Chamber and committees

Do you mean every single project?

There is certainly publication around where the Corra Foundation money is allocated. That is publicly available, and I will double check how often it is published. There is a great deal of scrutiny of alcohol and drug partnerships, much of which is published, too, either quarterly or through our annual report.

That is fundamental to the work that I lead on MAT standards, residential rehabilitation and improving support for families. Accountability and scrutiny are important at every level. The Government must model that to demonstrate that we are accountable and will engage constructively with any critique or performance review, and that we expect to find that throughout the system.

We must use every lever that we have available to us, and some of that will involve more regular reporting. We have quarterly reporting of residential rehabilitation placements that details area by area where the placements are being funded, and we can see a general improvement across the country. Similarly, on MAT standards, some areas are subject to monthly reporting and others are subject to quarterly reporting. It is also about investment and our following that investment very closely. There is a belt-and-braces approach. There is much more rigorous scrutiny and regular reporting, but that is coupled with additional investment.

There is a hands-on approach. Given the nature of the portfolio, my officials are in regular engagement with each and every area, and I spend a lot of my time directly engaging with families and local services. I will give the example of the work of the medication-assisted treatment standards implementation support team. We are being pretty hands-on with that. It needs to implement and ensure that we have an acceptable standard of delivery irrespective of where an individual or a family resides, notwithstanding that some areas will need to do things a little differently.

On our investment in family-inclusive practice and the whole-family approach, money has been directed to ADPs, but money has also gone to third sector organisations via the Corra Foundation. Through our multi-agency expert delivery group, we are doing an audit of how ADPs have utilised that uplift. We are currently working through that.

I have been around Parliament and Government for a long time. When I came into this post, I very much brought with me work that had been done in and around social security experience panels, which was about how we build things from the ground up and meaningfully engage lived, living or, indeed, front-line experience, to help build a system or new services. Again, that needs to be core business not only in drugs policy but elsewhere because, ultimately, services will not be as effective as they should be if they are not built in collaboration with the people who are going to use them or need them. That sounds obvious but, historically, many of our systems, such the healthcare system, can be quite hierarchical. With no disrespect to the clinicians out there, there can be a bit of “Doctor knows best”.

Over the past five to 10 years, we have begun to see a shift in mindset. It is about cultural change, which is why the work of the national collaborative is really important at national level, as is the work locally. There is funding for work to take place at local level to meet our expectation that every area needs to engage with lived and living experience. It is a fundamental principle in our work to tackle stigma that those who are impacted by drugs and alcohol have an expertise, and it is not just about listening to their voice—they have a role to play in redesigning services. That actually makes sense for everybody.

My sense—it is just my sense—is that we are further away from the start of this journey and are now closer to a conclusion, although I appreciate that it is perhaps not the specificity for which Mr O’Kane and other colleagues are looking.

I will say, and I hope that this is reassuring for the committee to hear, that, given the journey that the task force underwent and the work in which the Crown Office and Police Scotland were involved, we have come to a point at which we as a country and with all our different partners understand what the evidence tells us.

The question that remains is ultimately one for the Lord Advocate, around what she can and cannot do within her powers around statements of public prosecution policy. Criminal Justice Committee members will remember the statement that the Lord Advocate made to the committee about the need for a “detailed and specific” proposition that the community and Police Scotland would buy into. That is what we have worked towards. I am not the arbitrator or the judge of that work—that duty lies with someone else—but, whatever the outcome of this journey, I will always look to get the right solutions in place.

So far, I have committed to and allocated an investment of almost £40 million for existing or new services. That investment touches upon seven services. Those are in Argyll and Bute; at Harper house in Ayrshire; in the Lothians and Edinburgh alcohol abstinence programme; and the new mother and child recovery house in Dundee. We recently announced funding for the north-east, where Phoenix Futures will take forward a project to address the needs of that area. There is also additional investment for Crossreach in Inverness. Those are among the seven distinct investments in new and existing services or projects. That £38 million will increase capacity by 40 per cent.

I am pleased to say that some of those new services are now up and running. We made a commitment to go from 425 to 650 beds. The investment thus far takes us to 600, with some of those beds already in use.

As well as increasing capacity, we are improving access. We wanted to ensure that the existing capacity within the system was being fully utilised. Our information is now a couple of years old, but some establishments were not full to capacity following lockdown. That is why we directed £5 million of funding for residential rehabilitation and aftercare to ADPs across the country. We should never forget aftercare, which is a crucial part of the whole-system approach.

I hope that is helpful.

That is where our support of the work that is led by Public Health Scotland is really important. I know that Mr O’Kane is familiar with the RADAR—rapid action drug alerts and response—work, which is about putting out alerts when there are reports of new or novel substances.

We know that there was a spike from October to November. The overall figure for suspected drug deaths in 2022 was down 16 per cent, but there was an increase in the final quarter of last year. The figure in that quarter is the highest since 2021, although the number of suspected drug deaths for the year as a whole is the lowest that it has been in five years, and the figure in the quarter in which there was a spike was the ninth lowest out of the past 24 quarters. Nonetheless, I reiterate the point that I always make, which is that the figure remains too high.

We will have to wait for the passage of time. We will get more evidence when we receive the annual report, which deals with confirmed deaths. Until then, we will not know whether there is a relationship between the spike in deaths that we saw in the last quarter of last year and the public health alert in relation to nitazenes.

Synthetic opioids worry me greatly. Although we have a problem with synthetic benzodiazepines, that is not so much the case with synthetic opioids. However, it is necessary only to look at the experience in America and Canada to realise why I am deeply concerned. As far as engagement is concerned, I attended last week’s United Nations conference on narcotic drugs, which was in Vienna, although I can assure the committee that I saw very little of Vienna. That was an opportunity to engage with countries where synthetic opioids are an issue. I wanted to get a better understanding of treatment opportunities and what we would have to do differently.

If we were to have an issue with synthetic opioids, that would add to the case for safer drug consumption facilities, but the American experience thus far points to the fact that some of the treatments for opioids would continue to be effective. There are some issues that need to be managed with regard to the introduction to treatment—from a clinical point of view, that can be a bit harder—but the international evidence-based treatments for opioid addiction can work for synthetic opioids. We are highly alert to that.

I can well understand why the committee has grappled with that, because unplanned discharges from court with little or no support elevate risk. The baseline approach is that we need to reform and change the whole system. That begs the question of whether remand should be used less so that we can get better bail arrangements in place. That would help to prevent those unplanned discharges from court.

Some interesting work is being done around the country in this area. In Edinburgh, there is a really interesting nursing team that does crucial court work. I met it some time ago. Again, that is all about continuity of treatment for people with substance use difficulties.

I absolutely agree that we could reduce the number of unplanned discharges from court by reforming the use of bail—where that is appropriate, obviously, because public protection is always paramount—and reducing the number of people who are on remand. It really has to be about every part of the system—whether it is justice, health or social work—being in a position to respond to needs much more quickly and swiftly. That goes back to the importance of the throughcare standards.

Where we need a cultural shift or a shift in mindset is that, first and foremost, we need to see families as partners because, at the end of the day, they often know their loved one better than any service provider does. As well as working to support the loved one who is affected by substance use, we must ensure that individuals within families receive support for all their needs. Families have expertise that we really need to tap into, respond to and listen to. That is the raison d’être of the family-inclusive practice that is at the heart of the whole-family approach. We have attached funding amounting to £6.5 million a year to that via ADPs and the Corra Foundation. There is continuity of that funding.

That is why the audit is really important. Although it might not make me universally popular, I am asking for more information than ever before about what people are doing with Scottish Government funding, because it is important in improving consistency and accountability. I am accountable to Parliament and local services and local politicians are accountable to their communities. We are currently working through that audit.

As well as bearing down and scrutinising what is or is not happening, we are, through the multidisciplinary expert group, trying to provide practical, hands-on support.

There is on-going engagement with my officials, as you would expect. I would have to check when I last spoke to Police Scotland. In the past, I have had lots of engagement with Assistant Chief Constable Gary Ritchie, who was very involved in the task force.