Sir, - Like John Adams (November 15th), I was struck by the connection between your two editorials entitled "Drugs and Young People" and "Education for All" (November 10th).Most studies of drug abuse in Dublin show a clear association between early school-leaving and a high prevalence of injected opiate use in certain vulnerable communities. Problem drug use is most obvious in Dublin's physically, socially and financially deprived areas. It is essentially a "social" problem with important and sometimes disastrous medical consequences for those using drugs.
To date, as a society, we have concentrated our efforts on developing a range of medical services for drug users; it is hoped the proposed comprehensive services will be in place in the next few months. However, these services are directed at the end stage of the problem, not at the beginning. It is like pulling bodies out of the mouth of the river and trying to resuscitate them when we should be looking up river to prevent people falling in.
As a general practitioner working in Dublin's south inner city, I am confronted daily with ill health, much of which is the consequence of social inequity. One of the most effective and least expensive ways of addressing social inequity is through education.
The inner-city schools have the same pupil-teacher ratio as schools in more affluent areas, but with much fewer facilities. Falling birth rates and continuing depopulation in inner-city areas have led to school closures with teachers being moved out of the area. An important opportunity to achieve a better pupil-teacher ratio, which would have helped to redress some of the structural imbalance, was lost.
It is more important that our children leave primary school literate than that they have access to computers! It is an indictment of our education system that so many children from deprived areas leave primary school poorly equipped for further education and ill-prepared to face the mobs market. We know that the majority of drug users live in deprived communities, are poorly educated, unskilled and unemployed.
We should introduce a literacy test for children before they leave primary school and those not reaching an adequate standard should receive one-to-one teaching until they attain it. Further, we should introduce pre-school education into these vulnerable communities, along the lines of the "Head Start" programmes in the US. Professionally run nurseries should be sited in the flat complexes, with opportunities for young mothers to complete their education adjacent to their children.
Some of this work is currently being undertaken by voluntary groups and organisations such as Barnardos, but it needs to be put on a permanent and statutory basis. Many of the present schemes are funded by the health services when they should be the responsibility of the education services. We have a surplus of well-trained, motivated teachers who could do this work.
Access to good quality education is an important start and is a practical expression of cherishing all our children equally. - Yours, etc.,
Department of Community Health and General Practice, Trinity College, Dublin 2.