6. Deputy Shane McEntee asked the Minister for Community, Rural and Gaeltacht Affairs  if the Health Service Executive report of the working group on residential treatment and rehabilitation of substance users on the availability of dedicated drug residential services has been brought to his attention; his views on the report's recommendations. [18948/08]

Deputy Éamon Ó Cuív: I am aware of the report of the Health Service Executive working group on residential treatment and rehabilitation. My Department was represented on the working group and I welcome the recommendations therein. The HSE appointed the group to provide a detailed analysis and overview of known current residential treatment services and to advise on the future residential requirements of those affected by drug and alcohol use. Being focused on residential services, its scope was much narrower than that of the working group on drugs rehabilitation, chaired by my Department. However, it covers all substance abuse, and so includes alcohol which is not part of the current national drugs strategy.

The report makes a number of recommendations including the endorsement of the use of the four tier model of care as the framework for the future organisation of alcohol and drug services in Ireland, which involves the need for an appropriate level of service provision to best meet the needs of the individual client, from advice and referral up to specialist expertise to intensive interventions; emphasising the need for protocols to facilitate optimum inter-agency working; recommending the provision of dedicated high quality residential detoxification facilities including the provision of 127 dedicated beds, 50% each for drug and alcohol clients; recognising that detoxification is not an end in itself, a client-centered continuum of care is required to progress people towards recovery; quality assurance of residential services for alcohol and drug users; robust tracking systems to ensure that clients continue to get any support required; and involvement of families, in so far as is feasible in individual cases, in the care plan for recovering drug and alcohol misusers.

These recommendations are in line with those outlined in the report of the working group on drugs rehabilitation. While their implementation is primarily a matter for the HSE, I will support them in any way I can through the co-ordination of the national drugs strategy and I hope that significant progress can be made in that regard.

Deputy Michael Ring: Yesterday we had a report from the Health Research Board regarding the amount of drugs used in this country. There has been a 700% increase in cocaine users and the number of new heroin cases outside Dublin has doubled between 2001 and 2006. There has been a jump of 690% in cocaine users. The HSE issued this report but, on the other hand, it is not providing detox beds. It tells us we need 365 extra beds but at the same time it is cancelling the opening of new clinics. What is going on with the national drugs strategy? What will the Minister do if the HSE will not provide the necessary beds? In rural Ireland there are no detox beds for people with serious alcoholic problems. What will the Minister do if the HSE will not do the job it is empowered to do? We cannot have a major drug problem, with people needing detox and beds, and the HSE not having the will to provide beds. What will the Minister and the Government do?

Deputy Éamon Ó Cuív: We will continue to work with the HSE, which is the health authority with responsibility for this matter. Extra beds are being provided but more are needed. Whereas alcohol is a serious drug and one that is highly abused, it does not come under the drug strategy of my Department. Whether one can separate the problem of alcohol from opiate abuse is an issue we have debated many times in the past. We have an open mind on this and it warrants debate. It is worth noting that 50% of beds are needed for alcohol detoxification as opposed to drug detoxification but we will continue to work with the HSE on this matter.

Deputy Jack Wall: Regarding submissions to the national drug strategy, did the question of linking drugs and alcohol arise in trying to overcome the major problems that exist? Regarding the fragmentation of support groups in the country there does not seem to be any co-ordinated effort to align them to have a main thrust. There is a wonderful woman in Athy called Sister Concilio, who has facilities in Down, Galway, Bruree in Limerick, Cork and Athy. This was undertaken with her own initiative and funding. She has provided some residential services. There is also the St. John of God service. Is there any detailed evidence on amalgamating the two major problems in the submissions received? Regarding the overall picture, why is this so fragmented with so many groups seeking to alleviate the problem of drugs and drink?

Deputy Éamon Ó Cuív: Regarding alcohol misuse, we are having a series of public meetings. I attended the meeting in Sligo for a very short time but I will attend the meeting in Portlaoise. Alcohol and opiates are on a continuum and cannot be separated. We must examine the issue and are not at the conclusion stage because the meetings are still going on. They are being done on a round table basis to encourage people to interact. I am interested in the feedback from the ground. We have far too many structures. It has taken a long time to get cohesion between partnerships and Leader companies. I hope it will be worthwhile. We must find a balance between dealing with structures all the time, rather than issues, and ensuring we do not have too many structures and duplication and that we keep things tight and focused. There should not be endless consultation and no business. We must undergo the consultation and when we finish we will have a clear strategy to implement.

Deputy Catherine Byrne: It is encouraging to hear of the 50% increase in beds. One of the main problems with residential care or rehabilitation is the fact that there are over 12,000 people on methadone. In order to go into residential care they must be clean. When will a programme be introduced so that people can access the service so that they can be brought down on the drugs? At present they are in no man’s land.

Deputy Éamon Ó Cuív: We are going into HSE business.

Deputy Catherine Byrne: It is all drugs.

Deputy Éamon Ó Cuív: That is the problem. All we can do is keep working at the problem. I do not know if we have all the answers but we will continue to liaise with the HSE to move the process forward.

Vol. 654 No. 3
Other Questions
Thursday, 15 May 2008