Ms Niamh Randall:

Senator Dolan asked what are the issues beyond health. We need to ensure that there is an effective cross-departmental response to homelessness and housing issues. That means the Department of Social Protection taking action on income adequacy and rent supplement. It means education, training and employment opportunities. Once people move out of homelessness, it is important that they have meaningful occupations and an opportunity to engage in further training and employment. Housing is key because the link between health and housing is important. Ensuring that people have a stable housing environment is critical. If they have a stable environment, people, without prompting, will start looking at their drug and alcohol issues, reducing their levels of use and their mental health issues can become much more stable. We must ensure there is that support in housing because sometimes people might have a trigger, such as a trauma, and we might need to intensify that support in housing. It is critical that we have an open-ended, flexible response to support people. Income adequacy, a sense of tenancy security and stability, and ensuring that people have opportunities, such as those relating to education, training and employment, are key.

On the query about the ratio of cause and consequence, I have not come across anything that can definitively argue that. We often see people coming to our services after several things have happened to them. People do not become homeless and then end up in the Simon Community’s services. People often rely on friends and family for support. There is hidden homelessness whereby people are sleeping on floors and move around. When it comes to using services, it is difficult to work out what was the precipitating factor. The key point is prevention and early intervention. If we can intervene when people have health, drug and alcohol, or housing issues, we can intervene to stop this spiralling out of control.

Senator Colm Burke raised the issue of bedsits. We really welcomed the decision to look at this regulation. People were living in really awful circumstances, with poor quality accommodation and grown adults sharing facilities. There were also significant issues with health and safety, as well as a range of other matters. At this point, the real issue is the provision of social housing. The reason we are in this situation is because the State stopped building and providing social housing. We need to be clear that social housing provision is the solution. The quick fix to this is looking at vacant property throughout the country. There are approximately 200,000 vacant homes in Ireland and there should be mechanisms to ensure that they can be brought up to speed. We are awaiting the publication of the vacant homes strategy. It was due to be published before the recent Fine Gael leadership contest. We are now waiting for the new Minister, Deputy Eoghan Murphy, to publish it. It would be a really quick fix because these are low-hanging fruit due to the length of time it takes to build housing units. We need to be clear that this is the solution. My understanding is that there are approximately 1,000 bedsits remaining. Of those, between 50% and 60% would have fire and health and safety issues in any event. They would not be appropriate settings. We also need to look at quality of life for people. The last thing we need is people with mental health issues and ongoing pressures in their life living in tiny isolated places with poor light and space. It is not the way to go from our point of view.

We must look at diversity in housing provision. Up to 44% of those on the social housing waiting list are single people. Building three-bedroomed semi-detached houses around the country is not the way to go. We need to look at building a range of different types of accommodation and housing estates which can provide for people at different stages of their lives. Perhaps what we need to encourage is more residential mobility than we have. Often what happens is that people buy a home and it is a home for life. Maybe we need to look at opportunities for mobility. People often want to stay in their communities. If one had the opportunity to move into a smaller accommodation type within one’s community, more people might take up those particular options. We must look at diversifying what we are providing. We need to do it quickly.

Deputy Louise O'Reilly referred to children’s experience of homelessness. We know from research that children who experience housing instability and homelessness have a greater chance of experiencing homelessness in adulthood. We know this damage is being done. We are very much on the back foot on this issue. Additional supports have been provided in some of the bed and breakfast and hotel accommodation settings. One of the key issues is actually keeping children in school. Schools and teachers play an important role in this regard. One of the important developments was supports around transport to ensure that children could actually get to school. Some families were taking two or three buses to get their children to school because the setting they were in was so far away from the school. Having continuity and routine in school attendance is important. Again, the solution is moving people out of emergency accommodation quickly. It is about housing supply and, in particular, affordable housing supply.

Hidden homelessness is a really challenging issue. We know the number of people who are currently in emergency accommodation. We do not know the number of people who are struggling but we can guess. Figures from the CSO on overcrowding show that the number of people sharing housing has grown when the family size has actually reduced. We know there are increased amounts of overcrowding with people doubling and tripling up. Again, prevention is the key. If we can support people when we know they are at risk and vulnerable, that is important. Ensuring that there is enough information, advice and awareness in order that we can intervene quickly is key.

Medically supervised injecting centres are only one piece. They are a really significant and important development from a harm reduction and health promotion point of view. They are part of a suite of measures to respond effectively to drug and alcohol issues. We need a plethora of harm reduction services. We need naloxone and we need to look more progressively at heroin and opiate prescription and a range of other things. We need to look at criminalisation. We need to look at how we approach these issues, particularly at a time when people are making such changes internationally. We can learn from international experience but we need to be increasing beds. We need residential and detox beds. We need to ensure there are clear supports and referral pathways within the medically supervised injecting centres in order that if people make contact, especially people who are homeless, there is a real opportunity to make contact with people in a particular setting like that and link people in with further services and support. I will invite some of my colleagues in on some of those more practical issues and also the regional issues.