Seòmar agus comataidhean

I will attempt to be pithy, convener.

Alan Gray is right that, where hospital occupancy is sitting as high as it is at some acute sites, our clinicians’ ability to meet the patients’ needs and the efficiency of the flow of the hospital are reduced.

Hospital at home is another incredible example of how we can meet patient needs and expectations. Patients are treated literally in their own homes and are kept at home for longer. Our investment in the budget will take us on a pathway to reach 2,000 hospital-at-home beds by the end of 2026, which would make hospital at home the largest hospital in Scotland. That is right for patients and for the health service, and that is why it has been an important innovation in the NHS over the past years.

I do not remember saying that winter pressure is not as bad in reality. I am not sure where Mr Gulhane’s reference comes from.

There is pressure at all times of the year, and our health boards need to be able to have a surge capacity response to meet the demands on them. For example, at the peak of the last wave of Covid-19 in the summer, 600 beds in Scotland were taken up with Covid patients, which is equivalent to the capacity of Wishaw general hospital. We have pressures in winter, but that example illustrates that pressures and surges can happen throughout the year. That is why it is important that we give our boards the flexibility to be able to respond to those in ways that are right in their areas.

On what Mr Gulhane referenced in relation to NHS Tayside, the budget is about creating greater capacity in the health service to meet scheduled care demand and planned care and to reduce waiting times. We are working right now at increasing that capacity and ensuring that we can have a better run rate so that more patients are treated. We will eat into and erode the longest waits so that patients can get the treatment that they need.

Sorry, but will you repeat that? I missed what you said.

We are considering the recommendations carefully. There is a lot in the report that demonstrates the progress that we have made already. Some of the recommendations, such as strengthening local leadership and providing greater transparency, are areas in which we are already developing work. We welcome the report, and we are still considering our direct response to each individual recommendation, as the report was published only on 31 October.

We take seriously all the commentary that comes from Audit Scotland in general and in this area in particular. We will consider all the recommendations carefully and respond in due course.

Alongside my other updates, I will be happy to provide that information, if there is anything further on which to update the committee.

On Mr Doris’s first point, he touches on an area that we need to consider, which is whether there is a route by which we can collect robust data that is able to be published. We will consider whether more could be done in that regard.

On the second point, Maggie Page has already addressed the fact that support is available outwith the residential rehab picture and that people are being supported throughout their journey. Depending on the individual, that will shift between community organisations, statutory services and general practitioners; indeed, a variety of different individuals and organisations could and should be involved. Again, it will be difficult to audit that journey, as everybody’s journey will be slightly different, but I take the point about whether more could be done, and we will take that away and look at it.

That important area forms part of the suite of investments that are being made and the interventions that are available in order to provide a person-centred approach to responding to drug or alcohol dependency.

We have made particularly good progress on MAT standards 1 to 5, and I commend the alcohol and drug partnerships, as well as the statutory services that Paul O’Kane referenced, on the work that has been done.

Standards 6 to 10 have been more challenging, and we have more work to do on them. The intervention of some of my predecessors has been important in providing direction to alcohol and drug partnerships to meet the targets and to invest in interventions to ensure that the MAT standards are met.

Mr O’Kane queries whether there is confidence on timescales. I cannot give a guarantee today that we will meet them, but I believe that good progress is being made, as has been referenced. We will continue to support ADPs, as well as the statutory services involved, to ensure that the importance of meeting those timescales is recognised.

For some people, residential rehab and abstinence are the right route, while for others, a medically assisted treatment pathway works best. In trying to get it right for everyone, we must recognise the need for person-centred approach.

I will bring in Richard Foggo to provide more detail.

I do not have a specific timescale that I can articulate to you, convener, because the matter is still subject to negotiation and discussion with the United Kingdom Government. We have had constructive discussions with the Home Office on the drug checking pilot, and our interaction with it is important. We certainly believe that the evidence points to its being another harm reduction measure that can make a difference in saving people’s lives. It is linked to some of the work on the rapid action drug alert and response—or RADAR—system to identify issues with regard to the supply of drugs and to give people a greater understanding of what they are purchasing and, therefore, what they are using.

We want to take forward the pilot sites in Aberdeen, Dundee and Glasgow, and that, alongside the safer consumption facility, will help us take forward our work on the basis of harm reduction, and give people the opportunity to access treatment as a result. As with the safer consumption facility, signposting would be available to help people move towards recovery opportunities. Predominantly, it is all about ensuring that we reduce harm.

Yes. We will continue to work with local systems on ensuring that the money that is provided for ADPs is spent on the services that we would expect to be delivered.

ADP funding has doubled, as Ms Dowey recognises, and as is covered by Audit Scotland. There has been an increase in ADP funding, and that is provided both through the regular funding for alcohol and drug partnerships and through the increase that has been provided from the national mission funding.

There is local decision making at play here, and I do not want to cut across that, nor disrespect the principle of local decision making itself, as Ms Dowey will recognise. However, we are looking at how we can work with local systems. I have a wider interest, beyond this policy area, in our health and social care partnerships on issues such as social care and making sure that there is transparency about where the money is going so that services are tailored to the people who need them. That is as true for social care as it is, in this case, for people seeking alcohol and drug services.