British-Irish Council: Misuse of Substances

Ministerial Statements – in the Northern Ireland Assembly at 12:00 pm on 26th April 2021.

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Photo of Alex Maskey Alex Maskey Sinn Féin 12:00 pm, 26th April 2021

I have received notice from the Minister of Health that he wishes to make a statement. Before I call the Minister, I remind Members in the Chamber that, in light of the social distancing being observed by parties, the Speaker's ruling that Members must be in the Chamber to hear a statement if they wish to ask a question has been relaxed. Members participating remotely must make sure that their name is on the speaking list if they wish to be called. Members present in the Chamber must do that by rising in their place or by notifying the Business Office or the Speaker's Table directly. I remind Members to be concise in asking questions. I also remind Members that, in accordance with long-established procedure, points of order are not normally taken during a statement or the question period thereafter.

Photo of Robin Swann Robin Swann UUP

Before making the statement, I take the opportunity to place on record my thanks and to pay tribute to the firefighters and the leadership of the Northern Ireland Fire and Rescue Service (NIFRS), the partner organisations and the wider community, who worked tirelessly over the weekend to bring the fire in the Mournes under control.

I thank them, as Minister with responsibility for NIFRS, for the work that they did over the weekend.

With your permission, Mr Speaker, I wish to make the following statement on the British-Irish Council (BIC) misuse of substances work sector ministerial meeting, which took place in virtual format on Thursday 11 March 2021. Minister Hargey and I attended the meeting, and Minister Hargey has agreed that I make this statement to the Assembly on behalf of both of us.

The Irish Government lead the misuse of substances work sector, and hosted the ministerial meeting. As Chair of the meeting, Frank Feighan TD, Minister of State for Public Health, Well Being and the National Drugs Strategy, welcomed the delegations. The Northern Ireland Executive were represented by Deirdre Hargey MLA, Minister for Communities, and me, as Minister of Health. The Government of Guernsey were represented by Deputy Al Brouard, President of the Committee for Health and Social Care. The Isle of Man Government were represented by the Honourable Ray Harmer MHK, Minister for Policy and Reform. The Government of Jersey were represented by Deputy Trevor Pointon, Assistant Minister for Health and Social Services. The Scottish Government were represented by Mairi Gougeon MSP, Minister for Public Health and Sport, and Angela Constance MSP, Minister for Drugs Policy. The UK Government were represented by Jo Churchill MP, Parliamentary Under-Secretary of State for Prevention, Public Health Care and Primary Care. The Welsh Government were represented by Eluned Morgan MS, Minister for Mental Health, Wellbeing and Welsh Language.

This most recent ministerial meeting of the misuse of substances work sector was an excellent opportunity to engage with Ministers from the other BIC member Administrations on an area that is as relevant and important as it has ever been, the harms caused to individuals, families and communities by alcohol and drug use.

The meeting focused on ways to reduce alcohol consumption and opportunities to measure the effectiveness of addiction services, and considered how the future work of the sector can progress.

Ministers considered and reflected on the papers that were formally presented to the meeting. Those included discussions on 'Financial Mechanisms to Reduce the Consumption of Alcohol' and 'Measuring the Effectiveness of Addiction Services and Harm Reduction Interventions'.

Ministers noted the efforts across all member Administrations to decrease alcohol consumption and agreed that there was value in comparing approaches and sharing learnings from the emerging evidence base. They also recognised the importance of effective monitoring and evaluation to ensure that policy and practice are developed on the basis of sound evidence and that sharing this diversity of knowledge, understanding, experiences and learning across member Administrations affords a unique resource for enhancing monitoring and evaluation.

Ministers noted and agreed the content of the forward work programme for the misuse of substances work sector. To address the challenges for the sector, they agreed that focus in the coming years should be on the following five themes: considering the lessons of COVID-19 and the delivery of drug and alcohol services; reducing the risk of drug-related deaths; reducing alcohol-related harms through the use of financial mechanisms; considering joined-up approaches to meeting the health and social needs of people who are homeless and use drugs and alcohol; and engaging with the voluntary and community sectors to consider their role in the provision of drug and alcohol services, and in the development and monitoring of policy.

Each of the five theme areas is being led by one of the member Administrations. The Northern Ireland Executive agreed to take the lead on moving forward with theme 4, which considers joined-up approaches to meeting the health and social needs of people who are homeless and use drugs and alcohol. We will do that in conjunction with the British-Irish Council housing work sector.

Ministers also had the opportunity to listen to a presentation by Professor Dame Carol Black on prevention, treatment and recovery, which was informative and timely. Professor Dame Carol has been undertaking an independent review of drugs in England for the United Kingdom Government Department of Health and Social Care. Her presentation focused on part 2 of her review and provided insight into lessons learned from the review study. The overarching aim of the review is to ensure that vulnerable people with substance use needs get the support to recover and turn their lives around in the community and in prison.

I take this opportunity to thank Minister Hargey and British-Irish Council ministerial colleagues across the Administrations who participated so productively in the meeting last month. I welcome the council’s work sector activity and the way in which it provided us with a great opportunity to discuss the issues, look at emerging issues of concern, share information and good practice, and bring forward agreed actions and areas for collaboration.

I commend the statement to the House.

Photo of Colm Gildernew Colm Gildernew Sinn Féin 12:15 pm, 26th April 2021

I thank the Minister for coming along today and giving us this statement. First, I join him in praise and acknowledgment of the Fire and Rescue Service for its work in very difficult circumstances in the Mournes over the weekend. I also acknowledge that many of us, beyond the people who live there, who enjoy and like to visit that area of natural beauty feel a sense of deep regret for that loss. I ask everyone to be conscious of fire safety and the impact that the damage caused by carelessness or, indeed, the deliberate lighting of fires can have.

I also welcome the fact that the vaccine programme is now rolling out fully to 35- to 39-year-olds and acknowledge the good work that is being done in that respect. I encourage everyone in that age range to avail themselves of the vaccine in order to protect themselves and their families.

The recent health inequalities report contains data that shows that alcohol- and drug-related indicators continue to show some of the largest health inequalities that are monitored in the North, with rates of drug-related mortality in the most-deprived areas five times those in the least-deprived areas. The rates of alcohol-specific mortality are four times those in the least-deprived areas. What is the Minister's Department going to do to begin to address that ongoing historical trend in inequalities?

Photo of Robin Swann Robin Swann UUP

I thank the Chair for his question. Although the topic was not discussed at the British-Irish Council meeting, I know that it has been raised at the Health Committee and that the Chair has asked for a specific presentation about the health inequalities that we are seeing.

My Department continues to focus on a number of strategies and work streams that are already out there. The Chair will be aware of the new strategic direction for alcohol and drugs (NSD) phase 2, which has had £8 million of investment in health and social care provision for tackling and evaluating the work that needs to be done. The strategic framework to tackle the harm from substance use has been out for a public consultation, which closed on 12 February. My Department is analysing the responses that have been received, and a new strategy will be finalised before seeking ministerial and Executive approval.

Photo of Pam Cameron Pam Cameron DUP

I thank the Minister for his statement. The issues of drug and alcohol misuse have been ever more prevalent in society, and many people have concerns that, during the period of lockdown, substance misuse behind closed doors will have dramatically increased. The problem will have been further exacerbated by restrictions on, and withdrawal of, some support services for mental health and addiction. Will the Minister outline whether the Council will consider the importance of dual diagnosis services as part of its forward work plan? Often, the issues of poor mental health and addiction are intertwined.

Photo of Robin Swann Robin Swann UUP

I thank the Member for her comments. Again, this was not specifically raised at the British-Irish Council meeting. However, my Department is actively engaged on those issues and, as the Member will know, they are part of the mental health strategy that is out for consultation at the moment to see how that service can be developed and progressed across Northern Ireland so that nobody falls between the cracks. My Department intends to make sure that everybody gets the support that they need.

Photo of Cara Hunter Cara Hunter Social Democratic and Labour Party

I thank the Minister for his statement and for his commitment to improving the lives of those who are struggling with substance misuse. The topic of alcoholism has touched all of us in some way. Was there any discussion about how we can best support the families and children of parents who struggle with alcoholism?

Photo of Robin Swann Robin Swann UUP

I thank the Member for her comments. Our new substance use strategy will, quite clearly, deal with those issues. It is a commitment under New Decade, New Approach that the Northern Ireland Executive publish a successor to the current alcohol and drugs strategy. Our new substance use strategy, 'Making Life Better — Preventing Harm and Empowering Recovery: A Strategic Framework to Tackle the Harm from Substance Use' has been co-produced by the Department of Health, working in partnership with key stakeholders inside and outside government, including service users and their families.

Photo of Alan Chambers Alan Chambers UUP

I thank the Minister for his statement, and I concur with his remarks about the fires in the Mourne Mountains. They certainly could have been a lot worse but for the efforts of the firefighters.

Minister, as outdoor hospitality opens at the end of this week, followed by indoor a few weeks later, there is a real possibility that a large number of people from the Irish Republic, many of whom are still not vaccinated, will cross the border to socialise. Does the Minister believe that the PSNI, and the guards especially, have a role to play in emphasising the relevant travel restrictions and public health advice?

Photo of Robin Swann Robin Swann UUP

I thank the Member for his question and comment. Again, that issue was not covered at the British-Irish Council meeting, but I know that it is being talked and asked about.

Where cross-border travel is concerned, the Republic of Ireland's travel regulations are very clear: there should not be outside-county travel, and that includes coming into Northern Ireland. There is an onus not just on the guards and the PSNI but on those in the hospitality industry not to actively promote or seek cross-border business and trade while there is such a disparity in vaccination rates on either side of the border.

Photo of Paula Bradshaw Paula Bradshaw Alliance

I thank the Minister for his statement. I also place on record my thanks to the Northern Ireland Fire and Rescue Service for its efforts at the weekend.

Minister, you will be aware that the Irish Government are proceeding with the minimum unit price for alcohol and are planning to have it in place by the end of the year. Will you please outline whether that was discussed at the meeting? What is your Department doing to proceed with that in Northern Ireland?

Photo of Robin Swann Robin Swann UUP

I thank the Member for raising something that was discussed at the meeting.

[Laughter.]

While drug misuse is a key issue in Northern Ireland, alcohol misuse still causes more harm at a population level in Northern Ireland. In fact, alcohol misuse kills up to three times as many people in Northern Ireland each year as drug use. It is fair to say that alcohol remains our drug of choice, and we have the combined alcohol and drug strategy in order to increase the emphasis that is put on the harm that is related to alcohol misuse and to raise the issue on the public, media and political agendas. The harms caused by the misuse of alcohol are a major public health issue in Northern Ireland, and I believe that the introduction of legislation for minimum unit pricing for alcohol has the potential to be a key population-level health measure to address the issue. I have, therefore, made a commitment to have a full consultation on minimum unit pricing once our new substance use strategy is finalised.

The consultation on minimum unit pricing will examine a range of possible options for alcohol pricing, including the consideration of the emerging evidence on the effectiveness of minimum unit pricing following its implementation in Scotland and elsewhere. The policy considerations arising from the consultation will be brought to the Executive in due course.

Photo of John O'Dowd John O'Dowd Sinn Féin

I thank the Minister for his statement and answers thus far. Minister, I welcome the important cooperation across these islands and the particular focus on alcohol abuse. However, in order to deliver services, we need staff. What measures is the Minister taking to ensure that we have the staff and resources in place to focus not only on this piece of work but on other work that is important to the health service?

Photo of Robin Swann Robin Swann UUP

I thank the Member for his point. The strength of the British-Irish Council is shown because we can raise and discuss those issues, as they do not happen in isolation in Northern Ireland, the Republic of Ireland, Jersey or the Isle of Man. There is a lot of challenging work that can be done on asking, "Have I enough staff in the Department?" We recently looked at recruiting and bringing across a number of officials to the Department. I am not sure whether the Member is aware that the Department of Health is one of the smaller Departments in the Executive, although a lot of our other work is done by arm's-length bodies. The focus that we have on our substance use strategy and all the other strategies involves a wide range of interventions and support. Thankfully, as we come out of the pandemic, we can release officials back to their key areas of policy focus, which look at those pieces of work. When we no longer have to put such an intense focus on COVID and COVID-prevention measures, the Department of Health and the officials who work in it can get back to their core service.

Photo of Órlaithí Flynn Órlaithí Flynn Sinn Féin

I thank the Minister for bringing the statement to the House today. This has been touched on, but it is disappointing that there is no mention in the statement of dual diagnosis. I am conscious that it was not on the agenda.

Will the Minister commit to putting it on the agenda for the next BIC meeting? We know that many people who are battling substance misuse are also battling mental health problems. I have regularly discussed in Health Committee meetings the number of cases that we, as MLAs, deal with of people in crisis who cannot get help and support. On Friday, I met the family of Jack Brennan, a young man who lost his life in west Belfast three months ago. Sadly, he is one of many. Can the Minister give any firm commitment on when a dual diagnosis service could be in place here or a timeline for that? It would be great to act as that voice in wider meetings on that important issue.

Photo of Robin Swann Robin Swann UUP

I thank the Member, and I know her genuine interest in this area. It is something that she continually raises. Part of the mental health strategy and consultation is the recognition of the need for support for dual diagnosis and how we look after that. Northern Ireland is leading on the work stream around the joined-up approaches of meeting the health and social needs of people who are homeless and use drugs and alcohol, so there is an opportunity to further explore dual diagnosis under that work schedule. Again, I lead on that with the Member's party colleague Deirdre Hargey, the Minister for Communities. I will raise it with Deirdre, and we will see whether we can get it on the agenda for the next British-Irish Council meeting.

Photo of George Robinson George Robinson DUP

I thank the Minister for his statement. What measures are being taken — North and South — by the PSNI and the gardaí to jointly apprehend the godfathers who are peddling the lethal drugs, particularly to our younger generation?

Photo of Robin Swann Robin Swann UUP

I thank the Member. Again, it was not raised in the meeting because it is wider than just North/South cooperation. With regard to working closely with the PSNI and the justice system, there is a sharing of information to take the appropriate joint action to reduce the supply of and demand for drugs. A subgroup of the organised crime task force meets specifically to share information on drugs and to take joint enforcement action, such as Operation Pangea. The medicines regulatory group and the Department also work in day-to-day cooperation with a wide range of local, national and international enforcement partner organisations. That includes the gardaí, the Police Service of Northern Ireland, Border Force, HM Revenue and Customs and the National Crime Agency. It also extends as far as Interpol, which addresses the illicit supply of drugs and prescription drugs.

Photo of Mark Durkan Mark Durkan Social Democratic and Labour Party

I thank the Minister for his statement on this very important subject. Over the past number of years, we have seen an increase in the misuse of prescription drugs. Can the Minister tell us whether the situation is more pronounced here than elsewhere? Are there lessons that we can learn from other Administrations' efforts to tackle it?

Photo of Robin Swann Robin Swann UUP

I thank the Member for his question. We have seen concern not just about the misuse of prescription drugs but about prescription drugs becoming a commodity and now being sold rather than being used by the people who need them. Operation Pangea brings in the cross-sectoral approach in trying to tackle that and to identify those who are not only misusing but selling drugs, whether illicit or prescription drugs. That is why we need to take the fuller approach in how we tackle that. Our new substance use strategy, which I spoke about earlier, will also look into those specifics.

Photo of Karen Mullan Karen Mullan Sinn Féin

I thank the Minister for his statement. Minister, in theme 5, you talk about the community and voluntary sector's role. In Derry, there is a clear need for a detox centre of excellence for addiction. What priority have you put on that vital centre and the inclusion of the community and voluntary sector in working with it?

Photo of Robin Swann Robin Swann UUP

Again, it was not something that was specifically covered in the meeting, but, under the heading "Addressing Northern Ireland’s unique circumstances" in 'New Decade, New Approach', the UK Government committed to making funding available for a number of areas, which could include additional funding to support the Londonderry addiction centre. It is anticipated that the funding made available currently will not be sufficient to cover all areas set out in 'New Decade, New Approach'. However, I understand that the specific projects that the funding is aimed at supporting are to be determined by a joint board that includes the Secretary of State and the First Minister and deputy First Minister.

Photo of Daniel McCrossan Daniel McCrossan Social Democratic and Labour Party 12:30 pm, 26th April 2021

Minister, thank you for your statement. Drugs are a scourge on our society. A few short years ago, in Christmas week, I saw the devastation and pain that they can cause as I watched my aunt and uncle bury their very young son. He took a pill whilst out on a social night with friends, and he died.

Given that we are seeing an increase in the level of drug misuse in our communities, among young people in particular, what message do you, as the Minister of Health, have for those young people to steer them away from that?

Photo of Robin Swann Robin Swann UUP

The Member will be aware of the campaigns by the Public Health Agency and all the other organisations. One of the strongest messages has come from community activists on social media: "One pill can kill". It does not matter what or who is your source of information, it is about the recognition that one pill has the ability — the terrible ability — to end a life. Somebody may be seeking a release or think that it will bring about a good feeling, but it can cause the end of a life, and families and communities have to bear that pain and loss afterwards. I ask people to please step away from utilising illegal drugs, the misuse of prescription drugs and supporting what are criminal activities.

Photo of Rachel Woods Rachel Woods Green

I thank the Minister for his statement. I also thank the Northern Ireland Fire and Rescue Service for its ongoing work in dealing with the tragedy in the Mournes.

One of the five themes of work mentioned in the statement is reducing risk and harm. That is welcome. Does the Minister agree that, fundamentally, addiction and substance misuse are health issues and that, if we are really intent on reducing drug-related harm, we need to destigmatise addiction and remove the fear of seeking help? Does he also agree that decriminalising vulnerable people and boosting professional help services is the way forward, an approach otherwise known as the Portuguese model?

Photo of Robin Swann Robin Swann UUP

I thank the Member. It is about destigmatising those who seek help and want to end their dependence on drugs or even alcohol. That is why that work is done through the Public Health Agency, the Department and very many in the voluntary and community sector. Given that those services are supported through Community Pharmacy, it is unfortunate that they are seen as a threat, rather than the solution that they bring, because of a misunderstanding by certain sections of the community. I agree with the Member that we will help people by destigmatising their problems. We also need to make sure that the real focus and ire are directed at those in the community who are exploiting the needs of those people and are involved in criminal activity.

Photo of Alex Maskey Alex Maskey Sinn Féin

That concludes questions on the statement. I ask Members to take their ease for a moment or two.

We have a bit of a dilemma. We received the statement from the Minister for Agriculture, Environment and Rural Affairs only a few minutes ago, and it is a statement of, I think, nine pages. I propose allowing Members a few minutes to read the document. If Members will indulge me, rather than suspending for almost half an hour, we will suspend for 10 minutes. Are Members content to suspend for 10 minutes? May I take that as a yes?

Some Members:

Yes.

Photo of Alex Maskey Alex Maskey Sinn Féin

Thank you very much. We will suspend for 10 minutes.

The sitting was suspended at 12.33 pm and resumed at 12.46 pm.

(Mr Principal Deputy Speaker [Mr Stalford] in the Chair)