Seòmar agus comataidhean

Does either the Scottish Government or any individual health board currently seek to develop a policy for issues such as diagnosis recognition? I suspect that the answer to that will be no. We have heard about the extremely patchy responses that people get when they speak to their GPs about diagnoses provided outside the NHS. Does any health board seek to achieve consistency on that at the moment?

Is the consensus diagnosis approach ever used for adults?

Thank you.

I thank all the witnesses for their evidence. I am keen to understand a little more about the balance between the benefits for people who might have an adverse reaction or an emergency in a safer environment and the benefit of having reduced drug paraphernalia in the local community, for which there is clear evidence, and the concerns that have been expressed about there being more unknown faces around, whether those are service users or dealers. I could not see anything in the written submissions that tells me whether you collect information about where your service users are travelling from. It might not be easy to get objective data, but do you have a sense of whether people are travelling across the city or even from further afield or whether it is overwhelmingly people who would otherwise be using in another environment in the Calton area?

Good morning. I want to press you a little further on the issues that Paul Sweeney raised about the Thistle and, more generally, about how you see the future of safer drug consumption facilities.

We acknowledge that it is early days for the Thistle, and that a full evaluation is to come, but let us assume that it evaluates well. You pushed back a little on the issues around reserved legislation. For the life of me, I cannot understand why we did not devolve that legislation in 2016, when we addressed other irrational reservations in the Scotland Act 1998 on a consensual, cross-party basis. I wish that we had been able to do that. Let us assume that the Government will be successful in making the case either to change or to devolve the legislation, and that the legal barriers can be removed.

You presumably have some idea in your head already about what level of provision of that type of facility there ought to be in order to address the needs not just of one community but of multiple communities around Scotland. Do you have a sense of how extensive a network of that type of facility a city such as Glasgow ought to have, or that the country ought to have, if those legal barriers were removed and if the evaluation of the early phase proves to be positive?

I absolutely take the point about the connection to drug deaths and to places where there is a particular cluster, albeit that those patterns may change over time. Some of the evidence that we heard earlier and that we have read in the written submissions shows that that is not the only benefit of such a facility. It is clear that the reductions in drug paraphernalia in communities and in people being exposed to drug taking in communities and other settings are significant benefits.

There could be the opportunity to achieve those benefits in other parts of communities that may not have the same cluster of deaths at a particular time to justify a fixed facility. I am curious to know whether there is a sense in the Government or in the public health community in Scotland more generally of where this could go if the barriers were removed.

Have the new UK ministers that you mentioned shown an interest in visiting the facility and seeing for themselves what is happening?

Thank you very much and good morning to the witnesses. I am already learning a lot, so thank you very much for the evidence that you have been giving.

The issue of private diagnosis has come up a couple of times in the conversation already, and I wanted to ask some specific questions about that. We have heard the reasons why diagnosis is so important. We have heard the fact that private diagnosis may be quicker and easier to achieve if someone has the money. I am not quite clear whether that is entirely because of capacity in the private sector or whether it is because of different practices in the private sector.

We have heard about the unfairness and the amount of money that getting a private diagnosis costs. Mark McDonald mentioned people moving into significant debt because of that. He also used the phrase “wild west” with regard to the variation in standards, what private diagnosis consists of and whether it is recognised in other services. In the written evidence, we also see a big variation in what it costs and in the prices involved. Again, I am not clear on the reasons for that.

Can I ask you to either comment about the current situation or, ideally, say what the role of private diagnosis should be? Who would like to kick off?

I get the point, and I share that concern. However, I am also aware of other evidence that we have heard, especially in our earlier session, that many people who do not have access to the NHS find themselves being forced to go private and so going into debt. It seems to me that an approach that would involve contracting externally to the NHS, would not involve fees for individuals and families, and had an agreed standard of delivery so that its diagnoses would be recognised would feel better than what we have now.

Thank you all very much. That is really helpful.