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Thank you very much.

The bill’s policy memorandum says:

“The Bill also establishes a timescale to begin treatment of, at most, three weeks after being prescribed it but earlier if practicable. This is in recognition that time delays in receiving treatment impacts on the treatment having a positive effect, as someone can become more unwell in the period between diagnosis and treatment, potentially becoming seriously ill and in a state of trauma. In addition, delays in treatment can lead to scenarios where a person cannot take up the treatment after a period of time passes, for example if they have deteriorated in condition or lost faith that treatment will be provided that will help them.”

I note that the Salvation Army, WithYou and Turning Point have raised concerns about the need for preparatory work to be undertaken before individuals can begin abstinence-focused recovery treatment. Therefore, with regard to how the bill is drafted, is there a way to define that clearly, so that the time in which people enter into the process of preparation would count in relation to that three-week period? Could that be considered?

Yes.

In its written submission, the Scottish Drugs Forum mentioned the risk of gaming the system. Kirsten Horsburgh, could you perhaps elaborate on what your written submission said about that potential unintended consequence?

I reiterate my thanks to the wide variety of people who have made representations on a challenging area of potential legislation. The more that we have delved into the complexities of the issue, the more fraught the considerations have become. In the correspondence that the committee received, I noted a story of someone whose life had been set on a negative trajectory because of dementia, which led to their early retirement. That brought to the fore the wider implications of how we manage people’s healthcare in a wider setting. Similarly, if people have a sense that they are a burden on their friends and family, it might mean that they are inclined to support assisted dying, but it also raises questions of coercion. That is the moral conundrum that we are trying to contend with. Representations that we have heard reflect many of the difficulties that we face in trying to find a way through to the right course of action.

Thank you, convener. It is a pleasure to join the committee this morning.

I echo your comments about the work of Pinar Aksu from the Maryhill Integration Network and Doaa Abuamer from the Red Cross VOICES network, who drove the public campaign on extending free concessionary bus travel to people seeking asylum in Scotland, given the fairly onerous conditions in which they live, with no recourse to public funds and so on.

I am pleased that your efforts in the Conveners Group pressed the First Minister to consider the adoption of the policy. That was successful, although, as you mentioned, there was a mishap when the Government declined to carry it forward. I welcome the news that, in the most recent budget, the Government has included the policy in its programme.

I believe that the initial allocation in the budget for 2024-25 was £2 million, but the detail of how that latest iteration will be rolled out remains to be seen. That is where the concern of the petitioners continues to lie. There has been a stop-start approach from the Government in the past, and there is also concern that the scheme will not be on the same statutory footing as the other concessionary travel schemes in Scotland, including the over-60s scheme and the under-22s scheme. There is, therefore, a desire to ensure that it is done via statutory instrument, so that it is not some tokenistic measure that could simply expire after a year or so. The petitioners want a degree of permanence in the process, so, until that comfort is provided and the Government is prepared to furnish the committee with the detail of how the scheme will operate, I appeal to committee members to keep the petition open. We have had only a high-level commitment in the budget, which has never been progressed into how it will be operationalised.

Obviously, there is a real and continuing social need for the scheme. Government ministers expressed previously that it could be interdicted by adjustments to the no recourse to public funds rule by the Home Secretary. The nature of the change in Government since the election means that that risk is less obvious. There is a great opportunity to press ahead with the statutory instrument to introduce the scheme on a sure footing. Until we get that commitment from the Government, the petition merits being kept open.

I want to raise with the cabinet secretary correspondence that we have received from the Royal College of Nursing, which has expressed particular concern about the proposed reduction in the working week for the agenda for change staff. It claims that there had been mixed messages from the Scottish Government and health boards; indeed, it was aware of some boards proactively informing staff that further reductions would go ahead in April, and that people had made plans and arrangements accordingly. Therefore, the late announcement from the Government that a further reduction would not go ahead this year has resulted in a great loss of trust. Cabinet secretary, do you want to respond to those points from the RCN?

I thank the witnesses for their contributions so far.

You have mentioned in evidence issues with resourcing and some of the practical challenges that the bill’s aspirations or intentions might present. Do you have any modelling or understanding of what increases in demand might be generated in terms of workforce numbers or man hours, and of which areas that might be particularly problematic or challenging in?

The picture that you paint seems to be quite complex with regard to patient flow, interaction and presentation, and whether you would then induce demand by creating an easier interface.

It would be interesting to know, for example, whether requests for referral to residential rehab are not being fulfilled, and whether that illustrates unmet needs in a more critical sense—not necessarily assuming that X thousand people would theoretically benefit and that therefore we can convert that to capacity. As you said, myriad complexities and risks are associated with the subject. It would not be the case that everyone would turn up on the first day. I am just trying to get a rough idea of the scale of financial and other resource capacity that might be needed.

Also, what impact would the reporting requirements that are set out in the bill have on healthcare professionals?