Seòmar agus comataidhean

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.

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 appreciate the opportunity to join the meeting and I commend the three committees that are involved for joining forces and ensuring that there is joined-up scrutiny of our national mission, which aims to be joined up throughout every tier of Government and across Government.

Members will be aware that our work in response to the task force pre-dates the publication of its vital final recommendations. Work on the implementation of MAT standards and on our national naloxone programme has preceded the task force’s final report. Committee members will also be aware that, in January, we published a full response to the task force’s 20 recommendations and 139 action points. As well as holding a debate in Parliament, I shared our response to the 139 action points with the relevant committees. Since then, we have endeavoured to keep the committees and Parliament fully informed about where we are.

Colleagues, particularly those on the Criminal Justice Committee, have been following the Bail and Release from Custody (Scotland) Bill since January. That bill is of particular interest to me because it will put an end to prisoners being released on Fridays or before a public holiday, which will improve standards of throughcare. The bill will also change how we use bail.

Members will recall that I gave an update yesterday on the Government’s response to the rapid review of better ways to join up healthcare for people with co-occuring mental health and substance use conditions. As you would expect, I have met the Minister for Transport to work through some of the finer detail of the pilot of concessionary travel. We also continue to be very focused on the implementation of MAT standards. The committee will be well aware of the ministerial direction on that and of the monthly and quarterly reporting that different areas are subject to. I will update Parliament on that again in June.

We continue to make progress on access to residential rehabilitation, which is another pillar of the national mission. The monitoring report that Public Health Scotland published yesterday shows that, in the quarter from October to December last year, we had 228 statutorily funded residential rehab placements, which is the highest-ever number. That means that, over the lifetime of the national mission, we have funded more than 1,100 residential rehabilitation placements.

Our national mission reporting arrangements underlie all of that, and members will be aware of the outcome framework that we are working to. We also publish an annual report each year. The most recent one was published in August last year and there will be a further report later this year.

I have had many conversations with people over the piece in different formats. When I came into this post, I had a lot of introductory meetings but, given the independence of Police Scotland and the Crown Office, it is better to have a lot of the discussion at official to official level. The last thing that I would want to do would be to derail any plans or progress because it was perceived that I was interfering with the operational independence of Police Scotland or the Crown Office.

Do you mean every single project?

I appreciate the committee digging into the issue. Because drugs policy can rarely be considered in isolation, the debates in the chamber or during other committee appearances that I have been obliged to make have often been very wide-ranging. It has therefore been useful for me to take a specific issue in a specific locality and bore down into the detail. Thank you for that.

Thank you.

There are two points there, Mr Torrance. One is a more global point about the implementation of MAT standards. They are vital and they are a big part of the Government’s reform programme. They are about ensuring that people have quick access to and informed choice about their evidence-based treatment, and that services are planned and operate in a way that they anticipate people’s needs. All of that is connected to mental health and primary care, and the MAT standards are therefore crucial and not optional. Members will be aware of the statement that I made to Parliament earlier this year, and I will make a further statement next week.

On the specific issue of the prescription of medicine or opiate substitution therapy in police custody settings, MAT standard 3 requires people’s treatment to be provided to them irrespective of their setting. OST needs to be routinely available to those for whom it is prescribed in custodial settings if MAT standard 3 is to be met. All health boards, alcohol and drug partnerships and integration joint boards have accepted the importance of that and our shared agenda for implementation of MAT standards.

We have been engaging on the issues raised by the petitioner in committee with various police and healthcare networks, such as the Police Care Network and, to the best of my knowledge, the only place where there appeared to be an issue was in Elgin. However, I want to be clear—and the guidance and MAT standards are clear—about what should happen.

In my view, as Minister for Drugs Policy, any interruption of a person’s medical treatment is utterly unacceptable because of the consequences that the committee is well aware of. The interruption of someone’s medical treatment is discriminatory and not acceptable. Ultimately, the implementation of MAT standards will resolve the issue where it exists, and as I said, the issue appears to be specific to Elgin.

I hope to convey to the committee in the strongest terms that the practice, where it exists, is discriminatory and that we treat drug and alcohol problems as a health condition, so drug and alcohol treatment has to be on a par with any other treatment for any other condition.

On the broad point, health boards and IJBs should monitor that. Through their routine reporting structures, they can and do raise workforce issues with the Government and NHS Scotland.

On the work that I and my drug policy officials are pursuing on the implementation of MAT standards, a financial resource is attached to that implementation. When I spoke to the committee before the summer recess, I said that approximately 100 posts were going to be funded. That figure has increased. To be specific and more helpful, I know that Moray, where Elgin custody centre is, has been successful in recruiting staff to work in and around MAT standards. Similarly, NHS Aberdeenshire has sought a number of staff and has largely been successful with that.

I am not disputing that there are issues with the workforce but there are examples of where those have been overcome, either through additional resource to help with recruitment or through the redesign of services.