Dr. Barry Cullen:

Across any particular health area, specialists and generalists are required and they need to work together. My experience of the drug issue over a long period has been that the generalist practitioner is happy enough to let the specialist run with it. While there is a need for integration among those who work within the specialist system so that they work together on providing continuity of care and a framework has been in place for more than 12 years that supposedly facilitates that – it is called the national drug rehabilitation implementation committee, NDRIC – I do not believe there was any reference to it at the citizens’ assembly, primarily because it had not been rolled out properly. There is a framework for the agencies on the front line to work together, but in the absence of engagement with the mainstream, every single element within the specialist sector that requires a mainstream segment just creates another specialism, leading to there being many fragmented specialist services within the addiction arena. Guiding this is the fact that, overall, people working in mainstream services do not want to work with people who are caught up in illegal behaviour. That is a large part of the problem.