabilitation. We have financed a number of programmes, like the labour inclusion programme, and are working on a number of others. I visited a fascinating programme today which involves recycled clothes for export to Africa and which is doing extremely well. Not everyone on that programme has suffered from drug addiction but some have. There is therefore a good mixture, as the participants told me. There are many programmes already in place and we are well advanced on another which involves rehabilitation and educational training for a longer period outside Dublin. We are trying to get as wide a variety of programmes as we can and will try to build them up in coming years. There are many people who have come forward and said they will help, particularly in the area of employment.
That concludes Taoiseach's questions.