Thursday, 24 January 2019
Saincheisteanna Tráthúla - Topical Issue Debate
Drug and Alcohol Task Forces
I wish to raise with the Minister of State the level of funding for the local and regional drug and alcohol task forces. I thank the Minister of State for the time she took last week to meet and update me on the progress of the implementation of the current drug and alcohol strategy. During that meeting we discussed a number of issues. One issue I highlighted was my concern at the level of funding the local and regional drug and alcohol task forces receive. That funding relates to regional and local drug and alcohol task forces. I believe that the Minister of State is sympathetic and that she understands the problem. The problem is that we have to convince the Minister of State's colleagues and members of Government that this issue needs to be addressed.
It is worth putting onto the record of the House that the proposed funding for 2019 is exactly the same level of funding that was made available in 2018. The 2018 finding was the same as the 2017 budget, as it was for 2016, 2015 and 2014. For all of those years the budget allocation has been the same. In 2014, there was a reduction on the previous year of 2013. I understand and acknowledge that we have had a recession but we have come to a point in recovery. Drug and alcohol task forces are primarily funded by the HSE and the Department of Health. Funding going into the parent Department is increasing significantly year on year, but these projects are being left behind. The projects are struggling to survive and maintain the existing level of service, to pay the salaries of those people employed, and to meet new and emerging challenges. They are under huge pressure.
I have asked these questions in the past and I am aware that in her reply the Minister of State will say that additional one-off funding has been made available to improve the organisational effectiveness of the task forces, and that towards the end of the year there was additional funding. I put it to the Minister of State that if this additional one-off funding had been built into the base as core funding, we would have seen growth year on year. I have very real concerns about the effectiveness of one-off funding. It is a challenge for task forces to engage and introduce new programmes to spend that money. In real terms, when the funding runs out, the problem remains to be dealt with. Unfortunately, the reality of the situation is that the work done by the people involved in drug and alcohol task forces and the programmes that they support in our communities is a continual demand. It is regrettable but it is the reality. We will be facing addiction treatment and minimising its impact for a long time to come. If these programmes and projects are to be supported, they need to be supported financially.
I can see no reason at all, when the health budget has been increasing year on year, why the base core funding going to task forces has remained the same since 2014. I find this incredible. Apart from the physical strain it puts on the providers of these programme projects, the lack of support also undervalues them. People feel that they are being ignored, the work they do is not being recognised, and they do not get the same recognition as other groups. I do not know of any other group or programme, be it for capitation fees in schools or the recipients of grants given out by the Minister, Deputy Ring, to RAPID areas, that has been left static for that period of time.
I do not blame the Minister of State for this whatsoever. I genuinely believe that she realises the work being done by the task forces, but between us, and I include the other Members of the House in that, we need to convince the Minister for Health and the Minister for Finance that the funding made available in budget 2019 is inadequate. Rather than coming at the end of the year with a Supplementary Estimate, that budget needs to be amended at the start of the year so the money can be spent wisely in a managed and effective way to achieve the programmes set out.
I thank Deputy Curran for raising this issue. I know he is very passionate about it, as am I. I will go through my speaking notes first and then I will address some of the issues raised by Deputy Curran in his contribution.
Government policy in relation to drug and alcohol addiction services is set out in the national drugs strategy, Reducing Harm, Supporting Recovery - a health led response to drug and alcohol use in Ireland 2017-2025. Providing additional resources to enhance service provision is a key objective of the strategy. I welcome the additional funding provided for integrated treatment services for people in addiction and mental health issues in the HSE 2019 national service plan. The service plan also commits to improving healthcare services for people who are homeless. The service plan will also deliver more integrated and effective models of care for people with complex healthcare needs and who are experiencing severe health inequalities.
Drug and alcohol task forces play a key role in assessing the extent and nature of substance misuse in their areas, and in supporting community responses, as part of a co-ordinated approach involving all sectors at local and regional levels.
A total of €27.645 million was allocated to the drug task forces by the Department and the HSE in 2018. This level of funding has been maintained for the past number of years. A further €500,000 in once-off funding was provided to task forces in 2018. In addition, task forces were consulted by the HSE on the provision of €710,000 in once-off funding for priority projects and services in CHO areas in 2018. This funding is used to support community drug projects in order to deliver services which meet local priorities. I am very familiar with and greatly appreciate this valuable work in communities. Measuring the overall effectiveness of the response to the drug problem is an important objective of drug policy. Resources should be directed towards interventions and strategies which are most likely to lead to a reduction in problem substance use and an improvement in public health, safety and well-being.
The level of progress achieved in delivering on the national drugs strategy will be determined using performance indicators. To this end, the national drugs strategy commits to operationalising a performance measurement system by 2020. The system is primarily concerned with the overall effects of implementing the drugs strategy at a population level, including the effects on the health, well-being and quality of life of people living in areas served by the drug and alcohol task forces. Last year, I established a working group to revise and update the handbook for task forces. It is intended that the revised handbook will improve the overall governance and accountability of task forces. I hope to be able to provide that handbook in the next two or three weeks. The group is developing a governance code for task forces in line with best practice as set out by the Charities Regulator.
I appear to have mislaid a page of my statement. I cannot seem to find it. I will respond to some of the issues raised by Deputy Curran later.
The Minister of State referred to the fact that there will be an overall effectiveness model. I want to bring it to her attention that she provided the same reply on 23 January 2018. It is taking a long time to implement the model. At the same time, we are expecting the task forces to effectively operate on the budgets of 2014. That is not doable - it is not possible. I am all for accountability and for measuring the effectiveness of the various programmes. In the meantime, however, they must be funded. I am concerned that the lack of funding will mean that the projects will not be as effective as they could and should be.
The Minister of State also referred to once-off additional funding. I still believe that is not the most effective way to proceed. When money becomes available in a Department, this is one method of using it. However, increasing core funding, where there are managed programmes which provide certainty and which are effective, is much better than once-off funding. A lot of time goes into setting up those programmes.
On Monday night last, after our visit to mark the centenary of the first sitting of the Dáil in the Mansion House, I returned to Áras Chrónáin in Clondalkin where the Clondalkin drug and alcohol task force had an evening to present certificates to a number of people graduating from its addiction studies course. I chatted to those involved and two interesting things emerged. I spoke to the co-ordinator of the task force, who reminded me that when the it was established in the late nineties, the catchment area for which it was responsible had a population of 35,000. Today, it is 117,000. It was receiving more money then than it is now. We are setting the task forces an impossible task. When I was presenting the certificates, it dawned on me that some of the people had travelled from far and wide. I asked if there was huge interest in the course. There were 20 people graduating, but over 70 had applied for the course. I asked the co-ordinator why there were so many and was informed that other task forces do not have the funding to run similar courses. This is an example of the impact of the restricted amount of funding available. It is not tenable or feasible to state that we will wait and have a new model next year. I am appealing to the Minister of State to go back to the Ministers for Health and Finance and argue that there should be an increase in the allocation of core funding, rather than once-off additional payments being made over the course of the year. That would help us improve the position year on year. The base has been significantly eroded because the lower level introduced in 2014 has remained in place. This matter must be dealt with as a matter or urgency. The programmes and projects that should be supported in our communities cannot be as a result of the amount of funding available.
I want to make it very clear to Deputy Curran that the Taoiseach and the Minister, Deputy Harris, were very much a part of the launching of the new strategy, Reducing Harm, Supporting Recovery. The latter came into being as a result of a public consultations held throughout the country. At those consultations, it became very clear that task forces are unhappy because funding has not been increased. We will not talk about the past, however. We should focus on the future. In allocating more money in the latter part of 2018, I was very conscious fact that I was only providing short bursts of funding to fill small holes. In the coming weeks and months, I intend to look at the envelope I have and consider options for the provision of additional funding to task forces. However, I do not want to just give out money willy-nilly. I want to make a real impact and provide core funding from one year to the next. It is not good enough to give small amounts of money to a group and expect it to do good work with it. We need continuous funding, and I will be looking at that issue.
Although we did not have a great deal of success in getting money via the budget, we have received more funding in the past couple of weeks. I intend to look into how to use that money in the next couple of weeks to establish how that can be best spent within the task force areas.
On the task force handbook, it should be remembered that the existing version was released in 2011. It is time to examine the structures of the task forces and investigate where we might make gains and improvements in areas where what was envisaged has not worked as well as we hoped. There has been a very positive reaction from the people on the task forces who are responsible for the handbook. I hope the new handbook will be available by the end of the month.
I agree that projects cannot continue to be funded unless money is made available on an annual basis rather than in the form of once-off allocations. We have not been lucky in the past. As the Deputy is aware, last year was the first in a long time that the drugs policy department was allocated funding. Of the €7 million allocated previously, €2 million went to mental health and homelessness services and the other €5 million was spent on the implementation of strategy, not only in the context of drugs task forces but also within communities and the HSE. I am confident that in the coming weeks and months we will start to make an impact and allocate additional funding through the task forces. We will not just fund anything; the funding will be given for a reason. I am of the view that the only way to strengthen task forces is to provide them with continuous funding. In order to do that, we must have a proper model. I have looked at some of the issues regarding task forces and the many reports that have been compiled. For us to get this right, it is important that we begin this year by ensuring that any money available to task forces is allocated correctly and is strategically located within task forces so that it can make a difference in communities. Deputy Curran and I are singing from the same hymn sheet, but I need a few more weeks in order to put in place some of the funding that has been made available and to look at the areas in which we should be spending it in the context of the task forces and communities.