Drugs strategy review finds staff shortages and service disruption
Rural areas, young people and marginalised groups are reported as being 'disproportionately affected' by service discrepancies.
Meanwhile, the review found that annual funding arrangements and restrictive hiring policies have contributed to staff shortages and disruptions in service delivery.
The National Drug Strategy (NDS) is set out as a national framework for addressing substance use through a 'whole-of-government, person-centred, and health-led' approach that primarily frames substance use as a public health issue.
An independent review of the strategy, published today, found that several stakeholders also believe prevention efforts are underdeveloped, inconsistent and lacking national ownership.
The report compiled by Grant Thornton notes some progress and achievements but makes 10 recommendations for the future direction of the strategy.
The authors consulted with the Health Service Executive (HSE), the Health Research Board (HRB), members of the National Oversight Committee (NOC) and Strategic Implementation Groups (SIG) for the NDS, as well as service users and family members with lived experience of drug use.
Based on those engagements, it found that equity of access continues to be a concern, particularly for marginalised groups.
Prevention and early intervention efforts were found to be fragmented and inconsistently delivered, while recovery and service user involvement requires further formalisation and resourcing.
Additionally, the limited integration of alcohol policy and the 'gradual implementation of legal reforms', such as alternative sanctions, were identified as areas requiring strategic refinement.
Meanwhile, governance structures were found to lack clearly defined roles, mandates, and accountability mechanisms.
Stakeholders highlighted the need for strong national leadership, enhanced co-ordination across departments, and more inclusive decision-making processes that incorporate lived experience of service users.
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There were also calls for enhanced data integration and the establishment of a national research and evaluation centre.
The report also details claims of inconsistent reporting from all treatment providers which is further constraining the ability to assess the strategy's effectiveness.
Stakeholders reported that high attrition rates have been observed in different regions due to factors including limited funding.
There were repeated calls by some stakeholders for multi-annual funding commitments and targeted workforce investment to support more consistent and sustainable service provision.
Prevention efforts were widely viewed as 'under-resourced and lacking strategic focus'.
There was an emphasis on the need for early, community-based interventions that address root causes, such as trauma, poverty, and social disadvantage.
Evidence shows that early life experiences significantly influence later substance use.
The SPHE programme in schools was repeatedly cited for its inconsistent delivery.
Many stakeholders also felt that the NDS lacked clarity and strategic direction regarding alcohol addiction.
The Minister for Health, Jennifer Carroll MacNeill said it is 'essential' to assess how the more than 300 million euro in annual public expenditure on drugs delivers impact.
She said: 'The establishment of new HSE health regions presents a valuable opportunity to tailor drug treatment services to population needs and to ensure that both existing and new funding is allocated effectively and transparently.'
Meanwhile, Minister of State with responsibility for the National Drugs Strategy, Jennifer Murnane O'Connor, said: 'We have made significant progress in implementing the national drugs strategy, and I'm pleased that the independent evaluation documents the many achievements over the last eight years.'
She added: 'The recommendations from the independent evaluation will inform the development of the successor National Drugs Strategy. We need to move forward with new policies and better services to address the ever-changing drugs situation.'
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RTÉ News
18 hours ago
- RTÉ News
Decision to open two new surgical hubs in north west not 'political', says minister
Minister for Health Jennifer Carroll MacNeill has said the decision to open two new surgical hubs in the north west region is based on the data available and not "anything political". The plans will see the construction of a new surgical hub close to Sligo University Hospital, while at Letterkenny University Hospital in Co Donegal, a new surgical hub is proposed along with expanded oncology services. It comes after regional HSE management had previously identified a site in Sligo as the sole preferred option for a new surgical hub in the north west region. That decision was strongly criticised by Donegal-based clinicians, who subsequently met with Minister Carroll MacNeill and raised their concerns with her in relation to "population need and geographical logic". Minister Carroll MacNeill has now given her support to the opening of two new surgical hubs, following a proposal from the CEO of the Health Service Executive (HSE), Bernard Gloster. Such surgical hubs allow for the delivery of day-case surgeries and minor procedures. Speaking at Letterkenny University Hospital this afternoon, Minister Carroll MacNeill outlined her reasons for backing the opening of a hub in both Donegal and Sligo. Minister Carroll MacNeill said: "I appreciate that some of the narrative got hold that decisions had been made, but I have never made any decision until this weekend, when I got a business case from the HSE recommending two hubs, and I made a decision on that basis. "But I would say that my engagement in Sligo was very important, but my engagement here (in Donegal) was exceptionally important. "Being here on the 1st of May was very important. Listening and working with all of my Oireachtas colleagues and my ministerial colleagues. Everybody here, I met them, we talked to each other, we listened to each other. "I also had two very good meetings with the clinicians here, and I think all of those meetings were very, very important in not just understanding the need today, but understanding how surgery is developing and changing, understanding the demographic development of this region, the particular geographical pressures, and also seeing how impactful it is to deliver services locally, as we see in the Errigal hub, just just across the way." The Minister then went on to say: "This was the right decision, not because of a series of meetings, but because, from a data perspective and from a planning for the future perspective, this was just the right decision. "It's not anything political. This is the right thing for Donegal. This is the right thing for the north west. And I hope that we will see the benefit of these two surgical hubs, delivering for people to get quicker surgeries within a very short time." The Health Minister also added that her hope is for both hubs to be operational within two years. The plan, which has been given the green light today, will see the construction of a new stand-alone two-theatre surgical hub in Sligo. The Department of Health has said the facility will significantly expand elective surgical capacity in the region, and it will help reduce waiting times and improve access to scheduled surgical care. Meanwhile, a new two-theatre surgical hub will be built beside the existing Letterkenny University Hospital building, along with the addition of 30 ambulatory day oncology chairs - 15 new and 15 replacement. The Department of Health has said this dual investment will enhance both surgical and cancer treatment services in Co Donegal. The design of the new surgical hub in Letterkenny will also allow for future vertical expansion, addressing the long-term need for additional bed capacity in the region. The HSE will now begin drawing up planning applications for both sites, which will be prepared in parallel and include engagement with Donegal and Sligo County Councils. Áine Keating, a consultant in emergency medicine at Letterkenny University Hospital, and Pádraig McGuinness, a GP based in Fánaid in Co Donegal, are both members of the Surgical Hub Campaign Team, who previously met with the Health Minister. Mr McGuinness said: "It's an incredible day for Donegal, it's an incredible day for this hospital. The surgical hub for us is a statement of intent, I guess, by the HSE, and certainly by the Minister that this hospital is here today, but also this hospital is going to be the best that it possibly can be, and the hub is the first step in that process. "The Minister has always been data-driven with us. She always wanted the facts and figures. She drills down into them with deep, deep detail, and by doing that, she could clearly see that the need was here for a surgical hub in Letterkenny and in Sligo. "At the start of this campaign, we always said the best outcome here is one in each town, and we're going to have one in each town now, and that means the patients from this county won't be travelling long distances for their health care for the years to come". Meanwhile, Ms Keating said: "This was a data-driven decision. We presented to her (the Minister) in two very effective meetings, where she listened to the compelling arguments and the compelling data that we had shown her about the health care needs in Donegal; that we have a massive population, a very busy hospital that we need to sustain and to maintain services here. And through that, she has been able to deliver a surgical hub for us here in Letterkenny." Ms Keating went on to say that the campaign group will now turn its attention towards trying to get the surgical hub over the line in a time-effective manner, and it will be working closely with management throughout this process. Meanwhile, Regional Executive Officer for the HSE west and north west Tony Canavan, said the hubs will be "really important" in terms of reducing the waiting lists for elective procedures in counties Donegal and Sligo. Mr Canavan said: "These surgical hubs would mean that we would be able to treat patients much more quickly and with much greater degree of certainty." He went on to say that: "In Letterkenny, the hub that we're proposing to develop will also include day beds for people that are receiving oncology treatments, 15 brand new beds and a replacement 15 as well. "That will mean that people from Donegal can receive their chemotherapy close to home, and would be able to plan for that into the future as well". Mr Canavan also admitted that it will be a "challenge" to staff the new surgical hubs. He said: "There's no doubt it will be a challenge to staff all of these existing and additional services. That said, we have a model in place because we're developing surgical hubs in other locations around the country. "We will be using that model as a basis on which to work from for both the hub here in Letterkenny and the one in Sligo." The HSE classes a surgical hub as a facility which deals with "high volume, low complexity" elective procedures, treatments and diagnostics. Such elective procedures include biopsies, endoscopies, steroid injections, carpal tunnel treatment, tonsillectomies, cataract treatments, varicose veins treatments, hernia repairs and other keyhole surgeries. Once operational, each surgical hub is expected to deliver over 28,000 day-to-day cases, minor operations and outpatient consultations every year.
Irish Times
20 hours ago
- Irish Times
A father in Gaza: Our children are dying as the world watches. We don't want your pity
Mass starvation is now in Gaza . It is here. It is deadly. And it is getting worse by the day. Exactly two months since the Israeli government-controlled Gaza Humanitarian Foundation (GHF) began operating, more than 100 organisations including ActionAid published a letter sounding the alarm on hunger, urging governments to act. We are desperate for the world to listen. Massacres at the GHF food distribution sites in Gaza are occurring almost daily, with more than 1,000 starving people desperate for food killed to date. Thousands more have been injured. This is on top of the fact that nearly two million exhausted Palestinians have been forcibly displaced by Israel, with the most recent mass displacement order issued on July 20th, confining Palestinians to less than 12 per cent of Gaza. These conditions are impossible. READ MORE The starvation of civilians as a method of warfare is a war crime. In warehouses just outside Gaza, and even within Gaza itself, tons of food, clean water, medical supplies, shelter items and fuel sit untouched with humanitarian organisations blocked from accessing or delivering them. The government of Israel's restrictions, delays and fragmentation under its total siege have created chaos, starvation and death. Illnesses such as acute watery diarrhoea are spreading, markets are empty, waste is piling up and adults are collapsing on the streets from hunger and dehydration. Distributions in Gaza average just 28 trucks a day, far from enough for more than two million people, many of whom have gone weeks without assistance. As the letter from more than 100 organisations stated, the UN-led humanitarian system has not failed, it has been prevented from functioning. In my home city of Deir al-Balah in northern Gaza, where I am currently displaced with my family and working as a humanitarian worker for ActionAid Palestine, starving children are everywhere, sunken-eyed and limp in their mothers' arms, their skin hanging loosely on skeletal frames. Older children with limbs as thin as sticks walk around in a daze, eyes dull, too tired to play and too hungry to cry, their bodies failing from lack of food. [ The beaches here in Israel are full. Just an hour's drive away Palestinians are starving Opens in new window ] These children are dying in plain sight with heartbreaking images of emaciated bodies dominating newspapers and screens, telling the true story of what is happening in Gaza. And the world is watching. But not acting. I write this not only as a humanitarian worker, but as a father of three children in Gaza witnessing a catastrophe unfold before my eyes. A catastrophe not just measured in shattered buildings and bombs, but in the slow, agonising deaths of the population – especially children – from hunger and thirst. More than 90 per cent of Gaza's people are now facing either crisis-level or catastrophic levels of food insecurity, according to the latest Integrated Food Security Phase Classification report. That is nearly two million people – many of them children – who have run out of ways to feed themselves. One hundred and thirteen people have died from starvation since October 2023, and 81 of those are children. What we are seeing here is not a famine warning. It is famine, plain and simple. And it is claiming lives. Every day I see the heartbreaking consequences. Not just children with protruding ribs and swollen bellies, but parents who haven't eaten for days. People collapsing, not from injury, but from hunger. Malnutrition has become as deadly as the bombs. In displacement camps, families count themselves lucky if they get to eat one meal a day if they can find it. Fresh produce is virtually non-existent. A kilo of tomatoes that once cost $1 now sells for up to $30, if you can even find them. Shelves are bare, and the aid that trickles in is a mere drop in an ocean of desperate need. For newborns and infants, the situation is even more horrifying. Baby formula is almost impossible to find. When it does appear, it's often expired, or costs more than families can afford. In the absence of formula, mothers are mixing sugar and flour into water just to keep their babies alive. This puts their tiny bodies at enormous risk of illness and long-term damage. But what choice do these parents have? As a father, I am responsible for my children's needs, but it's hard to secure one meal per day for my family. As a humanitarian worker, I am also trying to help local communities and our people in Gaza, delivering what aid is available. But there is nothing much to be given to the people. Whatever is available is a drop in the ocean. People are no longer afraid of air strikes, they are afraid of starvation. I have spoken to neighbours who say they would rather die quickly in a bombing than suffer this slow, grinding hunger. Despite the global headlines, despite the footage of skeletal children and mothers crying over the tiny bodies of their babies, the world has failed to stop this devastation. World leaders offer words. Resolutions are passed and appeals are made. But still, the bombs fall, and the borders stay largely shut and famine deepens. And yet, this can be stopped. We are grateful to the Irish people for their support and the recognition of Palestine as a state. But governments must stop waiting for permission to act. We cannot continue to hope that current arrangements will work. [ I showed my friends in Israel this photo of a starving baby in Gaza and asked them if they knew Opens in new window ] It is time for them to take decisive action: demand an immediate and permanent ceasefire; lift all bureaucratic and administrative restrictions; open all land crossings; reject military-controlled aid distribution models; restore a principled, UN-led humanitarian response and continue to fund impartial humanitarian organisations. States must also pursue concrete measures to end the siege, such as halting the transfer of weapons and ammunition. The airdrops announced by the Israeli government over the weekend are a totally inadequate response to this crisis, and amount to nothing more than an attempt to whitewash a policy of deliberate starvation. This type of piecemeal arrangement cannot replace the legal and moral obligations by states to protect Palestinian civilians and ensure meaningful access to desperately needed aid. The lack of action is sickening. What will it take? History will ask what the world did while children in Gaza starved. I am writing this in the hope that my words will reach those with the power to make this nightmare stop. The people of Gaza do not need pity. We need action. We need food, medicine, clean water. We need the bombs to stop and the siege to end. We need borders to open to allow for humanitarian aid. We need the world to finally say 'enough'. Alaa Abu Samara is Gaza emergency response manager for ActionAid Palestine
Irish Independent
a day ago
- Irish Independent
Donegal and Sligo Hospitals to get new surgical hubs
Minister for Health, Jennifer Carroll MacNeill will visit Letterkenny today to make the announcement having already given the good news in Sligo early this morning on a visit to Sligo University Hospital. It comes as there had been concerns that a surgical hub would be located in Sligo only with Letterkenny being overlooked for the facility resulting in a possible downgrade of the hospital. However, Minister for Health, Jennifer Carroll MacNeill, has given her support to significant new investments in healthcare infrastructure for the North-West region, following a proposal from the CEO of the Health Service Executive (HSE), Bernard Gloster. The proposal includes a new surgical hub close to Sligo University Hospital, while at Letterkenny University Hospital a new surgical hub is proposed along with expanded oncology services. Speaking on the proposals, the Minister said, 'The Programme for Government committed to exploring the provision of a surgical hub for the North-West. I have consistently highlighted the need to ensure that patients in this region have access to sufficient and timely surgical capacity. Increasing surgical activity in the West and North-West is a clear priority. 'Today marks an important milestone in delivering on that commitment, and I am happy to support this proposal from the HSE. "I know Tony Canavan, Regional Executive Officer, HSE West and North West, and his team will now begin progressing these proposals, working closely with hospital management, clinical specialties, and the estates team to advance the design phase, secure planning permission, and prepare for tendering the construction works. 'These investments align with our Ambulatory Elective Day Care Strategy and the National Cancer Control Programme. They will ensure that patients in the North-West have timely access to high-quality surgical and oncology care. 'I look forward to returning to see the progress of these developments, which will make a real and lasting difference to people's lives in the region,' said Minister Carroll MacNeill. Letterkenny University Hospital will see the development of a new two-theatre surgical hub beside the existing hospital building, along with the addition of 30 ambulatory day oncology chairs – 15 new and 15 replacement. ADVERTISEMENT This dual investment will enhance both surgical and cancer treatment services in Donegal. The design of the new surgical hub will allow for future vertical expansion, addressing the long-term need for additional bed capacity in the region. To support this, a full Development Control Plan (DCP) for the Letterkenny University Hospital site will be commissioned to guide the sequencing of future developments. The HSE will now proceed with the development of planning applications for both sites, engaging with relevant local authorities, which will be prepared in parallel, ensuring a coordinated and efficient rollout of these critical healthcare projects. A new stand-alone, two-theatre surgical hub will be constructed in Sligo. This facility will significantly expand elective surgical capacity in the region. Drawing on the successful models already in place at Tallaght and Mount Carmel in Dublin, the hub will help reduce waiting times and improve access to scheduled surgical care. Donegal Minister of State, Charlie McConalogue, has welcomed confirmation from the Minister for Health, Jennifer Carroll MacNeill, of a new surgical hub for Letterkenny University Hospital. Welcoming the announcement, Donegal Minister of State, Charlie McConalogue, said: 'The proposal to develop a new two-theatre surgical hub beside Letterkenny University Hospital building, along with the addition of 30 ambulatory day oncology chairs - 15 new and 15 replacement – is excellent news for the people of Donegal. "The investment will serve to improve surgical and cancer services in the county.' 'I have stressed to the HSE that Donegal must be provided with its own surgical hub. "I have worked closely at political level in Government to ensure that a surgical hub will be delivered for Letterkenny and I thank the Minister for Health, Jennifer Carroll MacNeill, for her help and assistance. "I also welcome the announcement that patients in the North West will have access to high-quality surgical and oncology care,' Minister McConalogue added. Donegal Deputy Pádraig MacLochlainn welcomed the news that a second Surgical Hub will be located in the North West at Letterkenny University Hospital along with expanded oncology services, with the other one being at Sligo University Hospital. Speaking today, Deputy MacLochlainn said, "This u-turn by government is the most welcome of news this morning and shows the impact political pressure can have. "It was unthinkable that the locating of regional Surgical Hubs across the country would not include one being located at Letterkenny University Hospital. "This is testament to the hard work of all that campaigned, particularly the 171 doctors and clinicians who stood up and fought for fairness for the people of Donegal. Without whom, this would not have been possible. "Forcing a u-turn on this issue was a priority for myself and Sinn Féin colleagues Deputy Pearse Doherty and Cllr Gerry McMonagle, chair of the HSE Regional Health Forum West. "It is hard to put into words just how badly needed this expansion of services was. It will save lives and ensure the future of Letterkenny University Hospital. "There is still work to be done, but this is an enormous step taken today to improve Letterkenny University Hospital and healthcare in Donegal,' said Deputy MacLochlainn.
