There are a number of common themes running through the contributions. I share the concerns of members about those two major issues: alcohol and the widespread use of benzodiazepines. As regards treatment services being provided through the HSE, members of the committee will know that I have responsibility for primary care as well as the drugs strategy. Both areas of responsibility sit easily together as there is a lot of common ground involved. I would like to see much more involvement by GPs in providing treatment for drug users. There have been difficulties in that area and I am addressing them at the moment. I have met a number of the GP co-ordinators and we are examining that area. I want to involve more GPs, both at level 1 and level 2. There are issues concerning how the scheme works and how people are recompensed for their work. The fee structure often works against users making progress through the system, so they can get stuck as a result.
I am concerned about people getting stuck on methadone without having an adequate progression through the system. That is why I want to put the focus back on recovery, to ensure that people are enabled to the greatest possible extent to live a drug-free life. Both at the level of treatment centres and also with GPs, I do not want people going into methadone treatment and becoming stuck there indefinitely.
We are examining ways of ensuring there is that kind of progression by involving more GPs. I see no reason a large number of drug users' regular GPs cannot provide treatment for their drug problem, just as they treat them for any other health problem they may have. A certain cohort of drug users would be regarded as quite chaotic and would not be suitable for treatment in local GPs' surgeries. Many drug users, however, should be treated by GPs and, therefore, I want to see those GPs' services being expanded. I am working on that at the moment.
Alcohol is a major problem in this country and, as a society, we need to face up to it. This is not a marginal issue, nor something that only children in disadvantaged areas have a problem with. It is a problem for society at large and, as a society, we all drink too much. I hope that as part of the new strategy to tackle this problem we will set targets on reducing consumption levels across the population. Each and every one of us needs to address this matter across the social spectrum, urban and rural, male and female and including all age groups. I look forward to receiving the report of the steering group that has been examining this area for almost two years. I expect to receive it within the coming weeks. I will then take that draft strategy to Government with recommendations for an action plan.
I hope to bring forward specific proposals on three key areas of concern, the first of which is pricing. Since the groceries order was lifted in 2006, we have seen that alcohol is available so cheaply. In fact, there were figures used by the Alcohol Action charity recently which really brought it home to people. In terms of the maximum recommended intake per week to maintain a low rise in relation to alcohol, a woman can get to that point for a mere €6.30 a week and a man can get to the limit of his low risk threshold on €10 a week. That is merely a measure of just how cheap alcohol has become. This is an issue that must be tackled.
There was an earlier commitment to addressing it on the basis of below cost selling. That is easier said than done because there are all kinds of other factors that come into play that determine the price of alcohol where, for example, the large multiples are buying in bulk and get discounts. It is quite difficult to establish the actual cost and whether outlets are selling below cost.
For that reason, the steering group has been concentrating instead on the notion of minimum pricing related to the volume of alcohol in any particular drink. That is not straightforward either and we are seeking legal advice on that at present. Personally, I would be very committed to going that route if it were legally sound. That is the basis on which we are proceeding to address that problem. It is a key issue in the abuse of alcohol that it has become so affordable, especially for young people.
In tackling this problem, the other key area is the explosion in the number of outlets for alcohol. One can buy alcohol in every corner shop and every filling station. The big concern about that is that alcohol is displayed along with the sweets, biscuits, bread or milk and it normalises the idea of alcohol as a product. Alcohol is not a normal product for sale in a supermarket like food, milk, minerals or whatever. It is a potentially dangerous product and for that reason, it needs to be treated differently to other products. It was a retrograde step to liberalise the licensing laws in the way we did, which opened up the question of availability. Availability is a key aspect, not only in terms of normalising our attitude to alcohol but also in terms of making it much more accessible to young people.
The other area is clearly the availability of alcohol to those under age. There are a couple of factors here. We need to tackle the issue of distance selling where a "Prime Time" programme last year demonstrated how in Swords, County Dublin, teenagers were able to ring up both local off-licences and supermarkets to order alcohol over the phone and have that delivered and paid for with cash on the doorstep without any difficulty. That practice, I understand anecdotally, is a widespread problem. That needs to be tackled.
We also need to tackle the question of under age sales and there needs to be greater enforcement of the law in that area. I want a clear message going out to the law enforcement agencies that this Government is serious about tackling the problem of alcohol abuse, especially among young people.
The third area in that regard is, as Deputy Kelleher mentioned, the question of those over 18 buying alcohol for those aged 13 or 14 waiting outside. I am not satisfied that there has been adequate enforcement of the law in that area. It needs to be made clear to people that they are committing an offence by buying alcohol for the purpose of passing it on to those who are under age. I would like to see us being much more vigorous in that regard and there will be proposals on that in the new strategy.
The question of alcohol abuse and the place of alcohol in society is being taken extremely seriously, both by myself and by my Government colleagues. I hope to be in a position before the end of the year to bring forward significant proposals in that regard. I would very much like this committee to consider the role it may play in supporting those proposals. I am happy to come back to the committee at a later stage and look at some of the draft proposals. I hope to get to a point where we would have cross-party support for taking this issue seriously and doing something of real consequence about it in order that we can remove this terrible blight on society in terms of the dreadful damage alcohol does to individuals, families and the health and general welfare of people. It is costing us dearly in human terms but it also economically in terms of the pressures that alcohol abuse puts on the health service, lost days at work and loss of productivity. We have no choice but to address it. I hope I will have the support of the committee on a cross-party basis in addressing it in a serious way.
Benzodiazepines are another area about which I am very concerned. As the committee will be aware, the majority of those presenting for drug treatment are polydrug users. Often, it is cannabis or heroin in conjunction with benzodiazepines, and alcohol is a factor in many cases. This is something that was brought to my attention in my constituency. The Ballymun drugs task force identified this as a serious problem in recent years and it engaged in a project in which it worked with local general practitioners in the primary care centre. They came up with a scheme whereby two counsellors were employed to work in the primary care centre to facilitate GPs who where presented with patients who had difficulties with abuse of benzodiazepines so that there was an alternative course of treatment available and they could refer the person to the counsellor who was working in the same building. That had positive results.
As well as my experience in my constituency where it has been brought to my attention on a number of occasions, in meeting various groups dealing with the drugs issue and in visiting different communities over recent months, it has arisen time and again that there is a serious problem of overuse, overprescribing and over-reliance on benzodiazepines. With that in mind, I have taken an initiative on the question of prescribing. As part of my remit as Minister of State with responsibility for primary care, I have responsibility for medicines and I am looking at the question of prescribing patterns across a range of medicines and drugs. I will start that examination in respect of benzodiazepines. I have decided to take an initiative on the information available to us on persons on medical cards who are prescribed benzodiazepines as well as persons who avail of the community drugs scheme. As the committee will be aware, all of those data are available in the primary care reimbursement centre in Finglas. There are rich data available on exactly what is happening in prescribing for most of the population.
I hope, starting next month, that an in-house team within the PCRS will investigate those figures, look in detail at prescribing patterns in respect of benzodiazepines, and identify problem areas, problem practices, problem GPs in terms of their prescribing patterns and where patterns are out of line with national norms and best international practice. At that point, when we have the data to see the extent of the problem, we will take it to the next step further where that team will meet GPs where there are difficulties, address it at that level and work with those GPs to bring their prescribing patterns into line with best practice. I am starting that in October. I hope that in a matter of months we will have results from that and a clear picture. I have been hearing all of this anecdotally. I want to see the hard facts in terms of the scale of the problem and then decide on the action we will take. The preparation of that work is under way. It has been scoped for me and I hope it will start in October.
The question of waiting lists is a concern. Official figures from last December have been circulated. In the Dublin area, waiting times are approximately one month. That is an improvement but a month is still too long. If a person using heroin, in particular, has had a chaotic lifestyle and gets to the critical point of deciding he or she wants to do something about his problem, we need to be in a position to provide that service within days. I am aiming for two weeks. It is down to a month in most places and I would like further progress on that. Outside the Dublin area, progress has been made over recent years with a number of new services and clinics coming on stream. I referred to them in my opening contribution. They are producing results in the context of progress being made. Some tidying up had to be done in regard to the waiting lists because there was duplication. We have preliminary updated figures that show an improvement and I hope we can validate the figures and make them available. Progress is being made in this area. It entails acceptance of new treatment facilities and the recruitment of more GPs.
Schools play an important part. As with alcohol, availability is a key issue and we must tackle the availability of drugs. It is difficult to counteract a situation where schoolchildren pass dealers on the way to school or witness dealing taking place openly in their local shopping centre or on a street corner. It is difficult to counteract that through education programmes. Tackling the supply of drugs in the number one priority. We need to ensure schoolchildren receive good, soundly based education programmes related to personal development, the dangers of abusive substances and developing their self-confidence, and we need to ensure they remain in school. There are common threads in the profile of those most at risk of using heroin, in particular, such as poverty, family dysfunction and early school leaving. All those factors predispose people to abusing drugs. Education programmes in schools need to tackle the problem of low self-esteem and to provide education and employment opportunities for people as well as making them aware of the dangers of the abuse of alcohol and illicit drugs. Programmes are in place in schools and a group within the Department of Education and Skills is reviewing them to ensure they are up to date and relevant to where young people find themselves.
As Deputy Kelleher said, when a problem is identified in a school, the first indication something is wrong is the pupil being absent regularly, and that is a matter for the National Educational Welfare Board to address in the first instance. There are also counselling services within schools. The careers guidance and counselling office should be the first port of call, followed by working with the parents and then linking up with the available HSE services. In most areas, support and assistance are available where schools identify a problem. Whether they work through the local HSE office, the drugs task force or the social work service, they are linked to services quickly when abuse is established. That is the thrust of tackling the problem at that level. The younger the person with the drug problem and the sooner appropriate treatment can be provided, the better. The services supporting schools are reasonably good and we must continue with the awareness programmes.
With regard to cuts in services, we managed to maintain the budget reasonably intact for this year at €265 million. There are pressures on all budgets but there is an acceptance across government that we cannot afford to take our foot off the pedal on this issue. I hope we will retain the bulk of the budget for next year.