Frank Feighan (Sligo-Leitrim, Fine Gael) | Oireachtas source

Today's debate brought back a lot of the love Dubliners have for Dublin, but around the country we have a great love for Dublin as well. I think of the happy times coming up on the Sligo train, maybe to support Sligo Rovers or Roscommon, Leitrim or Sligo - anytime we could beat Dublin, which was not too often. I always remember those great days and happy times. It was a time before mobile phones, when the people of this country always met under Clerys' clock and then made their way around. Deputy Hourigan is right that many people from around the country have made Dublin their home. I see Deputy Durkan, who made his home in Kildare, in the suburbs of Dublin. I think of last summer and the beautiful time I had with my family. We came up to Dublin and took the DART out to Dún Laoghaire and the 46A back in, sitting up at the top of the bus. We went to all the usual places. They cost nothing. You can walk down Grafton Street or around Merrion Square or the Phoenix Park or just take a walk along the Liffey or through Temple Bar and you realise that Dublin is a beautiful city. There was huge positivity here today, and that is lovely to see. I think of places such as Trinity College, the Guinness museum and brewery, and Christchurch and St. Patrick's. I think of going to Croke Park, Dalymount Park and Lansdowne Road, as we still call it, and even Glenmalure Park and Richmond Park. Those are really happy memories. Dublin is our capital city and we are very proud of it. It has a long history, of which we are also very proud.

There are significant challenges facing individuals who are socially excluded in Dublin city centre, particularly those who are homeless and living with addiction. That is part of my brief, which I wish to talk about. As Minister of State with responsibility for the national drugs strategy, Reducing Harm, Supporting Recovery, I have lead responsibility for co-ordinating the implementation of the strategy across Departments and Government agencies. The national drugs strategy promotes a more compassionate and humane approach to people who use drugs, with addiction treated first and foremost as a public health issue. It is underpinned by the key values of compassion, respect, equality and inclusion. It is a priority for the remaining period of the national drugs strategy to 2025 to develop integrated care pathways and harm reduction responses for high-risk drug users, including people who are homeless, offenders, stimulant users and people who inject drugs, so as to achieve better health outcomes. These high-risk drug users have complex health and social care needs that make them vulnerable to drug overdose and premature death. Integrated care pathways are required to deliver the best outcomes for this cohort. Those pathways connect care settings between GPs, primary and community care providers, community specialist teams and hospital-based specialists. The experience of the Dublin Covid-19 homeless response provides a template for integrated care.

A key outcome indicator will be the reduction in drug deaths. Strengthening harm reduction responses to high-risk drug use associated with the nighttime economy, including proposals for drug monitoring, forms part of this priority. It is important we show compassion and understanding to people who are affected by drug addiction. As I have said before in this House, using stigmatising language makes it more difficult for these people to access services.

The Department of Health has worked closely with the HSE, drug and alcohol task forces and community-based organisations to provide services for socially excluded groups in Dublin city centre. Those services receive funding of €6.3 million per annum, including funding provided through drug and alcohol task forces. I firmly believe that addressing drug addiction and homelessness in Dublin city centre requires a multipronged approach, providing harm-reduction and prevention initiatives in tandem with treatment services. I wish to inform the House of the following harm-reduction health initiatives for marginalised people in the city centre.

During the Covid-19 pandemic, people with addiction issues and those who are homeless were identified as a vulnerable group. Additional funding of €4.2 million was provided to the HSE to expand opioid substitution treatment in 2020 and 2021, with an additional 1,000 clients given access to treatment. The HSE funds an assertive case management team involving Ana Liffey and Coolmine, working with people who are homeless in emergency accommodation in the city centre. That team also does outreach work with people who are homeless on the city streets. The HSE and Dublin City Council fund the law engagement and assisted recovery project in Dublin city centre. That project provides intensive case management services to people entrenched in street life in the city centre, specifically Middle Abbey Street, O'Connell Street and Talbot Street. Ana Liffey also provides city centre outreach and accessible nursing interventions daily to prevent overdose, to provide needle and syringe equipment, including sterile crack pipes, and to address drug litter in the city. It uses a mobile unit and an on-foot backpacking service. This service also trains peers in the use of naloxone, a lifesaving drug in the event of an overdose. I understand that this service works with approximately 350 individuals per annum.

Housing First is a housing model that aims to eliminate homelessness for people with a history of long-term rough sleeping who have complex needs around substance use and mental health. It provides direct access to permanent housing together with intensive housing and health supports, delivered mainly in the person's new home. From a health perspective, Housing First can be viewed as Sláintecare in action: the right care in the right place at the right time. Housing First is an expression of the Government's determination to break the vicious cycle between homelessness and ill health. As a social determinant of health, being homeless worsens the physical and mental health of those affected and makes people more vulnerable to problematic drug and alcohol use. Furthermore, homelessness undermines the effectiveness of healthcare services as it creates additional barriers for people in accessing treatment in a timely and integrated manner.

I reiterate my support for the establishment of a supervised injection facility in Dublin as a public health response to the high incidence of drug-related deaths due to heroin overdose in the city centre. The supervised injecting facility will save lives and reduce street injecting and drug-related litter in the locality. In budget 2023 we secured €4 million to expand the provision of drug and alcohol services to meet changing patterns of drug use and emerging trends. These services will benefit people in Dublin city centre. This investment will expand community-based drug and alcohol services, ensure the sustainability and increase the capacity of residential treatment services, mitigate the impact of drugs on children, families and communities and strengthen drug monitoring and harm reduction. It is anticipated that this additional investment will lead to an increase in numbers accessing drug and alcohol services across all regions; better supports for children and families affected by parental drug and alcohol use; more women and men in recovery from addiction; and a reduction in drug-related harms, overdoses and deaths.

I thank all Deputies who contributed to this debate on supporting the development of Dublin city centre through safety initiatives and the appropriate provision of emergency and other services. I acknowledge Deputies' concern for people who are homeless and living with addiction. I assure them of my commitment to continue to improve healthcare services for this vulnerable group. It was a very measured, useful and informative debate.

One area which I think Deputy Hourigan raised was the upcoming citizens' assembly on drug use. The citizens of Ireland have strong emotions and differing opinions on the use of drugs. I think that this citizens' assembly, which will happen early in the new year, will give potential contributions to the Government's health-led approach to drug use.

All members of society are directly or indirectly affected by drug use. This assembly will be another wonderful way of involving citizens in decision-making on our drug policy. That is appropriate. The community knows best and I look forward to the assembly taking place early in 2023. Arrangements are already in place to hold this assembly.

It has been a positive debate. Dublin is a magnificent city. It is our city, a city of Ireland but also a city of Ireland and the UK. Many people have come here from the UK, Europe and across the world. We are all proud of our city.

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