Home > Dail Eireann debate. Topical issue debate. Drug treatment programmes availability.

[Oireachtas] Dail Eireann debate. Topical issue debate. Drug treatment programmes availability. (28 Sep 2017)

External website: https://www.oireachtas.ie/en/debates/debate/dail/2...

Deputy Frank O'Rourke:  It is nice to have the opportunity to speak about this issue again with the Minister of State, but I am disappointed there has been no movement regarding drug treatment services or the setting up of a proper drug treatment centre in Kildare. Given Kildare has a population of 220,000 - 120,000 in north Kildare and approximately 90,000 in south Kildare - it is not good enough or acceptable that these resources are not in place. This has been an ongoing issue that I have raised in the Chamber with the Minister of State for over a year. I do not like having to reintroduce it into the House but I must try to have it progressed. Even in correspondence from the Minister of State herself, the Department and HSE officials, they have identified the lack of resources regarding a drug treatment centre in Kildare as urgent and a priority. That is the way they have categorised it. They have also identified that they had hoped to put the service in place in the last quarter of 2017. That is what was stated in the correspondence I received from the Department. Now we are in that quarter and, to the best of my knowledge, the service has not been put in place and there is not the wherewithal to make it happen anytime soon. That is unfortunate, extremely disappointing and no longer acceptable or good enough. At present our nearest drug centre is in Dublin, and the HSE will tell us when we make representations on behalf of individuals who need this urgent drug treatment service that there is a nine-month waiting list. That is wrong. I have factual information to show that people are waiting up to 18 months. They are deemed urgent, important or critical but they are still waiting up to 18 months and have not got the service they require. I have advocated for some time for community groups such as the Abbey Community Project Celbridge to get some State funding. It is currently without any State funding. The only support it gets is bucket collections. I hope this can be moved on and we can support such groups to help in cases such as these where dual diagnosis is required.


This feeds into the area of mental health, which we know is another area of critical need and support. These community groups are the people providing the services to help these individuals who require these drug treatment services and support which is not being provided. Four different families have contacted me in the past week whose loved ones were deemed suicidal, and the only service offered to them is referral to an accident and emergency department. We all know that the accident and emergency departments are not adequately equipped, do not have the appropriate supports and probably do not have the proper staff to deal with these individual priority cases that are specialised. They must be retained and managed there until such time as the necessary support and resources become available. They are being treated in an environment that is not good for them and is adding further stress to them and their families, not to mention the fact they are taking up resources, such as hospital beds, that may be urgently required for patients who need that care and attention.


I hope I have painted the picture, which I regret to have to do again only a short few months since last raising this issue in this House. The fundamental issue is when this drug treatment service and support will be put in place for Kildare and where it will be located. The latter is important from an access perspective. It should not be located in either extreme of the county. For individuals and families who are really struggling and need to access this service, sitting around waiting 18 months for it is not good enough. Being told they must travel to Dublin, where they cannot access support very easily because of infrastructure and a lack of transport at times, is not easy either. I await the Minister of State's reply.


Minister of State at the Department of Health (Deputy Catherine Byrne):  I thank Deputy O'Rourke for raising the issue of the provision of a drug treatment centre in Kildare. As the Deputy is aware, problem drug use continues to be one of the most significant challenges facing our country and is becoming more complex with a wider range of drugs being abused.


I wish to emphasise the Government’s commitment to tackling the drug problem. In July this year, together with the Taoiseach and the Minister for Health, I launched Reducing Harm, Supporting Recovery: A Health-led Response to Drug and Alcohol Use in Ireland 2017-2025. This document sets out the Government's strategy to address the harm caused by substance misuse in our society up to 2025. The vision of the strategy is to create a healthier and safer Ireland. Reducing Harm, Supporting Recovery emphasises a health-led response to drug and alcohol use in Ireland, which is based on providing safe, person-centred services that promote rehabilitation and recovery. It contains a series of actions which aim to reduce waiting times, provide greater equity of access to services around the country and remove potential barriers to accessing treatment by those with complex needs. Specifically, Reducing Harm, Supporting Recovery requires the HSE to identify and address gaps in provision in a range of settings across the country, including tier 3 treatment and rehabilitation services which provide specialist interventions, such as opioid substitution treatments. The intention is to increase the number of treatment episodes provided across the range of services available and strengthen the capacity of services for individuals with high support needs. As part its commitment under the strategy, the HSE will also examine potential mechanisms to increase access to opioid substitution treatments.


During 2017 in the region of €700,000 in funding has been allocated by the HSE to voluntary organisations in the South Western Regional Drug and Alcohol Task Force area, which includes Kildare, to help individuals with substance misuse problems and their families. In addition, the HSE provides counselling and outreach services in a number of locations in Kildare. A total of 112 people are currently accessing specialised services provided by level 1 and level 2 general practitioners, 145 people are accessing services through community pharmacies in Kildare and 74 people travel to Dublin for specialist treatment. At the end of July, 25 Kildare residents were on the national methadone waiting list.


The Department of Health is seeking resources in the Estimates process for 2018 to support the implementation of the new strategy. The outcome of this process will determine the funding available to address gaps in the provision of treatment and rehabilitation services. The question of a dedicated specialist treatment centre for Kildare will be considered in this context.


Deputy Frank O'Rourke:  I thank the Minister of State for her reply. With the greatest of respect to the Minister of State, I am still without much detail and I would much prefer to discuss this with her without a stock reply because that would have much more meaning and substance. The reality is that the information she has given me I have received from her on numerous occasions during the past year. I am well aware of not only the number of people who have been treated through GPs and pharmacies, but also the increasing number that must be treated in Dublin. The problem is that a number of families have been waiting 18 months to get on a methadone programme. I have made numerous representations on behalf of these families and they are still no further on. Some of them this week have presented as suicidal. That is the crux of the matter. I know the Minister of State is well-meaning and I understand she will try to do her best but I have been patient with the Government and her Department in this regard. I have correspondence dating back 12 months telling me this will happen, all things being equal, in the last quarter of 2017. Families have struggled, they have been patient and they have waited in the hope that this much-needed service will be provided. However, we still have no comfort this evening for the families sitting at home looking after loved ones who are waiting to get on one of these methadone programmes, who have been on a list for 18 months and who are at their wits' end, threatening suicide. That is the problem. While the Department waits to deliver the treatment service and treatment centre in Kildare, I respectfully ask the Minister of State to increase the resources in order that the people in need of this service in Kildare can access it as a matter of urgency. Perhaps she would do that for me as a matter of urgency. There are people who need this service, and it is not me identifying this need; clinical analysis has been done showing this need to access services. Will the Minister of State therefore increase the investment in this area to get these people the service they need next week while waiting to get the much-needed service into Kildare that we have been promised?


Deputy Catherine Byrne:  As I already said in my reply to the Deputy, one of the actions as part of the new strategy focuses directly on Kildare as well as a number of other areas as regards increasing the service on the ground. One of the problems that has arisen over the past couple of months is getting other tier 1 and tier 2 doctors to participate in methadone distribution and other services.

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