Mr. Andy O'Hara:

It goes back to looking at the people who are most marginalised, namely, people who use drugs and their families and communities. That is a collective. We have to have a strong infrastructure and framework because they are the people who will identify the emerging issues and gaps and then guide the collective responses. To answer the Deputy’s question around how we best identify where the gaps are, unless we are relying on that critical infrastructure, which is informed by national networks, we will always be at a loss. We will end up having another citizens’ assembly in ten years’ time and we will wonder how we got there. Going back to the Deputy’s question, there is evidence on all of the stuff we are saying here. There is international research. This is not the 1980s any more; we are not fumbling around. We have the research, evidence and models in this country but we have to trust in them and we have to share power.

The Deputy’s next question related to stigma in GPs and access to GPs. Stigma is massive and across the board. First, we have to understand how embedded in the system as a whole it is. It goes back to how we criminalise and stigmatise people because that informs people’s approach. They see people who use drugs as maybe less than them or that they have to decide for them. That leads to a harmful approach. This is why it is important to do advocacy. We have hundreds of advocacy cases and engagements where we know people are being discriminated against in GP settings. We know even around the country people cannot get into opioid agonist treatment, OAT, clinics because there are waiting lists. There are responses out there around nurses prescribing which are evidence based but they are not being implemented. Again, if you listen to people who use drugs, they will identify where the gaps are and we will be able to develop the collective response. It is about trusting people and believing in their agency to have power to be able to drive forward with the change.