JOINT COMMITTEE ON HEALTH AND CHILDREN debate -
Tuesday, 16 Nov 2010

Homeless Strategy: Discussion with Simon Communities of Ireland

Chairman

By virtue of section 17(2)(l) of the Defamation Act 2009, witnesses are protected by absolute privilege in respect of their evidence to the committee. If witnesses are directed by the committee to cease giving evidence on a particular matter and they continue to do so, they are entitled thereafter only to a qualified privilege in respect of their evidence. Witnesses are directed that only evidence connected with the subject matter of these proceedings is to be given and they are asked to respect the parliamentary practice to the effect that, where possible, they should not criticise or make charges against any person or entity by name or in such a way as to make him or her identifiable.

I welcome Ms Niamh Randall, Mr. Paul Sheehan, Mr. Sam McGuinness, Mr. Niall Mulligan and Ms Marlene O'Connor. The presentation has been circulated to the members who have had an opportunity to consider it. It is opportune as we approach Christmas that we hear from the Simon Community about the work that it does. I ask the delegation to give us the benefit of the executive summary of its presentation and we will then have a question and answer session.

Ms Niamh Randall

I thank the committee for meeting us because we appreciate it is a very busy time. I will do a whistlestop tour through the presentation highlighting some of the key points. The committee has had an opportunity to consider this in advance. We can then open the floor to some questions.

With me are my colleagues from the local Simon communities.

The current position is that we have The Way Home, the homelessness strategy. It is a good strategy but implementation is slow. There are clear Government commitments but we are not sure how needs, other than housing, will be met. There are delays in access to appropriate housing. The risk factors for homelessness are on the increase, for example, poverty and unemployment, and a whole new generation is at risk. There are contracting budgets across the public sector which will have an impact on the users of Simon Community services throughout the country.

During the year we undertook a health snapshot study that involved eight communities. The total sample population was 788 people, which although it was not all the people who used Simon services in that week, it is a significant sample and, therefore, some conclusions can be drawn. Of those who participated in the study, 56% experienced at least one diagnosed physical health condition, 52% experienced at least one diagnosed mental health condition and 28% experienced both conditions.

We also looked at the area of alcohol and drug use. Some 66% used alcohol, 38% used drugs and 15% were intravenous drug users. The percentage who experienced complications, arising from their alcohol use, was as high as 38% in the sample. We also looked at self harm and suicide and, again, the figures were staggering. Some 56 people had attempted suicide in the past six months.

What does this study tell us that is particularly important for the committee? It tells us that homelessness is about health as well as housing and it is also about many related needs or complex needs. Such needs include physical health issues, mental health issues drug and alcohol issues and people who experience a combination of all these. It is critical that people who are homeless have access to mainstream and specialist services. It is also essential to provide housing with supports and high support housing for those who need it.

What is needed? We need improved access to health care for those who have many related needs. Drug and alcohol services must be extended all around the country. This includes detoxification, rehabilitation and harm reduction services. It is essential to maintain existing specialist services and to expand those into the areas where they are needed.

The primary care teams and primary and social care networks must be rolled out as a matter of priority. It is important to end the inappropriate discharge practice because this means people are discharged straight into homelessness services late on a Friday evening. There needs to be access to housing with supports - low, medium and high supports and high-support housing for those who need it. It is important to have innovative, creative and targeted responses. The Simon communities have excellent examples of this happening all over the country.

In regard to budget 2011, it is critical that budget lines for homelessness are maintained at the very least at current levels. I include in this specifically the Department of the Environment, Heritage and Local Government budget and the Health Service Executive budget because responsibility for homelessness is divided between both, with the Department of the Environment, Heritage and Local Government having responsibility for accommodation but the HSE having responsibility for health and care needs for those who are homeless. It is critical that there are no more cuts for local Simon communities who provide essential services throughout the country.

The Simon communities have been providing local responses to local issues in Ireland for more than 40 years. Members can see from the slide the range of services Simon provides. Simon is perfectly placed within local communities to deliver on the challenge of meeting the many related health needs of people who are homeless. Innovative thinking and working in partnership would go a long way towards addressing this issue.

We would be delighted to take any questions.

Chairman

I thank Ms Randall for being so concise. Does any member of the panel wish to add anything before we move on to questions. Is there any burning issue that any of the panel wish to raise?

Ms Marlene O’Connor

I wish to reiterate a point made by my colleague, that is, the absolute and critical need for alcohol and drug detoxification and rehabilitation. It is extremely difficult to access those services in the west. On numerous occasions, during recent years, we have bought those services privately from money we raised on the streets. For those living in emergency accommodation, unless there is residential detoxification and rehabilitation services they go back to a shelter for the homeless in the evening which is the most conducive place to continue. Another concern is the urgent need for access to dental services. The committee will be aware that access has been reduced across the board and that impacts particularly on the homeless. Sometimes they try to access service through the social welfare system. However, many dentists are unhappy to take them on because they are afraid they will not be paid. As everybody knows, not only is a toothache very painful but it can lead to the non-diagnosis of other conditions and pericoronitis. Those are the two concerns that I consider are burning issues.

Chairman

Thank you, Ms O'Connor.

Mr. Sam McGuinness

One critical issue is that the longer people are on the street, the greater the difficulty they will have with physical and mental illness and drug addiction. The focus on providing housing is critical at the best of times or at other times. Another issue of which we have experience in several communities is the closer we bring the medical support to those in need, at least in the short term, the better, because in terms of value-added that saves a large amount of money at accident and emergency units and many issues that could occur later. Those are two further points to support what Ms Niamh Randall has said.

Mr. Niall Mulligan

I support what Ms Niamh Randall said in respect of the budget. The split between the Department of the Environment, Heritage and Local Government and the HSE is crucial. Following on from the point made by Ms Marlene O'Connor in terms of detoxification services, we have a similar issue in the north east in accessing detoxification and harm reduction services. In terms of Simon and working in partnership with the HSE, we have just got funding to set up a pilot community alcohol detox project. This is a fine example of a project that will cost approximately €130,000 next year and will help up to 40 people to access detox in the north east. The benefits for those individuals and their families is immense. The amount of money is almost minuscule and yet we can do a huge amount of work with it, if we work in partnership and have that access. Those are huge issues for us.

Mr. Paul Sheehan

Health is a critical element in tackling homelessness. It is often forgotten that a huge portion of the care budget comes from the HSE. Health is a central part of addressing long-term homelessness. Those who are long-term homeless tend to have the broadest and the most intense range of health issues right across the spectrum, and they need high support care. Much of the care budget for the high-support housing for those people comes from the HSE and that budget is critical in addressing long-term homelessness.

Deputy Jan O’Sullivan

I thank the delegation for its presentation. I will start with the detoxification services to which Ms O'Connor and others referred. I live in Limerick and I happened to be involved in a few cases where it was extraordinarily difficult to access detoxification services. In respect of one young man, eventually we got the services in north Dublin. Others have managed to get it in Cork but there is no service in the mid-west region. I am not sure about services in the remainder of the west. I was involved with a group trying to get funding. In fairness to the Minister of State, Deputy John Curran, with whom we dealt, he was very positive but, so far as I know, it has not yet come to fruition. What is the up-to-date position in respect of detoxification services becoming available around the country? It is vital because one cannot get the treatment unless one has the detox. Most centres will not take young people on their other programmes unless they have gone through a detoxification process. I strongly support the delegates on that issue.

As I understand it, the homelessness strategy in Dublin is under major review and there is an intention to do something similar around the country. Many services are being reconfigured and much change is taking place. How does that affect the Simon communities and the services they provide? It is a question of balancing the money from the Department of the Environment, Heritage and Local Government through the local authorities with the supports from the HSE. Obviously, as stated, health is a huge issue in terms of homelessness. Have the delegates any statistics to show that people's health improved greatly when they got a secure home, whether in a hostel - I do not know how secure that is - or in a more long-term solution to their problems?

Have the delegates seen or been able to monitor whether any marked improvements occur in people's health when they get some stability in their life, namely, by having a home? Earlier today I walked around Grafton Street and other streets where there were several people with signs stating they were homeless. I know there are difficulties with some people who may find it very difficult to avail of existing services. Are there adequate numbers of places for people who find themselves sitting on a cold street in Dublin in late November? Anybody who walks a couple of moments' distance from here will see such a person. There was somebody sleeping under a blanket directly across the road from Leinster House earlier today. That basic question concerns all of us. I thank the delegates for their presentation.

Senator Mary M. White

What is Ms Randall's position in the organisation?

Ms Niamh Randall

I am the national researching policy manager.

Senator Mary M. White

I am interested in the slide on suicide because currently I am dealing with a homeless person who has tried to commit suicide. I understand the lack of hope there can be about getting a place and I know how awful that is. As a point of political interest, I am a Member of the House since 2002 but I always used to vote for the former Senator, Brendan Ryan from Cork, because he was from the Simon communities. I would look at the names of candidates and the Simon communities tag was one I recognised. The Simon communities have a great brand recognition and reputation.

Will Ms Randall develop the aspect of suicide? There is a sub-committee on suicide in the Oireachtas of which I am vice-chairman.

Deputy Charlie O’Connor

I also wish to be associated with the welcome extended to our friends from the Simon communities. It is important that we take the opportunity to listen to the case they make. In his introduction the Chairman made the point it was important they should come to see us at Christmas. I am not critical of that but my sense is that homelessness is not only about Christmas. Deputy O'Sullivan just made a point. I am a proud Dubliner but I walk the streets of Dublin during off-times in Dáil sessions and just as she did I see people who are homeless and living on nearby streets.

Most of the Simon communities' delegates will know I live in Tallaght where homelessness does not appear to be a significant issue but I have always said, and have been brave enough to say, that in places such as Tallaght and other major population centres this issue should be dealt with on our own doorstep. We should not send our problems into the city, as we do. There should be a process whereby homeless people can be dealt with locally. If I may be parochial for a moment I wish to pay tribute to the Tallaght homeless advice unit based in Tallaght village which does an outstanding job getting across a positive message and helping people in a practical way. However, other than the Saoirse project in Tallaght village for women and families who are subject to violence my area does not have a homeless unit. It is not popular to go around Tallaght or anywhere else saying such a unit is what is needed but it is needed. We should not send people who are under pressure and vulnerable on the bus into town to try to access services. Some do not manage to do that and, as Deputy O'Sullivan saw, they find themselves in doorways here in my city. I, too, go around taking a look at the situation. It is difficult.

Two other points were made in the presentation which are relevant in the context of drugs and suicide. Senator White referred to one of them. Along with the Senator and Deputy Dan Neville I am a member of the Oireachtas sub-committee evaluating the high level of suicide, a matter brought to our attention on a regular basis. The challenges some homeless people have with drugs make for a major problem, in my community as everywhere else. In that regard, what sort of linkage do the delegates see between homeless people and drugs? Drugs make people even more chaotic.

When people talk about drugs they tend to talk about them as we understand the word but without including alcohol. The effect alcohol has on homelessness and other issues is often underestimated. That is an Irish way of thinking. There has been a lot of debate about this lately. It is almost accepted that as a nation we are happy enough drinking but we all know from our work, as the delegates know from theirs, that drinking affects people and becoming homeless can be part of the entire picture.

It is important that we support the work the Simon communities are doing. The Chairman made the point that every group has a case not make, not only those which will attend the committee in the coming three weeks. He stated it is important to balance everything together. In the previous session I spoke about cardiac rehabilitation, a matter I feel strongly about, but we should also be aware of homelessness. In my work as a local representative in a major population centre many people come to me who are homeless, for one reason or another. We must continue to challenge the services just as I know the Simon organisation will continue to do. It is important that it does so.

I often say there should be more joined-up thinking between the agencies making the case and the local and health authorities. For example, if one goes to the local authority and states that one is homeless one will be registered there and sent to the HSE which will ask if one has been to the local authority. I do not criticise those people but there is a lack of joined up thinking. I come across many people, not only in Tallaght but even in the city, who tell me that rather than go through that process with all its red tape they would hide in a field somewhere. It is an important issue.

My county, South Dublin, is twinned with Brent, in Wembley, Middlesex, England. I visited there a while ago, was taken around and met people who were homeless or were drug addicts. Where were they from? They were from Dublin - from Crumlin or Tallaght. I hope I do not distract from the point but these people went over to England because they decided they wanted to do something different. However, they remained homeless. At a time when everybody is competing for the attention of the political system and of Government in regard to resources, the Simon Community has a strong case to make and we should support it.

Chairman

It was a privilege to have the delegation in attendance today. I salute the delegates for the work they do. I echo some points made by Deputy O'Connor. The Simon communities' delegates highlighted the role of the Departments of the Environment, Heritage and Local Government and Health and Children, and the HSE. In my experience, very often there is a lack of joined up thinking and co-ordination at local level. One may be able to identify and source accommodation but the real problem comes with the lack of after-sales or after-placement service. One wonders what percentage of this cohort of people can use the supports in place.or be assisted to use them. There are many such support, whether the rental accommodation scheme, RAS, rent allowance, local authority or voluntary housing, or whatever. There are many initiatives in place to meet people's needs and it would be interesting to hear whether the delegates think there are enough. If their client group is not supported after securing a housing placement I take it that many will fall back into homelessness. We do not seem to address that problem adequately. Many local authorities have officers for the homeless but their focus appears to be on the placement rather than supporting people afterwards.

I wonder whether the public at large is aware of the enormity of the impact of alcohol and drug abuse or is aware of the input mental health issues have on homelessness. We hear it said that homelessness is associated with the recession but the real cause of homelessness is abuse of alcohol and drugs and a failure within the mental health services to support people at community level. Many of us will have seen that the policies on mental health care in the community in the past 20 years became abandonment in the community for many people, which we need to address.

Aside from the demand for places, of the cohort of people the Simon Communities of Ireland deal with, are there people who will not avail of accommodation services and, as Deputy O'Connor said, would not put themselves through the process of applying or being assessed but rather have made a very deliberate, if unwise, decision to remain on the streets? We are seeing all sorts of problems throughout the country owing to the lack of detoxification facilities. I recently met a residents' group in my constituency which advocates that people who were addicted to heroin in a particular estate should be evicted. However, when one seeks services for such people to address their addiction one finds they do not exist. Equally there must be a willingness on the part of the person with problems with alcohol or illicit drugs to seek help. At any given time how many people have reached the point where they want to avail of services if the services existed?

Ms Niamh Randall

I thank the members for their most interesting questions and their support. I reassure Senator Mary White that the former Senator, Brendan Ryan, is still very involved in the Simon Community at a national level and locally.

Chairman

He is actually from Kildare and not from Cork.

Ms Niamh Randall

Everybody is claiming him.

One of the important issues to highlight is that drug and alcohol use are both causes and effects of homelessness. Our health snapshot study indicated very high levels of use, with 66% of people using alcohol and 38% of people using drugs. There is a huge impact in terms of risk behaviours and health for someone who is homeless. International research has highlighted that people's risk behaviour tends to increase as their quality of accommodation reduces so well being becomes poorer with very high levels of risk behaviour for people sleeping rough, living in squats etc. We welcome that the new drugs strategy is a substance misuse strategy inclusive of alcohol. It is a move in the right direction, but it is very slow in terms of its implementation and impact throughout the country. It highlights the issue of joined-up thinking, and strategy and policy interface. Responsibility for these issues lies with the Department of the Environment, Heritage and Local Government, the HSE and then yet another Department, the Department of Community, Equality and Gaeltacht Affairs, which has responsibility for the substance misuse strategy. Interdepartmental, interagency and interdisciplinary working is essential for the people with the many related needs we are discussing.

Some of my colleagues would be better placed to respond to some of the other questions. Mr. Paul Sheehan from the Cork Simon Community will give some input on suicide and on health improvement as a result of engagement with the adult multidisciplinary team in Cork. Perhaps some of my other colleagues will contribute on the detoxification issue and Mr. McGuinness will speak about the implementation of the Dublin strategy.

Mr. Paul Sheehan

Deputy Jan O'Sullivan mentioned the reviews of the homeless strategies around the country. While a review is always to be welcomed, our concern in Cork would be that whatever is being reviewed should be done in the context of what is happening on the ground. We would be particularly concerned about two areas, both relating to health. First is reclassifying people who are living for a very long time in what we would call high-support houses. These are people who have the most intense range of health needs. The HSE care budget goes almost exclusively on people living in high-support houses. We would be concerned that if this group of people is reclassified then there is no longer a need to fund the care needs of those people. While that is acknowledged in the national strategy, it highlights that there are difficulties in reclassifying that group of people owing to funding issues. We would be concerned that that might be fast-tracked in some way in the review.

The second issue relates to the adult homeless multidisciplinary team in Cork. This is a group of GPs, a community nurse, psychiatric nurse, psychologist and psychiatrist. They are in place in the Cork Simon Community emergency shelter and in another shelter in the city run by the Society of St. Vincent de Paul. They work exclusively with people who are homeless and who have just come off the street. They are people who have difficulty accessing mental health services or a GP. They are people who do not even know where to start to get a medical card or people who do not know how to manage their own health when it comes to prescription drugs.

The team works very closely together, interacts with other health agencies across the city and has proved to be a great success. Last year more than one third of people using the services of the Cork Simon Community availed of the adult homeless team in almost 2,500 appointments. One can see the difference it is making in the people in the emergency shelter. People who are long-term homeless in the emergency shelter move on to high-support housing. Some people move on to flat and to independent living with a little floating support. In the emergency shelter there are very high levels of people with challenging behaviour. When people move on to high-support housing it reduces dramatically. When people move on to independent living practically, it is almost at zero and one gets the highest rates of people attending counselling on a regular basis. People are managing their own health with minimal intervention from the Cork Simon Community. People are looking for work and getting back into education; it is making a huge difference.

There is a suggestion in the review of the homeless strategy in the south-west region that that team would become part of the primary health-care teams that are being introduced, but we would argue that would be a backward step. The team was established in the first place so that people would be able to access this kind of health service quickly and easily with the minimal of fuss. If someone staying in an emergency shelter and needs to travel 2 km or 3 km to a GP, we have no idea whether that person attends that appointment, but when it is within our services we can actually escort the person to the appointment and ensure attendance. Afterwards we can liaise much more efficiently and effectively with the health advisers. That team has proved to be a critical part of delivering services for the homeless in Cork.

Many issues were raised on the subject of suicide this afternoon and we could do a very interesting body of research on all of them. The health snapshot study that we did in July looked at the basics, but on the suicide question, it involves people with significant mental and physical health conditions, and people using drugs and alcohol. For the most part they are isolated and do not have connections with their families. They have had difficulties in accessing mental health services, are on the margins of society and have been forgotten. What do people do on a day-to-day basis? On a good day they have access to emergency shelter but on a bad day they are on their own and literally on the street. That area alone would merit considerably more research to establish what is going on and what needs to be done to address it.

Mr. Niall Mulligan

I will deal with the issue of detoxification and the wider area of addiction. As the Chairman said, accommodation is one thing, but where people get the supports they need, particularly with addiction, is a major issue for us. We cannot deal with detoxification in isolation. I accept there is a dearth of detoxification beds in the north east and, as Ms O'Connor pointed out, the same is true in the west. It is almost impossible for us to get somebody into residential detoxification for either alcohol or drug addiction. Rather than sitting there and giving out about it, our response is to try to do something about it. Not everybody needs to go into residential detoxification; people can get detoxification very safely and securely within the community and there are many benefits to that, including staying linked into their families and social structure, and not moving them 200 or 300 miles from where they live.

Hence the development of the community detoxification unit in our area, but it will not work unless there are other services to complement it. There is no point in us detoxifying people unless they are prepared for it. We need to have done some work beforehand in terms of counselling and support, and they need to know what they are getting into. Equally it will not work without after-care for them. Detoxification will bring up many issues that have been hidden for a long time. After they get through the physical side of the process, part of it is dealing with their emotional and psychological issues. It is very much concerned with counselling, after care and rehabilitation. It is a package. If we place somebody or somebody gets accommodation if those structures are not in place it is almost inevitable that somewhere along the line he or she will revert to the situation to which Mr. Sheehan referring, trying to access emergency accommodation, etc. The positive thing is that, in terms of linkages, the regional homeless consult the forms which have been established and are now linking with regional drugs task forces. There is commonality between the two areas. We recognise that homelessness and addiction are highly linked.

Chairman

Is the delegation seeing things happening on the ground?

Mr. Niall Mulligan

We are beginning to, yes. There are issues which we can discuss for a long time. If one gets the right people and commitment, tries to move egos out of the way and get on with why we are here to sort out a particular problem, one can move mountains. It does not cost a huge amount of money. Addiction is a huge issue for us. What has been happening in Dublin, Cork and Galway over the past ten or 15 years is now creeping into towns such as Dundalk. The statistics for emergency accommodation indicate that the ages are reducing and the amount of people who are intravenous drug users are increasing. We have to respond to that and we are doing so.

Another issue raised by Deputy O'Sullivan was the long-term health and improvement of people who were moving out of emergency accommodation and into long-term supportive independent accommodation. It is true that their health does vastly improve. One of the issues for us is that we tend to link in and continue to support a great number of people. We are now seeing individuals who we would have known for 20 or 30 years, they are now moving into their 60s and the health issues which they experienced in younger years are revisiting them. We are their family and support, and have to pick up on that. It is like looking after one's aged parents. That is why we exist.

Ms Marlene O’Connor

A number of aspects bring things home in a very stark way. There is, as Mr. Mulligan said, the need for detox and rehabilitation but there is also a need for harm reduction programme because some people are not ready to be fully detoxed and then abstain for the rest of their lives. It has to be approached in a number of ways. When I listened to my colleagues, I recalled that there is a four-month waiting list for the methadone clinic in Galway. If I was ready to go to the methadone clinic today where would I be in four months time? I may have gone somewhere else, bought it on the street or continued using.

A sessional doctor or nurse once a week could make that manageable. There are interventions which are not expensive, as several of my colleagues have said. There are other interventions which would cost more money. However, the are interventions which could make a vast difference to the health prospects, lifestyles and future lives of a great number of people. Some 50% of the people with which we work live in shared supported accommodation, some with floating support and some with high support. They have moved on from homeless services and are being supported by us in the community to whatever their level of need is.

The funding for that comes from the HSE which is why it is critical to maintain it. It is critical for people's opportunities to maintain a relatively stable lifestyle and not revert to homelessness. One thing that worries me about the homeless strategy is the ambition that people will not be in emergency accommodation for six months or not need to sleep rough. When people move from those situations they have two critical needs, namely, somewhere to move to and support on an ongoing basis. Support needs then taper off over time. It is cost effective, efficient and gives a great return.

It seems to be lost sometimes in the ambition to succeed that nobody will sleep rough on or live in emergency accommodation for longer than six months. Another thing which is sometimes forgotten is that many of the people with which we work, as my colleagues have said, have complex needs. They have poor physical and mental health and sometimes a history of addiction or an active addiction and need support.

Mr. Sam McGuinness

Part of the reason the Simon Community started was because Anton Wallich-Clifford, who was a UK probation officer, came to Ireland to find the source of the problem that he found in prisons, hospitals and everywhere else in the UK. Unfortunately, some of those problems still exist. We have our own detox, rehab and aftercare facilities which have been in place for some time and have been the great saviour of many people.

On the services available in Dublin and in the regions, all of the hospitals with which we have a relationship have needle exchanges, harm reduction and wet rooms. We welcome people with all levels of difficulty, whether it is substance or alcohol abuse or otherwise. The idea is to get to people at the crisis stage, stabilise them and give them support. Support means that they are supported in long-term residential accommodation because they have critical needs of which they cannot manage elsewhere or that they are brought into their own housing with whatever supports are needed.

I have been critically involved in the Dublin plan and it is the opposite to a revolving door. There is an architecture, structure and proper standards in place. There are standards for tenancy and the premises in which people live. The critical issue for us is that to make that happen we need housing. To establish strategies to proceed on that basis we need to de-stack private emergency accommodation or long-term shelters which, unfortunately, we have put in place for cold weather. One would think housing is readily available at this time but we have other conundrums such as the financial situation, the developments which are stuck in NAMA, the banks which have no money and will not support leasing arrangements. In addition, people hold differing views on whether leasing will work.

That has caused the plan to slow down a bit. It is critically important that the homeless agency is given the full support of all Deputies in the Dáil because if, for some reason, it could be put aside because of changes on 1 January, the plan could not be completed. The plan is unique in the public and private service. All organisations, including local authorities who have come together, the HSE and NGOs, are part of the plan. It is a plan which is totally supported in Dublin. It has regionalised the contact and outreach teams, the support for prevention and a lot of areas which were focused on Dublin city or some of the local authorities.

A critical element is localisation, to which Deputy O'Connor referred. We are very precious in some areas and we believe that we cannot have a service in our backyard or that it was not invented here. As a country and individuals we have to get over that attitude because the great things about the hostels and accommodation we now have is that we are bringing in people to stabilise them. We have a hostel on Harcourt Street which is just five doors from Copper Face Jacks. There will always be more noise coming out of Copper Face Jacks than from No. 27 Harcourt Street. It is amazing what happens there. Instead of people being down a lane, with their difficulties and vulnerabilities, they are inside in the wet room or the day room with nurses close at hand, because we have those facilities there. It is critical that we have this hostel.

It is also critical that we open up our successes to communities as much as we can, because we are all about successes. I know the situation in Tallaght and Clondalkin. When I was out with the South Dublin County Council estate management group last week I was talking to them about this. We must make people aware that homeless people could have been any one of us. The longer we keep people homeless and stack them up in homelessness the longer it will take to move them to the next best place.

We know alcoholics and people who take drugs and who live in their communities. They never became homeless. They live at home happily and get support. When one is homeless one is totally lonely. One has no hope and is beset by all kinds of difficulties.

The plan that is happening in Dublin is important. I share it with my colleagues and we believe in it. Everybody has different views of how it would fit in their community but we believe it is critical to have a plan. The infrastructure is right and the machine is there and is working with the local authorities, the public service and non-governmental organisations to make it work. We are committed to it.

We need to move on the housing piece. Unless we open up what I call the back end we will not de-stack the places that were put in under the cold weather strategies of the last five years. We have a number of shelters. We have, at least, moved them all to 1 a.m. closing. However, some time ago I brought the Minister of State, Deputy Finneran, around them. At that time people went in at 9 o'clock at night and had to be out at 9 o'clock in the morning. That is not civilised.

Senator Mary M. White

It is ridiculous.

Mr. Sam McGuinness

So, we have moved those hostels to 1 o'clock, with resources that we found through donations from the public. Most of us are in the same predicament. The amount of work we have got from the State is probably 50% of what we need to run our hostels, but we have been imaginative. For example, we have just started up a mobile bus unit in Dublin city. We work with Chrysalis on it and it goes around and stops at various places in the city to give people medical help. We have done that with donations we have received. Some day this country may once again be wealthy enough to provide support for that.

In the meantime, Simon will be here next year with the resources we have today. We will find money somewhere and get on with what happens. It will be very tough next year. There is no doubt that we are finding many more people on the street, not just because of the frailties caused by drugs and alcohol but also because of the frailties caused by financial stress. It is causing great difficulty in many homes. Some homes that had one person working, and maybe two, now have no-one working. Deputy O'Connor knows well what it is like. What do households who have no-one working do? That is where the couch surfing starts and eventually people fall out onto the street. Then, we hope we will catch them.

Chairman

You make reference to localisation and we are all conscious of the opposition that groups such as yourselves have faced in local communities when trying to provide hostel or long-stay accommodation for people who are associated with those communities. I deplore that. It ill-behoves any public representative to be involved in campaigns of opposition to provision for the most vulnerable in society.

Senator Mary M. White

Hear, hear.

Deputy Charlie O’Connor

As they do.

Chairman

As they do. I deplore that. When Simon clients who have been in long-stay supported accommodation want to move on to mainstream housing, albeit supported, surely there is no shortage of availability, whether through the rental accommodation scheme or straightforward rent allowance? Simon should not be experiencing difficulty in sourcing accommodation for people at a time when there is a massive over-supply of housing. If you are experiencing difficulty in that area, where is that difficulty coming from? What is causing it?

Ms Marlene O’Connor

One of the areas causing a problem is the sheer number of people on the local authority housing waiting list, considerably more people than there had been and considerably more than there are houses. People who are homeless and on the local authority waiting list are competing with many more people than they used to.

Chairman

However, there are more-----

Ms Marlene O’Connor

There are three bedroomed semi-detached houses, which are neither the preferred nor a suitable option for one person. They are automatically over-accommodated.

Chairman

I do not like disagreeing with you, Ms O'Connor as you are the expert. However, it appears to me that there are a large number of empty apartment accommodation across the country, much of which should probably never have been built. One wonders why that type of accommodation cannot be sourced.

Mr. Sam McGuinness

The Dublin reconfiguration model known as Pathway to Home has a requirement for 1,200 units this year. The Minister of State, Deputy Finneran, meets the directors of housing every week to see how that plan can be executed. There is great difficulty providing the accommodation. That is the reality. There is a lot of difficulty getting the accommodation. That is very hard to understand but it is the reality. The directors of housing have not been able to find the accommodation.

Recently, another scheme was brought in. Colleagues of mine in Threshold are trying to find 200 pieces of rented accommodation that would help to satisfy the requirements, piece by piece. Unfortunately, we have only six weeks to the end of December, which is the last day for the plans. The intentions for 2010 that were put in place when these plans were written will be difficult to achieve.

Chairman

I am still not following you. I know what is going on in County Kildare, where there are more units of private rented accommodation available than people to take them up. Where I am experiencing difficulty in people getting placements it is because they have a history of anti-social behaviour or belong to an ethnic group that a private landlord may not want to take, which is also deplorable. Are you suggesting that local authorities are prioritising people from their waiting lists ahead of people who have a background of homelessness?

Ms Marlene O’Connor

I do not think that would be totally fair. The competition is around the numbers and the fact that very little local authority housing has been or is being built this year. There has been little, if any, in Galway.

There is a problem with the private rented sector. Bearing in mind that the tenant will be at home for most of the day, because he or she is not going out to work and does not have family and other supports, we would expect accommodation to be of a reasonable standard. If the accommodation is of a reasonable quality the rent is almost certainly above the cap for rent allowance. If the rent is not above that level, the landlord may or may not sign receipts so the person can claim rent allowance. In many cases tenants receive the rent allowance but add sums of up to €30 or €35 out of their social welfare payment in order to secure the accommodation. What is left after paying the rent is insufficient to exist. This totally ignores the question of young people who are on the very reduced social welfare payments of €100 or €120. That is not going to sustain anybody in the private rented sector, no matter how grotty and cheap the place is.

Chairman

We could debate this for a very long time. Perhaps we should not go there.

Deputy Charlie O’Connor

I would like to take up the point the Chairman made. I do not want always to talk about Tallaght, but I know about Tallaght. Do not tell anyone I do this, but I often go into my office late at night to sign my letters and be ready for the next morning. Any time I come out I meet people who are still about; I put it as delicately as that. I could bring the witnesses around Tallaght, as the Chairman has said, and show them blocks of vacant apartments. Nobody is using them. I receive e-mails most days from good people who tell me their local authority should bulldoze those apartments to the ground. I cannot get my head around that. This is not just occurring in my community. Throughout the country there are vacant units of accommodation that were not required - that is another issue - and that are not being used. Within sight of them, there are people with nowhere to live. Someone, some day, will have to make a brave decision in this regard. It is not just a question of my community because, as the Chairman stated, it is a national question. Somebody will have to grasp the nettle because what is occurring makes no sense.

It is a very sensitive issue. My suggestion does not go down terribly well in some communities. As the Chairman stated, there are vacant units everywhere and homeless people everywhere.

Deputy Jan O’Sullivan

The laws of private property are such that people own these properties, unless the Government intervenes and changes the law-----

Deputy Charlie O’Connor

They are still there.

Deputy Jan O’Sullivan

-----or changes the cap for rent allowance. It is exactly the same in Limerick as it is in Galway. I refer in particular to one-person units because the cap is lower for them than it is for family units. The units advertised in the local newspapers at the weekend or by estate agents are mostly above the limit. Everybody knows that the limit pertains to the actual cost, not the amount of money one can get to support what one can add oneself. It is a real problem.

Mr. Sam McGuinness

I share the Deputies' frustration over accommodation availability. We have been stacking people in emergency accommodation for some years around the greater Dublin area. We all know that. There have been a number of plans, including plans for enhanced leasing schemes and rent supplement. There is a famine of housing in a land of plenty. The difficulty is loosening up the housing. Many of the housing problems have been complicated by our current financial position. Getting our hands on blocks of accommodation means somebody expects somebody else to pay for them. It is not in the hands of the developers in many cases but in the hands of the banks. The banks are not prepared to accept the amount of money that others, such as approved housing bodies, are prepared to offer them, or the money available under the schemes that the Government has put in place. There is constant energy, certainly in the greater Dublin area, devoted to finding accommodation. The directors of housing are on the case but housing is not becoming available as fast as we need it.

Chairman

We may choose to consider this early in the new year.

Deputy Jan O’Sullivan

Is there a way in which one could work through voluntary associations?

Mr. Sam McGuinness

I ask for all the help we can get on that score.

Chairman

I thank the delegation for its presentation. We will do what we can to support it. Does Ms O'Connor wish to make a concluding comment?

Ms Niamh Randall

I thank the members for meeting us today. We know this is a very busy and important time. If the members take anything away with them today, it should be the importance of regarding homelessness as more than a question of housing. It is also associated with health, including mental health, drug and alcohol issues, and a range of complex needs. The fact that Simon is perfectly placed to respond to these needs in local communities should be borne in mind. There are excellent solutions and services throughout the country.

Chairman

I thank the delegates for their presentation and the manner in which they have dealt with the questions. We look forward to further engagement. We all hope to be around to continue to engage with the delegates.

We will meet again on Thursday, 25 November 2010 for the quarterly update with the Minister and chief executive of the Health Service Executive.

The joint committee adjourned at 5.15 p.m. until 10 a.m. on Thursday, 25 November 2010.