Debate contribution: Treatment and Recovery Centre in the North-west

Debate contribution by Mr Mike Nesbitt on 4 March 2025.

MLA

Mr Mike Nesbitt

Party at the time

Ulster Unionist Party

Date

4 March 2025

Type

Debate contribution (made as a minister)

Business

Opposition Business

Heading

Treatment and Recovery Centre in the North-west

Assembly identifier

Official Report component 4833427

Read the official Assembly record

Text

Principal Deputy Speaker, thank you very much. I thank also the proposer of the motion and the Members who moved the two amendments. I do not think that we can ever spend too much time raising awareness of the harms of substance use and putting a focus on all that we can do collectively to try to address this topic. As Members will be aware and as has been stated in the debate, tackling health inequalities has become a passion of mine, and, currently, the largest inequalities in health relate to substance use. In the most deprived areas, for example, drug-related deaths are almost six times higher than in the least-deprived areas. In the Western Trust area in 2022, there were 26 drug-related deaths, each with a devastating impact on family, friends and community. While the conversation often turns to drugs, we should also remember the impact of alcohol. In 2023, 68 people in the Western Trust area died from alcohol-specific causes. That is simply unacceptable, and I am therefore committed to taking action. We also know of the cost to the health service and to Northern Ireland. It is estimated that substance-related harm costs us up to £1·5 billion a year. Again, however, I emphasise that we should primarily focus on the human cost. Despite some positive progress, such as a reduction in the number of young people drinking alcohol or using substances, the level of harm has been increasing. That is driven by a range of factors, including the availability of new substances, increased complexity of cases and polysubstance use. Our strategy, Preventing Harm, Empowering Recovery, therefore acknowledged that we require a revised, joined-up, whole-system approach to our services in Health and Social Care (HSC) and across other Departments. The motion helpfully recognises the links between substance use, mental health, housing and economic inactivity. While the substance use strategy is Health-led, it rightly recognises that a whole-system approach is required to address not just the causes of substance use but the causes of the causes. All those sectors are part of the strategy's implementation and of the programme board that oversees delivery. Substance use is also an issue that knows no borders, and my Department works closely with colleagues in Ireland and across the UK through the British-Irish Council and four nations ministerial meetings on the topic. On delivery in Health, Members may be aware that I launched the HSC substance use strategic commissioning and implementation plan in November of last year. The plan has been co-produced by the Public Health Agency and the strategic planning and performance group (SPPG). It creates a new whole-system, outcomes-focused strategic service delivery plan that covers all tiers of service provision for substance use, and it will last for the next four years. The plan addresses various levels of need relating to substance use in our population, and it encompasses service provision ranging from early intervention and preventative services to specialist inpatient detoxification and residential rehabilitation services. The plan is part of our wider health reform agenda, which stresses the importance of using our existing services in better ways to meet the needs of the population. As part of that reform agenda, an independent review of tier 4 addiction services has been commissioned by the SPPG as an accelerated work stream within the commissioning and implementation plan. The aim of the independent review is to scope the needs of our population relative to current hospital inpatient detoxification and residential rehabilitation services for substance use issues. The review is in draft and has been subject to a 12-week public consultation that closed on 19 February. The review makes 20 recommendations to support the development of a regional specialist assessment, treatment and recovery network. This will enable people to receive the right assessment, the right treatment and the right support at the right time, in the right place and from the right people. The consultation on the review received 55 responses, of which 66% came from the Derry City and Strabane District Council area. Early analysis of the responses indicates a high level of agreement with all 20 recommendations, ranging from 85% to 99% support for the proposals. Subject to further analysis of the consultation responses and the required departmental approvals, the recommendations will be prioritised for implementation by the SPPG and the Public Health Agency this year and going forward. It is important to note that the review does not recommend that a new dedicated treatment and recovery centre be developed in the north-west but instead that joined-up working be improved and better pathways developed between existing services.

Such services include community detoxification services, community addiction teams and community mental health teams, early intervention and prevention services and primary care inpatient detoxification services and residential rehabilitation.

The report's recommendations will most notably impact on current residential rehabilitation provision, with the recommendation that such services should be subject to a regional procurement exercise. It is intended that, by taking a procurement exercise regionally for residential rehabilitation services, there will be a beneficial impact for people requiring those services, with consistency and equity of access to services on an evidence-based approach. The recommendations of the regional independent review also concur with the findings of the local population-based needs assessment for the Western Health and Social Care Trust area in relation to substance use. That needs assessment was commissioned by the PHA and the SPPG to better understand the needs of the population in the north-west area and to identify gaps in services. It identified the wide-ranging impact of substance use in the Western Trust area. It requires a comprehensive, whole-system response to the development and improvement of services and support in order to bring about lasting change for the population. It further identifies the need to support the development of recovery communities across the Western Trust area and to increase the use of data and performance information to ensure that future commissioning decisions are informed by an understanding of what works and take cognisance of changing trends. The implementation of the recommendations made in the assessment are being considered in the Western Drug and Alcohol Coordination Team, with the support of the PHA, the SPPG and the Western Health and Social Care Trust. I am also pleased to note the recent announcement of PEACE PLUS funding of €8 million for an innovative community detox-plus project in Northern Ireland, and that is namely in the Western and Southern Health and Social Care Trust areas and the border counties of Ireland. That funding has been secured through the collaborative health and social care addiction services investment area's PEACE PLUS healthy and inclusive communities theme, and it will contribute towards the more efficient delivery of health and social care services relating to addictions. Service providers in the north-west area will therefore develop enhanced and comprehensive community care for those with problematic alcohol use, with the primary objective of mitigating the harmful effects of alcohol on individuals, families and communities, while addressing the socio-economic issues that continue to undermine the health and well-being of our population. That will be achieved by supporting adults in safely detoxing at home or in a community space rather than within residential services. My Department is currently funding a pilot project in the north-west, the aim of which is to improve the physical and mental health of individuals directly and indirectly impacted on by problematic substance use. Funding has been provided to Addiction Recovery Coaching, a community-based, not-for-profit addiction recovery organisation in Derry/Londonderry. To Members who have mentioned ARC, I say that I have visited it and been inspired by the leader, Gary Rutherford. I have not just visited; I have invested in that service. It is led by people with lived experience of substance use and addiction, as well as by mental health professionals and accredited therapists. Their work promotes an understanding of the recovery pathway and a reduction in the stigma associated with addiction. That support is provided through access to physical activity, professional support and reconnection with community. It complements and supports the work of other community and statutory services. We need no reminder that those impacted on by drugs and alcohol use are our sons and daughters, our brothers and sisters, our mothers and fathers and our friends and colleagues. Almost everybody in this region has been or knows somebody who has been affected by substance use, so it is an issue that touches us all. Please let me take this opportunity to once again restate my commitment to making a positive impact in relation to substance use across this region. One comment that I want to reply to is that of Mr Carroll. It is about the causes of the causes. It is not enough just to say, "Alcohol use or substance use causes ill health". What causes people to abuse substances in the first place? Yes, poverty is absolutely a key factor, and that is why I say to the House that tackling this is not just an issue for the Department of Health: we need an all-Executive, all-systems approach to tackling it.

I thank the Member for his intervention. I understand his position. My position is that, if we can tackle the causes of the causes, the need for prosecutions will go away. I know that he does not think that there is a need for prosecution now. Others take a different view, however. Let us therefore tackle the causes of the causes so that the issue does not arise at all.

Yes.

I thank the Member for his intervention. The fact that the law dates from 1971 suggests that it may well be fit for review. The Member is taking me into the area of a different debate, and it is a debate that I would very much welcome the House having, including our debating taking a position on whether we are in the right place, and have been since the early 1970s, or whether it is time to look at taking a different approach. Again, for me, the fundamental is to look at the causes of the causes and how we address them. Without wishing to stir things up or to divide the House, I gently say that I note that the motion and, indeed, the two amendments call on me:

"to prioritise the delivery of a fully funded, purpose-built addiction treatment and recovery centre in the north-west".

During the debate, however, nobody has yet suggested what I should deprioritise in order to make that happen. Should I deprioritise the building of the children's hospital at the Royal so that we have the capital for the centre in the north-west? Should I deprioritise nurses' pay so that we have the resource to fund the operation of a centre annually? That is part of the problem. If we are to do this, we need capital and resource, and I do not see them becoming available. I therefore reaffirm my commitment to doing what I can to help those who are subject to substance use and abuse, but we have to be realistic about what is possible.

1,850 words. Text as published by the Northern Ireland Assembly.

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Assessed 21 October 2026 at 12:06 UTC by jev-1.13.0 (requested as typesafe/jev) under rubric 2026.10-r9, methodology 1.9.

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