Seòmar agus comataidhean

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.

That is where our support of the work that is led by Public Health Scotland is really important. I know that Mr O’Kane is familiar with the RADAR—rapid action drug alerts and response—work, which is about putting out alerts when there are reports of new or novel substances.

We know that there was a spike from October to November. The overall figure for suspected drug deaths in 2022 was down 16 per cent, but there was an increase in the final quarter of last year. The figure in that quarter is the highest since 2021, although the number of suspected drug deaths for the year as a whole is the lowest that it has been in five years, and the figure in the quarter in which there was a spike was the ninth lowest out of the past 24 quarters. Nonetheless, I reiterate the point that I always make, which is that the figure remains too high.

We will have to wait for the passage of time. We will get more evidence when we receive the annual report, which deals with confirmed deaths. Until then, we will not know whether there is a relationship between the spike in deaths that we saw in the last quarter of last year and the public health alert in relation to nitazenes.

Synthetic opioids worry me greatly. Although we have a problem with synthetic benzodiazepines, that is not so much the case with synthetic opioids. However, it is necessary only to look at the experience in America and Canada to realise why I am deeply concerned. As far as engagement is concerned, I attended last week’s United Nations conference on narcotic drugs, which was in Vienna, although I can assure the committee that I saw very little of Vienna. That was an opportunity to engage with countries where synthetic opioids are an issue. I wanted to get a better understanding of treatment opportunities and what we would have to do differently.

If we were to have an issue with synthetic opioids, that would add to the case for safer drug consumption facilities, but the American experience thus far points to the fact that some of the treatments for opioids would continue to be effective. There are some issues that need to be managed with regard to the introduction to treatment—from a clinical point of view, that can be a bit harder—but the international evidence-based treatments for opioid addiction can work for synthetic opioids. We are highly alert to that.

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.