I move: "That the Bill be now read a Second Time."
I am pleased to introduce the Misuse of Drugs (Supervised Injecting Facilities) Bill 2017 to the House. This is an issue that is very close to my heart. Like many Deputies, I have worked tirelessly for many years in my local community. I have seen at first hand the destructive power of drugs and drug addiction. I have seen what it does to people, to their families and to whole communities. It is truly awful and heartbreaking. This Bill is one part of a much bigger piece of work that needs to be done and is being done to reduce the impact of drugs, drug abuse and addiction in Ireland today. The soon to be completed national drugs strategy will seek further to shape this approach.
There is a problem with street injecting in Dublin and other cities and towns in Ireland. I have seen it on my own doorstep and I know many Deputies will have witnessed it themselves. It is unhygienic and unsafe. Street injectors are at risk from diseases such as hepatitis C and HIV. They risk getting ulcers and other infections. Ultimately, they risk death from overdose. The wider community and the general public are also at risk due to the discarded syringes left behind on streets and in alleyways. Nobody chooses to inject drugs on the streets, down an alleyway or behind a bin. This is where the most desperate in our society have been driven. We must reach out to help those who find themselves in this most chaotic stage of addiction.
The establishment of supervised injecting facilities is one way of reaching out to these people. An injecting room is a controlled environment where drug users may inject drugs they have brought with them. These facilities have proved to be effective in reaching out to these marginalised groups, those who use drugs on the streets or who have little interaction with existing services. In an injecting centre, drug users can get access to clean injecting equipment. There will be trained staff to provide emergency care if they suffer an overdose and there will be an opportunity to have minor health issues treated by a doctor or a nurse. They can access other health and social care services where previously their addiction or their personal situation meant they were unable to do so. An injecting centre can be a way back from the desperate situation in which a lot of street injectors find themselves. As a result, the injecting centre will also help with other problems associated with injecting on the street, including drug-related litter and the local amenity.
We are not alone in considering this course of action. There are around 90 drug consumption rooms operating around the world. They are in cities such as Luxembourg, Copenhagen. Barcelona, Sydney and Vancouver. Last autumn, the first centre in France opened in Paris. Two more are planned. Last year, Lisbon approved a proposal to open up a centre as soon as possible. Glasgow is also working towards opening a centre, the first of its kind in the UK. Evidence from the long-running sites demonstrates a reduction in fatal overdoses and the risk of transmitting blood-borne diseases. They show a decrease in the amount of public injecting. There are significant reductions in drug-related litter. A fourfold reduction was seen in Barcelona with an almost 80% reduction in Copenhagen. Drug consumption rooms have been operating for over 30 years and nobody has ever died as a result of an overdose in any of them.
First and foremost, injecting centres are a form of harm reduction. I know that the idea may seem strange at first and I can understand people's initial reaction to the idea of an injecting centre. I was sceptical when I first stepped into this role but I have read the evidence and met with doctors and counsellors who work in them. I have spoken with police officers who worked in the area. My officials and I have visited centres in Europe. The evidence is very clear. Injecting centres do not promote drug use. They do not create, cause or permit drug crime. An injecting centre is not a free-for-all for those who want to inject drugs. It simply works to prevent injury and death and connect people with health services. The evidence shows injecting centres do not cause an increase in the use of drugs or drug-related crime. There is no evidence for the so-called "honey-pot effect".
This Bill and injecting centres will not be the solution to the drugs problem but drug use and drug addiction is a complex and difficult problem. We have to try something different to help these people who are marginalised because of their addiction. An injecting centre cannot work in isolation. It must be part of a wider framework of services. It should only be one part of a range of harm reduction measures that we should be able to use to address the issue. Injecting centres can also only succeed through co-operation and engagement between key local stakeholders - health care workers, the gardaí, local authorities and, importantly, local communities. This legislation is only the first step on that road. I have asked the HSE to establish a working group to identify the practical issues of setting up a pilot service in Dublin city centre. I reassure Deputies that no decision relating to a final location has been taken. As part of this work, the HSE will be undertaking a process of consultation, including with local stakeholders and communities.
In A Programme for a Partnership Government, we committed to supporting a health-led rather than criminal justice approach to drug use. The programme reaffirmed this Government's commitment to legislate for injecting rooms and this Bill is a priority for this Dáil session. This Bill will not establish the location of the facility. It simply provides enabling legislation where currently it is illegal to provide or use such a centre. However, it is intended that the first centre will be a pilot to determine the suitability and effectiveness of injecting rooms in an Irish context.
I know many people have concerns about where the first pilot facility will be located. I assure the House that no decisions have been made. First, we must bring forward this enabling legislation before those steps can be taken.
Under the Misuse of Drugs Act 1977 it is currently an offence to provide an injecting centre. Service users would also be guilty of several offences. A change to existing legislation is required to facilitate the introduction of these centres. The previous Government approved the drafting of heads to provide for injecting centres.
The Bill contains 13 sections. I will proceed to explain each section in turn.
Section 1 deals with interpretation. The provisions it contains are standard and they include a number of new definitions for the purposes of the Bill. The section includes definitions for "drug", "licence" and "supervised injecting facility". The definition of "drug" will include controlled drugs and psychoactive substances, sometimes referred to as "head-shop" drugs. The type of injectable drugs that service users bring in to the centre will not be restricted to heroin, for example. To do so would not assist in reducing the harm associated with these newer head-shop drugs.
Sections 2 and 3 cover application for a licence and the granting of a licence. Section 2 provides for the information that should be included in an application. This will include the name and relevant experiences of the person applying for a licence. The address of the proposed premises and the details of the proposal to be put in place for the operation as well as clinical governance of the centre must also be supplied. Should any application not contain enough detail, the Minister is enabled to seek further information.
Section 3 provides the criteria by which the Minister may be satisfied to consider granting a licence. These include, but are not limited to, consultation with the Garda, the HSE and others, as the Minister considers appropriate. It also includes the matters the HSE will consider when advising the Minister on the appropriateness of such an application. The HSE is best placed to assess the clinical governance and operational protocols proposed for a premises and to ensure that it is fit-for-purpose. In addition, there will be consideration of whether the location of a proposed centre is appropriate given the level and nature of drug use in any area. The HSE will advise the Minister accordingly.
Section 3 also grants the Minister the authority to attach conditions to a particular licence. These conditions shall be informed by consultation with the Garda, the HSE or others. Such a licence will be for a fixed period. However, it may be surrendered by the licence holder, or suspended or revoked by the Minister. The licence may also be extended by the Minister following consultation with the HSE and the Garda.
Sections 4, to 6, inclusive, deal with the surrender, suspension and transfer of a licence. These sections provide for a licence holder to be able to surrender or to seek to transfer a licence for a particular centre. However, written notice of a fixed period must be provided to the Minister before a centre can be closed. These provisions ensure that adequate service provision continues should the effectiveness of a centre remain positive.
Section 5 provides for the Minister to revoke or suspend the licence based on the input of the Garda or HSE with immediate effect should there be a serious and immediate risk to life. Under this section, the conditions attached to a licence may be amended or added to, as the Minister sees fit, and may take into account the views of the HSE, the Garda and others.
In Section 6 the licence for a particular premises must be transferred to another licence holder to maintain continuity of service, should this be considered necessary.
Section 7 includes the definition of an "authorised user". It also provides the authority of a licence holder to permit a person to be in an injecting centre. An "authorised user" will be an individual who is on the premises of the injecting centre in accordance with the conditions of the licence and with the permission of the licence holder. A person cannot be an authorised user outside of the centre. To become an authorised user, advanced, overwhelming and complex registration with the service will not be required. However, the status of authorised user will depend on the premises of the licence holder. Therefore, a service user who has been asked to leave the premises, or who will be in breach of the conditions of the licence, will not be afforded exemption from certain offences under the Misuse of Drugs Act.
Section 8 relates to the obligation of the licence holder to provide information. Section 8 provides for unidentified data to be shared with the Minister or the HSE for the purposes of evaluating the centre. Personal records cannot be shared.
Section 9 relates to the liability of the licence holder. This section provides an exemption for the licence holder from liability for providing an injecting centre and any assistance, advice or care given to an authorised user.
The Bill has been carefully drafted to address the health-related harm associated with public injecting while ensuring that the misuse of drugs legislation remains undiluted. Section 10 provides that certain sections of the Misuse of Drugs Act 1977 will not apply under certain circumstances. Section 3 of the 1977 Act makes it an offence to be in possession of a controlled drug. The offence of possession of a controlled drug would not apply to an "authorised user" as defined under section 7 of this Bill. Section 19 of the 1977 Act makes it an offence for the occupier, controller or manager of any premises to permit the possession, manufacture, production or preparation of a controlled drug on the premises. The licence holder for an injecting centre will be exempted from such an offence. Finally, section 21 of the 1977 Act provides that it is an offence to contravene or fail to comply with the regulations made under the Act. This section of the Bill ensures that authorised users will not be in breach of the relevant regulations.
Section 11 relates to provision of access for An Garda Síochána. This section provides for a member of the Garda to enter an injecting centre without a warrant for the prevention or detection of offences. It is normal practice for police in other countries to call into injecting centres on a regular basis.
Section 12 provides for the Minister for Health to make various regulations for the purposes of the Bill and section 13 covers the Short Title, collective citation and commencement provisions. These are standard provisions.
I am pleased to bring forward this legislation. It is a compassionate and practical response to the chilling reality of drug users injecting and overdosing in public. Injecting centres create a safe harbour for chronic drug users. The centres will provide a controlled place for people to inject, but they will be far more than that. I believe in a health-led and person-centred approach to the drug problem. This is also about people and looking after the most vulnerable and marginalised in our society. The human cost of public injecting is clear and keeps adding up. The cost includes lack of dignity and the effect this activity has on people's health, well-being and safety. We know these facilities are not the solution to the drugs problem. Many other steps are needed. However, I am committed to do everything I can to help those who need it most. I hope and expect that all in the House will fully support the Bill and help to ensure its smooth and speedy passage through the Oireachtas.