Mr. Aaron O'Connell:

Deputy O'Connell asked about the impact on people living in hotel accommodation. One of the dangers in the provision of temporary accommodation is that it can seen as a long-term solution. We need to be really clear that it can never be that. There are not just huge difficulties for children, it puts stresses and strains on relationships and this doubles back onto children, causing trauma and stigmatisation. The housing crisis is driving the crisis in homelessness and the related health issues. We need to plan for a long-term solution to this problem.

Senator Colm Burke referred to the situation in Cork. We have tried to focus on pushing for long-term stable accommodation where people have their own front door. Deputy Durkan mentioned sheltered housing. There is a place for everything and a one-size-fits-all approach does not necessarily work. The more independence we can create, the better people's health and well-being will be and consequently, we need a range of options. Some people are transient and we had such a case in Cork. The GP with the adult homeless team made a decision and the person was involuntarily admitted for treatment. Such cases are exceptional but they also require responses. There may be additional costs but if the services do not provide for such people we need to ask why they are falling into that scenario. What preventative measures can be taken? Everybody is different and we deal with individual scenarios as they arise. We should not lose anybody simply because of putting a cost per head on a particular provision. Everybody needs to be valued equally and the best way to provide for these people is to have a spread of services and access to them, wherever they live. Community services in such areas need to be flexible and aware of the complexity of the issues with which people present, particularly those with issues related to addiction and mental health. All front-line services need to be versed in these issues and to upskill as necessary. Everybody needs to understand at what stage people are in the continuum of provision. The services need to support each other and while we can be critical of the HSE in many ways, the adult homeless team in Cork is working very well. It is a classic case of partnership working and people adapting to work together. The difficulty is that there is not enough of this and there are gaps in nursing hours, occupational therapy etc. We need to resource them and make them more effective. The work is collaborative and innovative, and is exemplified by Dr. Austin O'Carroll in Safetynet Primary Care. Such things show the way and it is really important that the upper echelons of the HSE understand that they are effective and need more support.