Chamber and committees

Yes, I believe that it has. As it often does, Audit Scotland made an important and serious point about our needing transparency. The criticism of that is that we will have to ask for lots of information that we then have to publish and people will complain about the resource that is attached to that. We have heard Ms McNeill raise a fair point about the bureaucracy around that.

For clarity, I accepted Audit Scotland’s point, and I believe that we have demonstrated transparency through our reporting on the national mission; our annual report, which is available for people to read; and the publication of quarterly reporting around things such as publicly funded residential rehabilitation.

That is an important point. Obviously, local partners are accountable for the implementation of both reports from the Dundee drugs commission. The commission has done an impressive amount of detailed work. From my engagement with the local ADP and, crucially, senior leaders in the integration joint board and the health board, I know that there is a commitment to taking that forward.

What is most notable to me is that there have been attempts at a real reset of the relationship with the third sector. We have not spoken much about the third sector this morning but, not just in Dundee but elsewhere, we need leadership in that regard. We need meaningful partnership and a bit more parity of esteem between statutory services and the third sector. I see some movement on that in Dundee. I am happy to provide further information on that to Ms Chapman directly.

I just want to say—very briefly and without trying to interfere with the management of the committee—that my officials met with police on 17 January in relation to safe drug consumption facilities. They also met with the Crown Office on 18 January, and they met with the Glasgow Health and Social Care Partnership on 23 January. I want to put that on the record.

The charter was published in November, and the stigma action plan was published in January as part of our response to the Drug Deaths Taskforce report. The principles of the plan are that stigma kills and we need to tackle it, that people who are impacted by drugs and alcohol need to be at the heart of shaping and informing service and, crucially, that we need to consider drug and alcohol problems as health conditions first and foremost. However, the purpose of the plan is to take the charter and turn it into concrete action, and the vehicle for doing that will be the accreditation scheme that will be developed.

It is important to say that the Scottish Government will start by looking at where in our policies we are inadvertently excluding people as opposed to proactively including them. It is also an important point that the Government will lead by example.

We have had considerable local interest—people are beginning to approach us and ask more about the action plan and how they could be involved in any accreditation scheme—and there is also a bit of international interest in the work that we are pursuing in the area. Although some of the work of the national collaborative is focused specifically on the human rights bill, it will also amplify voices, and part of its work will be on the sharing and dissemination of best practice in tackling stigma and responding in a human rights-based way.

It is fair to say that we are on a journey and we still have some distance to travel, but the Scottish social attitudes survey provided some quite interesting reading about people’s responses to a public health approach.

The majority of people who took part in the survey said that they are not concerned about working next to someone who has a drug or alcohol problem but, when asked whether they would be concerned about living next door to someone with a drug or alcohol problem, they gave different answers. We are beginning to see a shift—although I appreciate that that may appear to be anecdotal—where people are moving toward a public health approach, and they want to focus on what actually works to get people the help that they need and get them into treatment and recovery.

Of course, I think that the zeitgeist in all this is the lived experience community, because that community is visible proof that recovery is possible, and we know from the Scottish social attitudes survey and other evidence that contact with someone who has lived or living experience is what changes people’s attitudes the most.

With regard to the whole-family approach, there very much is a presumption in the MAT standards that family involvement is, by and large, a good thing. Of course, individuals will have different circumstances in which that might not be appropriate, or it might not be what the individual who is in treatment or recovery desires.

However, even in cases such as, for argument’s sake, that of a son who does not want his mother fully informed, there are actually reasons for some involvement, and some residential establishments do that very well. The Lothians and Edinburgh abstinence programme, which is led by Dr David McCartney in Edinburgh, has a families group. On a week-by-week basis, the staff do not necessarily go into the care of individual loved-ones but they will say, “This is the shape of the programme—this is what we are doing this week and this is what you might expect.” There are always ways to engage and be helpful and support a family member, even if consent has been withdrawn to share private medical information. Scottish Families Affected by Alcohol and Drugs is also doing some work just now, which is much more focused on models of care and service delivery and standards in and around that. I think that that will be very important moving forward.

As I indicated in my last update to Parliament on MAT standards, we are on a journey to really bear down on people to get the standards, as they stand, implemented. However, at some point, we need to come to the question of how MAT standards evolve. MAT standards will need to be more explicit about treatment in and around different substances, and they could be more explicit around things such as leadership, how we better support women and how we work better with families, because working with families is core. It should be core not only to what we do in drug policy but to what we do in the early years, education and housing support. That is not a nice extra—it has to be our core business, and we have to get the core and the foundations right.

All of us are at one on that, I think. I do not need to repeat to this audience the worldwide evidence about safe drug consumption facilities, which is irrefutable. They are not a silver bullet but they save lives, and the scale of the challenge in Scotland is such that we need all solutions at our disposal.

There would have been an easier way to do it. I will happily answer questions on that, if required. However, I and my party made a commitment that we would leave no stone unturned.

It is not all in my gift. We have an operationally independent police force, and the Lord Advocate and the Crown Office are independent; nobody here needs me to give a lecture on why that is. However, it is encouraging that the proposal that was submitted to the Crown Office was supported by Police Scotland and Glasgow City Health and Social Care Partnership.

It will be for the Crown Office and the Procurator Fiscal service to take matters forward. They are continuing to work well with Police Scotland and it is important that they continue that work, which, as the committee will know, is around the policing of any facility, should it be required. It is imperative that clarity exists on that point for both the public and police officers.

I have done everything that I can up to this point. As everybody else here is doing, I am waiting on the conclusion of those vital discussions between the Crown Office and the police and on any forthcoming decision from the Lord Advocate. I will have to respond to that decision—whatever it is—in due course, and I give you my absolute commitment that I will do anything that I can within my gift, because safe drug consumption facilities work.

Ms McNeill raised important pragmatic issues. After having put £10 million into the implementation of MAT standards, we have closely monitored recruitment. It is a mixed picture—some areas have done very well with recruitment and others have struggled more.

We have always provided continuity of funding and I have continuity in my budget. People can apply for multiyear funds through the Corra Foundation. Some of that resource has been accessed by services as well as by the third sector. We give alcohol and drug partnerships clarity and continuity.

I understand the argument for simplifying funding routes. We may get to that point if we have a simpler, whole-system approach. However, I wrestle with the need to ensure that investment that has been earmarked and allocated to support families has gone to support families, or that money that I have earmarked and allocated to improve access to residential rehabilitation is being spent on residential rehabilitation and after care.

I am not unsympathetic to that point about a simpler process, but the position that I have arrived at is that, in order to tackle the drug deaths crisis here and now, I have to follow the money and ensure that resources get to where they are needed. I appreciate that that will require a level of monitoring and that we will need some bureaucracy to scrutinise that. We may be able to change that when we get to wider reforms, perhaps of the ways in which alcohol and drug partnerships, or wider drug and alcohol services, function. At the moment, I am absolutely following the money and will not apologise for that.

That is why we should not look at the whole-family approach in isolation. It is why our response to the task force came from Government as a whole, although individual work to tackle poverty and inequality is being led by Shona Robison and there is work to reform our justice system and an investment in housing. All those things are connected.

The idea that drug policy must not be seen in isolation lies at the heart of the national mission. The social determinants of good or poor health must be tackled. The cross-Government approach means that we are making commitments not just for this year but for future years.

Our equalities framework has six outcomes and six cross-cutting themes, one of which is recognising equality. That includes the particular needs of women but is also about how we can better reach the black and minority ethnic community.

As well as the Aberlour work that you outlined, and the work of Phoenix Futures at Harper house, which I will touch on in a moment, it is also really important to look at the perinatal mental health work that Kevin Stewart and Clare Haughey are involved in. There is substantial investment in refreshing and updating that work to support women who have mental health issues or use drugs. Much work has been done to change generic, universal and specific health services.

I had the great pleasure of visiting the first of Aberlour’s mother and child recovery houses in Dundee a month or so ago. It was quite an experience. The initiative is part of our work to keep the Promise. As a former social worker, I know the impact of families not being kept together.

We also know that, although significantly more men than women die, the rate of increase among women has been faster in recent years. Ten or 15 years ago, the ratio of deaths between men and women was wider; now, it has narrowed. To take, as you suggest, a gender-informed approach, there are many reasons for that, but at the heart of it are the trauma and grief that women experience when they lose their children. We need to work harder to keep families together—to keep mothers with their babies.

Aberlour will open another mother and child recovery house in the central belt. I await an update on that and I hope that we will have more to say on it in the not too distant future.

The work that Phoenix Futures is doing in Harper house will also be revolutionary. It is a national family service for mums, dads and children aged up to 11. Not just as a minister but as an MSP, I take very seriously my obligations to keep the Promise. Families should not be parted due to a lack of support and a lack of service. The evaluation on Harper house will inform us all for many years to come.

Sorry—would you repeat that?