253. Deputy Andrew Doyle asked the Minister for Health if he received a copy of the Being Young and Irish – Take Charge of Change report from the Office of the President, Áras an Uachtaráin as part of President Higgins series of seminars with young persons here which took place in Dublin, Galway, Monaghan and Cork in 2012; if he has noted the Take Charge of Change declaration made by the participants; the steps he has taken arising out of the report’s findings in order to achieve young person’s vision for Ireland; and if he will make a statement on the matter. [14532/13] 

Minister for Health (Deputy James Reilly): I share the concerns raised in relation to the health related issues in the report "Being Young and Irish - Take Charge of Change." A number of initiatives are currently being progressed by my Department in relation to these issues and these are outlined below.

Mental Health: Government policy on mental health is guided by A Vision for Change, the 2006 Report of the Expert Group on Mental Health Policy which proposes a holistic view of mental illness and recommends an integrated multidisciplinary approach to addressing the biological, psychological and social factors that contribute to mental health problems. The report recommends a person centred treatment approach which addresses each of these elements through an integrated care plan, reflecting best practice, and most importantly evolved and agreed with both service users and their carers. Reach Out, our National Strategy for Action on Suicide Prevention (2005 – 2014) makes a number of recommendations in relation to fast-track referrals to community-based mental health services, effective response to deliberate self-harm, training, stigma reduction, etc. This Government has prioritised the reform of our mental health services and is committed in particular to the delivery of more and better quality care in the community. In this regard substantial additional funding has been provided in 2012 and 2013 primarily to further strengthen Community Mental Health Teams in both children’s and adult’s mental health services, to advance activities in the area of suicide prevention, to initiate the provision of psychological and counselling services in primary care, specifically for people with mental health problems and to facilitate the re-location of mental health service users from institutional care to more independent living arrangements in their communities. Key initiatives progressed by the National Office for Suicide Prevention in 2012 includetheprovision of a wide range of awareness and training programmes including safeTALK and ASIST (Applied Suicide Intervention Training) which trains participants to become more alert to the possibility of suicide in their community, the continuation of the National Awareness Campaigns which, last year, specifically targeted men and young men, the funding of partner agencies and projects and the development of the recently launched Guidance for Post-Primary Schools on Mental Health and Suicide Prevention developed with the Department of Education and Skills. 

National Drugs Strategy 2009-2016: The National Drugs Strategy sets out drugs policy in Ireland for the period up to 2016. Drugs policy encompasses five pillars - supply reduction, prevention, treatment, rehabilitation and research and clear actions are in place for implementation. Good progress is being made across the actions of the Strategy, with the involvement of the statutory, voluntary and community sectors. Progress continues to be reviewed through the Oversight Forum on Drugs which is chaired by the Minister of State, Deputy Alex White.

Suggestion to Legalise Cannabis: International research shows that significant physical and mental health risks are associated with long-term cannabis use. These include increased risks of developing lung and throat cancer (smoke from cannabis contains more carcinogenic tars than does tobacco smoke) and risks associated with the development of mental illness, such as schizophrenia and depression. The potency of cannabis products can also vary greatly. The 2011 NACD study The potency of THC in cannabis products reported the growing concern about the significant rise in the potency levels in some cannabis products over the last number of years, particularly in herbal cannabis. Concerns have also been raised that cannabis produced in Ireland, and used relatively quickly, has a higher potency than imported varieties. There is also evidence that cannabis plants generally are being genetically engineered to ensure they produce high levels of THC (tetrahydrocannabinol). Legalisation would be likely to lead to greatly increased levels of experimentation, leading to significantly increased levels of sustained long term use causing increased health problems in our society. Indeed, the situation that pertained only a few years ago in Ireland in regard to the volume of new psychoactive substances sold in headshops illustrates this point. People were prepared to experiment with readily available legal products, despite the publicity regarding the consequences. Legalisation would be unlikely to significantly reduce the level of criminality surrounding the broader market in illicit drugs. Also, if cannabis was legalised, it would most likely be strongly regulated and probably heavily priced to influence demand (as in the case of tobacco). This in turn could lead to the continuation of an illicit market on similar lines to the black market of cigarettes. Overall, the amount of money likely to be raised in tax would be small in relation to the health and other implications arising. Cannabis was re-classified from a Class C drug to a Class B drug in the UK in 2009. This decision was taken in the light of the "real public concern about the potential mental health affects of cannabis use, in particular the use of stronger forms of the drug". 

Finally, any possibility of legalising cannabis has to be looked at in a European and global context. A unilateral decision to legalise its use here would most likely lead to Ireland becoming a destination for those from other countries who wish to use cannabis. In view of the evidence available I am not in favour of legalising the use of cannabis at this time. 

Disability Services: The report, "Being Young and Irish 2012 – Take Charge of Change" from the Office of the President highlights similar issues considered by the Department's recent Value for Money and Policy Review of the Disability Services Programme which was published in July 2012. Minister Kathleen Lynch recently approved the National Implementation Framework of the Value for Money (VFM) and Policy Review of the Disability Services Programme which was published on the Department's website (www.doh.ie) on 28 February last. The development of the Framework is one of the key actions identified in Future Health, the recently published Strategic Framework for Reform of the Health Service 2012 – 2015. It supports the message coming through from Future Health regarding the need to restructure service delivery, and improve organisational, financial, governance and accountability systems with the aim of providing a more effective and more accountable service. The vision of the Disability Services Programme as set out in the VFM Review is "to contribute to the realisation of a society where people with disabilities are supported, as far as possible, to participate to their full potential in economic and social life, and have access to a range of quality personal social supports and services to enhance their quality of life and well-being". The recommendations in the Review describe how this vision is to be given tangible effect. The National Implementation Framework determines how the recommendations from the VFM Review are translated into concrete actions. It assigns responsibilities for those actions, and specifies time-lines for their completion. It also identifies priorities and key performance indicators. The Framework describes the project management and monitoring processes which are needed to make sure that the reform of the Disability Services Programme is achieved in a planned, timely and cost effective manner. 

The implementation of the recommendations in the manner set out in the National Implementation Framework will ultimately improve the lives of people with disabilities in the following ways: people with disabilities and their families will have more choice and flexibility in the services they receive and will have more control over how they access these services; services and supports will be tailored to meet individual need and will support greater independence and social inclusion; the move to individualised budgeting will be underpinned by a standardised needs assessment to ensure fairness and transparency in the way in which funding is allocated; supports and services will be delivered with greater equity, transparency and accountability and will be more cost effective. 

Alcohol: The report of the Steering Group on a National Substance Misuse Strategy 2012 contains a number of recommendations to, inter alia, reduce the consumption of alcohol in general and are grouped under the five pillars of Supply Reduction, Prevention, Treatment, Rehabilitation and Research. Real and tangible proposals are currently being finalised on foot of the recommendations in the report, primarily in the areas of legislation on minimum unit pricing; access and availability of alcohol; advertising and sponsorship. The Cabinet Committee on Social Policy has also considered the matter and it is intended to bring forward specific proposals for consideration by Government as soon as possible. In the meantime, work on developing a framework for the necessary Department of Health legislation is continuing. 

Tobacco: My Department is currently developing a new tobacco policy with the aim of de-normalising tobacco smoking that will lead to a tobacco free society. There is a particular emphasis on children. It is envisaged that this will be completed by the middle of this year.  

Dáil Éireann Debate
Thursday, 21 March 2013