Home > Seanad Éireann debate. Commencement matters - Community care [Community based services].

[Oireachtas] Seanad Éireann debate. Commencement matters - Community care [Community based services]. (14 Sep 2022)

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

Senator Mary Seery Kearney: I appreciate the Minister of State taking this matter at short notice. CityWide Drugs Crisis Campaign has highlighted in advance of budget 2023 that drug and alcohol task force community projects are places where lives are changed and lives are saved. These organisations do extraordinary work. During the past year, in one drug task force area in which I have experience, alcohol and cocaine were the most common drug problems. There was an increase in cases treated for cocaine of 83%. Alcohol treatment also increased twofold with twice the numbers supported compared to 2020 and 2021. Benzodiazepine cases increased in the same period by 150%. The task force area also experienced an increase in drug debt intimidation.

These are exceptional projects and they have not had their funding restored since the savage cuts of the recession that was triggered by the banking crisis. There has been no increase in core funding since 2013. They are serving more people in the community with less money than they had prior to 2011. In the meantime, the cost of everything has increased, especially now we are facing an absolute crisis. I acknowledge there have been strands of ad hoc funding such as strand 2 in 2019, cocaine money in 2022 and the community enhancement fund in 2022. As much as they are welcome, they are normally for new initiatives and do not contribute to the sustainability of projects and core funding.

I want to paint a picture of a current situation faced by the St. John Bosco Youth Centre, an exceptionally well-run centre. They have taken great steps with their efficiency and prudent governance decisions to maximise their funding in the service of their community. I have their permission to share their experience. Their building is 1,500 sq. m. It was built at various stages by the community of Drimnagh between the 1950s and 1970s. The centre opens seven days a week, 51 weeks a year. It is open in excess of 90 hours a week. It is used by a wide variety of groups, including youth work projects, Youth Café, Montessori, Merchant's Quay Project, Solas youth justice project, addiction support groups and the Dublin 12 drug and alcohol task force. It is also utilised by different nationality groups as well as for community events. The centre sees 600 people in its services and activities daily. The Bosco has an exemplary record of managing its finances and has shown itself to be a really resilient organisation over its 70 years. It has a record of being extremely prudent and has demonstrated through the cuts in its energy bills that it has taken steps all along to make the most out of the money it has and to be as sensible as possible in the decisions it makes. However, on 22 September the centre will run out of contract with its gas supplier. That will bring it from 2.5 cent per kWh to possibly 17 cent per kWh, a sevenfold increase in the cost. To put this as an average monthly cost, it will go from €700 a month to €4,900 on average.

The current energy crisis represents a big threat to the community and voluntary sector. I would say it poses an even bigger threat than Covid did as it does to our whole society. Just as the development of vaccines and effective public health measures were the way to minimise the threat of Covid, there is an urgent need to put in place a plan to limit the cost impact on organisations within the community and particularly for those who are struggling with drug addiction. We hear all about business supports. We hear about the cost of living interventions. I have great faith in what is going to be in the budget. We hear about lots of other measures but it is really important that no one is left out. Community organisations, especially in the space of drug prevention, treatment and support must be sheltered from the storm of the cost of living. The most vulnerable must be protected. I am asking that there is advocacy and a strong voice in this place to make sure these organisations have their core funding increased to meet the cost-of-living crisis.

Minister of State at the Department of Health (Deputy Frankie Feighan): I thank the Senator for raising this issue. I welcome the opportunity to update the House on funding for community-based drug and alcohol services and acknowledge the role of Senator Seery Kearney as chairperson of the Dublin 12 drug and alcohol task force.

Senators may be aware that the Department of Health completed a mid-term review of the actions in the national drugs strategy, Reducing Harm, Supporting Recovery, which, as Senators are aware, is a health-led response to drug and alcohol use. Based on the learning from the mid-term review, six strategic priorities for 2021-25 were identified. One such priority is to enhance access to and delivery of drug and alcohol services in the community. The priority seeks to enhance community care for people who use drugs by providing health and social care services at the community level to meet identified health needs. This will be supported through the development of a drugs services care plan formulated on the basis of the six new health regions agreed by the Government in 2019. A particular focus will be put on ensuring access to services for women, people in rural areas, ethnic minorities and the LGBTI+ community. This priority will consider models of care for people who use drugs and have comorbidities. It will also address the stigma linked to drug use and drug addiction and its impact on access and delivery of health services.

I am happy to inform the Seanad that, as the Senator outlined, in December 2021 I created a €2 million fund, namely, the community services enhancement fund, to enhance community-based drug and alcohol services. The fund supports the aforementioned strategic priority under the national drugs strategy for 2021-25. The Department also provides €28 million for 280 community-based drug and alcohol services annually.

Under section 39 of the Health Act 2004, the HSE provides financial assistance to organisations by means of a grant. Section 39 legally underpins the provision of services similar or supplementary to a service the HSE may provide. In October 2018, an agreement was reached by the parties at the Workplace Relations Commission, WRC, in respect of a process of pay restoration for staff employed in section 39 organisations who met certain criteria, rather than the types of individual workers who are employed in them. Only organisations that received in excess of an agreed specified amount from the HSE by way of the service level agreement process were included. It must be acknowledged that section 39 organisations are privately owned and run and that their terms and conditions of employment, once in line with employment legislation, are strictly between the employer and the employee.

During the Covid-19 pandemic, the Department developed a framework for the restoration and continuation of drug and alcohol services in a planned and appropriate manner in line with public health advice. To support the framework, the Department provided once-off funding of €480,000 in November 2020 for the restoration of drug and alcohol services, including the adaptation of services and premises, online meetings and personal protective equipment. The Department also provided an additional €2 million for residential drug and alcohol treatment services in 2021.

Senator Mary Seery Kearney: I thank the Minister of State but what we really need to know is that, when it comes to budget 2023, the cost-of-living hike and crisis that are facing these organisations is going to be met with increased core funding. While I appreciate the initiatives that have been taken - the community enhancement has certainly been valuable - it is the core funding that actually needs to be increased. Even if we did not have energy, cost-of-living and inflation crises, 2013 was an awfully long time ago. How can extraordinary organisations such as the St. John Bosco Youth Centre meet a jump from €700 to €4,900 in its average monthly energy cost?

The answer to that is they cannot do so without shaving either staff or services to the 600 people who attend their premises every day. While the prevalence of drug use is the same across all societies and sectors, the greatest impact of drug use is where there is greatest deprivation. Such communities are in a stranglehold. We must make sure community organisations are safeguarded and strongly supported.

Deputy Frankie Feighan: I am very much aware of the increased financial pressures being exerted on community-based drug and alcohol services as a result of inflation and the increased cost of living. The Senator outlined the case of the St. John Bosco Youth Centre in Drimnagh. The fact that the gas contract price has gone up from 2.5 cent per kilowatt hour to possibly 17 cent per kilowatt hour or from €700 to €4,900 per month is unsustainable. My officials and the Government are very aware of the matter. The additional operating costs for community-based drug and alcohol services and other section 49 services will be considered as part of the 2023 Estimates process.

I thank the Senator for raising this issue. It is a significant concern for these services and services across the board. My Department is taking this on board. The next two weeks will be interesting but we hope the matter will be addressed in the budget. I have brought this message very clearly to the Minister for Health and the Minister for Finance.

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