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Official Report: search what was said in Parliament

The Official Report is a written record of public meetings of the Parliament and committees.  

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Dates of parliamentary sessions
  1. Session 1: 12 May 1999 to 31 March 2003
  2. Session 2: 7 May 2003 to 2 April 2007
  3. Session 3: 9 May 2007 to 22 March 2011
  4. Session 4: 11 May 2011 to 23 March 2016
  5. Session 5: 12 May 2016 to 5 May 2021
  6. Current session: 12 May 2021 to 12 February 2025
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Displaying 1240 contributions

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Meeting of the Parliament [Draft]

General Question Time

Meeting date: 6 February 2025

Neil Gray

Absolutely. Scottish Government officials are currently determining how best to allocate the additional funding for primary care to ensure that we realise the maximum benefit from that investment. The investment will be used for a range of initiatives, including to increase capacity in general practice and to make it more consistent across Scotland. It will deliver a new acute anterior eye condition service during 2025, which, with the community glaucoma service, will free up to 40,000 hospital appointments a year. We will also be expanding the pharmacy first service, so that more clinical conditions can be treated by pharmacists, and targeted investment in the dental workforce will improve capacity and patient access, with a review of existing incentives for rural practices.

Meeting of the Parliament [Draft]

General Question Time

Meeting date: 6 February 2025

Neil Gray

I accept the situation that Carol Mochan has set out with regard to the four-hour standard. We have rehearsed and discussed some of the issues that are driving that, including the hospital occupancy and delayed discharge issues that Oliver Mundell and Emma Harper have referenced. This morning, I met Colin Pullman, the executive director of the Royal College of Nursing, to discuss the RCN’s report on corridor care, and I committed to exploring further how we can, consistently, have a greater sense of what the picture looks like and, therefore, how we can address it.

Meeting of the Parliament [Draft]

Miscarriage Care

Meeting date: 6 February 2025

Neil Gray

I thank Beatrice Wishart for mentioning the facility at the Gilbert Bain hospital, which I was able to see when I was in Shetland last year. I heard directly from people that it is important not only for patients but for staff that that separate space is available to ensure that mothers and families are treated with dignity and compassion at the most difficult time in all our lives.

Meeting of the Parliament [Draft]

General Question Time

Meeting date: 6 February 2025

Neil Gray

I do not know the detail of the case that the member raises, but on the face of it, I agree that it is unacceptable. With longer-term cases, such as the one that he has referenced, there is often complexity, but I am very clear that the current level of delayed discharge, particularly the considerable variation across different areas, is not acceptable.

As a result, the Government has been working with local health and social care partnerships and the Convention of Scottish Local Authorities to identify key challenges and barriers to hospital discharge, as well as identifying shared good practice to support improvements. The work includes the provision of more direct whole-system support to areas such as the Highlands and Dumfries and Galloway, which face the biggest challenges with delays.

I am confident that our collaborative work in that space will deliver improvement, but I know that more needs to be done to support it. That is why the 2025-26 budget includes a commitment of an additional £100 million in funding to tackle delayed discharge by, for example, further expanding the hospital at home service. If approved by the Parliament, that funding will support our ambition to grow the hospital at home service to 2,000 beds by December 2026. That would make it the biggest hospital in the country, and would help address hospital occupancy and delayed discharge issues.

Meeting of the Parliament [Draft]

General Question Time

Meeting date: 6 February 2025

Neil Gray

It is for health boards and their planning partners to plan and provide services that best meet the needs of local people, including those in rural areas, in a way that is consistent with clinical best practice, national policies and frameworks. One example that Oliver Mundell might be interested in is that NHS Dumfries and Galloway was one of two boards to implement the new digital dermatology pathway last year, allowing patients to benefit from faster diagnostics and assessment of skin conditions. Once fully rolled out, the programme will impact 400,000 patients in Scotland over three years and reduce waiting lists by 36,000 hours.

Meeting of the Parliament [Draft]

Medication Assisted Treatment Standards

Meeting date: 5 February 2025

Neil Gray

As we expand our residential rehabilitation capacity, we need to get clarity and ensure that those pathways are robust. That is part of the capacity building that we must deliver. I will provide greater detail on that to Douglas Lumsden in writing.

Meeting of the Parliament [Draft]

Medication Assisted Treatment Standards

Meeting date: 5 February 2025

Neil Gray

I thank Stuart McMillan for the work that he does locally.

Integration authorities for health and social care have a legal responsibility to plan and deliver treatment and recovery services for people who experience drug harms. In June 2023, ministers issued a letter of direction to NHS chief executives and local authority chief executives and chief officers, which requested that they personally sign a public delivery plan for implementing the standards. Those bodies cannot work alone—they must work alongside others, through alcohol and drug partnerships, to ensure that people receive the integrated services that they need.

Following that ministerial letter of direction, the requirement for local areas to provide quarterly update reports on progress against their implementation plans is continuing.

Meeting of the Parliament [Draft]

Medication Assisted Treatment Standards

Meeting date: 5 February 2025

Neil Gray

The assessments come through Public Health Scotland. I hope that that gives Michael Marra some reassurance, although I recognise the concerns that he raised with me, some of which we are following up on.

Michael Marra also sought clarification on what the Government’s intention is with regard to what will come after the national mission. Today, I have set out my willingness—in fact, my desire—for there to be collaboration across the chamber, as well as with local alcohol and drug partnerships and all interested parties, on what we do to build on the national mission. Paul Sweeney made the point that the work will not have been completed by the end of the national mission. He is right. We will still have work to do, and it will be in all our interests to ensure that we work together to agree on what the framework should look like and on the areas that we need to focus on to ensure that we continue the work to reduce harm and drug-related deaths.

Meeting of the Parliament [Draft]

Medication Assisted Treatment Standards

Meeting date: 5 February 2025

Neil Gray

Brian Whittle raises a very important point, which has been debated by politicians and public health experts. There is undoubtedly a clear correlation between areas of poverty, social deprivation and deindustrialisation and areas that have high rates of drug-related deaths.

The national mission is important in addressing the issues that people who have a substance dependency face, but the wider work to tackle poverty, which has been the Government’s number 1 priority, is also critically important, because it goes to the heart of the health inequalities that drive some of the issues that we are facing today.

Brian Whittle raises an important issue that all of us must consider.

Meeting of the Parliament [Draft]

Medication Assisted Treatment Standards

Meeting date: 5 February 2025

Neil Gray

I take this opportunity to update the Parliament on progress regarding the implementation of the medication assisted treatment standards and the wider work of the national mission.

First, I acknowledge the suspected drug death figures that were published as part of Public Health Scotland’s latest rapid action drug alerts and response—RADAR—surveillance report, which highlighted that there were 215 suspected drug deaths between September and November 2024. The 10 per cent reduction on the previous quarter is welcome, but the number of drug deaths remains much too high and serves as a stark reminder of the work that remains to be done.

Behind every statistic is a person and a life that has been lost needlessly. Those people leave behind grieving loved ones, who bear those tragic losses. To them, I offer my sincerest condolences.

That is why the work of the national mission is so important. Its clear-cut aim is to reduce the number of drug deaths and improve lives through a holistic approach. The statistics on harms caused by alcohol are also alarming, and we are committed to tackling those in conjunction with drug harms.

I also acknowledge the recent report of the people’s panel on drug-related harms. We are considering its findings and I look forward to providing evidence to the joint committee and setting out our response later this month.

The MAT standards are a key element of our national mission. They take an evidence-based approach to enable the consistent delivery of safe, accessible and high-quality drug treatment across Scotland. In July 2024, Public Health Scotland published its third national benchmarking report, which provided an assessment of the status of implementation of the standards as of April 2024. Ninety per cent of standards 1 to 5 were assessed as fully implemented and 91 per cent of standards 6 to 10 as partially implemented. Although that is positive, I am fully aware that much work must still be done to ensure the successful implementation of all 10 standards. The benchmarking report acknowledges areas of good practice, but there is still some way to go before everyone, everywhere, can benefit from the same level of support. We continue to work closely with local areas and partners to ensure that measures are in place to support implementation.

More broadly, much of the work of the national mission supports the implementation of the standards and beyond. I will highlight a few of those areas now.

MAT standard 8 commits to improving advocacy for people who use drugs. In December, the First Minister and I had the pleasure of attending the launch of the charter of rights. Developed by the national collaborative, it draws on the experience of those with lived and living experience of substance use. The charter supports people who are affected by substance use to realise their human rights and seeks to empower them to demand the care and support that they need. It also provides those who deliver services with a clear reminder of their duties to ensure a standard of care that reflects those rights. Taking a holistic, person-centred approach that supports improved access and empowers people to make informed choices about their care will support a human rights and health-based approach to the treatment for any substance.

We recognise the importance of adapting services to ensure that people who seek help are able to get the right support at the right time. That is especially important in the area of mental health and substance use, where evidence suggests that needs can intersect and that, to effectively treat one, we must address the other, too. That is the focus of MAT standard 9.

The Government is committed to ensuring that we work across policies and portfolios to better understand common issues and how to resolve them. We are supporting better working links between services and driving a culture of inclusivity that puts the needs of individuals at the heart of everything that we do. In that vein, we commissioned Healthcare Improvement Scotland to produce an exemplar protocol on mental health and substance use, which builds on best practice from across the country and internationally. The protocol, which was published in September 2024, outlines how mental health and substance use services can work better together to deliver a whole-system approach. Building on that, we have commissioned Healthcare Improvement Scotland to support local areas to adapt that protocol to their circumstances, ensuring that the workforce have the tools that they need.

We also know that women who use substances often face unique, gender-specific challenges when accessing treatment and support, which is why we are committed to taking a gendered approach and ensuring that women can access the right services for them when they need them. That includes our work on developing a good practice guide to help local areas do more to support women who are affected by substance use—and their babies, during the perinatal period—along with efforts to upscale residential rehab services that keep women and families together.

More than £5.5 million has been committed, in conjunction with our whole family wellbeing fund, to support the establishment of two houses run by Aberlour Child Care Trust that are specifically designed to support women and their children through recovery. We confirmed last week that an additional £1 million of funding will be made available to support Aberlour’s important work with women and children who are affected by drugs. That additional funding will allow more women and infants to receive the support that they need during that crucial period.

Beyond that, we will also invest a further £1.5 million in broader alcohol and drug services in the next financial year. The additional funding will allow us to support even more people to achieve their own recovery. That whole-family approach is not only a key focus of our approach to recovery, but also a fundamental component of our commitment to keep the Promise. Today is the fifth anniversary of the Promise, and it is important that we acknowledge the important role of early intervention and prevention in keeping families together when it is safe to do so.

I recently saw for myself the impact that early intervention can have on young people’s lives when I attended the launch of the new routes service in East Lothian, which is delivered by Circle. It was one of the most impactful visits that I have had the pleasure of experiencing as a minister. The routes service meets young people who are affected by substance use where they are, providing whatever holistic support they need. The results speak for themselves—the service breaks intergenerational cycles of substance use and supports our young people to achieve their goals. Thanks to the whole family wellbeing fund, the service is now available in eight areas of Scotland.

A core pillar of our national mission is to increase access to and the provision of residential rehabilitation. Our vision is for residential rehabilitation to be available to everybody who wants it, and for whom it is deemed to be clinically appropriate, at the time that they ask for it and in every part of the country.

We are also committed to increasing by 300 per cent the number of people who are publicly funded for their placements, with the aim of funding 1,000 people per year by the start of 2026. A recent report that was published in December 2024 by Public Health Scotland concluded that we successfully achieved that target in 2022-22. However, we remain ambitious to sustain and build on that success, so we have made £2 million available this year via the additional placement fund to support that endeavour.

Delivering the MAT standards and advancing the broader national mission requires a skilled and resilient workforce. We are grateful to those who deliver drug and alcohol services, and we recognise that addressing current workforce challenges will not be a quick fix. In spring 2025, the Scottish Government will introduce and support the implementation of a suite of drugs and alcohol workforce publications that have been developed in collaboration with stakeholders. They will outline the knowledge and skills that are required by those who support individuals who use substances, and they will also facilitate access to a range of training opportunities and outline guiding principles for employers to ensure consistent care and support in the workplace for individuals with lived and living experience. As a package, those publications will help to support opportunities to enter, develop and sustain fulfilling careers in the drug and alcohol sector.

As we approach the final year of the national mission on drugs, our attention is turning to the future. Learning from our progress to date and ensuring a smooth transition to the next phase will be key. We have made significant progress in building prevention, treatment and support approaches to reduce the harms caused by substance misuse. However, reducing alcohol and drug-related deaths and wider harms will remain a key priority. It is our intention to work in collaboration with our stakeholders and partners, including those with lived and living experience, to plan for the next steps in addressing the harms caused by drugs and alcohol in Scotland. I look forward to progressing that engagement, including across the chamber.

Moving forward, continued implementation and sustainability of the MAT standards remains a priority. We must also continue to be responsive to emerging threats and ensure that services can continue to adapt to meet those new challenges. MAT implementation should remain at the forefront of our efforts through the remainder of the mission. The standards reinforce a rights-based approach to treatment and emphasise the importance of allowing people to make informed decisions about the types of help that are available to them, which is vital in delivering on the ambitions of our national mission.

In that respect, I hope that the Parliament will join me in supporting the efforts and actions that the MAT standards and the overall national mission set out to achieve. I look forward to the next benchmarking report publication in the summer. I believe that, if we work together, we will transform the lives of individuals and families across Scotland.