The next item of business is a debate on motion S6M-07469, in the name of Angela Constance, on the national drugs mission: cross-Government response to the Drug Deaths Taskforce report, “Changing Lives”.
14:59
Every life lost to drugs is as tragic as it is unacceptable. As we enter a new year, we continue to face a public health emergency, and we must not underestimate the scale of the crisis.
Last July, the Scottish Drug Deaths Taskforce published its final report, “Changing Lives”. The report was the culmination of three years’ work examining the drivers of our drug deaths crisis and providing evidence-based recommendations for change. I again thank all those who were involved in the work of the task force for their dedication and commitment.
We have not waited for that final report to act. Since the formation of the task force, we have announced our national mission and we have taken a wide range of actions to save and improve lives. Many of those actions were informed by the task force as its work developed, including the medication-assisted treatment standards and the roll-out of naloxone.
The task force’s message was clear: change is needed and change is possible. The “Changing Lives” report set out 20 recommendations and 139 action points, reflecting the complexity of the needs of people who are at risk of a drug death and the scale of the challenge that we face. Meeting that challenge requires a whole-Government response. Indeed, a truly national mission requires an approach that involves us all.
Today, we have published our cross-Government response, which is underpinned by two transformative principles. First, we will treat problem drug use as we do any other health condition. Taking that approach across Government will help to ensure that every area considers what adjustments are needed to ensure that people who are affected by problem drug use are included and not discriminated against. The second principle will also help to ensure that that happens, by including representatives with lived and living experience of problem drug use in the co-production of policies and strategies in any and all areas of policy or service delivery that affect them.
Our cross-Government response sets out more than 80 actions. Although there are significant challenges in tackling the drugs crisis, we are determined that a lack of investment should not be one of them. Despite the huge fiscal challenges that we face, today’s action plan is supported by spending commitments totalling more than £68 million for the remainder of this parliamentary session.
Drug dependency is a health issue with undeniable roots in poverty. Therefore, our response highlights the work of the Scottish Government to tackle poverty and inequality, the social determinants of health, as well as actions on early intervention and family support.
I know that of particular concern, across the chamber, are the testimonies that we still hear far too often of people seeking help and being turned away or told that a service cannot support them, particularly when a person has a wide range of needs. The task force and the Government are clear that no door should be the wrong door and that there should be a more personalised and joined-up approach to support. Getting it right for everyone—GIRFE—is about providing a more personalised way to access help and support when it is needed, by placing the person at the centre of decisions that affect them. People who are accessing addiction services have been identified as one of five key themes for the new GIRFE pathfinders, which will test that approach using a co-design method.
We will also invest a further £2.4 million over three years to implement the recommendations from the rapid review of care for people with co-occurring mental health and substance use conditions. We know that people often need to travel to access services and support, which can be a barrier to treatment, particularly in rural areas. We will therefore work to update the referral process for access to the concessionary travel scheme and will explore the feasibility of expanding the scheme to people with a substance dependency, with £500,000 being made available for an initial pilot.
The successful implementation of MAT standard 7—which is all people having the option of MAT shared with primary care—will see better joined-up working, which will help to address the wider health needs and inequalities of people who use drugs. To enable that, from April 2023, we will ring fence £30 million—£10 million a year—for the remainder of this parliamentary session from the Scottish Government’s enhanced services allocation for primary care services to support specific services related to drug treatment.
We will continue to embed a whole-family approach and family-inclusive practice, building on the framework that we published in December 2021. I am particularly pleased to announce £4 million in funding to expand Routes—a programme for young people who are impacted by substance use in their families that is supported by Scottish Families Affected by Alcohol and Drugs.
Recognising the breadth of needs that people with problem drug use often have, there are also actions on dentistry to develop a programme to meet the oral health needs of people who use drugs, actions on education to ensure that provision for our children and young people reflects the latest evidence on what works in drugs education, actions on employment to maximise access to and the impact of our existing employability services, and actions on housing including the introduction of new duties to prevent homelessness.
The actions that are set out in the cross-Government response also include prioritising early intervention in the criminal justice system, using custody for remand as the last resort, ensuring that people with problem substance use in the prison estate can access the support that they need, and removing barriers to people accessing services and treatment on release from prison. For example, the Bail and Release from Custody (Scotland) Bill will end liberations on Fridays or in advance of public holidays, which have presented a significant barrier to many people accessing services on liberation.
As I set out in my statement to Parliament last month, we know the challenges that our workforce faces and we have brought together an expert group to develop a longer-term workforce action plan, as the task force recommended. I confirm today the provision of £0.5 million per year to deliver that plan and a further £480,000 per year for additional recruitment to the very successful addiction worker training programme. Recognising the importance of having a trauma-informed workforce and services, today’s publication also includes investment of up to £1.1 million per year in the national trauma training programme.
Section 2 of today’s publication outlines our response to the task force recommendations that relate specifically to drug services and policy. Alongside that, we have published a supporting document that provides our current position on each of the task force’s 139 actions. We have regularly discussed in Parliament the importance of stabilisation and crisis services as part of a suite of options that need to be available for people. I am therefore pleased to announce that our task force response includes an £18 million commitment to develop stabilisation and crisis care services, over and above our investment of £100 million in residential rehabilitation. We will better align crisis stabilisation, detox and rehabilitation to reflect the full range of recovery pathways.
All the actions that are outlined in today’s publication can and will make a difference, but we know that stigma too often prevents people from seeking support or puts barriers in their way when they seek it. Stigma kills, and actively fighting it is a crucial component of a human rights-based response to Scotland’s drug deaths crisis. Section 3 of the publication includes our stigma action plan, which I committed to in the debate on stigma last year.
As a Government, we will lead by example by reviewing our policies to remove barriers for people who are affected by substance dependency. However, we also recognise the need for broader change. We will develop and implement a national programme of activity, including an accreditation scheme for organisations, to improve awareness and challenge stigma across public life. That will challenge public stigma, encourage individuals to examine their unconscious assumptions, educate people on the harms that are caused by stigma and celebrate the positive outcomes of recovery in all its forms.
I will conclude, Presiding Officer. Today’s publication of our cross-Government response to the task force marks the next, even more ambitious phase of our national mission. It demonstrates the actions that we will take to ensure that people who need support for their drug use, and their families, can access both that support and any other public service that they need—
Will the minister take an intervention?
I am about to finish, I am afraid. Mr Marra may have missed the boat. Do I have time, Presiding Officer?
We might not have time in hand later in the debate, but at this point there is a little time in hand.
I will take the intervention if Mr Marra is really brief.
I appreciate the opportunity that the minister gives me. My intervention is in relation to the publication this week of the report from the ministerial oversight group for mental health in Tayside, and the comments about the continued lack of interaction between mental health and substance misuse services. I know that that is an issue that we have talked about in the chamber before, but it would be good to get on the record the minister’s observations about that report and what actions she wants to see in order to take that forward.
I am grateful to Mr Marra for that intervention. I have that report here. It is a very thorough report and I have to say that it very much aligns with the work that I am pursuing on the implementation of MAT, which is, of course, crucial to the overall integration of substance use and mental health services. It also aligns with our rapid review into mental health and substance use care—on which I will come back to Parliament with a further and more detailed response—and it aligns with our observations on the very recent Mental Welfare Commission for Scotland report. I assure Mr Marra that I take the report very seriously and that, where it relates to my portfolio interests, I will be pursuing that very vigorously indeed in relation to not just Tayside, but the length and breadth of Scotland.
To conclude, I very much believe that the actions in the cross-Government plan that we will take will help to ensure that people who need support for their drug use, and their families, can access the right support at the right time, and also ensure that they can access any public service that they might need without facing stigma or discrimination.
I agree with the task force that change is possible—indeed, change is happening—and I look forward to hearing the contributions of colleagues from across the chamber.
I move,
That the Parliament welcomes the cross-government response to the Scottish Drug Deaths Taskforce final report, Changing Lives; supports the transformational principles underpinning that response of treating problem drug use as any other health condition is treated, and ensuring that people with lived and living experience of problem drug use are included in the co-production of policy and strategy development in any area of government policy or delivery that affects them; recognises that cross-government planning and activity is needed to support the National Mission, and that this has resulted in over 80 actions; acknowledges the publication of the stigma action plan, which will play a vital role in the culture change required, and recognises the role of the Scottish Parliament in this regard, and believes that, with commitment across government, the Parliament and beyond, it is possible to save lives and improve health and wellbeing.
I invite members who wish to speak in the debate to press their request-to-speak buttons now. I call Sue Webber.
15:11
I would first like to mention, without seeming to be too confrontational to start with, that it was quite a challenge this week for us to look at a motion from the Government without the cross-Government response having been published in enough time for us to come together as a team. However, I welcome the fact that, following discussions that I had with the Government, we got sight of it, albeit that that was only yesterday. I want that on the record.
Consensus across the chamber is always key for this topic, but Conservative members often find that we are caught between a rock and a hard place. We wanted with all our hearts to fully back the Government motion, but members will note that we have lodged an amendment to it, albeit that it is quite subtle. I want that on the record, as well.
I welcome the inclusion of dentistry, education and housing, and reinforce that we welcome the report and the cross-Government response to that report.
Two basic principles have underpinned all the Scottish Drug Deaths Taskforce’s work. The first is that drug-related deaths are preventable and we must act now, and the second is that Scotland and the Scottish Government must focus on what can be done within the powers that are available.
The Scottish Drugs Deaths Taskforce published the report, “Changing Lives”, in July 2022. As I said, I welcome the chance to speak to it today. I met the chair, David Strang, at the time of its publication in the summer, and we had a very frank and positive discussion. We all want to reduce the tragic numbers that we face. It goes without saying that every single death that is brought about by misuse of drugs is a tragedy—not only for the victim, but for their families, friends and loved ones, and the communities in which they live.
More should, and could, be done on tackling drug-related deaths in Scotland
“until there is a meaningful and sustained downward trend in drug-related deaths.”
That is a quote from the report that we are welcoming. Something must change, and we can be that change. That is a specific recommendation from the DDTF report. We can be the chamber that unanimously stands together, puts politics to one side, says that enough is enough and ensures that we have meaningful and sustained action that will save lives.
Under the Scottish National Party, drug-related deaths have continued to get out of control. The current strategies to help people who are struggling with addiction have failed and are still failing—there are just not enough of them, or they are not being put in place fast enough where it matters, on the front line. Scotland still has the highest drug-related death rate in Europe, and the rate is 3.7 times higher than the rate in the United Kingdom as a whole. We cannot forget that.
As I have said, we all agree that every death is a tragedy. There can be no doubt that our drug deaths crisis continues to be an emergency, but saying that repeatedly here in the chamber, in reports and in press releases does not save lives. Real embedded change—societal change—and action will save lives.
I want to reinforce several recommendations in the “Changing Lives” report. It said that
“all people at high risk of drug-related harm”
should be
“proactively identified and offered support.”
It said that MAT standards should be fully implemented by May 2024, and it went on to say that
“Overarching treatment and recovery guidance, with defined and measurable standards, should be developed and implemented.”
According to the report, services need to co-ordinate better to ensure that every person is offered support, even after they leave a service. That relates to what Mr Marra said earlier about Tayside.
The report also says that drug users should be
“better supported when they leave prison than when they entered.”
I will highlight two of those points further: implementation of MAT standards and support for drug users on leaving prison. Support for drug users on leaving prison is vital, when we consider the fact that the number of prisoners who are caught with drugs in Scotland’s jails has increased by a staggering 1,100 per cent since Nicola Sturgeon became First Minister. Figures from the Scottish Prison Service reveal that in 2021-22, the number had soared to 1,832 instances. The number of deaths in Scottish prisons is also at a record high: in the past two years, at least 25 of them were the result of drug use.
The shocking level of drug use in Scotland’s prisons is unacceptable and is a damning indictment of the Scottish National Party’s soft-touch justice.
I was really pleased to hear Sue Webber say that she wanted to put politics aside. Before she makes political attacks, she might want to reflect on what she said at the start of her speech, because such attacks help no one.
I am stating facts. If they are too hard for Gillian Martin to face, I cannot apologise for that. I said earlier that there are often red lines. I am mentioning some of them. When it comes to justice—[Interruption.]
We should not have commentary from a sedentary position. Please continue, Ms Webber.
Thank you, Presiding Officer.
The level of drug use in Scotland’s prisons is a symptom of the failure to support people in our prisons, who demand as much right to recovery as people outside our Scottish Prison Service. Many of them want to escape the cycle of addiction and to access recovery programmes. The SNP Government slashed funding for addiction services—
Sue Webber has mentioned several times Douglas Ross’s proposed right to recovery bill. We have not seen the detail of the bill, but I probably speak for the whole chamber when I say that there is a desire to support it. For the record, will the bill acknowledge the importance of things like safe consumption rooms, pill checking and heroin-assisted treatment?
I have not mentioned the right to recovery bill yet—I will do so in closing. Those elements are not included in the scope of the bill, which is all about access to recovery services, but I will refer to them later.
The second point that I want to highlight is the report’s recommendation that MAT standards be fully implemented by May 2024. I agree that MAT standards must be implemented, but it is disappointing that the Scottish Government failed to introduce MAT standards by April 2022, which was the original intention. The Scottish Conservatives are calling for urgent action to be taken to ensure that standards 1 to 5 and 6 to 10 are fully implemented by April 2023 and April 2024, respectively.
All of us, across the chamber, can agree that more action needs to be taken. As a result of the continuing crisis the Scottish Conservatives will not oppose drug consumption rooms—more specifically, the pilot of such rooms. However, we have serious reservations about their operation. We must remember that drug consumption rooms are not a magic bullet and will not solve all our problems. Chief Constable Iain Livingstone has said that we need to proceed with caution. Although we support most of the recommendations in the report, more needs to be done. The gap continues to widen between the warm words of the SNP on the drugs deaths scandal—
The member must bring her remarks to a conclusion.
Thank you, Presiding Officer.
The gap continues to widen between the warm words of the SNP on the drugs deaths scandal and the reality of how little action it continues to take on the ground.
As I have said today, the Scottish Conservatives believe that a different approach is needed to help people who are suffering from addictions. The SNP Government must finally start listening to front-line experts and back our right to recovery bill, which would guarantee treatment for those most in need.
I move amendment S6M-07469.3, to leave out from “cross-government response” to end and insert:
“publication of the Scottish Drug Deaths Taskforce final report, Changing Lives; supports the transformational principles of treating problem drug use as any other health condition is treated, and ensuring that people with lived and living experience of problem drug use are included in the co-production of policy and strategy development in any area of government policy or delivery that affects them; recognises that cross-government planning and activity is needed to support the National Mission, and that this has resulted in over 80 actions; acknowledges the publication of the stigma action plan, which will play a vital role in the culture change required, and recognises the role of the Scottish Parliament in this regard; believes that, with commitment across government, the Parliament and beyond, it is possible to save lives and improve health and wellbeing; welcomes many of the report’s recommendations, including that individuals should never be turned away from treatment and therefore urges the Scottish Government to back Douglas Ross’s Proposed Right to Addiction Recovery (Scotland) Bill, which would enshrine in law a right to treatment, so that all people with addiction in Scotland can get the support they need; notes that the report states that ‘While we believe legislative change is required, more should—and can—be done in Scotland under current constitutional arrangements’; believes that the Scottish Government should accelerate its focus on tackling drug-related deaths until there is a meaningful and sustained downward trend in the number of drug-related deaths; regrets, therefore, the recent decision to cut the alcohol and drugs budget for 2022-23 by £1 million; notes, with disappointment, that the Scottish Government failed to introduce Medication Assisted Treatment standards by April 2022, and calls for urgent action to be taken to ensure standards 1-5 and 6-10 are fully implemented by April 2023 and April 2024, respectively.”
I call Paul O’Kane to speak to and move amendment S6M-07469.2. You have up to six minutes, Mr O’Kane.
15:20
In opening the debate for Scottish Labour, I would like first to take the opportunity to commend the work that was done previously on the issue by my colleague, Claire Baker. She has been a strong advocate for people who are affected by addiction, their families and communities, and has had a relentless and forensic evidence-based focus on the Scottish Government’s work and on what more we can do in terms of finding new solutions that have been proved to have an impact in other parts of the world. That is certainly the vein in which we intend to continue to approach the issues.
We are debating the subject early in this new year. In doing so, we reflect once again on the tragic costs of drugs deaths in Scotland in the year past. As always, I seek to put at the heart of our debate those who are bereaved and, indeed, all those who continue to live in pain.
I know that members across the chamber want to see tangible progress being made on drug deaths and are supportive of action that serves to meet that objective. Scottish Labour supports the objective of the national drugs mission, which is to tackle the public health emergency of drug deaths.
We acknowledge the Government’s having provided its response to the “Changing Lives” report today, and the list of 80 actions that have been taken across Government. I recognise some of what Sue Webber said about availability of that information, but I am grateful to the minister for provision of that response. There is much in the document. Of course, we support concerted Government action across all portfolios. However, we must ensure that we do not lose ourselves in the detail and that we are making the right progress on the actions that can make the most difference.
There has been a myriad of reports—10 in two years. We must ensure that the reports and action plans do not just sit on shelves, but are backed by delivery and support for people in their lived experience. That means that we, in Scottish Labour, must be honest and call out areas where we feel that still not enough is being done, as well as issues on which the Government is still falling short, even by its own standards. It has been three and a half years since the Government established the Scottish Drugs Deaths Taskforce but, tragically, the most recent figures show the second-highest number of drug-related fatalities on record in Scotland, and bring the total number of drugs-related deaths since 2007 to over 12,000.
It has been almost two years since the First Minister announced a national mission to tackle the drug deaths crisis. However, progress has often been slow—indeed, it has often been painfully slow for so many people.
The member will know that some of the areas that we mutually represent, such as Inverclyde, are stubbornly high up the league table of drug deaths. Does he think that enough has been done to target specific parts of the country where there is clearly a propensity for much higher drug-taking criminal activity than there is in other parts of the country? Is enough resource getting to the front line in areas such as Inverclyde?
Jamie Greene has made an excellent point about areas where there are substantial challenges. My colleague Michael Marra will, no doubt, speak about Dundee and the experience there.
Having met service providers in Inverclyde, I think that it is clear that there has to be more resource. That is needed just to keep the lights on and the doors open in many of the third sector services. I have had correspondence with the minister on that issue and am keen to work on supporting those organisations, as well. We need a relentless focus on areas where the issues stubbornly persist. I am sure that we will hear much about that from around the country, in the debate.
I am concerned that, to date, Scotland has no drug-checking facilities, and that we have not yet got a single overdose prevention centre. The latest estimate of the number of people who are living with substance dependence in Scotland is over seven years old, having been published for 2015-16. In addition, the Government has not yet provided a workforce plan to overcome the workforce challenges that are experienced across our health and social care services, and which are particularly acute in addiction and rehabilitation services.
I am also concerned about cuts to alcohol and drug partnerships and to third sector providers and others, which have been exacerbated, as I have just mentioned, by the cuts to local government funding. Indeed, we should all be concerned about the role that ADPs will have and about the associated discussions around them, as the Government presses forward with the national care service.
Will the member take an intervention?
I am not sure. Is there time in hand?
There is a wee bit of time.
Okay.
Bearing in mind that I have given continuity to alcohol and drug partnerships, I am somewhat curious about the cuts that you have mentioned. I wonder whether you would acknowledge, too, the £65 million of national mission resource that has been put into the third sector.
Members need to speak through the chair.
I said in my response to Jamie Greene that I am cognisant of that third sector funding. The minister and I have discussed, in particular, the third sector providers that I mentioned. There is an issue, however, about baseline funding, which ensures that third sector providers can meet their core obligations and remain financially viable, over and above the additional funding that is levered in, so further discussion is needed in that space.
We need to ensure, too, that ADPs are front and centre of our response and that they continue to receive support so that they can move forward in communities. I stress that this is not about scoring partisan political points; it is a genuine belief and offer from me in my role. We have to acknowledge some of the discussion that has been had with Audit Scotland, for example, in relation to overarching plans for the drug and alcohol problem. The Parliament’s own Public Audit Committee considered that the scale of the drug and alcohol problem that Scotland faces is perhaps not always fully understood because of a lack of available data.
We have to look at things such as medication-assisted treatment standards and the Government’s commitment on them. The goal posts have been shifted. Full implementation of the standards was originally planned for April 2022, but as we have heard already, that has shifted. We want decisive action to ensure that the date is not delayed further, because the MAT standards will be crucial in moving forward and dealing with the issues.
I am very conscious of the time, Presiding Officer.
Families and communities need the Scottish Government to meet the magnitude of the moment. The focus must now shift to a relentless programme of delivery and implementation of meaningful steps to properly address this public health emergency. It has to start immediately with the MAT standards and full publication of a workforce plan for alcohol and drug partnerships.
I move amendment S6M-07469.2, to insert at end:
“; regrets that over 12,000 people in Scotland have tragically lost their lives to drugs since 2007; notes that it is three and a half years since the Scottish Government established its Drug Deaths Taskforce, but that the most recent figures show the second highest number of drug-related fatalities on record; is concerned by the slow progress with implementing the Medication Assisted Treatment standards, in addition to concerns that the proposed National Care Service could distract from Alcohol and Drug Partnerships (ADP) in delivering these standards, and calls on the Scottish Government to urgently publish a workforce action plan for ADPs.”
15:27
I welcome the debate. It is refreshing to see the regularity with which we address this very important issue. Given the tone and tenor of the speeches so far, this debate, unlike many others, carries a consensus across the Parliament, which I welcome. I welcome, too, the publication of the report. I endorse its findings and offer the minister the support of the Liberal Democrats in that regard.
As we are all acutely aware in the chamber and beyond it, our drug deaths crisis is a stain on our conscience across this country—it is a national outrage. We need only look at the official statistics to see how far we still have to travel. In 2021 alone, more than 1,300 people succumbed to this awful affliction—which is an illness, not a crime. That is a 445 per cent increase since we started recording drug-related deaths in 1996. In fact, in those 25 years, approximately 15,000 lives have been cut short because of drugs. Those deaths are accompanied by countless people who will never be able to hug their loved ones again; countless families have been left with a permanent hole—tears and rents in our communities. It is our duty as elected representatives to put an end to that toll and human suffering.
It is therefore heartening to see some important policy outlined in the report, particularly regarding integrated family support, which is a matter that I have tried to raise since I first came to the chamber from a charity in a sector that works specifically with children who are affected by parental substance use, and on which the Liberal Democrats have campaigned for a long time.
However, it concerns me that, over the years, despite the many debates, reports and pledges, the changes that we have made and that the Government has enacted have been painfully slow—the pace has been almost glacial. I hope and believe that we are starting to see an acceleration in that process. Our country cannot afford to rest on its laurels or act slowly.
The services that are available to people can be life changing and life saving. However, they can be so only with the right infrastructure. It is therefore vital that we give more support to those providing care, particularly those in our national health service. We must employ more staff and offer more training in our hospitals, our general practitioner clinics and our pharmacies. We need to recognise the different requirements of service users in urban and rural areas—the minister will know that I have raised many times the issue of same-day access to treatment services in areas of rurality.
That also involves giving more resources and funding to our local communities, and trusting in local relationships, as those are the people who are most knowledgeable and best placed to offer support. Often, those meaningful relationships are what can offer people with chaotic substance-using behaviour a route out and a route to more comprehensive support, and they can act as a lifeline when times get tough, as they invariably do.
However, it is not enough to view this crisis at face value. We must address the prevalent link between substance abuse and poverty. Last year, people from deprived areas were 15.3 times more likely to die from drug misuse than people in more affluent areas. That is because the causes of drug addiction are complex and the risk is increased with the higher levels of trauma, adverse childhood experiences and poor physical and mental health that we know go hand in hand with deprivation.
We are currently in the midst of the worst cost of living crisis that our country has faced in living memory, which means, by extension, that more citizens will be engulfed into poverty and, therefore, that more people will be at risk of addiction. It is only by giving tangible support to those who most need it and tackling the huge rates of inequality within Scotland that we can begin to address this problem at its root.
Given the scale of the crisis, we need radical solutions. Although attitudes are rightly beginning to shift away from viewing this problem as a criminal justice one, such a move needs to be mirrored in our legislation. We want to start that with the introduction of safe drug-consumption rooms, which we know are capable of effectively reducing drug-related harm. I hope that we will hear from the Lord Advocate on that soon. Moreover, the Government must outline plans for a network of those services, which would hasten their roll-out should the outcome of the Lord Advocate’s consideration be favourable to that approach.
We also need to work with the Sentencing Council to ensure that those who are prosecuted for personal use are referred to treatment and rehabilitation, as a first port of call, rather than incarcerated.
My amendment, if successful, would bring about the roll-out of drug-testing facilities. I was made aware of the crucial part that they can play in reducing the number of drug-related deaths due to a tragic case in my constituency late last year. I will say more about that particular example in my closing speech.
It is not our job as legislators to pass judgments on situations that have been brought about by experiences that we cannot fully understand, nor do we move any nearer to a solution by doing so. We need radical solutions that are holistic and directly address drug-related harms while tackling the socioeconomic and childhood roots of addiction.
We need to ensure that our public sector and local authorities have all the tools that they need to offer support, so we should not slash their budgets. It is then and only then that we can begin to rid ourselves of this stain on all of our consciences.
I move amendment S6M-07469.1, to insert at end:
“; further believes that the Scottish Government must use its response to the Drug Deaths Taskforce report to propel effective and immediate action to tackle the continuing high numbers of drugs deaths in Scotland; asserts that there are some actions which can be undertaken now, such as the implementation of drugs testing facilities, as seen in other parts of the UK, at events such as festivals, to prevent harm; acknowledges the current work being done to implement safe consumption facilities in Edinburgh and Glasgow, and calls on the Scottish Government to start preparing plans immediately for a Scotland-wide network of facilities so that those outside of the central belt have access to lifesaving spaces.”
15:33
Any life lost as a result of drug harm is a tragedy, and the Scottish Government is absolutely committed to implementing approaches that we know work to save lives and reduce harm. The Scottish Drug Deaths Taskforce’s report, “Changing Lives”, contained 20 recommendations and 139 detailed actions for the Scottish Government to consider. The report represented almost three years’ work, with contributions from a broad range of people with expertise in the area, including those with living and lived experience—I know that the minister is focused on listening to examples from those people.
One of the areas that I have a particular interest in is tackling drug-related stigma, which requires action from all levels of government and, indeed, the wider population. The “Changing Lives” report states that “Stigma kills people”. The report focuses a lot on tackling stigma and discrimination. Stigma is not only damaging to individuals’ mental health and sense of self-worth; it discourages people from coming forward to seek the help that they need.
Stigma is particularly harmful in rural areas, in which communities are often very tight knit—Alex Cole-Hamilton has just mentioned that—and in which it can be harder to seek treatment because of the fear of prejudice and discrimination.
Section 3 of the “Changing Lives” report states:
“Primary care settings offer a key environment in which direct care and treatment can be offered to people”
who are affected by harmful drug use. Treatment services that are offered by, for example, GPs, dentists, community nurses, pharmacists and pharmacy technicians can also help to address issues around access to drug treatment services in rural areas and, therefore, reduce stigma.
I picked up the issue of stigma with NHS Education for Scotland and asked whether mandatory education could be created and delivered, perhaps in an online module, for all health and social care staff, including pharmacists and allied health professionals, as opposed to stigma education being provided just for those working in alcohol and drug services.
You might recall that, when I was on the Health, Social Care and Sport Committee, we received some quite harrowing evidence from people in Dumfries, which is in your area, about some of the challenges that they faced at their pharmacies. What are your comments on that?
Members need to speak through the chair.
Absolutely. From the conversation that we had in the Health, Social Care and Sport Committee, I picked up that issue directly. We have taken action locally, and the alcohol and drug partnership team is well aware of the issue. It took action, and that issue has been dealt with. I thank Sue Webber for raising that issue.
I am keen to explore whether mandatory education related to stigma will add to Scotland’s work to ensure that people can access the treatment that they need without prejudice and judgment, and I hope that we can make progress. That is really important, based on my experience as a nurse and a nurse educator and on hearing conversations involving people whom I worked with in the past.
Peer navigators and peer support workers are also crucial in supporting people in treatment and in overcoming stigma. Those workers can and do make a difference to people’s lives. The “Changing Lives” report notes that the
“provision of navigator services across Scotland is patchy. Coverage in the central belt is good, but rural areas are less well catered for.”
I know that the minister is very much aware that issues in rural areas must be addressed, and I know that she has engaged with the Dumfries and Galloway and Scottish Borders alcohol and drug partnerships and NHS boards. I welcome that.
The expansion of navigator services nationally, supported by a comprehensive framework, standards and guidance, might help to remove the postcode lottery that many individuals now face in accessing services. Community-based services that link to the hospital navigator service are necessary, and knowledge of local areas is imperative for navigators.
I absolutely welcome and endorse the vital work that We Are With You is conducting. It uses the peer support model. I met the local team at the Buccleuch Street centre in Dumfries just last year. I ask the minister for a commitment that peer support services will be supported and expanded, particularly in rural areas.
In the minister’s statement to Parliament in November, she stated that she wanted to expand the scope of the MAT standards so that they include treatment options for benzodiazepines. I am aware that there is current research regarding a naloxone equivalent for benzodiazepines, and I would be interested to hear an update from the minister on treatment options for benzos. Obviously, that doesnae have to be today—I know that we are meeting soon.
The Westminster war on drugs has been an abject failure. Instead of solving problems, it has made them worse by stigmatising people who use drugs and creating barriers to tackling substance addiction.
The UK Government’s latest white paper—“Swift, Certain, Tough: New Consequences for Drug Possession”—sets out a three-tier framework for adult drug-possession offences. Those proposals are contradictory to the public health approach that is being taken in Scotland, and they could undermine aspects of the national mission if they are implemented here. I know that the Minister for Drugs Policy has written to the UK minister to express opposition to those policies being operated in Scotland. I challenge Conservative members to do all that they can, by making representations to their Westminster colleagues, to ensure that that policy does not impact on our approach in Scotland.
Without reform of the law, efforts to tackle the drugs crisis in Scotland will always be impeded. That cannot happen, so I welcome the steps that are being taken by the minister. I know that it isnae a quick fix; long-term work needs to take place. I know that the minister is working hard to reduce the number of drug deaths in Scotland, and I look forward to my continued engagement with her.
15:40
Preventing problem drug use indeed requires a whole-systems response across Government. A public health approach to tackling a decade of Scottish Government failure is the right way forward, so long as—and this is important—that public health approach is complemented by cracking down on violent organised crime and on the drug dealers who profit from the illicit and immoral trade in Scotland.
Given that organised crime does not respect borders, surely it makes sense to join an already established cross-border initiative, with £59 million of investment, that is already helping to tackle drug dealing criminal networks? I am interested in understanding from the minister why, if the Scottish Government is so keen on tackling the harms of substance abuse, it is not co-operating with the rest of the UK on project ADDER—addiction, disruption, diversion, enforcement and recovery—which could have seen more funding directed to places such as Dundee that have a significant problem.
I can reassure the member that we participate in the learning network for project ADDER and that Police Scotland, as he would expect, co-operates with all law enforcement agencies across the UK. However, I am sure that the member will appreciate that, where other approaches undermine a public health approach, we also have our red lines.
Thank you for that response.
Our response to drug abuse requires strong health interventions, but we also need to cut the head off the snake. We need a targeted criminal justice approach to better target drug supply chains. Given that Scotland’s drug deaths rate is almost five times the rate seen down south and is higher than any in Europe, we must make Scotland a significantly harder place for organised crime groups to operate in.
Before I move on to matters that are directly focused on treatment and rehabilitation, I will deal with the contentious issue of drug consumption rooms. We will not oppose the establishment of a pilot project. We can then gather evidence in a Scottish setting and use that evidence. However, let us not underestimate the legal complexity; there are legitimate concerns. If the route that the Scottish Government is going to take involves drug consumption rooms, I am interested in finding out the following: what will the location criteria be? Could people in possession of drugs, travelling to a drug consumption room, run the risk of arrest? Also, can we protect workers in such rooms from civil liability if a user experiences a medical problem or, tragically, dies?
We will not oppose a pilot project but, as Police Scotland’s chief constable has said, we need to proceed with caution. I will add that this caution also applies to establishing licensed drug-checking facilities where people can anonymously submit samples of psychoactive drugs for testing.
Given the rate of drug deaths, which is currently running at around one drug death every seven hours, does the member not agree that we need to proceed with a degree of urgency rather than caution and that, although I acknowledge those concerns, there are quite clear solutions to addressing all those concerns, which have been well known for some years now?
We need to be moving with urgency, but we must not move in the wrong direction, because that could be as bad as moving slowly.
Dr Gulhane says that we need to move forward with caution and not in the wrong direction. Does he accept that we are not pioneers in this? The approaches that we are discussing, such as safe consumption and pill testing, are used quite extensively internationally and have been shown to save lives.
It is not clear that it would work in a Scottish setting, and that is the point. Pilots are needed to see how such things work in what is a different country.
Everybody who seeks treatment for addiction should be able to access the necessary addiction treatment that they require, with an obligation on NHS boards, Scottish ministers and others to provide treatment and to set up reporting arrangements so that the quality of and access to the treatment that is provided can be monitored and reported on to the Scottish Parliament. That will ensure that individuals may access a preferred treatment option unless it is deemed to be harmful by a medical professional. A statutory right to addiction and recovery treatment services should include community-based, short and long-term rehabilitation; community-based and residential detox; stabilisation services; and substitute prescribing services.
Our proposed right to addiction recovery (Scotland) bill also aims to prevent individuals who are seeking drug and alcohol treatment from being refused access to it. I am pleased that another planned outcome of the task force’s report is to establish a national approach to substance abuse and harm prevention that incorporates drugs, alcohol and tobacco.
We need to ensure that far fewer people in Scotland develop problem drug use. I am interested in seeing how the plan seeks to strengthen the evidence for how best to deter the use of recreational drugs, to ensure that adults change their behaviour or face tough consequences, and to prevent young people from starting to take drugs in the first place. Of course, as the minister knows full well, delivery is everything.
De facto decriminalisation of drugs does not seem to have worked as planned, as it has contributed to increased admissions to psychiatric hospitals since the introduction of the measure for class B and C drugs. The Scottish Government pledged to fully implement MAT standards, which define the consistent delivery of safe and accessible drug treatment and support, by April 2022. However, delivery of those standards has been put back two years. Given the well-documented pressures on our NHS, including record staff vacancies, record accident and emergency waiting times and GP practices being at breaking point, I am keen to understand whether the Scottish Government intends to deliver on the recommendations of the task force, particularly the calls to operate more drug services in the evening and at weekends and to provide emergency 24/7 care.
In 2021, there were 1,330 drug-related deaths in Scotland—too many. We need a credible, strong and well-resourced plan to tackle the problem. It must amount to much more than just an announcement. The country needs a commitment from the Scottish Government to deliver.
I declare an interest as I am a practising NHS GP.
15:46
I was struck by a paragraph in the report by the Drug Deaths Taskforce, because I thought that it really challenged us. It said:
“The biggest thing that needs to happen ... is culture change. For far too long, people who use drugs and their families have suffered the effects of discrimination and stigma in society, in the media and in services. They have been demonised, criminalised and ignored. Shamefully, discrimination is even enshrined in UK law, which actively discriminates against people with drug dependency in crucial areas of human rights.”
As politicians, we can come to the chamber with our views on how to help people in Scotland who are at risk of death from drug use. I do not have any personal experience of drug misuse either professionally or in my personal life, and I am aware of that every time I speak on the topic. With some exceptions, most members who are speaking today are in that position. We have not had to see our children struggling with addiction, wondering whether they will ever become healthy again, and we have not had to live in a constant state of anxiety about what might happen to them. We may not have experienced the damaging effect of a stigma being attached to our health needs. That is why the commitment in the Government’s response to the task force to work with those who have lived experience is vital.
The work that was started in 2022 with the national collaborative, which the minister has built on with her comments today and the recommendations that she has made, is so important. The phrase “nothing about us without us” must apply to people who have been affected by problem substance use. They simply have to be involved in the development of our policies, strategies, treatment and support, and in addressing the wider factors that contribute to their life-threatening relationship with drugs—and so must their families. If we leave them out or pay lip service to them, the mission to end drugs deaths will simply fail. In the short time that I have had to read the Government’s response to the report, I was pleased to note its key acknowledgement that
“People’s experiences do not fit neatly in one policy area and so our engagement and participation must take into account the vicious cycles of problem substance use, homelessness, lack of income, unsafe environments, lack of access to education and other basic services.”
Angela Constance cannot do all that herself in her portfolio. She needs to work with people across the Government and society, as that is the only way that we will be able to tackle the problem. The vast majority of people with problem drug use tend to have suffered some kind—or, indeed, many kinds—of trauma. Many people have led a life of poverty, and many have suffered abuse or childhood insecurity. No one who is standing to speak in the debate should ever ignore the root causes that have led someone down a path of problem drug use. We need to be treating causes as well as symptoms.
Problem drug use is a health inequality. With that in mind, I think that dealing with drug deaths is a whole-Government endeavour that expands into portfolios across the Government. We urgently need to tackle poverty and inequality to address all the health inequalities, but that goes double for problem drug use, because thrown into the health inequality mix is the justice element, which can compound trauma, reduce life chances even further and make recovery even harder and sometimes impossible.
I was pleased to see that the Government’s response mentions women who have multiple pregnancies and are not allowed to keep their babies. I have said a few times in the chamber that my daughter is a student midwife. I have been quite shocked at how often she has come home from a shift in Aberdeen maternity hospital and said that she has cared for a young woman who cannot keep her baby—often for the second or third time. That is heartbreaking, and I commend the Government’s moves to have more family residential rehabilitation units, some of which have been recently announced, although that is just one action that we need to take to help mothers who are struggling with their substance use.
Such situations are complex and need multiple actions. I am encouraged by the funding that the minister announced today to support vulnerable parents and break the cycle so that, with such interventions, some of those mothers might one day be able to have a family of their own in recovery.
We need to leave entrenched political ideology on drugs at the door. That is why I got a bit upset when we talked earlier about keeping politics out of this, because it does not help at all. Earlier in the week, I was struck when Jackson Carlaw talked in another debate about a time—I do not think that it was while I have been here—when the Parliament took health off the political football pitch. He made a really strong point; maybe we need to make such a commitment for drugs policy, stop the blame game, get together and—as Ms Constance has often said—throw the kitchen sink at this.
When I previously spoke about the subject, I said that politicians in Scotland and in the wider UK have been too wary of following other countries’ radical approaches—Paul O’Kane mentioned that in his excellent speech—and have ignored the fact that some of those approaches have been successful, as Alex Cole-Hamilton mentioned in his intervention. If the work of the national collaborative and the discussions with people who have lived experience come up with radical approaches, we will need to work across parties and across the Government to be open to those suggestions. We need to turn our eyes away from right-wing commentators, tabloid editorials and Mr Angry of Arbroath writing in the letters pages of The Times, because those people do not have the answers, whereas people with lived experience and their families very likely do.
15:52
I welcome the debate and the work of the Scottish Drug Deaths Taskforce. We all know that Scotland consistently has the highest drug deaths rate in Europe, and we all appreciate that the drug deaths crisis is complex and caused by a range of factors, including the types of drugs that are used and the high levels of poverty and deprivation in Scotland. We must also be honest about the fact that Scotland faces similar challenges to those of many other countries and the response has been slow.
Safe consumption facilities have operated in many parts of Europe for about three decades. They offer the opportunity to reduce the risk of disease and death. I say to Conservative members that the evidence is that such facilities do not increase drug use or the frequency of injecting.
On 3 November 2021, the Lord Advocate noted in evidence to the Criminal Justice Committee that any proposals for drugs consumption facilities would require to be
“precise, detailed and specific, underpinned by evidence and supported by those who would be responsible for policing such a facility”—
in particular,
“Police Scotland.”—[Official Report, Criminal Justice Committee, 3 November 2021; c 20.]
The Crown Agent wrote to the Criminal Justice Committee this week and said:
“the pilot presents significant operational challenges in relation to policing any facility; no doubt made more difficult by the lack of a clear legal framework. Prosecutors continue to work closely with the police to ensure that there is a clear plan for the policing approach to such a facility. There has been recent and ongoing correspondence with the Chief Constable of ... Scotland in relation to outstanding issues which require to be considered.”
I know that the minister advised the joint committee meeting—of the Criminal Justice Committee, the Health, Social Care and Sport Committee, and the Social Justice and Social Security Committee—that she was still awaiting advice from the Lord Advocate on the legality of such facilities, and I would be grateful if she could provide the chamber with an update on whether advice has been obtained and what the timescales are for progress on that issue.
I did not intend to make an intervention, but I am aware of the letter that Katy Clark referred to—it came 14 months after the Lord Advocate gave evidence to the committee on a pilot drug consumption room. I find it slightly concerning that the letter specifically states that there is no timeframe as to when that information might be made available. I know that Katy Clark cannot answer that particular question, but I would be very grateful if the minister could do so when she is summing up.
I thank the member for that helpful intervention. The reason that I have raised that issue is in order to make the point that the progress that we are making is too slow. I know that the minister has been awaiting that advice and I appreciate that she has probably been pushing for it, but I have to say that we need to see action.
In 2020, the First Minister said that it was her Government’s responsibility to deal with that crisis and that she would not shy away from that. However, despite the fact that we declared a public health emergency three and a half years ago, at a minimum, there have been a further 11,500 deaths and 26,000 drug-related hospital admissions.
As a member of the Criminal Justice Committee, I would like to focus on the justice section of the Government’s response. Like others, I have not had much opportunity to consider the full document, but it would be fair to say that the approach that is outlined in the response is quite different from many current practices in the justice system. I know that the minister has worked in the justice system and will have first-hand knowledge of that. Drug abuse and use in prisons is endemic. We know that many people who were not drug users before they went into prison are introduced to drugs in prison. The task force recommendation is that
“the Scottish Government should make key changes to fully integrate a person-centred, trauma-informed public health approach to drug use in the justice system.”
I support that approach and I support what the Government says in its response. However, I am not clear how that relates to the justice legislation that is currently being brought before this Parliament. We know that Scotland has the highest jail population in western Europe and the highest numbers of people on remand. The number of people who are on remand in prison is now approaching almost 30 per cent of the prison population. It is far from clear what the public safety test—in the Bail and Release from Custody (Scotland) Bill that is currently being considered—will be, and it is far from clear that it will result in what the report is asking for, which is that bail should be available and that remand should be used only as a last resort.
I very much welcome the worthy ambitions that are in the response, but I think that we face massive challenges. The justice budget is facing real-terms cuts, and many of the recommendations in the report will require significant resources. I look forward to what the minister has to say and I welcome what is in the report, but I think that we need to do a lot more work.
15:59
In 2021, 1,330 people in Scotland lost their lives to drugs. As we know, each such death is a tragedy. I echo the view of my colleagues that the number of drug deaths in Scotland is simply unacceptable.
We are all in no doubt that our drug deaths crisis is a public health emergency. However, we are starting to see positive progress as we tackle it. Police Scotland data shows that, during the 12 months to September 2022, there were 21 per cent fewer drug deaths than there had been during the 12 months to September 2021. However, it is important for us to recognise that, although there has been a reduction, a lot more work is still to be done.
The first core principle of the Scottish Drug Deaths Taskforce’s report is the most important. Drug deaths are preventable. We must act now, and it is everyone’s responsibility to take action. Today, the minister has outlined that the cross-Government response to the report has so far resulted in more than 80 actions to drive forward our national mission.
As other members have done in their contributions, I will focus on the view that we can tackle drug deaths by ending stigma and taking a public health approach. In 2005, the World Health Organization dubbed Glasgow the murder capital of Europe. In the previous year there had been?83 murders?in the city, where gangs were known for their crime culture. Police in Glasgow decided to rethink their strategy. They set up a?violence reduction unit,? guided by the philosophy that violence is a public health issue. Violent behaviour spreads from person to person. To contain it, we therefore need to think in terms of transmission, risk, symptoms and causes. Thanks to taking such an approach there was a dramatic reduction in crime in Glasgow and it became a model that other countries could follow. A public health approach worked for that and I fully believe that it could work for drug deaths, too. I am pleased to hear that the Scottish Government shares that view.
Statistics and evidence are, of course, important, but if we get too bogged down in them we run the risk of taking the humanity out of the problem. By taking a people-centred approach we can get to the root causes of addiction and support people who are addicted. After all, it is important to remember that no one makes an active choice to have a drug addiction.
As always, the minister has been very honest about our monumental task and the amount of work that is required. However, I would welcome more powers being handed to her and to the Parliament to take further, more radical action. The Royal College of Physicians of Edinburgh notes that bold action is required to tackle the issue. It supports decriminalisation of the possession of drugs and the provision of safe drug consumption facilities. However, we know that the policy area that includes criminal justice sanctions for drugs offences is currently reserved to Westminster. Without control of that, we cannot possibly take an all-encompassing public health approach. We are where we are, though, and we will do all that we can with the limited powers that we have. I am pleased to see that in the budget the Government has increased to £160 million its investment in reducing the avoidable harms associated with drugs and alcohol. That is much needed and will help to address the many complex factors that come into play.
As we know from many studies, drug deaths are closely related to deprivation and austerity. Research published by the University of Glasgow and the Glasgow Centre for Population Health suggests that, across the UK, people are dying younger as a result of austerity brought about by the UK Government. Such austerity has two impacts: one is reducing the levels of important services such as those for addiction, housing, mental health and welfare rights; and the other is cutting individual incomes through reductions in social security payments, leading to further drug use as a coping mechanism or an escape from grim reality. Furthermore, the research shows an association between cuts to disability-related social security payments and increased drug-related deaths across all local authority areas in Great Britain. The Scottish Drugs Forum said that today’s drug use in Scotland is linked to the economic impact of deindustrialisation in the 1980s.
The reason that I mention all that is that, all too often, our national conversation on drug deaths is warped and misguided. We still hear people saying things such as “People make their own choices” and “They get what they deserve”. Not only is that outlook completely wrong; it is inhumane. That is why it is so important that we make tackling the stigma around drug use a priority.
In my Ayr constituency, a new support organisation called Harbour Ayrshire has been set up by local businesses and is already doing fantastic work to help people with addiction issues. It focuses on prehab, rehab and aftercare to empower individuals to become independent and get involved in their local communities, and it also provides employment opportunities through those businesses.
I will end my contribution by recounting a moment from several years ago that really touched me. As a councillor at the time, I was listening to an inspirational man who had managed to break his addiction to drugs and had become clean. He used the following analogy, which has always stuck with me. If you come across a dying, withering plant in the corner of a room, do you go over and tell it to get its act together, then ignore it? No, most people would water it, nurture it and give it what it needs to grow and flourish. That is the approach that we and the Scottish Government must take. We must stop stigmatising people with addiction issues as Scotland’s shame.
16:05
I thank all the people who contributed to the Scottish Drug Deaths Taskforce report, the task force members and, for advance sight of the Government’s response, the minister. The task force’s report is wide ranging and comprehensive. I will focus on a couple of key recommendations.
Recommendation 4, regarding an approach of no wrong door and holistic support, is key in ensuring that people receive support and treatment when and where they need it. Support must cover all services to capture the points at which people with an addiction engage with a service. We must be aware that that initial contact might not come through a health service and that the service providers in settings such as housing also need the correct training and guidance to properly support people with an addiction. Such training must be trauma informed. Many people who are dealing with an addiction also deal with trauma and other mental or physical health issues, and we must ensure that any training that is provided to people who deliver services takes account of a person’s entire circumstances. We know that stigma and poor experience with services might stop people continuing to engage with services and, when such engagement breaks down, that might prevent people seeking help again in the future.
To address recommendation 4, the cross-Government response to the task force report points to a large number of strategies, and it will be good to ensure that there are specialist support services available to the people who need them. However, with so many initiatives, there is the potential for people to find their situation spread across multiple initiatives, which can lead to people falling between the gaps. I would be keen to know from the minister, either in summing up or now in an intervention, whether she believes that we have enough of a balance of strategies to ensure that, on the whole, people cannot fall through the gaps between services.
Action on all the recommendations must be closely linked, but recommendation 4 on a no-wrong-door approach and recommendation 10 on a national stigma action plan have to be in sync if we are going to tackle some of the reasons why people do not seek help.
The minister and many members across the chamber recognise the impact that stigma can have, and I am pleased to see that work is under way to address that through the stigma charter. As ever, we must continue to be responsible with language and ensure that we do not use stigmatising language and challenge it whenever it is used.
For many people, recovery is lifelong, challenging and not always a linear path. I have had the privilege to speak to many people who are in recovery, and there is a piece of the recovery journey that we do not currently talk about enough: keeping people well once they have completed treatment with acute services.
I visited a Lanarkshire recovery community, and a young woman spoke to me about how, having stopped using drugs, she had to rebuild her life. Often, we think about the structural things that people need, such as housing and income. However, she told me about the impact on her of not having hobbies or not even knowing what food she liked and disliked and the journey that she has taken to discover those things. She told me that, when going for job interviews, being asked questions such as, “What do you do in your spare time?”—I am sure that we have all been asked such questions—were hugely daunting for her. She believed that society expects people to have such things all figured out by the time that they are adult and that, for those without already established family or friend support mechanisms, providing access to courses or groups could help them to find out some of those things about themselves as well as connect them to their communities.
Since speaking to that young woman, I have heard the same from other people in recovery, and I thank them for their open and honest reflections. Some told me that, even with strong community links, they felt a sense of embarrassment in not knowing what they liked and disliked. That is another type of stigma that we need to tackle. I would be grateful if the minister, either in closing or after the debate, would provide examples of where such work is already happening and how we can share good practice to ensure that we continue to keep people well once they have completed the acute period of their recovery.
People deserve a rich and full life, regardless of their journey. Once someone has gone through the trauma, poverty or deprivation that has led to their addiction, has endured addiction and the stigma and turbulence that that causes in a person’s life and has sought help and come through rehabilitation, the least that they deserve is a fulfilling and full life, with all the things that we take for granted. I hope that we can find ways to support that in the future.
Many other issues are raised in the report that have also been raised in briefings that we have had, such as that of reform of UK drug law, which we fully support. As I have said many times before, the Misuse of Drugs Act 1971 is out of date and is now hindering some of the good work that is being done. The Royal College of Physicians of Edinburgh has spoken about decriminalisation. As a party, we support that. We previously welcomed the Lord Advocate’s decision on diversion from prosecution.
There is broad recognition across the chamber that, although the justice system has a part to play in supporting prisoners to deal with drug addiction, we need to take a public health approach to what is a public health emergency.
I thank again all those people who have been involved in the work of the task force, all those who have shared their lived experience and all those who are working hard in services across the country to implement the changes, who are making a difference.
16:10
It is with mixed emotions that the Scottish Parliament once more debates the shocking and challenging subject of drug addiction. It represents such a horrible life experience for far too many families and wreaks havoc on too many communities around the country.
As a teacher, it was not unusual for me to come into contact with children whose families were affected by drug addiction. That is a huge burden for a child, and for their struggling parents and carers, to carry. There was an understandable reluctance to ask for help with the addiction, for fear of the children being separated from their parents. In such circumstances, the role of schools in providing a stable and nurturing environment for the child, while the family receives holistic and individualised support, cannot be overstated. It undoubtedly contributes to positive long-term outcomes.
I welcomed the opening last November of Harper house in Saltcoats, where parents can be treated for addiction without being separated from their children. Harper house accepts referrals from right across Scotland. I hope that more family-orientated rehabilitation centres like Harper house can be funded across the country. There is a great need for such an inclusive and non-judgmental approach to recovery.
Today’s debate is an opportunity to focus on the urgent and challenging actions that are called for by the Drug Deaths Taskforce. Quite rightly, its final report demands that the Scottish Government focus on what can be done within devolved powers. In the light of that, I welcome the Scottish Government’s commitment to provide an additional £50 million of funding in every year of the current parliamentary session to deliver a significant reduction in deaths and harms.
The task force called for Scotland to develop
“the most extensive naloxone network anywhere in the world”.
In 2021-22, the number of take-home naloxone kits issued was just under 30,000, which represented a 29 per cent increase on the previous year. Nearly 65 per cent of people who are at risk of an opioid overdose have been issued with a kit. That is a welcome expansion of the network.
I believe that the Scottish Government is committed to embedding the public health approach at all stages, including throughout the criminal justice system. As the task force has so powerfully declared,
“Addiction is not a crime and you cannot punish people out of addiction.”
As colleagues across the chamber have mentioned, internationally, different public health approaches have been taken. I recognise that those cannot be transplanted in a different country, but they are worth noting. It is more than 20 years since Portugal decriminalised the public and private use, and the possession, of drugs. That marked a radical departure from a criminal justice-based approach to drug use to a public health-based one. Portugal has gone from having one of the highest drug death tallies in Europe to having one of the lowest. Decriminalisation of possession of drugs led to a halving of the number of problem drug users and a huge reduction in petty crime, which freed up law enforcement to tackle other crime.
I will keep my intervention brief. The architect of that programme said that it was not the decriminalisation alone that was the solution; it was only half of the solution. The other half was about providing front-line services and support to those people whom it diverted from prosecution.
That is a valid point. I am not saying that decriminalisation is the answer in and of itself, and I have outlined that the Government wants to provide the other half of the solution, which Mr Greene mentioned.
The situation in Portugal does not mean that there is no police intervention when an individual is found to be in possession of drugs, but it means a different response. If the person has less than the legal limit for individual possession, they are required to report within three days to the commission for the dissuasion of drug addiction, where they are interviewed and evaluated by a team of health professionals to assess whether they are in need of treatment. Every individual is then invited to attend a treatment facility. Eighty per cent of people accept referral, including those who are not problematic users. As well as providing access to high-quality treatment and recovery options, there is also access to a psychologist or counsellor to discuss their drug use. That massive transfer of focus from punishment to access to treatment has been highly successful in reducing drug deaths and petty crime.
We must acknowledge that a key underlying factor of drug deaths in Scotland is poverty. In 2021, people in Scotland’s most deprived areas were 15 times more likely to have a drug-related death than those in the least deprived areas. Tackling poverty is a key priority for the Scottish Government and I urge it to continue to fund benefits such as the Scottish child payment and other essential anti-poverty measures.
The inequality that stokes our appalling drug deaths statistics must be undone if we want to see a dramatic reduction in drug deaths and drug misuse and an increase in hope and wellbeing in communities where those are currently sadly lacking.
16:17
Today, we are addressing an area of national shame. Scotland’s drug deaths epidemic is out of control, and we are in need of urgent leadership in order to stop the surge of preventable deaths.
As my colleague Sue Webber pointed out, the problem in Scotland seems to be bigger than it is in other parts of the United Kingdom. Scotland has a rate of 245 drug deaths per million people, while England has a rate of 50 and Wales has a rate of 47.
I want to clarify the language that the member used. He said that the drug harm issue is “out of control”. Is he aware that the most recent statistics on drug-related deaths showed a decrease—albeit a small one—in the numbers? However, I am absolutely not playing down the issue.
I point out that the number of people who have sadly died is totally unacceptable. There has been progress but, as a number of members have pointed out during the debate, one death is too many. We need to look at it from that perspective.
It is not a new problem. We have known for many years that we need a response to illegal drugs. We have seen a lack of intervention over a number of years, and we are reaping the consequences. We need to make a dramatic change in our approach if we are to do anything about the issue and deal with the unthinkable death toll.
There is no silver bullet to deal with the drugs crisis. No one does the subject any justice by pretending that one single policy can fix an issue as complex as this one. Instead, it will be the implementation of a number of different initiatives that will act as pieces of the wider puzzle. One such measure is ensuring that those on the front lines of the battle have the tools that they require, and naloxone is one such tool.
The ability to mitigate the effects of an opioid overdose for a short period can be the difference between life and death. Between 2020 and 2021, take-home naloxone kits helped to treat an estimated 1,377 overdoses. In many cases, that has saved lives that otherwise would have been lost.
Far more can and should be done to get life-saving naloxone into the hands of those who need it. A third of the people who are deemed to be at risk of an overdose do not have access to it. We need to significantly broaden the circle of organisations and institutions that can distribute it and facilitate the police, homelessness charities and social workers to reach as many addicts as possible. I would be interested in hearing whether the minister has any proposals to roll it out further across Scotland. That seems to me to be an easy and effective way to make a real difference.
Consumption rooms have been floated as a possible measure to address drug deaths by giving those who struggle with addictions a safe place to consume drugs with supervision. Personally, I have major reservations about that proposal. A number of logistical and legal factors must be considered, including whether it would be a crime to possess drugs while travelling to a consumption room and what liability the Government would have in the awful event of someone dying at one of the sites. As my colleagues have said, if we are to trial consumption rooms, we will need to ensure that they work in a Scottish context, and any data that is collected must be fully analysed before we take any further steps.
I want to make it clear that helping those who struggle with addiction is tackling only half of the problem. Illegal drug use has to be tackled at the root of the problem, which is supply. Those who traffic in drugs are profiting directly from the trading of substances that not only ruin people’s lives but, very sadly, often end them. We must do everything that we can to stop this immoral trade and l will support any measure that will bring these criminals to justice. Every tool that we have at our disposal should be utilised to find avenues through which drugs can come into our country, so that we can block and stop them.
However, that is not going to happen on its own. Governments have to be proactive in plugging the holes, so I am disappointed that the Scottish Government has refused to sign up to project ADDER, which is a UK Government scheme to tackle drug dealing and organised crime. I note what the minister said about that in her intervention on my colleague Sandesh Gulhane, but I ask the Scottish Government to think again. The scheme has been very successful so far, so it is hard to see the logic in the Scottish Government not taking part, especially when we consider that the project has helped to seize 27 million benzo tablets that were destined for our country. I ask members to imagine the incredible difference that could be made for the people of Scotland if there was full co-operation on the issue between both Governments.
The long and the short of it is that something has to change. We cannot allow the trend that we have seen over a number of years to continue, with lives being needlessly lost and families being torn apart. There are measures that can be taken and I implore the Government to get a grip on the crisis. We do not need warm words. We need action and leadership. It is not just a matter of telling everyone what we would like to do. It is a matter of rolling up our sleeves and getting the job done. I hope that all of us across the parties can be involved in that process.
The final speaker in the open debate will be Paul Sweeney.
16:23
Scotland’s drug deaths crisis is the most important and pressing issue that this country faces today. I have said before and I say again that we must not shy away from the crisis, and the action that we take to tackle it must be bold, radical and, most important, swift.
That action will take many forms, including the roll-out of the MAT standards; ensuring that access to treatment and rehab is available to anyone and everyone who needs it; the overhauling of a criminal justice system that criminalises and warehouses vulnerable people in Victorian prisons; and the roll-out of overdose prevention centres. There is no one silver bullet, and I acknowledge and applaud the Government’s recognition of that simple fact, which has been shared across the chamber this afternoon.
It is against that backdrop that I turn to the Scottish Drug Deaths Taskforce and its report. There is a lot to be welcomed in the report. I particularly welcome the emphasis on treating the drug deaths crisis as a public health issue and tackling the scourge of stigma that is faced by those who are battling addiction, and also the report’s unequivocal backing for overdose prevention centres. It is filled with recommendations, many of which we have seen before, and that simple fact goes to the very heart of the issue. We can have all the reports in the world with the best recommendations possible, but, if there is a failure to implement them, they are a waste of time.
Take overdose prevention centres as an example and as a litmus test. We have been talking about those for almost a decade now and we are generally all in agreement as to their efficacy, but we are still waiting for so much as a pilot to be initiated. They are not some fanciful idea that is way outwith the scope of the Government to implement. Indeed, the Scottish Drug Deaths Taskforce chair has said:
“We believe that safer drug consumption facilities can be implemented now under the current legislation”.
So why the hold-up? I understand that a proposal for a pilot in Glasgow was submitted to the Lord Advocate more than six months ago, yet here we are—no further forward and with no mention of that in the minister’s opening speech this afternoon.
The Crown Office and Procurator Fiscal Service is saying that it is too complex to do, that there is a myriad of issues, that the chief constable is not up for it, that that is such a shame and that we do not have a timeframe for it yet. I am afraid that that is just not good enough. It is a disgrace when we have people dying and when we have seen the efficacy of that approach in Glasgow through the unofficial pilot run by Peter Krykant. Eight lives have been saved—what more context do we need? Let us get on with it; let us bang those heads together and get it sorted. If it needs to be the First Minister who does that, so be it.
Those prevention centres are far from the only area where the Government’s actions have not aligned with the expectations set. Let us look at the MAT standards. The minister came to the chamber in the autumn to inform us that the Government’s implementation of the MAT standards 1 to 5 by April last year had failed miserably, with just seventeen per cent of the standards being fully implemented and just one of the ADPs fully implementing MAT standard 1 by the agreed time.
It does not stop there. The Scottish Drug Deaths Taskforce report talks about the importance of implementing all 10 MAT standards by May 2024, yet the Government’s target for full implementation of those 10 is not until 2025, and we are no further forward on the commitment made two years ago by the First Minister on the widespread roll-out of diamorphine or heroin-assisted treatments. Those are still basically statistically irrelevant in the front to tackle Scotland’s drug deaths emergency.
The report also talks about funding fit for a public health emergency, yet we know that the budgets of local authorities, who are largely responsible for the delivery of many of the services relating to drug death prevention, have been decimated and continue to be cut every financial year. As I said, the report is full of welcome recommendations, but we have seen it all before and, frankly, actions speak louder than words.
Before I wrap up, I will make a more general point, which is that, unfortunately, a vacuum has been created when it comes to drug policy, which is deeply concerning. In the past year, we have seen proposals for legislation from Opposition members but nothing whatsoever from the Government. I do not say that to score points or to grandstand, and I certainly do not say it to decry the laudable work being done by the minister. I simply say it because it is emblematic of a structural inertia that seems to exist at the heart of Government, despite the efforts of the minister to turn it around.
It has been said to me that if this was about any other group of people, the crisis would have been fixed a long time ago. Although I do not want to believe that to be the case, it is an unfortunate and observable reality that the longer it drags on and the more time we waste, the more difficult it becomes to dispute that there are certain people in certain positions of power in this country who just do not think that it is worth the hassle.
I do not envy the scale of the task that the minister has in front of her. Scotland’s drug deaths crisis existed for a long time before she was responsible for the portfolio. However, my worry is that, based on the current trajectory, flatlining as it is but still at a sky-high rate relative to any other comparable country and jurisdiction, and despite the efforts that she is making, it will exist long after she ceases to have responsibility for it. That is a national tragedy.
We move to winding-up speeches.
16:29
It is always difficult to follow Paul Sweeney in a debate such as this, because, among us all, he has the most visceral, real-life experience of the issues. He has helped to stabilise people in the very worst strains of addiction; sometimes, he has even helped to save their lives. I congratulate him for that and recognise his work in that regard.
I welcome the minister’s commitments on the report, particularly her remarks on stabilisation services. I would not say that she and I have crossed swords on stabilisation, but I have raised the issue with her several times. Therefore, it is gratifying to hear that that is now a primary focus for the Government, given that those services have been something of a Cinderella service in drug treatment provision in this country. I am also gratified to hear the minister talk about rurality. I have raised the issue of same-day services several times before.
On the actions that are outlined in the report and the Government’s focus on families affected by parental substance use, let us remember that someone who is born into a family where parental substance use is prevalent will, from day 1, suffer an adverse childhood experience. We know that adverse childhood experiences are, in large part, the cause of much of the addiction in our communities. If we offer comprehensive and holistic support to those families, we can break that cycle. Kaukab Stewart gave an excellent description of a service in her constituency that is hoping to do exactly that.
The report is comprehensive. It needs to be, because it is not just about what people ingest or put into their arm. It is about the other factors that follow them around in their life, and it is about their access to housing, training and their routes into the employment market. Oftentimes, we can stabilise people, but they go back into communities where there are toxic relationships and triggers that restart the cycle. If we can help them out of that with a level of social mobility, we will have succeeded.
I support Sue Webber’s amendment—there is much in it that the Liberal Democrats agree with. However, it asks us to sign up to the proposed right to addiction (Scotland) recovery bill right now. We are moving forward with that in an atmosphere of good faith, but we cannot write blank cheques on it. I have picked up today, in some of the remarks from the Conservative benches—
We heard from members from all parties about the importance of listening to the voices of those with lived experience. If the member has read the article on drugs in December’s edition of Holyrood magazine, he will realise that the author, who is from Faces and Voices of Recovery UK—FAVOR—and who worked with us on developing our proposed bill, has such lived experience—he has nothing short of that. Surely, the member must understand the value of signing up to the bill.
I make no prejudicial remarks about where we will end up on that bill. I have told Douglas Ross that we will move forward in good faith. At the same time, there are fundamental areas of disagreement about our parties’ approach to drugs policy. We have heard some of that with regard to safe consumption rooms, pill checking and so on. Although those approaches are outside the scope of the bill, that suggests that elements of discord might arise. I hope not, and I make no prediction about that.
Paul O’Kane was right to put bereaved loved ones at the very heart of his remarks. We should all do that. Let us not forget the torment that they face, which has sometimes been increased by the actions of this Parliament. Colleagues will remember their postbags being filled with correspondence from the families of loved ones who had succumbed to addiction or overdose, who were waiting months, if not years, for a toxicology report to give them some closure on the circumstances of their loved ones’ passing. That was a direct result of political decisions that led to cuts in that service. Those are the unintended consequences of some of the actions in which we participate.
Today, I am thinking in particular of the parents of a woman from my constituency who was killed at an event on 29 October at Terminal V at the Royal Highland Centre at Ingliston. She died after taking harmful substances that she had ingested for pleasure. She took them before she arrived at the festival because she knew that there was a zero-tolerance approach on site. I met representatives of Terminal V after the fact. They have one of the safest facilities in the world. They have security and state-of-the-art healthcare facilities, but they could do nothing for my constituent, because she had ingested the pills before she got to the venue. If Terminal V had had a pill-checking facility, she might not have taken the pills beforehand and it might have given her a lifeline.
We have seen the effect of that at drug-testing facilities that are already offered at festivals in England and Wales. A three-year research project that was conducted by the University of Liverpool and The Loop, which is a charity, found that, in 15 per cent of cases, pill-checking facilities revealed that drugs were not what the person who bought them had expected them to be. Two thirds of festival-goers would dispose of their drugs if they were unsure about what they contained, and, at festivals where drug-testing facilities were in place, nobody died. That is another example of something that works.
I come back to my intervention on Dr Gulhane, who is anxious that we should not rush into solutions. However, Paul O’Kane is right: we must rush into solutions, because the emergency is at our door. It is not the case that it might not work for Scotland. We are not the pioneers of safe consumption rooms—those have been working and saving lives effectively in countries across Europe for years. What is sauce for the goose is sauce for the gander. We need them in Scotland right now.
I conclude by paying tribute to some members for their excellent speeches. Emma Harper was quite right to talk about stigma, which is a massive barrier that we face in getting people into treatment and changing the attitude of society to all of this—
I must ask you to conclude, Mr Cole-Hamilton.
I will close on that point. I assure the Government that the Liberal Democrats will support its motion.
16:35
I am happy to add my thanks and the thanks of Scottish Labour to those who have been involved in the Government’s response to the final report of the Scottish Drug Deaths Taskforce.
Today, we will have to abstain on the Tory amendment for the same reason as Alex Cole-Hamilton will: we must wait to see the publication of the right to addiction (Scotland) recovery bill before we can add our support to it.
We are happy to support the Liberal Democrat amendment, the contents of which Alex Cole-Hamilton has set out so eloquently. We will also support the Government’s motion, because we want to try to maintain a level of unanimity around the general approach, for which I think there is broad support.
I have to say, though, that reading the Government’s response today has left me deeply underwhelmed. The report was another opportunity to signal a step change in the pace of the approach. If there is consensus in Parliament arising from the debate today, I believe that it is this: we must increase the pace of change.
We know that drug deaths in Scotland are now the second worst that they have been on record. With the current rate of change, it will take decades and decades to resolve the situation, and tens of thousands more lives will be lost to drug deaths if we continue on the path that we are on at the moment.
I would gently say to some SNP members that the suggestion that this situation is not grotesquely out of control must be immediately dismissed from their minds, because the situation is grotesquely out of control.
I do not think for one second that any of my SNP colleagues underestimate the challenge ahead.
One thing that I would put to the member is in relation to the UK Government’s consultation on its white paper. It focuses on demand, possession and use, and it continues to take a justice-orientated approach. Would the member not agree that, when it comes to use and possession, a public health approach, which the Scottish Government is attempting to take, is much more appropriate?
There is clear unanimity in support of that, at least from Scottish Labour. We absolutely support taking a public health approach to the issue—that has been our position for a long time.
Paul O’Kane has pointed out that it has been three and a half years since drug-related deaths were declared a public health emergency and that it has been two years since the declaration of a national mission. However, we have no proper implementation of MAT standards. The First Minister told us that that they would be rapidly implemented.
We must recognise that what is happening is far from rapid. We have no drug-checking facilities, as has been highlighted; we have no overdose protection pilot; we have no workforce plan; and same-day prescriptions are available in only one ADP in Scotland.
The minister asked for recognition of funding that has been brought forward. The Public Audit Committee has told Parliament quite clearly that we do not have a proper account of the scale of the challenge to measure whether that funding is appropriate.
However, the report of the Scottish Drug Deaths Taskforce, which we are responding to today, called the funding that is available to alcohol and drug services “woeful”. That is the task force’s word, not mine. It is clear that more needs to be done in resourcing as well.
We recognise that we require further information on both mental health and substance misuse services as well as on their interaction. When I intervened on the minister, I highlighted what is in the report on NHS Tayside. I hope that the minister will support the need for a Government statement on that report, because I think that that is critical. Scottish Labour has called for that today, and we would like to see the mental health and public health ministers in front of Parliament answering questions. After all, this Parliament called for that report and ministers commissioned it, so let us hear from ministers in response to it.
Emma Harper, who made an outstanding speech, as well as Alex Cole-Hamilton, raised the issue of same-day access to services in rural areas, for which I have great sympathy. I have also highlighted that issue in the chamber on occasion but not nearly as eloquently. We must set that against the full retraction of health services in villages and small towns. That is the context in which many rural communities are operating.
Jamie Greene contrasted that with a request to focus on areas of acute problems. I would highlight the issues in Dundee in that regard. More than anything else, as important as funding and having a focus on resources are, the pace of change—making change happen—seems, frankly, to be the single biggest problem in Dundee. Changing the services to the kind that we need requires absolute leadership.
I will close on what I believe to be a point on which real consensus has emerged in the debate. There is a lack of any real detail on what a consumption room pilot would look like. We need to see that proposal from the minister. Katy Clark has talked about it; Russell Findlay has highlighted it in his brief contribution; and Paul Sweeney, as ever, has talked eloquently about the need and the demand for it. I believe that Parliament is demanding that from the minister. Could she address that issue in her concluding remarks? Is a proposal on her desk? When will that be published?
16:40
I thank all members for their constructive and considered contributions. I offer the condolences of Conservative members to anyone watching the debate who has been affected by the issue of drugs and by the passing away of someone in their family because of them. It is an issue that touches all aspects of life; any one of us, even in public life, will have close experiences of the devastating effects that substance abuse has on a person and on the unseen victims of addiction—our friends, partners, families and the people around us.
I commend many of the contributions that have been made today, including those by Siobhian Brown, Gillian Mackay and Kaukab Stewart among others, who shared personal experiences and anecdotes about the devastating effects that drugs are having in their communities, and about some of the very good work that is happening. I point to the work that is being done in Saltcoats, parts of Lanarkshire and elsewhere.
I welcome the fact that progress has been made in the past calendar year on reducing Scotland’s drug deaths, which one member mentioned. However, it is a small reduction and the drug problem remains our national shame, as does our problematic relationship with alcohol and other substances, which I have previously spoken about in great detail.
Having read the motion and the various amendments to it, I think that we have approached the debate in the tone that it merits. There is, of course, some argy-bargy around the semantics of voting and amendments, but we will support the Government and the premise of its motion today. We have one or two issues with the Liberal Democrat amendment, but only in the sense that the Criminal Justice Committee, of which I am a member, has not had a chance to consider the repercussions of what it suggests. If that amendment is agreed to, we will, unfortunately, not be able to vote for the amended motion.
All that amending, voting, and talking is one thing—that is procedural stuff, and we are very good at talking. However, it is the doing that matters. Sue Webber was right to point out in her opening speech that, as the report makes clear, drug deaths are preventable, but that requires action and action requires resource.
There are roles for all of us because, as Gillian Martin pointed out, it is not just a Government problem; it is an everyone problem. However, none of us in Opposition can legislate easily, as the Government can. I know that, because my colleague Douglas Ross is going through a very lengthy process, which is why we have not yet published his proposed right to recovery bill. I know that Mr Sweeney is doing the same with his bill on an issue in which he believes strongly. Those things take a lot of time. I know that, as someone who already has a member’s bill in the system. I am afraid to say that the nature of the process is that members’ bills often end in failure. The reality is that the Government, its ministers, its directorates, its public bodies and its agencies can act far more quickly and easily than any of us in the chamber can.
In the example of Inverclyde, which Paul O’Kane mentioned, and Michael Marra’s examples from Dundee, we see that real action that is taken at pace can make a difference. If one treats the addiction, one can prevent the death—I want to give that important message today.
In my opinion, the task force is a step in the right direction overall and is, by its very nature, an acceptance and an acknowledgement by the Government that there is, indeed, a crisis that needs urgent and focused action.
The one thing that I took away from my brief reading of the report—given that it unhelpfully came out only yesterday—is that one cannot fight addiction on one’s own. We have to consider that when we look at what the Government is or is not doing. Help must come in a form that is timely, appropriate to the individual, well resourced and unending for as long as it is needed.
The Government has, rightly, taken an absolute battering in the chamber over its historical failures. However, it is never too late to turn things around and it is never wrong to say “Sorry”, although that is not easy for a Government to do. I appreciate the work that the minister is doing, but it is still the case that too many people are being let down.
I say to Gillian Martin that this is not a blame game—certainly not on my part. That is not my style. This is about responsibility and accountability, and it is the job of Opposition members in Parliament to hold the Government to account.
As Katy Clark did, I want to talk about the justice interactions, because that is an area of the conversation in which I have a great interest. The reality is that our drug death epidemic reaches far into our justice sector in a range of ways. We have talked a little bit about prisons—I think that the word “endemic” was used to describe the situation with drugs in our prisons. Some 41 per cent of prisoners who enter custody in Scotland do so having had problematic drug use before they enter custody, so I understand that there is a real interaction between drug misuse and the criminal justice system. It would be naive to think otherwise.
However, the reality is that drug deaths in our prisons have risen sharply. There were, sadly, nine drug deaths in 2020. The figure rose to 15 in 2021, and the recent figures paint a worrying picture of the situation in 2022. In prisons, the trend is on the way up, even though the trend in the rest of the country is on the way down.
The issue is not just about preventing drugs getting into prisons; it is about addressing the underlying reasons why prisoners are taking drugs in the first place. Is it to do with a lack of meaningful activity? Is it coercion? Is it simply the conditions that they are in? We talk about Victorian conditions in prisons, and HMP Greenock is a perfect example of that. It is disgraceful. It is horrifying and inconceivable that someone can go into custody without a drug problem and leave with one. How can that happen in modern Scotland?
The issue of organised criminal gangs using the prison system is important. An inmate I chatted to in private when I visited HMP Edinburgh told me how easy it is to get drugs in prison. He said, “Give me five minutes and I’ll come back with some drugs.” That is worrying to me—not just as an MSP but as a member of society. Individuals are coming out of prison with a problem that is worse than the one that they went in with, which surely has to be a matter of importance.
I do not have time to go into the wider issues around diversions from prosecution, but I will say that we must look at the data on that. I want the Government to produce quantitative data on the decisions that it makes about diversion, and how that relates to consumption and use in the wider population and to reoffending rates. I do not have that data, but I wish I did. If we had it, perhaps we could have a proper debate about it. The issue is important with regard to any class of drugs and any decisions that the Lord Advocate makes.
I will not rehearse the arguments about consumption rooms, but I will say that no one on the Conservative benches can make that policy happen or stop it happening; that power lies with the Government.
I will close by saying that no one has a monopoly on ideas in the area. We will have to work together, but we must also learn lessons. The lesson that we can all learn from today’s debate is that, on all sides, politics sometimes perversely does the opposite of what it is meant to do, which is to do good. It will get in the way unless we do what is required of all of us, and that is to agree where appropriate and disagree where necessary. I think that today’s debate has reflected that well.
16:48
I thank each and every member who has participated in today’s debate. Although it might not always seem like it, I always appreciate and reflect on the contributions that members make, the causes that they champion and the casework that they often bring to my attention.
I also notice that many members have attempted to turn down the volume a wee bit on the politics—that is something that I always try to do. However, I accept that, although we can depoliticise the issue a wee bit, that does not remove the need for clear accountability and leadership. I have always sought to practise what I preach, and the scrutiny that I subject others to is exactly the same scrutiny that I am open to.
It is fair to say that there is more that unites us than divides us, and I appreciate members’ almost unanimous support for the detail of the recommendations and the actions in our plan that, of course, are evidence based, with some of that evidence coming from international sources because, as Alex Cole-Hamilton rightly said, we are not pioneers in this area.
Once again, I reiterate my thanks to everyone—past and present—who has served on the task force, and I put on record my thanks to drug policy officials and other colleagues across Government.
I have always made every effort. That comes in part from having a period of time outwith Government; to be direct and plain speaking, I think that it is called “a period of reflection”. I have never demurred from describing the scale of the challenge, acknowledging the pain and the heartache, or, indeed, showing my frustration and anger at the pace and progress. I was very straight with Parliament a number of times last year—most recently in December—about issues relating to MAT standards. I will not repeat what I stated, but members will be aware of the unprecedented action in respect of scrutiny and financial and practical support. I will, of course, continue to return to Parliament on the issue of the MAT standards and the action plan on a six-monthly basis.
I recall what was described as “unprecedented action” in terms of ministerial direction that was given to certain alcohol and drug partnerships in health boards in that regard. What can the minister publish and put in the Parliament’s domain to tell us about the instructions that have been given to those groups, the names of the accountable persons, the substance of the conversations, and the pressure that is being put on people to deliver changes at pace?
Senior leaders and who is accountable at the local level should be published, and improvement plans should be published at the local level. The last time that I checked—which was before Christmas, in advance of coming to the chamber for the MAT standards statement—that had happened in the vast majority of cases. However, if there are particular examples that members want me to pursue, I would be more than happy to follow them up.
I also outlined in the statement what information would come to Parliament in June in respect of specific reporting on progress on the update to the red-amber-green assessment.
Like other members, I am not going to prejudice my judgment on the right to recovery bill. I want to see it and be reassured that it is inclusive of all treatment options. However, I can give the assurance that I will participate in the parliamentary process in good faith.
In the meantime, the Government will continue with its own legislative programme, including the work that Mr Brown is pursuing relating to the Bail and Release from Custody (Scotland) Bill and ending Friday liberations, and our work relating to the human rights bill, which is about putting into Scots law internationally recognised human rights that are ultimately enforceable in court.
The national collaborative—that independent voice of lived and living experience and families—is developing the charter of rights. The implementation plan is not just about ensuring how we can put into practice the highest-attainable standards of physical and mental health in the context of the human rights bill but about how we can do likewise with people’s right to housing, education, a healthy environment and social networks, all of which are determinants of good health.
I agree whole-heartedly that more can be done in Scotland and that more is being done in Scotland with the powers and resources that we have. After all, in an earlier incarnation, I was the minister who took through child poverty legislation without full powers over tax and welfare. When I was an employment minister, I reduced youth unemployment, despite having no access to employment law. Therefore, I think that I am a good example of the ever-pragmatic optimist. I will always roll up my sleeves and deal with the hand that I have been dealt. However, I know that there are constraints.
I hope that people support the task force’s call for change in equality law regulations, which exclude people with addictions, unless they have an addiction to prescribed medication under the disability regulations. We also need to have a mature debate, discussion and review of the Misuse of Drugs Act 1971.
I kindly say that we need to move away from the rhetoric of soft justice. Our focus should be on what works.
What works in terms of public protection, which is the absolute priority? What works in terms of prevention? What works in terms of rehabilitation? What works to make each and every community and individual safer?
Certainly, the one thing that we know works in prevention terms is those prevention centres and this pilot is critical. We need to get sight of the timescales, so could the minister please update the chamber on that?
I cannot even begin to describe the impact that visiting OnPoint, the safer drug consumption facility in New York, had on me. It took a long time for me to process that. What I can say is that it has only ever increased my resolve to do everything that is within my powers to overcome barriers so that Glasgow can be the next city, following on from Dublin, to have such a lifesaving facility.
I do have to be really direct and candid with members in the chamber: the feedback that I have received through my officials to my inquiries is very similar—almost identical—to the feedback that committee members have received.
I cannot speak on behalf of the Lord Advocate or the Crown Office, but I can reassure members in the chamber that if anything is within my gift or my power, I will absolutely do it. Of course, there would have been an easier way to do this, but I will not make that perhaps more political point in today’s debate.
Will the minister take an intervention?
Actually, I am going to move on—I have taken two interventions from Labour members.
We have had some discussion around finance. Record funding is going into tackling Scotland’s drug deaths crisis. People will have seen the draft budget, which has a £12 million additional resource going to the national mission.
I will also reiterate a point that I made earlier, that multiyear funding is available to third sector organisations and we are supporting organisations with an increase in relation to the cost of living crisis.
I am also determined to follow the money, because this is not just about quantum; it is also about impact and about ensuring that money is reaching where it is intended to reach.
I will quickly say to Alex Cole-Hamilton that I am with him in spirit in terms of what he has outlined in his amendment to the motion. For some of those more arcane technical reasons, I cannot support the amendment because he is technically asking me to do something that is not within my legal powers.
In terms of drug checking facilities, I would say to him that there is only one drug checking facility in the United Kingdom that is licensed by the Home Office, which is The Loop in Bristol. It is open once a month, on payday weekend. [Angela Constance has corrected this contribution. See end of report.] I want to see drug checking facilities in at least three of our cities and we are engaging closely with the city leads on those applications that have to go to the Home Office, including the details in and around that. I am happy to talk to Alex Cole-Hamilton in more detail about that point.
In the time that I have left, I will say that I agree with Jamie Greene—no one can fight addiction on their own, and that of course applies to services and indeed to politicians. When I came into this post, I made a commitment to ensure that drug policy and the national mission would be joined at the hip, whether that is in relation to education, prevention, housing and homelessness, employment, criminal justice, mental health or our efforts to tackle poverty and inequality.
I recognise that everybody is much more than their drug or alcohol problem. No one should be defined by their substance use issue. That is why tackling stigma is so important. We also have to recognise that people with lived and living experience are assets and that they have a contribution to make to every aspect of society, not just to drug policy.
I very much believe that our plan demonstrates how we are including people and not excluding them, as well as how we are scaling up our efforts. The Routes programme will expand into five new areas; Planet Youth will expand into eight regions; and Housing First is already in 25 local authority areas, with another two coming on stream, recognising that home is much more than bricks and mortar and that homelessness is much more than a housing policy.
In addition to our new, extended, residential rehabilitation services and the 891 funded referrals into residential rehab over the lifetime of the national mission, we will build on that progress and maintain momentum with £18 billion going into stabilisation services. That will also be a platform for change in terms of out-of-hours services.
I disagree with some colleagues in the Labour Party about the national care service, because I want to bring drugs services into the mainstream and core, universal services. That is why I want it to be part of the national care service, which is the biggest reform since the establishment of the NHS, in the same way that I want drugs services to be mainstreamed as part of our primary care response. With our pathways work, whether that is mental health, GIRFE, MAT or trauma, we are reforming services across the length and breadth of Scotland.
Minister, please conclude.
Finally, Presiding Officer, we know that there is no one solution. Our work is complex, but we are in the business of mending and preventing broken lives. Our journey is both a sprint and a marathon. We are acting now, but we are also making long-term commitments. We will build on our progress and maintain momentum. There is much work to do, but I commend the report to the Parliament.