Mr. Tom O'Brien:

The HSE is only one part of the continuum of care. The external review has suggested recovery is the way to go. In the past it was treatment based. It was a 15 to 20 year old service that was focused on methadone. There are discussions at the methadone implementation committee on using buprenorphine and naloxone treatments. We have also recognised that there is a serious gap when somebody leaves one of our recovery centres and moves into a treatment or homeless environment in which others are using. We have met Mr. McAleenan to discuss a new step-down facility which will, I hope, have no time limit in getting people into a new facility where there would be ongoing treatment and counselling supports available for them. The area manager in HSE Dublin North has passed this. We are developing a national approach to service provision.

In Waterford where I am from and Dublin there is a difference in the treatment options available for clients. The national addiction advisory group, together with the HSE and Mr. Pat Dunne, assistant national director for primary care, are looking at standardising the clinical approaches to treatment. That is also a recovery model. We know that in many cases people have been on methadone for too long and that we need to offer alternatives to them. We are, therefore, looking at that issue also.

I am working as part of a sub-committee of the advisory group on an ICT system with a case management piece which will follow clients through their recovery process. I hope that ICT programme will produce data indicating the gaps in an individual's treatment options. The HSE is also bringing service users on to its boards of management and boards of rehabilitation and we are looking at producing updated leaflets for clients on what types of care service are on offer to them outside methadone maintenance only.

There is a great deal going on. Our review coincided with the report and it is interesting that both found that the recovery model and the service user are central to the process.