Chamber and committees

It is clear that we have work to do to build on the foundations that have been put in place by the national mission. We are looking to provide systematic change in the availability of services and the types of interventions that we make. As has been demonstrated today through the lines of questioning, the Government is supporting a variety of interventions, from the implementation of the MAT standards to safer consumption facilities, and from drug-testing facilities to residential rehab. There is a broad range of interventions at play, and those take time to build up.

I recognise that there might be a feeling or a perception that there is a disconnect, but I believe that we are making progress. I say that because of the interactions that I have had with families, who say that progress is being made.

We have more work to do—that is clear, and the perception that Ms Dowey narrated demonstrates that. We need to ensure that we deliver demonstrable change that is felt at a local level and by individuals and their families. That is certainly what our collective effort is geared towards across the Government, in partnership with local authorities, health and social care partnerships and alcohol drug partnerships, with those in the community and voluntary sector who are involved in this area, and with families and advocacy organisations.

I would be happy to provide that, convener.

I will bring in Maggie Page to talk about that area in a moment.

In the discussions that I have had with family members—those who are currently experiencing having a family member with a drug dependency and those who have lost a loved one through drug-related death—they tell me that stigma is one of the areas in which the national mission has been of greatest importance and where it has made the biggest strides. The shift in that respect, allowing people the space and the opportunity to feel confident about accessing services, both for themselves and their family members, has, they tell me, been incredibly important.

I felt that particularly keenly when I visited the service in Dumbarton, and during the private session that the First Minister and I had when the travelling Cabinet visited Ayr last week. Family members believe that the reduction in stigma is having a major impact on people feeling able to come forward.

That is why it is so important that we take a public health approach to the issue, as opposed to a justice approach. It is about keeping people in their communities and supporting them with some of the issues that underlie their drug, or indeed alcohol, dependency. As Richard Foggo has set out, it is important to acknowledge the clear correlation with poverty.

I will bring in Maggie Page to talk about the timescales in order to address Ms Haughey’s specific question.

I will be honest. I do not know why 1,000 was set as the target, and whether that is the right measure of—I do not think that “success” is the right word, but I think that Ms Wells understands where I am coming from. That target predates my involvement, so I do not know why it is 1,000.

What we can demonstrate is the clear progress that is being made on the availability of residential rehab. Audit Scotland recognised that in its report, to go back to Ms Dowey’s line of questioning.

We need to demonstrate that we are making progress across all areas. We are reducing stigma, thereby giving people the opportunity to access support and breaking down the barriers to that support, as well giving their families the opportunity to receive support. The progress that has been made in access to residential rehabilitation beds is a sign of that progress.

Again, as I say, I honestly do not know the reason behind 1,000 being the target, and it will be for us all to judge whether that is the right measure. The important thing is that demonstrable progress is being made in availability and in the capacity of the system, and that is clear.

I expect that that will form part of the audit work on bed availability that Maggie Page referred to. If we have further detail at local authority or health board level once that work is complete, we will certainly seek to provide that to the committees.

Ms McNeill touches on another really important area, which is the awareness and availability of services. Given that the question is about residential rehab, I again think back to my interaction with families who have a loved one or family member currently experiencing drug or alcohol dependency or who have lost loved ones to drug or alcohol dependency. Their lived experience is of prime importance and those families take a very clear view that availability of rehab and the awareness of the routes to that are improving. That is not to say that everything is all right or perfect, but it is improving.

As for access to residential rehab, medical professionals carry out clinical assessments as to whether such an approach is appropriate for a particular person. I think that Ms McNeill will recognise that it would not be right for me to interfere with the clinical decision-making process, but I do think we must ensure wider awareness in the health service and in community services of the availability of rehab and of what might be right for a particular person if that is not the right route.

I go back to Ms Dowey’s questions on the need for clarity about what is available in communities and the role of alcohol and drug partnerships and community organisations that help with signposting. The next stage will be to ensure that we can give people a clear picture, so that, if one particular route to recovery is not right for them, they can be aware of other opportunities.

I absolutely concur with Mr O’Kane. That is a serious concern. I repeat that our interventions were not made lightly, and ministerial directions are not made often. We expect ADPs not just to implement the MAT standards but to provide greater awareness of them.

When we are talking about getting it right for everyone, it is important to recognise that that is particularly important for those with an opioid dependency. Across the country, cocaine use is prevalent and has been implicated in a rising number of drug-related deaths, but we do not currently have a medication-assisted treatment pathway available. That is why it is important that we look in the round at all the interventions that are available.

I am absolutely clear about the importance of making continued progress on the MAT standards, because, for a great many people, that helps to save lives. It reduces harm and gives them a pathway to seek recovery. I do not want there to be any quibbling about whether we are committed to that—we are, and I take very seriously the statistics that Mr O’Kane mentioned.

I met the new Secretary of State for Health and Social Care, Wes Streeting, pretty early in his tenure, and we are due to meet again soon. However, the issues that we are discussing were not covered in our ministerial discussion.

I will bring in Richard Foggo to talk about interactions that officials have had, but I think that it is safe to say that there is greater recognition from the new UK Government of the importance of taking a harm reduction, public health approach to tackling the issue of reducing drug and alcohol-related deaths. I am hopeful that we will have a constructive relationship on that basis to allow us to see progress on some of the areas that we are discussing. Those areas will include the safer consumption facility and the drug-checking facility, which the convener asked about, but I hope that the interaction of those things with reserved legislation will be open for discussion, too.

I know that there is interest in other areas; Edinburgh is looking closely at such facilities, too. The scheme is a pilot, so we are starting from a smaller place. If it is successful, we can, based on the test-and-learn process, build it up from there.

If it is successful, I expect that we will consider wider participation in addition to the facilities in Aberdeen, Dundee and Glasgow. Those cities have particular challenges, but the issue is facing all communities across Scotland.

There is certainly scope, and this is a pilot. The health and social care partnership, alongside the Government, will look at the success of the centre being set up as it is, and at what might be possible if we were to explore alternative or increased opportunities. Mr Sweeney made a suggestion in relation to the work that Peter Krykant did. That is potentially part of the exploration, and I am certainly not ruling any of that out, because we want to respond to what the evidence demonstrates works. It is important that we have the pilot so that we can demonstrate that it works. If further innovations could provide greater help and support, both the Government and, I would expect, the health and social care partnership would explore those.