Caoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein)
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I wish to highlight the community sector's experience of the past two years of the new national drugs strategy, Reducing Harm, Supporting Recovery - A health-led response to drug and alcohol use in Ireland 2017-2025. Key policy decisions are not being brought for discussion and agreement to the national oversight committee or the standing sub-committee, as was supposed to happen, and are instead being largely made within the confines of the Department of Health and the HSE. This centralised decision-making has the knock-on effect of the drugs and alcohol task forces not being enabled or supported to carry out the role assigned to them in implementing the strategy at local and regional levels. The fact of the matter is that communities are being excluded from a role in key decision-making, breaking a key commitment given by the Government in the new strategy.

I acknowledge the work and commitment of CityWide, the community sector voice in this field across the greater Dublin region, and tell the Minister of State the actions that CityWide believes, based on its experience, need to be taken. First, the Department of the Taoiseach needs to take responsibility for oversight of the new strategy. Second, the Taoiseach should convene a national forum of all national drugs strategy stakeholders to set out clearly what is expected of them in their roles in implementing the strategy in line with the principles therein. Third, a community development plan should be put in place at the core of the national drugs strategy. My read of this situation is that the bottom line is that the drug and alcohol task forces must be allowed to do as the national drugs strategy promised, that is, co-ordinate an inter-agency approach to the implementation of the strategy in the context of the needs of their respective regions and areas.

The second part of my Topical Issue matter moves from the wider experience of Dublin and the rest of the country to my constituency. I recently received correspondence from the Cavan Drug and Alcohol Service, which provides a service to the Cavan-Monaghan constituency. I will read from the first paragraph to give a sense of the seriousness of the matter. It comes from a letter to the Minister of State, Deputy Catherine Byrne, for whom the Minister of State is standing in today, issued on 11 October. It reads:

After almost two decades of delivering community based support services across Cavan and Monaghan CDA Trust CLG (AKA Cavan Drug Awareness) is now making plans to wind down operations and dissolve the company by the end of 2020. Our organisation has received no increase in funding for several years in spite of rising rent, insurance and other costs. We will be unable to retain staff due to being unable to pay increments in line with cost of living increases or invest in new training opportunities for them. At present CDA Trust CLG is the only dedicated addiction support service for two counties [Cavan and Monaghan] part from local methadone prescribing GPs and [a] valued colleague in the HSE.

The service is treating in the order of 50 individuals every week. This service is hugely important in a constituency such as Cavan-Monaghan. What will the Minister of State do to address the deficiency in resourcing?

Finian McGrath (Dublin Bay North, Independent)
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I thank the Deputy for raising this important issue. I will take the debate on behalf of the Minister of State, Deputy Catherine Byrne.

Government policy on 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. The strategy commits to expanding the availability and geographical spread of relevant quality drug and alcohol services and to improving the range of services available.

Drug and alcohol task forces play a key role in assessing the extent and nature of the drug problem in local communities. They also ensure that a co-ordinated approach is taken across all sectors to address substance misuse based on the identified needs and priorities in their areas. The Department of Health provides in the region of €28 million per annum to supporting task forces through various channels of funding, including the HSE. In 2019, the Department, through the HSE, provided €927,813 to the North Eastern Regional Drug and Alcohol Task Force. From this allocation, the task force provided €212,000 to CDA Trust. CDA Trust provides a range of valuable services to individual families and the wider community affected by drug and alcohol use and misuse in Cavan and Monaghan. CDA Trust also gets funding from the Department of Employment Affairs and Social Protection to provide a drug rehabilitation community employment scheme.

The Minister of State, Deputy Catherine Byrne, recently received correspondence from CDA Trust indicating its intention to wind down operations by the end of 2020. It identified two key issues: delays in the transfer of funding from the HSE and communication difficulties between the HSE and the North Eastern Regional Drug and Alcohol Task Force. The Minister of State asked officials in the Department of Health to seek a report from the HSE and the task force on these issues.

In 2019, the Department secured additional funding of €1 million to implement key actions in the national drugs strategy. From this funding, the Department provided the task force with an additional €20,000 to support its work, 50% of which is recurring on annual basis.

This funding can be used to enhance services and meet operating costs. The Department of Health is also providing an additional €190,000 over a three-year period for the young people's substance use support services in Cavan and Monaghan. This strategic health initiative will improve access to health services for young people whose lives are affected by problematic alcohol and substance use in the two counties. The initiative will develop and strengthen collaborative working across the counties to support the delivery of integrated holistic services through a continuum of care model, that is, education and prevention, and treatment and rehabilitation. This initiative was developed by the task force and the HSE following consultation with local stakeholders. The Minister of State, Deputy Catherine Byrne, would encourage the CDA Trust to engage with the task force and the HSE to see how it can participate in the new young people's substance use support services.

Caoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein)
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Again, in the very short time I have, I think it is important first of all to deal with the bigger picture. In July 2017, CityWide wrote to the Taoiseach indicating its welcome of the Government's commitment to maintaining and building on the key principles of inter-agency partnership and community participation, but the experience in the intervening two years, as I have already put on the record in my opening contribution; is simply not ticking the box. It is a very serious matter. We need to ensure that the structures in place are working to ensure that communities have a real voice in the decision-making process. Any examination of the facts would demonstrate that that is not the situation that has applied over the past couple of years.

In relation to the CDA Trust in Cavan and Monaghan, it is very important to recognise that as we enter the fourth quarter of 2019, the situation is that the quarterly allocation of funding to the CDA Trust has not yet presented, with the result that it has to try to exist on an overdraft arrangement until such time as the fourth quarter moneys are released. I could go into it in greater depth with the Minister of State, Deputy Finian McGrath, but I am telling him what the factual position is, and it is intolerable. It is also intolerable that the trust's returns in relation to quarterly activity and expenditure reports that have been presented to the North Eastern Regional Drugs and Alcohol Task Force, NERDATF, in good time are not compatible with the HSE's own assessment of these matters, with the result that there is duplication in the work to be undertaken in terms of administration and oversight, rather than in front-line provision of real care and supports for those who need it most.

Despite the reply that has been read into the record by the Minister of State, Deputy Finian McGrath, and that whatever hand the Minister of State, Deputy Catherine Byrne, has had in its construction, it is not reflective of the reality of the current crisis situation that we face in Cavan and Monaghan.

Seán Ó Fearghaíl (Kildare South, Ceann Comhairle)
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The Deputy's point is made.

Caoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein)
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This is not an idle threat by the CDA Trust. I ask the Minister of State to use his influence and good offices to bring pressure to bear for a resourcing adequate to the needs of this valued service.

Finian McGrath (Dublin Bay North, Independent)
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I agree with Deputy Ó Caoláin's point on the valuable work done by CityWide. I am aware of many great people who have worked in that organisation for many years.

Measuring the overall effectiveness of the response to the drug problem in Ireland is an important objective of drug policy. Resources should be directed towards interventions and strategies that are most likely to lead to a reduction in problem substance use and improvement of public health, safety and well-being. The level of progress achieved in delivering the national drugs strategy will be determined using performance indicators. The Minister of State, Deputy Catherine Byrne, is committed to implementing an integrated public health response to substance misuse with the twin aims of reducing harm and supporting recovery. Working in partnership with the task force and the regional health organisation, she is confident that the allocation of an additional €1 million in 2019, which will be paid in 2020 and beyond that on a recurring basis, will make a significant contribution to achieving this objective.

I agree with Deputy Ó Caoláin that nobody should be excluded and that there should be strong consultation with local communities. I also agree that there should be strong community development plans. I feel very strongly that these issues should be tackled because we have a significant problem with drugs in this country. I will use any influence I have to push this issue.