Finian McGrath (Dublin Bay North, Independent) | Oireachtas source

I thank Senator Colm Burke for raising the matter of people who are homeless in Cork city and for giving me the opportunity on behalf of my colleague, the Minister of State, Deputy Catherine Byrne, to update the Seanad on improvements in health services for this population.

Implementing the national drugs strategy, Reducing Harm, Supporting Recovery 2017-2025, is a Government priority. The strategy identifies people who are homeless as having a higher risk of problem drug use. Their difficult and chaotic life experiences expose them to many health and social risks, including mental health issues. The Minister of State, Deputy Byrne, is aware of the recent study published by Cork Simon on the quality of life of the homeless population in Cork city. The study identifies the routes into homelessness and highlights the many vulnerabilities of homeless people and their challenges in finding a place to call home. The study indicates the high levels of addiction among the Cork homeless population. At same time, there is good engagement with addiction services and other services, with many people either abstinent or in treatment. That is positive. However, the lack of independent housing is minimising the opportunity for improvements in mental and physical health and for reduction in alcohol and drug use.

In the first instance, the social determinants of the health needs of people who are homeless must be addressed. These are underpinned by income inequality and poverty, lack of material resources, limited access to employment and, of course, homelessness.These are whole of government issues and involve a range of stakeholders.

The Department of Health is supporting the national implementation of Housing First, including in Cork city. Under Housing First, the priority is to support a person who has experienced homelessness into permanent housing as quickly as possible without any preconditions. In line with the Sláintecare report, the Department and the HSE are developing new models of care that deliver more effective and integrated care to people with multiple, complex needs who are homeless. The Department has invested an additional €6 million to improve health services for homeless people since 2016, bringing the total health expenditure on homelessness to €36 million. Earlier this year, for example, the Department funded a new step-up, step-down intermediate care facility run by the Simon Community in Dublin. This facility will provide person-centred care for people who are homeless and who require nursing and related care prior to hospital admission and after discharge from hospital.

The Minister of State is aware that the HSE is developing a number of initiatives to improve health services for people who are homeless in Cork. There have been ongoing discussions with Cuan Mhuire on the development of a step-down facility for people who exit its detoxification and rehabilitation services. The Minister of State has been advised by the HSE that it is very supportive of Cuan Mhuire proceeding with this facility. I understand the HSE will discuss this option with Cuan Mhuire as part of a review of its local service level agreement and the Minister of State looks forward to a positive outcome from that review.