I am delighted to be in this House to introduce the Misuse of Drugs (Supervised Injecting Facilities) Bill 2017. With the support of Senators I hope it will be possible to have it enacted as soon as possible. As I mentioned in the Lower House, I feel I am part of a relay team. I acknowledge the role of the then Minister for Health, Deputy Varadkar, and the then Minister of State, now Senator Ó Ríordáin, in particular for moving this issue forward and the many others who have worked for years to get the concept of an injecting centre in Ireland off the ground.
Last autumn injection centres opened in Paris and Lisbon and a centre will open shortly in Glasgow. There is a problem with injecting on the streets of Dublin and other cities and towns in Ireland. I have seen it on my own doorstep. Many Deputies have spoken in the Dáil about seeing parents and children observing this on their way to school. I am sure many Senators in this House have witnessed street injecting. It is unhygienic and unsafe. Those injecting on the street are at risk of contracting disease, such as hepatitis C and HIV. They risk getting ulcers and other infections. They are at risk of death from overdose. The wider community and the public are also at risk due to needles and syringes left behind. We need a new approach to tackling the problem. While I am not saying that the injection centres are the solution to the public injecting problem, there is evidence to support that they contribute to a significant improvement by reducing public health risk, overdose and improving public areas. Supervised injection centres exist in a number of other countries. These centres are aimed at the hard to reach population of drug users and are based in locations where there are significant problems of public drug use. The aim is to reduce the risk of disease and death linked with public injection and to provide access to health and treatment services. They provide a controlled place where people can inject, but much more than that, they provide a place to rest and have a chat and to access the services people need.
I believe in a health-led and person-centred approach to the drug problem. This is all about people and looking after the most vulnerable and marginalised in our society. The human cost of injecting in public is clear and keeps adding up in terms of the lack of dignity and the effect it has on a person's health, well-being and safety. We know that these centres are not the sole solution to the drugs problem and many other steps are needed, but I am committed to doing everything we can to help those who need it most.
In the programme for Government we have made a commitment to a health-led rather than criminal justice approach to drug use. First and foremost, injection centres are intended to be a form of harm reduction. If people are going to take drugs, they should be informed about the risks, they should be able to do so as safely as possible, and they should know what to do if something goes wrong. Together with needle exchange, overdose education and a supply of Nalaxone, injection centres and other tools help to reduce the risk of harm to people who inject drugs. Harm reduction interventions like those do not prevent people from choosing to stop taking drugs. While they do not stop people from engaging with treatment in the future, they may give the service users the chance to live long enough to seek treatment when they are ready to do so.
There is currently significant debate about national and international drug related matters. Many such matters will be examined as part of the new national drugs strategy which is at an advanced stage of drafting. However, they should not deter us from the goal of this Bill. The sole purpose of this Bill is to permit the provision and use of an injection centre. For us to open a pilot supervised injecting centre, we need this Bill. Under the Misuse of Drugs Act 1977, it is currently an offence to provide an injection centre. Service users would also be guilty of several offences. A change to the existing law is required to permit the introduction of this service.
The Bill contains 13 sections and I will explain each section in turn. Section 1 deals with the interpretation. The provision is standard and includes a number of new definitions for the purpose of the Bill. The section includes definitions for drug licence and supervised injection facility.
The definition of "drug" will include controlled drugs and psychoactive substances, sometimes referred to as "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 experience of the person applying for a licence and the address of the proposed premises. The application should include details of the operational and clinical governance arrangements for the proposed centre, which includes proposed wraparound services and referral pathways. If an application does not contain enough detail, the Minister can seek further information. Section 3 provides the criteria the Minister should consider when granting a licence. These include, but are not limited to, consultation with An Garda Síochána, the HSE and others as the Minister considers appropriate. They also include the matters the HSE will consider when advising the Minister on the appropriateness of an application. The HSE is best placed to assess the clinical governance and operational protocols proposed for a premises and to ensure 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 in such a case. In this way, a centre will be located based on need in areas where there is a significant public injecting problem. Section 3 also grants the Minister the authority to attach conditions to a licence. Licences will be for a fixed length of time.
Sections 4 to 6, inclusive, deal with the surrender, suspension and transfer of a licence. These sections provide for a licenceholder to be able to surrender or to seek to transfer a licence for a particular centre. 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 a licence with immediate effect based on the input of the Garda or the HSE should there be a serious and immediate risk to life. Under this section, the conditions attached to a licence may be changed or added to, as the Minister sees fit, taking into account the views of the HSE, An Garda Síochána and others. Section 6 allows for the transfer of a licence for a premises to another licenceholder to maintain the service if necessary.
Section 7 provides the definition of an "authorised user". It also provides the authority of a licenceholder 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 licenceholder. A person cannot be an authorised user outside of the centre. The status of the authorised user will depend on the permission of the licenceholder or person in charge at the time. 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 exempt from certain offences under the Misuse of Drugs Act. The eligibility of a person to become an authorised user refers to regulations that may be put in place to prevent the use of the centre by certain groups of people, for example, those under 18 years of age, those who are not chronic intravenous, IV, drug users and those who are pregnant. The making of any such regulations should be informed by clinical practice. Appropriate referral resources are expected to be put in place for anyone who presents to a centre but is not considered suitable to use it.
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 provides an exemption for the licenceholder, or any person acting under the direction of the licenceholder, from liability for providing an injecting centre and any assistance, advice or care given to an authorised user.
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 to do certain things with a controlled drug on premises. The licenceholder for an injecting centre will be exempted from such an offence. Finally, section 21 of the 1977 Act makes it an offence to break or fail to comply with the Misuse of Drugs Regulations. This section of the Bill ensures authorised users will not be in breach of the 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 not intended that the Garda will be continually in a centre watching over authorised users. It is normal practice for police in other countries to call into injecting centres regularly. This offers peace of mind to the authorised users, the staff and the wider community and ensures no one can attempt to profit through dealing or preying on vulnerable drug users in the centre.
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 the Bill. It is a compassionate and practical response to the chilling reality of drug users injecting and overdosing in public. I hope all in the House will fully support it and help ensure its smooth passage through the Seanad.