Dáil debates

Tuesday, 7 December 2021

Saincheisteanna Tráthúla - Topical Issue Debate

Health Services

10:50 pm

Photo of Ruairi Ó MurchúRuairi Ó Murchú (Louth, Sinn Fein)
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We are here to discuss the planned removal of the community and voluntary addiction network groups from the national oversight committee on the delivery of the national drugs strategy. We believed the removal was going to happen on Friday. A number of us met and the Minister of State will have received a letter as well as communications from a number of people on this matter. There has been a stay of execution and there is talk of further discussion, which needs to happen. I am seeking real engagement. The concern is that we will go through the motions only for what we feared happening last Friday happening anyway.

There is another concern. There were six groups: the family addiction support network steering group, CityWide, UISCE, the voluntary addiction network teams and two additional bodies that changed from time to time. The difficulty is that we believe this number will be reduced to four and then become the civil society forum. The problem with having a civil society forum is that the Department will make a determination as to which personnel will sit on it. This does not reflect accountability, transparency or the idea of the national drugs strategy having ground-up community representation. It is similar to what is happening on the regional drugs task forces. Whether one is dealing with the Department or the HSE, community organisations will say that they are dealing with corporatism. We would be dealing with corporatism and bureaucracy and the cutting out of the community voluntary sector. That is not good enough and we need to get commitments today.

Photo of Joan CollinsJoan Collins (Dublin South Central, Independents 4 Change)
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For 25 years, our national drugs strategy has been underpinned by a community development approach. In 1996, the then Minister, on behalf of the State, acknowledged to community leaders who had been campaigning on the drugs issue for years that the then Government had not listened. The Minister set up a partnership structure that included community representation as a right to ensure that would never happen again.

With the publication of the midterm review, it appears that the Department is attempting to bring that partnership to an end. In the review document, the Department is effectively writing the community sector out of the national drugs strategy. It is altering the definition of "community" to remove the engagement with the wider community and has set out proposals for new structures that would remove the community networks that represent their sectors as core constituents of the strategy. There is no evidence base for the proposed changes to the structures, and adequate time and space have not been allowed for the networks to consider them. A brake has been put on the process, though. The national oversight committee was supposed to meet on Friday but the Minister has agreed that the Department will hold further discussions with the community sector.

The community sector has noticed that something is going on within the drug strategy. It is either a political decision, a HSE-driven decision or a Civil Service decision to try to take the community out of "community". I do not support that and I hope to hear a positive response from the Minister of State to the effect that the community will be part of the structure and will be listened to within it.

Photo of Aengus Ó SnodaighAengus Ó Snodaigh (Dublin South Central, Sinn Fein)
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I do not know which genius thought this one up but this is the last thing that anyone who knows anything about the drugs task forces, the national drugs strategy and community involvement in drugs services would dream up. Communities have been central to the partnership and the framework of trying to tackle the problem within them. They are the experts in many ways. It is a pity that Departments, Ministers and so on sometimes dream up changes to things that are working. If it is not broken, do not fix it, especially where communities are involved. It took a lot of time to win the communities' trust. I was there during the time of Concerned Parents Against Drugs and the Coalition of Communities Against Drugs, COCAD, when communities had considerable mistrust of the system as they saw it - the Garda, the then health boards, Ministers and so on. Communities bought into the partnership approach. They saw it as an opportunity to frame national policy on an issue that was affecting them directly as communities, mothers, fathers or people who were addicted to drugs. They were able to inform that policy instead of having a policy that was dreamed up somewhere else being imposed on them.

It is sad that the situation has come to this and that there is an "uncivil" row, as it were. I do not know where the title "civil society forum" comes from. It would usually be "civic". We need to consider what the likes of Mr. Fergus McCabe fought for. It was not to be excluded or sidelined. Rather, it was to be central to all of the strategy around drugs.

11:00 pm

Photo of Mark WardMark Ward (Dublin Mid West, Sinn Fein)
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There has been a deliberate attempt to erode community resilience across many Departments, and not only the Department of Health. Last week, it was about dismantling the local jobs clubs, and this week it relates to community involvement in the drugs strategy. There seems to be a direct threat from the Government to communities and their resilience. Any chance the Government has to erode such resilience is grabbed with both hands.

I am a former member of the Clondalkin drug and alcohol task force. I worked on front-line community drugs services for many years. The last one I worked on was in Deputy Ó Snodaigh’s area in Inchicore. I saw the value of the role the community played in our strategic plans and strategies and how it engaged and informed what was going on there. Who is better placed to do that outside our communities?

There has been a deliberate attempt to reduce the number of community groups on the national oversight committee from six to four. As part of this, a decision has been made to remove the likes of CityWide Drugs Crisis Campaign, the National Family Support Network and Uisce, on behalf of the community sector and the voluntary drug treatment network, from the national oversight committee.

A cross-party group, including members of the Minister of State’s party, met with CityWide last week. The last question I asked CityWide was what engagement it had with the Minister of State, Deputy Feighan, in this process. The meeting was a public one. It informed me that it had no engagement with the Minister of State. Despite making numerous attempts in that regard, a meeting did not happen. I have been made aware that the position has shifted since the meeting last week and that is to be welcomed. What will be the implication on funding for CityWide and other voluntary community addiction services? Will their funding stream be impeded by this decision?

Photo of Frank FeighanFrank Feighan (Sligo-Leitrim, Fine Gael)
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I thank the Deputies for raising this important issue. I welcome this opportunity to confirm for the House the continued participation of the community and voluntary sector in the national oversight committee for the national drugs strategy.

I convened a meeting of the national oversight committee on Friday. My door is always open to meeting various groups. I have met CityWide on many occasions. It has been part of various deputations I have met previously. The meeting was attended by three representatives from the community and voluntary sector, representing CityWide, the National Voluntary Drug and Alcohol Sector and Uisce, the service user organisation. A fourth position remains vacant and will be filled in due course. At the meeting, I provided reassurance that there is no proposal to remove community and voluntary groups from the national oversight committee. This appears to have arisen from a misunderstanding by CityWide of the Department's proposals to establish a civil society on drugs. I also dispute the accuracy of the claim that community groups are being written out of the national drugs strategy. To be clear: Reducing Harm, Supporting Recovery, a health-led response to drugs and alcohol use, remains in place as the national drug strategy until 2025.

As the strategy is a dynamic process, there is flexibility to introduce new actions to address emerging issues in the period from 2021 to 2025. To this end, I recently published the mid-term review of the actions in the strategy. Based on the learning from the mid-term review, six strategic priorities for 2021 to 2025 were identified. These priorities strengthen the health-led approach, reflect commitments in the programme for Government and align with the EU drugs strategy and action plan for 2021 to 2025. I assure Deputies that the priorities complement and build on the five goals in the national drugs strategy. The interagency approach involving a partnership between statutory, community and voluntary bodies remains central to the strategy, as does strengthening the resilience of communities to respond to the drug problem.

One of the strategic priorities is to address the social determinants and consequences for drug use in disadvantaged communities. This priority recognises the additional challenges arising from drug use in disadvantaged communities, including the Traveller community. It will address the underlying social and economic determinants that increase the prevalence of problematic drug and alcohol use in certain communities. It will also tackle the criminality and antisocial behaviour associated with the drug trade that impose a heavy burden on communities. These issues require action across the Government to promote community development and community safety. The drug and alcohol task forces and community drug projects also have important roles.

There are a number of horizontal themes to support the strategic priorities. The first is the involvement of service users in the design and delivery of services based on a human rights perspective and the promotion of health literacy. The second is active and meaningful participation of civil society in the development, implementation and evaluation of policies and services. The third is good governance, accountability and mutual respect by all partners. The fourth is cross-sectoral funding and the targeting of additional resources. I believe that the oversight structures to drive the implementation of the strategic priorities for the period from 2021 to 2025 will strengthen the partnership approach and give a stronger voice to civil society organisations in developing national policy, including the lived experience of those affected by drug and alcohol addiction.

Photo of Ruairi Ó MurchúRuairi Ó Murchú (Louth, Sinn Fein)
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It is fair to say that communities have been failed over the years. This is where we are starting from. When we talk to any organisation working in the community and voluntary sector that deals with drug addiction and the communities that are being ravaged by it, they tell us that it has become more difficult to deal with the State. I hope that what the Minister of State is saying will be the case, that there will be no diminution in the number of groups sitting on the national oversight committee and that the determination will be made by those groups and not by someone from the Department. The groups are currently very worried.

Photo of Joan CollinsJoan Collins (Dublin South Central, Independents 4 Change)
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I accept the point made by the Minister of State that CityWide and the community sector have not been taken out of the equation and that CityWide, the National Family Support Network and Uisce will continue to be on the national oversight committee. If the groups are not named to be on the committee, they are not recognised. It is important that they are named. I hope we will continue to see that positive continuation of the partnership in the meetings with the Department of Health.

Photo of Aengus Ó SnodaighAengus Ó Snodaigh (Dublin South Central, Sinn Fein)
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I welcome the Minister of State's clarification. I hope that it will stand the test of time and that, as he presented it, this was a miscommunication. I know the Minister of State’s track record on the drugs issue. I accept that he personally might not want to go ahead with this but there has been tension all along between communities, community groups and some in the Department and the HSE. I urge the Minister of State to be cautious in that regard.

Photo of Mark WardMark Ward (Dublin Mid West, Sinn Fein)
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The Minister of State mentioned in his statement that there had been a misunderstanding on the part of CityWide. I have worked with front-line organisations in addiction centres, and they have experience of the way things work. They do not make mistakes or misunderstand what is happening. CityWide was unequivocal in what it said: it did seek a meeting with the Minister of State, Deputy Feighan, and there was no acknowledgement of the request. I did not say the Minister of State turned down the request, but there was no acknowledgement by him of the request for a meeting. A line needs to be drawn under the issue.

I welcome the initiatives the Minister of State outlined. I hope they happen, because we cannot erode any more community services or community resilience.

Photo of Frank FeighanFrank Feighan (Sligo-Leitrim, Fine Gael)
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I again thank the Deputies for the opportunity to confirm the continued participation of community and voluntary organisations in the national drugs strategy.

The interagency approach involving a partnership between statutory, community and voluntary bodies remains central to the strategy, as does strengthening the resilience of communities to respond to the drug problem.

Community organisations will continue to have an active role in the design and delivery of the strategy, both at local level through the drug and alcohol task forces and at national level through the national oversight committee.

I acknowledge the concerns of one organisation regarding its continued involvement in the national drugs strategy, and I understand the point made by Deputy Joan Collins. I know from long experience that the key to addressing legitimate concerns is not though megaphone diplomacy but through direct communication between parties based on mutual respect. I will meet those parties again to see if we can iron out any difficulties.

I look forward to working with all stakeholders, including community groups, voluntary service providers and people with lived experience of drugs, to deliver the strategic priorities for the strategy over its remaining years. Deputy Ward spoke about a meeting and I will follow that up in the morning. My office is open at all times. People have my number or they can email me, and I will be only too delighted to meet to try to resolve this issue. I thank all the Deputies for being balanced. I will try to work to ensure we get a satisfactory outcome that we all can be happy with. There are issues and it is a very difficult issue but I hope we will be able to resolve it in the coming days and weeks. Again, I thank all of the Deputies.

11:10 pm

Photo of Joan CollinsJoan Collins (Dublin South Central, Independents 4 Change)
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What issues is the Minister of State talking about?

Photo of Frank FeighanFrank Feighan (Sligo-Leitrim, Fine Gael)
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I think there was a miscommunication or a misinterpretation of exactly what is happening. I think that was clarified at the meeting last Friday and I hope that, in the coming days, we can clarify this even further.

Photo of Ruairi Ó MurchúRuairi Ó Murchú (Louth, Sinn Fein)
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There should be no diminution in numbers.