Deputy Maureen O'Sullivan: I wish I was not addressing this issue, but I am very happy it was chosen and that I have the opportunity to highlight two programmes working with those in alcohol recovery whose funding is being cut. Barrymore House will be temporarily closed for the month of June. It is the only residential treatment programme for problem drinkers and gamblers in the north eastern HSE region. Áit Linn has 74 active clients, which means that 74 families are being supported through the programme there. Referrals come from the individuals concerned, their families and communities, social workers, nurses, doctors, the GPs in the area and Beaumont Hospital and the Mater hospital.

These programmes offer 12 weeks of psycho-educational sessions which look at the health and psychological effects of alcohol misuse. They also look at the triggers for relapse during that period. The clients go into a treatment group for a minimum of 26 weeks. In the course of those 26 weeks, they help people to adjust to abstaining from alcohol and the pressures of being abstinent. They also offer couples therapy and family therapy. Social workers may be involved in cases if there are issues of institutional, domestic or sexual abuse. A further 26 weeks of aftercare are offered. During the aftercare period, a lot of work is done re-establishing the client within the family. They work on employment and education and also support people as challenges arise. Individual and group counselling is also offered.

All of this proves that the cycle of addiction can be broken and that those in recovery can heal and transform their lives. In my opinion, which I am sure is shared by the Minister for Health, we have reason to expand that kind of service and not to cut it. The centres also have a waiting list, but people on it will be supported through motivational interviewing and client-centred counselling; therefore, there is a link with people while they are waiting to go on the programme. There were 180 referrals in 2014. They run a weekly walk-in clinic in Beaumont Hospital in conjunction with liaison psychiatry there. It is a brief intervention clinic. Áit Linn is seeing a significant take up of places on its programmes from people who have presented at Beaumont Hospital and the Mater hospital with alcohol-related issues. They provide training on alcohol misuse to Dublin City Council's social work team to use with council tenants who have tenancy issues relating to alcohol misuse. They have held conferences and were involved in the Strengthening Families programme for parenting in 2014. They also provide support and training for organisations who work with the homeless like the Simon Community. They also constantly review and evaluate their programmes.

We know that there is an escalating tide of alcohol-related physical and mental harm. Here are two programmes that are trying to address that issue.  We know that the cost of alcohol misuse to the country is approximately €3.7 billion, while the HSE addiction service budget was reduced by €2.5 million for 2015. A decision was made at national level that each health directorate would receive what it spent in the previous year so funding was taken from addiction services and reverted back into primary care. Addiction services must be separate, although they are part of primary care in a certain way. We cannot afford to cut programmes for those who want to recover. The Minister knows that catching people at that optimum moment when they are motivated to try to overcome their addiction is crucial and both of the programmes to which I refer do exactly that. I await the Minister's response with interest.

Minister for Health (Deputy Leo Varadkar): I thank the Deputy for raising this matter. This Government is committed to tackling alcohol misuse in Ireland and the widespread harm it causes. Alcohol is causing significant damage across the country, affecting the workplace and children and imposing a substantial burden on all in Irish society.

The Public Health (Alcohol) Bill which my Department is currently drafting is a part of a suite of measures agreed by the Government in 2013 on foot of the recommendations in the steering group report on a national substance misuse strategy 2012.  The Public Health (Alcohol) Bill incorporates a number of the recommendations in that report and addresses the underlying factor behind alcohol misuse, namely affordability, availability and attractiveness.

The Health Service Executive national service plan 2015 aims to progress the implementation of the national substance misuse strategy including the community mobilisation pilot on alcohol initiatives in five drug task force areas and the further development of a co-ordinated approach to prevention and education interventions in alcohol between all stakeholders including third level institutions. The HSE provides services to prevent and treat addiction to alcohol. People who present for alcohol addiction treatment are offered a range of interventions namely initial assessment, comprehensive assessment, the Minnesota Programme, brief interventions, individual counselling, self-help, peer support or a combination of these. The delivery of these services is based on the four tier model of treatment intervention and services are designed to respond to the individual's specific identified needs. This care model implies that clients should be offered the least intensive intervention appropriate to their need when they present for treatment initially. Interventions range from community and family based supports and primary care services through to specialist support services either in the community or residential settings….

[For the full debate, click on this link to the Oireactas website]