Joe Costello (Dublin Central, Labour)
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This is a serious health issue that has not received as much attention as others. I attended a packed meeting last Tuesday night in St. Bricin's, Arbour Hill, on the extent of prostitution in the general area of Montpelier, Arbour Hill, St. Bricin's and surrounding areas in the Oxmanstown and Stoneybatter part of Dublin. It was quite clear that there has been a considerable escalation in the incidence of prostitution in that area alone. Last month I tabled a question to the Minister for Justice, Equality and Law Reform. Arising from that he had two gardaí specifically appointed to patrol the area and to focus on prostitution and how to deal with it. Many young women and even children have been accosted by the clients of prostitutes, and even local residents have been accosted by the women and insulted if they said anything to them.

There is a serious problem. The statistics the Minister gave me on that occasion showed that there had been 115 arrests in 2002 and 117 in 2003 and that these were being processed. Last Tuesday night, the meeting heard that the two gardaí designated to deal with the matter had been effective in arresting 38 in the month of April alone. If this is multiplied by 12 that would be 456, which would be a fourfold increase on the numbers arrested either in 2002 or 2003. Once gardaí were dedicated to dealing with the issue, many more people were arrested. Clearly the issue is much broader than people had originally thought. It has undoubtedly escalated.

That is one side of the matter. The other side is the question of health. We know there is a considerable amount of sexually transmitted disease and that HIV, drugs and prostitution go together. The health of the clients must also be considered. They can be infected or, in turn, infect some of the women plying their trade. There is a major health issue to be considered and it remains under a shadow in terms of being effectively dealt with because the law criminalises prostitution and those associated with it.

Has the Minister of State a health treatment centre or liaison unit in place that would be proactive and outgoing and that could meet with prostitutes in a non-confrontational context to enable them to receive the health treatment they often need but may be afraid to seek out or which might not be available in the normal manner that health services are usually available? We need something of this nature to ensure the necessary checks and screenings for disease take place so that the health of the women is regularly reviewed and that a system of protection against sexually transmitted disease is in place. I would like to know what steps are being taken by the various health boards or the Department of Health and Children or the hospitals and whether individual local units or services are available. What is in place on a policy scale in broader terms to deal with this particular health problem?

Ivor Callely (Dublin North Central, Fianna Fail)
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Irish policy is that health care is available to all. The health boards have statutory responsibility for delivering these services. Deputy Costello focused on an area at the centre of the city so I will refer to the services being provided by the Eastern Regional Health Authority which has in place a women's health project whose aim is to promote the health and well-being of women involved in prostitution. The Deputy said this should be provided in a——

Joe Costello (Dublin Central, Labour)
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In a non-confrontational manner.

Ivor Callely (Dublin North Central, Fianna Fail)
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That is the manner in which it is provided. The women's health project provides a wide range of services including user friendly drop-in clinics, sexual health screening with contraception advice and provision, cervical smear screening, STI screening, hepatitis C, and HIV testing with pre-test counselling, vaccinations, addiction services, community welfare advice, outreach services, training and most important, education. The women's health project liaises with other agencies to identify the specialist needs of women trafficked into the country for sexual purposes to assist in developing appropriate services. The project is represented on the eastern regional committee on violence against women and on the ERHA working committee to deal with needle exchange and health promotion for the national drugs strategy. The ERHA also provides funding for Ruhama, a religious voluntary organisation that works with women involved in prostitution and trafficked women. It provides a full range of services to women involved in prostitution to ensure full utilisation of health board facilities or other services as appropriate.

It is important to recognise that it is not just women who are involved in prostitution. In this regard, the ERHA funds the Gay Men's Health Project which promotes sexual health among gay, bisexual and other men who have sex with men. All men attending for the first time are encouraged to have a full STI screen and blood tests for HIV, and other sexually transmitted diseases. Outreach and counselling services are an important function of GMHP. The service provides one-to-one support and advice on sexual health, STIs and screenings, isolation and relationship problems. Education is a very important aspect of raising awareness of the dangers of engaging in risky sexual behaviour which could result in a sexually transmitted infection. Health boards undertake information and awareness activities at regional level and among the issues addressed is the prevention of sexually transmitted infection. The ERHA is developing a sexual health strategy which focuses on prevention and management of STIs. One of the recommendations of that strategy will be that support for services available to those working in prostitution should continue to be provided.

The health promotion unit of my Department in conjunction with the Crisis Pregnancy Agency has commissioned a national survey of sexual knowledge, attitudes and behaviours. This survey will provide robust and comprehensive data to effectively plan sexual health policies and strategies and to inform effective approaches to promoting positive sexual health messages. This information will assist efficient allocation of resources and provide quality baseline data for future surveys to monitor change over time and allow for long-term planning. In addition the HPU continues to invest in ongoing education and awareness strategies, for example, the convenience advertising campaign which runs nationwide in pubs, clubs, colleges and places of entertainment. The HPU is also working with the CPA to deliver integrated sexual health messages, most of which specifically target the I8-35 age group. There are specific services in place to protect the health of those involved in prostitution and I am confident these services make a difference to the lives of the people concerned.