Wednesday, 5 April 2017
Misuse of Drugs (Supervised Injecting Facilities) Bill 2017: Second Stage
I am delighted to be in this House to introduce the Misuse of Drugs (Supervised Injecting Facilities) Bill 2017. With the support of Senators I hope it will be possible to have it enacted as soon as possible. As I mentioned in the Lower House, I feel I am part of a relay team. I acknowledge the role of the then Minister for Health, Deputy Varadkar, and the then Minister of State, now Senator Ó Ríordáin, in particular for moving this issue forward and the many others who have worked for years to get the concept of an injecting centre in Ireland off the ground.
Last autumn injection centres opened in Paris and Lisbon and a centre will open shortly in Glasgow. There is a problem with injecting on the streets of Dublin and other cities and towns in Ireland. I have seen it on my own doorstep. Many Deputies have spoken in the Dáil about seeing parents and children observing this on their way to school. I am sure many Senators in this House have witnessed street injecting. It is unhygienic and unsafe. Those injecting on the street are at risk of contracting disease, such as hepatitis C and HIV. They risk getting ulcers and other infections. They are at risk of death from overdose. The wider community and the public are also at risk due to needles and syringes left behind. We need a new approach to tackling the problem. While I am not saying that the injection centres are the solution to the public injecting problem, there is evidence to support that they contribute to a significant improvement by reducing public health risk, overdose and improving public areas. Supervised injection centres exist in a number of other countries. These centres are aimed at the hard to reach population of drug users and are based in locations where there are significant problems of public drug use. The aim is to reduce the risk of disease and death linked with public injection and to provide access to health and treatment services. They provide a controlled place where people can inject, but much more than that, they provide a place to rest and have a chat and to access the services people need.
I believe in a health-led and person-centred approach to the drug problem. This is all about people and looking after the most vulnerable and marginalised in our society. The human cost of injecting in public is clear and keeps adding up in terms of the lack of dignity and the effect it has on a person's health, well-being and safety. We know that these centres are not the sole solution to the drugs problem and many other steps are needed, but I am committed to doing everything we can to help those who need it most.
In the programme for Government we have made a commitment to a health-led rather than criminal justice approach to drug use. First and foremost, injection centres are intended to be a form of harm reduction. If people are going to take drugs, they should be informed about the risks, they should be able to do so as safely as possible, and they should know what to do if something goes wrong. Together with needle exchange, overdose education and a supply of Nalaxone, injection centres and other tools help to reduce the risk of harm to people who inject drugs. Harm reduction interventions like those do not prevent people from choosing to stop taking drugs. While they do not stop people from engaging with treatment in the future, they may give the service users the chance to live long enough to seek treatment when they are ready to do so.
There is currently significant debate about national and international drug related matters. Many such matters will be examined as part of the new national drugs strategy which is at an advanced stage of drafting. However, they should not deter us from the goal of this Bill. The sole purpose of this Bill is to permit the provision and use of an injection centre. For us to open a pilot supervised injecting centre, we need this Bill. Under the Misuse of Drugs Act 1977, it is currently an offence to provide an injection centre. Service users would also be guilty of several offences. A change to the existing law is required to permit the introduction of this service.
The Bill contains 13 sections and I will explain each section in turn. Section 1 deals with the interpretation. The provision is standard and includes a number of new definitions for the purpose of the Bill. The section includes definitions for drug licence and supervised injection facility.The definition of "drug" will include controlled drugs and psychoactive substances, sometimes referred to as "head shop" drugs.
Sections 2 and 3 cover application for a licence and the granting of a licence. Section 2 provides for the information that should be included in an application. This will include the name and relevant experience of the person applying for a licence and the address of the proposed premises. The application should include details of the operational and clinical governance arrangements for the proposed centre, which includes proposed wraparound services and referral pathways. If an application does not contain enough detail, the Minister can seek further information. Section 3 provides the criteria the Minister should consider when granting a licence. These include, but are not limited to, consultation with An Garda Síochána, the HSE and others as the Minister considers appropriate. They also include the matters the HSE will consider when advising the Minister on the appropriateness of an application. The HSE is best placed to assess the clinical governance and operational protocols proposed for a premises and to ensure it is fit for purpose. In addition, there will be consideration of whether the location of a proposed centre is appropriate given the level and nature of drug use in any area. The HSE will advise the Minister accordingly in such a case. In this way, a centre will be located based on need in areas where there is a significant public injecting problem. Section 3 also grants the Minister the authority to attach conditions to a licence. Licences will be for a fixed length of time.
Sections 4 to 6, inclusive, deal with the surrender, suspension and transfer of a licence. These sections provide for a licenceholder to be able to surrender or to seek to transfer a licence for a particular centre. Written notice of a fixed period must be provided to the Minister before a centre can be closed. These provisions ensure that adequate service provision continues should the effectiveness of a centre remain positive. Section 5 provides for the Minister to revoke or suspend a licence with immediate effect based on the input of the Garda or the HSE should there be a serious and immediate risk to life. Under this section, the conditions attached to a licence may be changed or added to, as the Minister sees fit, taking into account the views of the HSE, An Garda Síochána and others. Section 6 allows for the transfer of a licence for a premises to another licenceholder to maintain the service if necessary.
Section 7 provides the definition of an "authorised user". It also provides the authority of a licenceholder to permit a person to be in an injecting centre. An "authorised user" will be an individual who is on the premises of the injecting centre in accordance with the conditions of the licence and with the permission of the licenceholder. A person cannot be an authorised user outside of the centre. The status of the authorised user will depend on the permission of the licenceholder or person in charge at the time. Therefore, a service user who has been asked to leave the premises or who will be in breach of the conditions of the licence will not be exempt from certain offences under the Misuse of Drugs Act. The eligibility of a person to become an authorised user refers to regulations that may be put in place to prevent the use of the centre by certain groups of people, for example, those under 18 years of age, those who are not chronic intravenous, IV, drug users and those who are pregnant. The making of any such regulations should be informed by clinical practice. Appropriate referral resources are expected to be put in place for anyone who presents to a centre but is not considered suitable to use it.
Section 8 provides for unidentified data to be shared with the Minister or the HSE for the purposes of evaluating the centre. Personal records cannot be shared.
Section 9 provides an exemption for the licenceholder, or any person acting under the direction of the licenceholder, from liability for providing an injecting centre and any assistance, advice or care given to an authorised user.
Section 10 provides that certain sections of the Misuse of Drugs Act 1977 will not apply under certain circumstances. Section 3 of the 1977 Act makes it an offence to be in possession of a controlled drug. The offence of possession of a controlled drug would not apply to an authorised user as defined under section 7 of this Bill. Section 19 of the 1977 Act makes it an offence to do certain things with a controlled drug on premises. The licenceholder for an injecting centre will be exempted from such an offence. Finally, section 21 of the 1977 Act makes it an offence to break or fail to comply with the Misuse of Drugs Regulations. This section of the Bill ensures authorised users will not be in breach of the regulations.
Section 11 relates to provision of access for An Garda Síochána. This section provides for a member of the Garda to enter an injecting centre without a warrant for the prevention or detection of offences. It is not intended that the Garda will be continually in a centre watching over authorised users. It is normal practice for police in other countries to call into injecting centres regularly. This offers peace of mind to the authorised users, the staff and the wider community and ensures no one can attempt to profit through dealing or preying on vulnerable drug users in the centre.
Section 12 provides for the Minister for Health to make various regulations for the purposes of the Bill, and section 13 covers the Short Title, collective citation and commencement provisions. These are standard provisions.
I am pleased to bring forward the Bill. It is a compassionate and practical response to the chilling reality of drug users injecting and overdosing in public. I hope all in the House will fully support it and help ensure its smooth passage through the Seanad.
In the words of Deputy Michael Harty, "The aim of this piece of legislation is to provide for the licensing of supervised injecting facilities in order to enhance the dignity, health and wellbeing of those who inject in public places." Fianna Fáil supports this Bill, which would introduce supervised injection facilities. It is designed to avoid drug-induced deaths. It is obviously not the sole answer to the drug scourge we have. The Government will have to increase funding to detox centres to allow people who want to tackle their addictions to get the support required. Increased investment in education is also much needed.
I understand some of the legitimate reservations raised, but the centres should provide safe space for drug users to help ensure they use clean needles and dispose of them properly. At present, people are injecting on street corners across Dublin city and, as such, measures to tackle this, even in the short term, must be piloted. We want to see regular reviews, including feedback from stakeholders, undertaken to measure the Act's success if passed. For too long we have invested taxpayers' money in schemes which do not work and which are a waste of money while being of no benefit to the user. This Bill must not turn out this way.
Ireland has the highest proportion of intravenous heroin users in Europe, and the rate of drug related deaths in Ireland is three times higher than the European average. This is a shocking statistic which again leads me to call for greater investment in education and detox centres. A supervised injection centre must be a gateway to effective treatment, rehabilitation and intervention aimed at harm reduction for those suffering from addiction. This cannot be another Band-Aid on a failing health service. The injecting rooms should be based in centres and as part of a network of services and supports so that they facilitate early intervention and offer a pathway to recovery for drug users. The centres, if successful in tackling drug related harm, have the potential to become a longer-term viable public health measure which seeks to provide a safe and supervised space for people to deal with their addictions. Nonetheless, this is only one part of a solution to the overall drug problem in Dublin in particular. However, it has the potential to be a part of that answer so that, at the very least, individuals ravaged by addiction have the opportunity to retain some dignity while we work to try to help them beat their terrible addictions.
Notwithstanding my comments, I have liaised with many people involved in this sector, including Councillor Frankie Keena, who is based in Athlone and who has done much voluntary work over the past 20 years in the Athlone and Westmeath region. He highlighted some very valid concerns, one of which is whether this legislation would effectively legalise the possession of heroin within the four walls of these centres. The Act states that if a service provider identifies an area that needs such a centre, the Minister has the power to decide where the centre goes and there is no provision for consultation with elected members of local authorities or the public. My other concern is the staffing of these centres. What if, God forbid, a service user overdoses and dies in such a centre? What emergency facilities will be in place? How will staff members be protected from a medical and legal viewpoint? This issue must be teased out further. Finally, it is somewhat disconcerting that we are almost dependent on drug pushers, and the criminality associated with that, to feed this service.
I hope these valid concerns can be explored on Committee Stage. We are not ruling out proposing further amendments to the legislation.
I thank the Minister for bringing this legislation forward. I pay tribute to her for her five years of work in the health committee under the previous Administration. I am aware of her commitment to this issue and I appreciate the work she has done. I also pay tribute to Senator Ó Ríordáin who did a huge amount of work on this when he was a Minister of State. I thank him for that.
This legislation is the correct way to deal with this issue. It will provide protection for people who are injecting drugs. It is about trying to provide some support for those people and to protect them from contracting other infections and diseases. It is an appropriate way to deal with it. It will not be easy to establish the system initially but once it is up and running it will provide clear evidence of its benefit not only to the people who are, unfortunately, drug users but also to the wider community. We have much work to do in this area. Senator Swanick is right about education, both in secondary schools and universities, to try to reduce the number of people who get involved with drugs. It will not be easy but we must put more effort into it.
One of my concerns, and the Minister referred to it in her contribution, is the authorised users and those under 18 years of age, those who are not chronic intravenous drug users or those who are pregnant. This arose in the health committee previously. When somebody is pregnant and on drugs it causes a problem when the baby is delivered. A number of children are going into detoxification after they are born. I am not sure that we have done enough work in that area in terms of giving support to girls and women who are pregnant and are on drugs. Due to using the drugs for a long period of time they are unable to get off them during their pregnancy. It is not clear that we provide enough support for them. Perhaps the Minister would deal with that.
Section 8 of the Bill provides for unidentified data to be shared with the Minister and the HSE. It is important that it is unidentified so the people using the facility do not feel at risk. However, it is important that we monitor this and get appropriate data to help us devise and further develop services.
The other issue is the risk for the licence holder. That is appropriately dealt with in section 9 to ensure there is no legal liability for the licence holder. This means we will not restrict somebody from applying for a licence when he or she can offer appropriate facilities and appropriate supervision in the facilities. We have a long road to travel in this area. What is happening in Dublin is beginning to happen in Cork. Needles are being found in the side streets near one of the methadone clinics. Obviously it means that the methadone facility is used as the centre where people make contact. My concern is that where there is a injecting facility, and there is a facility established in Dublin, there will also be a higher risk of dealers being attracted to the immediate area. It is something that should be considered. I raised it with Senator Ó Ríordáin earlier.
Can we put legislation in place which would provide for a higher penalty for anybody who is found dealing drugs within a particular radius of such a facility? I am not sure if that is possible but it is something we should consider. I realise it will not deter dealers or move them away, but at least it would be an additional mechanism to discourage people from using the injecting facility as a location to deal. The same could apply to areas near methadone facilities. We should examine whether that is covered by existing legislation and, if necessary, bring forward amending legislation. It might even be something we could include in this legislation. Perhaps the Department would consider that suggestion. The people who will be attending these facilities are already under pressure and they will be under additional pressure if dealers are openly assembling in the immediate area of the facilities. It is something that might be taken into consideration.
I welcome the Bill. It is the appropriate way of dealing with this issue. However, we have much work to do and this is just one step in that regard.
I welcome the Minister of State. I welcome the legislation and I commend Senator Ó Ríordáin for pushing it forward. It is a first step in moving away from treating addiction as a criminal matter and towards treating it as a public health issue. The most recent data available from the national drugs-related death index show that almost two people died each day in 2004 because of poisoning, trauma or medical causes linked to drug use or misuse. Almost 700 people died 2014 and a similar number was reported in 2013. We can deduce, therefore, that two people die each day, which is an epidemic.
The aims of injecting centres are to reduce the acute risk of disease transmission through unhygienic injection, to prevent drug-related overdoses and deaths and to connect high risk drug users with addiction treatment and other relevant health and social services. These aims are all health related. Addiction is a health issue, not a criminal issue. I have nothing but compassion for those who are suffering due to drugs. I will return to this point later. If ours is to be a society that helps and is all-encompassing for people who suffer in this way, we should provide a health-based response to the drug problem, not a judgment-based criminal response. Is this legislation good for the overwhelming majority of ordinary Josephine and Joe Soaps who are not drug addicts? I believe it is.
First, I will address the positive impact these centres will have on the families of addicts. Having an addict in the family can be agonising. There is constant anxiety and worry about the person's health, well-being, estrangement, behaviour and his or her impact on other family members. The centres will assist in alleviating some of this worry. If addicts are getting access to services that will protect their physical health and also create a starting point for recovery for them, their families will give a small sigh of relief. Families should not have to carry the worry of an addict alone. If we move towards a health-based response, as this legislation does, we are showing them that we view their family member as somebody who deserves help, rather than somebody they must cover up for and carry alone in isolation and embarrassment.
Second, it is a public health issue to have drug users injecting in public places. We all experience rightful disgust when needles are left in places such as parks and schools where they could infect the public and children.At least four children I know of have needed health monitoring and tests after playing with blood-filled syringes and needles, thinking they were toys because they had seen them so often. They have had to undergo in-depth six-month blood tests for HIV, hepatitis C and other infections.
The drug injection centres would address this very serious problem and would also treat addicts with the same compassion with which we treat everybody else who has an illness. I heard earlier, at the briefing held by Senator Ó Ríordáin, that in Sydney, Australia, there was a huge reduction in the cost and impact of public drug use once a supervised injection centre was opened. We are not being pioneers here and we know this approach works.
I said in my opening remarks that I believe the movement towards treating drugs as a health problem should be welcomed. In my time as a psychiatric nurse, I have had vast experience of people who suffer both a mental health issue and an addiction issue. In fact, the two are closely linked. I am hosting two events in my constituency in the coming months on the treatment of dual diagnosis which will shed light on the link between mental ill health and drug addiction. A study by the UK Department of Health put the figures at 75% of users of drug services and 85% of users of alcohol services who also experienced mental health problems. The link between addiction and mental health illness is very real and very important, and it is not something we can ignore. There is a lot of shame, distrust and stigma around both mental illness and addiction. If these centres can be compassionate, non-judgmental places, then maybe we can break through this distrust, shame and stigma, revolutionise the treatment of dual diagnosis and give people hope.
I have one reservation about the legislation and it follows from a discussion I had with a worker in my local area. As the Minister of State knows, the area of Rialto has been destroyed in parts by generational drug addiction. It is coming around now but workers on the ground have questions in regard to trust and how gardaí will engage with these centres. Under section 11 of the legislation, gardaí are permitted to be on the premises without a warrant for the detection of offences other than those to supply under section 10. Presumably this is to prevent persons dealing on site or other offences. However, as we know, these centres will be staffed by a mixture of social care personnel. As is best practice in other projects, the worker from my constituency believes it should be up to the centre staff to engage gardaí if needed. Having a situation where gardaí can drop in and keep an eye on people will deter many users from accessing the centre. In this worker's words, what is the point of the service then?
Supervised injection centres are not the be-all and end-all of treating drug addiction but they are a welcome first step towards treating addiction as a public health issue. I am encouraged to hear there will also be counselling and intervention services. However, I believe these centres need consistent reviewing and monitoring, particularly after the pilot but also into the future, to ensure it is not a case of, "There you are. There's your centre. Be quiet. Inject in peace and leave us alone, and we will all just forget about each other." Instead, these centres should be used as a piece of the puzzle that is needed to treat addiction and, hopefully, we can move forward to become communities that do not suffer at the hand of this disease and the stigma around it. I look forward to the passage of the Bill through the Seanad. Agreeing on locations is another job of work for public representatives and local authorities but let us get this legislation through as a starting point.
I will start by providing Senator Colm Burke with a solution to drug dealers that is not a penalty and I would be happy to work with him on it. That solution is the possibility of prescribing in heroin injection centres to do away with the problem, although we are probably a few decades away from that idea.
I welcome this legislation hugely on a personal and a professional level. I remember that I first started looking into the possibility of supervised injection rooms during the first ever drugs work I did with young heroin users in Cushlawn. What alarmed me most then was when one of the lads came looking for me when he could not bring around one of his friends after he had injected. When I got there, rang the ambulance and put him in a recovery position, I noticed cigarette burns all over him. I asked the lads how he had got burned and found out that, for some reason, there was a culture which meant that if people overdosed in company, others would stick a cigarette in their hand so that it shocked them and woke them up.
This was the level of education and understanding at the time around addiction. Young people were resorting to all sorts of made-up ideas of what they should do to protect their friends or to bring them out of an overdose. They often did not ring an ambulance for fear the Garda would come as a result of that historical negative relationship that exists between the Garda and drug users. That is why the one part of the Bill I am concerned about, much like Senator Devine, is around the access of gardaí to the centre due to that historical relationship between young people, drug users and gardaí. I wonder how we can begin to mend some of those relationships so that people will not be afraid to use the centre, especially if they have a warrant or an outstanding charge which might impact on them using the service. So many homeless people do not make it to the courts or to their probation appointments and there will be bench warrants issued for them, and so on. If they know a garda can access the centre, will that put them off using it? This is not to say gardaí will in any shape or form abuse that. It is more the perception of the authorised user that they could access it. As someone who has worked in homeless services for a long time and who has had to deal with the issue of drug dealing, I know the staff are very quick to respond to any sign of drug dealing within a homeless service. I ask that something be done to ensure we encourage some sort of communication between the Garda and the people who run the service before gardaí gain access. This would mean we would not damage any further the relationship between drug users and the Garda.
Obviously, this is an area I have worked on for a long time. I will conclude as I think the other speakers have hit the main points. When I first looked into the issue of supervised injection in 2000, I thought it would never happen and that there was no point in pursuing it. I remember meeting a researcher, Tim Bingham, who now works for the HSE and who had done a lot of work on this. When I met him a few years later, I still thought it was so far out of reach that we would never achieve it. What I most want to do is commend and compliment the Minister of State, Deputy Catherine Byrne, on taking this on and running with it. It is a great honour to be able to stand here in the Chamber as someone who has worked on addiction and who has been affected by addiction in a million different ways throughout my whole life. It is great to watch this legislation go through the House. I thank the Minister of State for that.
Like Senator Ruane, I find it difficult not to be emotional while speaking on this Bill in this Chamber along with Senator Ruane, Senator Kelleher, who has worked in the homeless services in Cork, and the Minister of State, Deputy Catherine Byrne, who has been so supportive of this legislation. We have people from the Ana Liffey trust in the Visitors Gallery, including Marcus Keane and Tony Duffin, who have spearheaded the campaign for this legislation for quite a long time. I had the Minister of State's role in the previous Government, as she knows. When I first came across the Ana Liffey project and listened to the humanity of what they were trying to achieve, it was very difficult to find any logical reason this city and country would not pursue what other cities and countries have pursued. This is not, as others have said, a pioneering facility and, in fact, there are 88 such facilities across Europe, as well as one in Sydney and others in North America.
The fundamental point is that these facilities will save lives. We have the third highest overdose rate in Europe. We have people today injecting in alleys in the open air, which is extremely dangerous. They are liable to contract any type of blood-borne disease, such as hepatitis C or HIV, but they are also likely to die. This reality was brought home to me during the 1916 commemorations when there were two deaths of young men in Dublin city centre within a stone's throw of the GPO, one, ironically enough, in the toilets of Connolly Station, where a young man overdosed and died, and another young man overdosed and remained for two nights in Foley Street in the north inner city. It did not make the news at all.Nobody noticed because nobody cared because, on some level, Irish society has decided it is their own fault. We have a mentality of victim-blaming when it comes to heroin overdose or heroin use. The different types of media reporting is remarkable; if a student dies as a result of taking a pill in a nightclub, all the commentary will be about the future that young person could have had and why politicians are not doing more. However, if someone dies of an overdose in a toilet in Dublin or in Cork, there will not be one column inch or one report about it.
There are some journalists who need to be congratulated for the way they have supported this Bill - Stuart Clarke from Hot Press and Cormac O'Keeffe from the Irish Examiner were both very supportive of this initiative. However, there have been others in the Irish media who continually dehumanise and degrade those in addiction, using terminology which dehumanises them and undermines them. They perpetuate this problem and they will misrepresent what we are trying to do in this Chamber.
I want to congratulate people from the Minister of State's own party, including Deputies Paschal Donohoe, Leo Varadkar and Frances Fitzgerald, who backed this idea from the beginning. I also congratulate people from my own party such as Deputy Joan Burton, Deputy Jonathan O'Brien from Sinn Féin who was very supportive of this from the very beginning, Independent Deputy Maureen O'Sullivan, and Deputy Jack Chambers from Fianna Fáil, who made a submission in support to the national drugs strategy.
This initiative will save lives. On that basis I do not see how anybody can logically have any issue with it. Obviously the regulations will have to be investigated carefully. For many people it is a jump into a radical new way of thinking when it comes to drug policy. However, I would ask anyone who has a question about this if it was their brother or sister - because it is someone's brother or sister - or if it was their father, mother or child, where would they want them to inject if they were sucked into hopeless addiction. Would it be behind a skip or in a toilet, or in a facility which is surrounded by services in a compassionate and more safe manner? That is the question. Nobody has ever died in an injecting centre anywhere in the world. It is the first step on the road to recovery.
This will fail if all we give people is a room to inject. It has to be a suite of services so people will be able to take that first step on the road to recovery. It is remarkable that no matter where I go, people quietly approach me. They tip me on the shoulder and thank me for what I have done on injecting centres, saying their son or their brother had died of an overdose, but they are ashamed to say it. If this was any other health issue we would have a packed Gallery here, there would be a rally outside because people want to give voice to the fact that people are literally dying on the streets. However, they do not do it over heroin overdoses because we have continually managed to dehumanise this debate and blame the victim.
I congratulate the Minister of State for taking this on and internalising it and driving it forward. I am so proud to stand here with other people in this Chamber who are making this happen. There are other parts of the country crying out for a centre of this nature but this is a good, decent thing we are doing today. Sometimes it is not easy in politics to stand up for the person who is most vulnerable, who will be demonised and dehumanised in Irish media and often in politics as well. Today politics is actually standing up for that individual. Lives will be saved and the Minister of State is to be commended for that. I cannot wait until this legislation is passed and we can have a centre that is open and we realise that all of us collectively were right in pursuing that, and I am sure that it will be the first of many. I congratulate the Minister of State and support her 100% in the passage of this Bill.
I welcome the Minister of State and I congratulate her and the Government for its vision. I also pay my compliments to Senator Ó Ríordáin. I remember him speaking very passionately about this in the House when he was Minister of State. I myself have spoken about it on many occasions. Some 25 years ago I advocated the legalisation of opioid drugs and rather curiously, I was supported in that by the late Deputy, Dr. John O'Connell, who was then Fianna Fáil spokesman on health. We have come a long way since those days.
I have three comments on the Minister of State's speech. First, as with other colleagues, I completely welcome the Government decision that this should be a health-led rather than a criminal matter. It should never have been a criminal matter. As I recall, anti-drug legislation was first introduced in the early 20th century at the instigation of the pharmaceutical companies so it has a rather dubious background.
The Minister of State says regarding section 3 that there should be consultation with the Garda, the HSE and so on about the granting of licences. It may lead to some friction, but I would also suggest that it would be good policy to also include local communities and bring them along in this matter.
Finally, the legislation excludes people who are under the age of 18, those who are not chronic intravenous drug users, which is okay, and those who are pregnant. I understand the difficulties in dealing with people who are underage or who are pregnant but if we look at the reality, they are probably going to get the drugs - in fact, I guarantee they will - and they are going to inject them somewhere. We need to look very carefully at that. There may be legal reasons particularly for those under 18, I do not know, but if people are taking drugs, if they are chronic intravenous drug users, whether they are under 18 years or pregnant, if they are going to do it anyway, surely it is better that they do it in a decent facility.
I remember an experiment many years ago. I think in both cases they were done by Catholic priests, one in Rotterdam and the other in Liverpool, where they introduced injection facilities in the crypt of their churches. Criminal activity in the local area dropped by 80% but then some do-gooder went and reported it to Maggie Thatcher who was around at the time and of course it was slammed down and shut to the detriment of people living in that area.
These drug injecting facilities should not all be located in the north inner city. This is not NIMBY-ism, it is just that our back yard is full to bursting, we have so many of these kinds of centres already. I think they should be shared out proportionately although I do, of course, recognise -----
Absolutely. Shrewsbury Road, yahoo. People can come and get their fix on Ailesbury Road. That is a very good idea.
I do understand that where there are concentrations of drug addicts that is where the centres need to be. Supervision is vital. It has to be made clear that drug peddlers should be cleared out of the immediate vicinity. That is one of the problems we have in my area. I very rarely see anyone injecting. I do not often see that many needles and so on, but I sure as hell see the drug peddlers clustering like seagulls around the facilities for people who are addicted to drugs.
These provisions will lead to a substantial decrease in deaths among these unfortunate people because the dosages will be measured and the purity will be assessed so they will be getting decent drugs. Then there is the question of clean needles which is vital because people do pass on HIV and hepatitis C from contaminated needles so that will also be very largely eliminated.
I am very glad to have been able to speak on this Bill to strongly support the Minister of State and to compliment the Government on its courage and vision in introducing this kind of legislation. I cannot see the gentleman from the Ana Liffey Drug Project in the Gallery from this distance, my eyesight is not terribly good, but I want praise the work they have done for many years in this city.
I thank the Minister of State for bringing this important legislation before the House.We reflect upon the nature of legislation, and when people ask about the role of Government and the work of the Oireachtas, today is a good example. I commend Senator Ó Ríordáin on his work as a Minister of State in beginning this process. The Minister of State referred to a relay race but I should also mention the Minister of State at the Department of Justice and Equality, Deputy Stanton, for the work he did. It is easy for us to be speaking here today because whether we are candid about this or not, we know we need a new approach to tackling the problem of drug and alcohol misuse. I acknowledge the people in the Gallery today and the work they do. I have met them. When I was Chairman of the Committee on Health and Children, we did some work in this area and our first report was on this area. I highlight the work done in Cork by the Tabor Group and by the Cork local drugs and alcohol task force. As Senator Norris said, people will get drugs and inject. The Minister of State was very honest when she said the injecting centre will not be the solution. It is not a panacea.
We must reflect on best practice internationally too. The Minister's speech, the report from the Oireachtas Library and Research service and other contributions cite a host of cities around the world. I agree, however, with Senator Ó Ríordáin that this aims to save people's lives and to humanise the problem. We cannot, as a society or government, despite what some might think, create different types of people. We are all human beings, and wherever we live, we are entitled to the same access to treatment and supports. We must put it in that context. I have spoken to people in Cork and others around the country who work at the epicentre and deal with drug misuse and its associated problems, I am certain we have their support. Like many of her predecessors, the Minister of State is travelling the country and was in Cork recently where she spoke and listened to people. The function of the national drugs misuse strategy is to engage with stakeholders. They are the people who work day in, day out, trying to highlight, solve the problems of, and work with people who misuse drugs.
Regardless of whether we like it, people will inject in public and in unsafe places. I know many places in my city where that is a problem. We need to tackle that. Senator Ó Ríordáin is right about the health issue. That is why when the Minister of State, Deputy Stanton, was Chairman of the Committee on Justice, Defence and Equality and I chaired the Committee on Health and Children, we held a joint meeting of our committees on the issue of drug misuse because it was not a question of justice or of punishing or capturing the drug addict or the person who injects but of ensuring a holistic, whole-of-Government approach to this.
I am pleased the local drugs task force in Cork is supportive of this. It is a pilot scheme which can be rolled out in other areas because we need to ensure that medically supervised injecting centres are provided. It is not a question of airbrushing or pushing people out to the margins but of ensuring those who are isolated and vulnerable and do not necessarily want to be associated with or come forward to be helped have an environment where they can be helped, reached out to, and worked with towards treatment. I was very pleased the Minister for Housing, Planning, Community and Local Government, Deputy Coveney, turned a sod on Fellowship House, which will be another important asset in Cork in the treatment of people with problems arising from misuse of drugs and alcohol. It is a whole-of-community approach. We need to ensure we have residential detox and rehabilitation beds, in particular for polydrug users.
This is a good day. Many deserve credit for their courage. This will not be universally popular but we are doing the right thing and that is why all of us in the House must support the Minister of State. I am glad she is the person piloting this in the Oireachtas because she has empathy and sincerity and works at the coalface in her community. She does not have an arsenal of degrees but she has the worthwhile attribute of being a person who listens, who enjoys common sense and wants to see the right thing done.
I commend the courage of the Government, Senator Ó Ríordáin, and the Minister of State, Deputy Stanton, led and inspired by people working on the front line from Ana Liffey. I also speak from my experience of eight years working for the Cork Simon Community. It is above all a matter of dignity. It is bad enough to have an addiction but for a person to have to crawl into a grubby undignified space in a public zone to take a substance which is not going to be great for him or her but which his or her body needs and is unable to do without it, and for that person possibly to die in that place, friendless and without help, is not something that any civilised society should tolerate. It is a first step towards addressing this difficult problem which very often was not created today or yesterday. It often affects people let down by their families or the State, people leaving care. The next step in their difficult lives is to be injecting in a public space in front of us all. This is above all a question of dignity but it also offers hope and possibility for people.
The pilot will be in Dublin but this needs to be considered in Cork. We are being grown up in Dublin but we need to be grown up in other places. We should have many locations rather than one big place that everybody gets het up about, as it were, and that is a honeypot for dealers and others. I commend Senator Devine's solution that it is a voluntary corps in the Garda. I think Senator Ruane would also support that.
I fully endorse this Bill. It is another aspect of Ireland growing up and facing up to its challenges, offering dignity and hope to people who have often been let down but also seeing light at the end of the tunnel. I commend all present and this important legislation.
I feel inadequate. Listening to the contributions and over recent months I have learnt that there are many people who know about addiction and who have witnessed family members struggling with their addiction. There are many who, sadly, have lost loved ones because of addiction. This Bill brings forward a new beginning for people, particularly chronic users. It is clear from the programme for Government, which Senator Ó Ríordáin would be familiar with because it happened in his time, that the Government wants this to be a health-led rather than a criminal justice-led approach to supervised injection facilities.
There are difficulties whenever something new and different is introduced, especially this. Several contributors have spoken about An Garda Síochána and its role. From my experience of speaking to people in other countries, particularly having visited Copenhagen before Christmas, the role of the police in a supervised injection facility is very much monitored by the people running it. They invite the police in. That is what we are considering. It is an illegal drug, inside or outside.Therefore, An Garda Síochána has the right, if it wishes, to enter the building if it suspects that someone is entering it for reasons other than those for which he or she should enter it. From considering the services available in Dublin in particular, I have always been of the understanding that An Garda Síochána has a pragmatic approach to people using services, whether clean injection facilities, Merchants Quay Ireland, the Ana Liffey Drug Project or any others, and that gardaí out on the beat are the people who know who the addicts and dealers are. They see them daily.
In this regard, the policing of a service such as an injecting facility is very important. It is important that there be that respect for the Garda and the people using such services, that visits to injection centres be carried out in an appropriate way and that people will not be arrested on premises simply because they are there. They go into the centre to use their drugs because of their illness - and it is an illness.
In this regard, I agree with Senator Devine, who has much more experience talking about mental health than I would ever have. Many of us have seen in our families, whether immediate or wider, people who have mental health issues or addiction issues. Most of all, what we need to do - and a number of people have said this and I have said it myself in the past - is to treat people as human beings because that is what they are. We are all citizens of this country. We all deserve certain rights, and sometimes people who are labelled as addicts do not have those rights. They are seen as misfits in society, people who brought it upon themselves and people who do not deserve services.
If the Bill is passed, as I hope it will be, it will shed a different light on people who are chronic users. There are huge difficulties regarding where the centres will be located and there will be as we go forward. When the Bill is passed and the services go out for tender, it is my understanding that there will be consultation, as there must be. There is no point in having it now because we do not know where the centres will be located. If we have consultation with the public, we might as well go to Cork and have the consultation - no offence to Cork.
What we must first do is seek the tenders, find a place to locate the centres and base this on the evidence. The HSE and the committee set up through the HSE are mapping the entire centre of Dublin and the location of the facilities, where people are injecting, where they are unfortunately dying on the street and in their homes and the paraphernalia left around. All of this is centred around the inner city and the cohort in the capital city, particularly around what I would say are areas people come into because they are homeless, because of begging, because of their addiction and because of other reasons. Therefore, there is no point in putting the service out in Dún Laoghaire or anywhere similar because that is not where people are going. There is no point in providing a bus that would pull up on the side of the street and deal with people queuing and then move to another side of the street because that is not the way it should be done. These people need privacy. They need a little dignity when they go into these centres. Above all, they need to know that when they go into the centre, there are enough capable doctors and nurses and there is a wraparound service. That is what the injecting facility should be all about.
The Senators asked many questions, half of which I probably will not get through. Senator Ó Ríordáin said that no one has died in any of these injecting centres, and I reiterate that fact. Naloxone is now being distributed by families and so on, and it will be used in the services. There is every chance that people who overdose will not be found wanting because they will be in a service that will be able to react immediately to them.
I take Senator Ó Ríordáin up on one thing he said about the media and about shame surrounding addiction. He is absolutely right. The media in this country love bad news, and the bad news is often a picture of someone dead down a laneway or lying in a skip from an overdose. They love such pictures because, unfortunately, they sell newspapers. However, this is not what the Bill is about. It is about caring for people who are chronic users and who are very ill. It is a health issue, and the reality of this will be seen in the next few months. We owe these people that opportunity to be able to go into a clean and safe environment.
Senator Ruane spoke about decriminalisation, and I know she is focusing on that in a Private Members' Bill. I am glad to have the opportunity to be able to sit down and talk to her about that into the future, and sooner rather than later. One point Senator Buttimer raised concerned the work the Minister of State, Deputy David Stanton, has done examining the Portuguese model. The justice committee established how it would go forward with a health-led rather than an offence-led approach for people who have been involved in criminality in respect of illegal drugs. That work must continue. As part of the national drugs strategy, it is our intention to review the report of the steering committee of the strategy and put into it an alternative approach to responding to those who have a history of offending. I have no problem sitting down with Senator Ruane and probably people from the Department as well.
I knew it was in the pipeline but I did not think it had happened that quickly. I would be delighted to attend.
I wish to refer back to something Senator Devine said about living in an area which down through the years has had its fair share of addiction problems, particularly in respect of young people and the families left behind. Any public representative, whether in Cork, Dublin, Limerick or elsewhere around the country, could relate to what she said about meeting young people particularly, and families that have been scourged by addiction. I refer to families and children who for whatever reason have been involved in very serious drug-related activity. Young children playing in parks and on streets raise health issues when, for example, they come across discarded needles, and this can have an effect on families. There was one such case last year in my constituency. A young lad playing ended up with a prick on his finger from a discarded needle. I understand the anxiety of parents in terms of what would happen if things did not turn out the way they did, but they turned out well enough in the end.
I will read a little from my notes. I know I have not answered some of the questions asked but I will come back to the Senators-----
Many questions were asked, and I will have to decipher some of my handwriting.
I thank the Senators who took part in the debate on the Bill. Before I reply to a number of the points that have been raised, I reiterate that the Bill is about reaching out to those people who are chronic drug users and who may also face other problems such as mental heath issues and homelessness. Every person who uses drugs is a human being with a family and a community. Unfortunately, drug use can affect schoolchildren, students, mothers and fathers. What they have in common is drug use which has a problematic effect on their lives and which may impact on their relationships with their families and friends and the wider community and society.
The problem of street injecting is not always apparent, especially when it occurs in areas that are already socially deprived or neglected. It is even less apparent when it affects those in society who are marginalised, such as homeless people. No one chooses to inject drugs on the street. This is what the most desperate in our community and our society are driven to. We must reach out to help them, and this is what this Bill and the injecting centre aim to do.
The Bill does not provide for an exact location of the injecting centre in line with the experience of other countries. The location of the centre should be considered where the need of drug users is greatest. The views of local stakeholders should also be considered. As I said last week in the Dáil, the supervised injecting centre will be located where need is greatest. This is why I have asked the HSE to set up a working group. The group is engaged in a process of identifying where the effects of public injecting are most prevalent. The group will address the particular issues of setting up a pilot service, including consultation locally and ongoing monitoring and evaluation.
In that regard, as a Minister of State, a public representative and a citizen of this country, wherever this centre is located, I want the residents and the community around it to be fully aware of what it will do before it opens. If we do not inform them, if we do not have consultation, it will only highlight other matters that need not be highlighted. I think there will be a real buy-in. I spoke about injecting centres last week at a meeting in the Liberties at which the issue was raised. I was very surprised by the reaction from people in general when they got the full gist of what the centre was about.
It is the intention on passing the Bill to open an injecting centre on a pilot basis in Dublin city.Cork wants one as well. I will just throw that in for what it is worth. The pilot will be subject to an ongoing monitoring review with input from An Garda Síochána, the HSE and others. This pilot centre will be subject to a thorough evaluation in order to assess it in the Irish context, and how it meets the needs of people who inject drugs and indeed the wider community. The results of this pilot will inform decisions about any further injecting centres, including whether the pilot centre should continue to stay open. These decisions will be evidence-based.
The Bill clearly sets out that the licence issued will be for a defined period of time. The Minister is not obliged to grant a licence under the Bill and similarly the Minister is not obliged to renew a licence. Under section 5, the Minister is empowered to suspend or revoke a licence. This can occur when the Minister is satisfied that the licenceholder is no longer eligible to hold the licence or is in breach of the conditions of the licence or any relevant regulations made under the Act. The Minister will consult with the HSE, An Garda Síochána and others who may bring issues to the attention of the Minister in that respect. While I expect the pilot centre to be successful, if for some reason it is not, the Minister is not obliged to renew the licence or grant a further licence. If the evidence does not support the pilot service continuing, or if ongoing monitoring suggests that the centre is not operating as it should, the Bill enables the Minister to revoke the licence.
This Bill has been very carefully drafted to address the health-related harm associated with public injecting while ensuring that the misuse of drugs legislation remains undiluted in any way. Possession of controlled drugs will continue to be an offence outside an injecting centre. Possession for sale or supply will remain an offence both inside and outside the centre.
I will close with a statement I made in the Dáil last week about a poem. I will not go through the poem. I have taken three lines out of it which I believe are key to what supervised injecting centres should be about. It is a beautiful verse, but I would just like to recite three lines:
To life anew
That is what we are able to do with injecting centres. This Bill and this supervised injecting centre will open doors and restore hope. I thank the Chair and all the Senators for their contributions and for their knowledge around this issue. Anybody who has been in the Seanad this afternoon has already made a huge impact with this Bill, not only as individuals but in communities as well. I thank the Chair again and I thank the officials from the Department for their services over the last couple of weeks, particularly in putting the Bill together and helping me bring it through the different Stages. We are not finished yet but we are getting there.