Mark Ward (Dublin Mid West, Sinn Fein) | Oireachtas source

It is fine, work away. If it is good news the Minister of State can interrupt me. I have no problem with that.

According to the response from the HSE, CHO 3, which includes Limerick, Clare and north Tipperary, has been identified as the first adult diagnosis team and many of the team members have already been recruited. That is welcome. However, the response also stated that CHO 3 had recently identified possible issues with the building site and that the HSE was advised in December 2022 that a building inspection by an engineer is planned to take place, possibly in January 2023. I am not sure whether an inspection has taken place yet. We are now in February. It just seems to be another hold-up. I ask the Minister of State to find out what is happening with that.

CHO 4, which includes the Cork and Kerry teams, has been identified as the second adult dual diagnosis team site. The HSE said that as there were no applicants for the consultant post, external agencies, through the Public Appointments Service, have been involved in trying to recruit a consultant from other countries. Has any progress been made in filling this post yet? What concerns me is that the letter says the remaining posts in CHO 4 will only be advertised once the consultant has been identified. Why is this? Why can we not start building whatever multidisciplinary team is needed while there is a vacuum with the consultant psychiatrist? There seems to be an issue with recruiting consultant psychiatrists in the Kerry region in general at the moment with the Maskey report and CAMHS and everything else that is going on. While we are still looking, and I have no doubt that the HSE is actively looking for a consultant psychiatrist for this post, why can we not start recruiting the multidisciplinary team? That would make a lot of sense. The response also says that accommodation for this team has been identified and that it is co-located with the community alcohol programme and the HSE addiction services, which will enable better cross-divisional working. This is welcome but we need urgency around staffing this facility.

CHO 9 has been identified as the first adolescent dual diagnosis hub team site. It is welcome that adolescents are being looked at as well. A team will be advertised shortly in partnership with HSE social inclusion. This is positive but it is also not. I mentioned the Keltoi centre already. The HSE says that following discussions with CHO 9, it has been agreed in principle for the Keltoi centre in St. Mary's Hospital in the Phoenix Park to be used as the HSE's national dual diagnosis rehabilitation centre. Deputy Naughton's predecessor in this role, Deputy Feighan, was sick to the back teeth of me bringing up the Keltoi centre with him every chance I got. I welcome that there seems to be progress on this. The site was closed temporarily three years ago as part of Covid measures and then it stayed closed due to the emergency with international protection applicants and Ukrainian refugees. I welcome that it looks like the facility is reopening. This would make a real difference for those with a dual diagnosis who detox from whatever substance they had been addicted to. It is a vital facility for rehabilitation.

The reason I talk about it so often is that it is a facility I know very well from my previous role. I know it has saved lives. Previously, if someone was going into say Cuan Dara in Cherry Orchard for a detox and coming off whatever street drugs they were on or coming off methadone, there was no door-to-door service from Cuan Dara to the Keltoi centre. What used to happen was they would do their detox and then they might wait four, five or six weeks to go into the Keltoi centre. In that gap after they left, some people would have a relapse and go back to drugs. They would start using drugs at the same level they were using before they detoxed and they would overdose and sometimes die. I know a lot of people who would have passed away like that. There was a campaign on the ground by me and other front-line addiction workers at the time to close that gap and provide a door-to-door service. That way, people would finish their detox and could go straight into the Keltoi centre for rehabilitation. It was vital. Since that centre closed, that piece is not there anymore and it is a missing piece of the jigsaw. I urge the Minister of State to do everything she can to make sure that promise is kept and that facility is reopened.

In some CHO areas, we have the staff but we do not have the buildings and in others we have the buildings but not the staff. Let us put our heads together and see if we can get this working. We have a chance here to get this right. I will leave it at that. I am positive today. I had a good week this week. As I said to the Minister of State earlier, I had a good engagement with the HSE on CAMHS and I genuinely believe things will start moving in a positive direction. Hopefully with the programme of work around dual diagnosis that is coming in the next year, we can see progress on this as well. I thank everybody who took part in the debate and I thank all the staff for staying back for the late shift. I will shut up now so we can all go home.

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