Dr. Austin O'Carroll:

We are going to share the questions. Senator Dolan raised the issue of cause and consequence. I agree with Ms Darcy. To clarify, I work as a GP in inner city Dublin, but I have also worked in many homeless hostels since 2002. I see some of my patients in my surgery, in homeless services a few months later and back in my surgery a few months on again. As Ms Darcy stated, this is because poverty is the key cause of homelessness.

The majority of people who end up homeless do so because of poverty, but the mechanisms of how they end up there are complex. When I first started, there were two main mechanisms. Drug addiction played a large part. It is endemic in poverty and intrinsically associated with it. Mr. Alastair Storey refers to how there is a cliff at the edge of poverty, namely, homelessness. Many people end up in homelessness because of drug addiction. The dilemma then is that their addictions get worse. The same is the case with alcoholism, which was the classic stereotype of a homeless person in the 1990s. It is the same mechanism. It was probably more spread throughout social society than just in poverty, but it was more concentrated in the latter.

Since the recession, drug addiction has worsened in the inner city, which is affecting the homelessness figures, and alcoholism is re-emerging. We see many people involved in polysubstance abuse - drink and drugs. It is a major problem because it is very difficult to treat such people. While it is not easy to treat either on its own, having the two together makes it incredibly complex.

Everyone agrees that the main issue in recent times has been economic homelessness. It is worsening. I saw two people this week, one on Monday and one yesterday, who had become homeless. In recent weeks, I have seen more and more patients who have become homeless because of poverty. I referred to "economic". As with the person whom I saw on Monday, people can become stressed out because of, for example, the pressure of being a single parent or managing in the social welfare system. They might miss one rental payment. Landlords now have no sympathy and, because the market is so intense, people are out if they miss a rental payment. The situation is complex, but the real issue is poverty.

Another issue is a self-created one, namely, the lack of social housing, which Ms Darcy discussed. Ireland has 7% social housing. In the Netherlands, the figure is 33%. That is a significant difference. As we all know, our social housing stock has shot down since the 1980s. I will revert to the question of social housing when we discuss the bedsit issue, but Dr. O'Reilly will answer some of the other queries.