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I believe that it is, because we have included in the bill the ability for ministers to increase some of its provisions. Section 9(1) says that a “drug”

“includes any intoxicant other than alcohol”.

What is meant by “alcohol” is clear, but, because “drug” means “any intoxicant”, if a new drug comes on the market that is deemed to be an intoxicant, it will be covered by section 9(1).

You also mention the MAT standards, which are important. Last week, we heard a lot from the cabinet secretary and witnesses about the standards. Again, the bill seeks in no way to replace the MAT standards but to work alongside them. The committee will be aware of this, but it is important that others understand that the MAT standards have no statutory underpinning. The bill would make statutory provision. That is the difference; the bill provides a legal framework. People have an ambition to deliver the MAT standards, but the standards have no statutory underpinning.

I gave that quite a lot of thought. I am trying not to be overly prescriptive and I do not want to say too much in the bill. There are elements of that that could be included in the code of practice. It is important that people who are entitled to residential rehab, in the view of the medical professional, get it in some form.

Drafting the bill is difficult, because we have not achieved even the Scottish Government’s target for additional beds—it is due by March 2026. We do not know where all the beds will be. Some will be with independent providers and some will be available through the health service. It was a decision not to include any specific choice. It is not like people will get their top three options, but I absolutely agree that services are very varied in what they offer and how they offer it.

That would go back into the discussion that the individual would have with the medical professional. The medical professional would determine a course of treatment that people could follow to hopefully overcome their drug and alcohol addiction issues, not a specific destination that that person should go to. I would be happy to look at that, but I worry that it would add complexities that would make it more difficult to deliver the bill. We could certainly tease that out during future stages, because it deserves wider consideration.

I mentioned nicotine because it came up in earlier evidence sessions. Mr Whittle discussed the idea that some people could be addicted to nicotine and some people could be addicted to chocolate. The definition in the bill relates to substances that intoxicate people and to which they become addicted. Someone can become addicted to prescribed drugs, so that would be covered under the bill.

Ms Fraser, do you want to add anything?

It means people who, at present, treat people with drug and alcohol addiction. It could be a general practitioner or a nurse practitioner—people who are authorised to prescribe any of the treatments that are listed in the bill. I picked up from the evidence from Dr Peter Rice and Dr Chris Williams that there are concerns that the definition might result in independently contracted GPs and pharmacists making treatment determinations—I think that that was your question, convener. Dr Rice said that he was relaxed and Dr Williams said that he was comfortable with the position because of the sound governance arrangements that would be in place.

There will obviously be opportunities for people to take legal action, but I know that the cost will be of significant concern for some. Legal aid options will be available. A number of standard options are in place to allow people to appeal any determination. I listened closely to what the Law Society and others said on the issue, and I think that it is right that, when something is enshrined in law and a guarantee is given to people, they should be able to appeal should the outcome not be the one that they are looking for.

I also hope that, ultimately, by enshrining the rights in law and by shining a light on the issue in your committee and in Parliament, we will send a very strong signal that the rights should be delivered and that, when medical professionals believe that someone deserves and is entitled to a certain form of treatment, they should get that. I hope that that would negate much of the need to take anything into the legal sphere, because people would understand that the right for people to get the help and support that they need and want had been enshrined in law by the Scottish Parliament.

Again, I would say that the wider psychosocial aspects would in no way be impinged on if the bill were to go through. A number of treatment options are specified in the bill, because we are taking a narrow focus on just this element of the drug and alcohol addiction journey that people go on. As Annemarie Ward said in her evidence, if there is criticism that the bill is too narrow in scope, perhaps that just means that the bill aims to do one small thing in the best possible way. That is quite a good way to look at it.

I understand those concerns, but I hope that I can reassure you, Ms Harper, and the rest of the committee that the bill would in no way diminish the other aspects of drug and alcohol rehabilitation for those who seek help and support but would simply add to them.

I heard that loud and clear. I put in that requirement to begin with because I wanted to give as much support as possible to an individual seeking help, and I felt that that face-to-face interaction would be important. Of course, you can still have face-to-face interaction in rural or island communities. As I represent the Highlands and Islands, I know—as does Ms Harper, as a representative of the south of Scotland—that those communities have built up resilience in relation to some of the challenges of meeting in remote and sparsely populated areas. However, I cannot disagree with anything that Ms Harper or the witnesses have said. That is why I am keen and would be happy to look at an amendment at stage 2 to widen the scope of that provision. To go back to the point that Ms Whitham and the convener made, I do not want anything to be exclusionary. It would be absolutely an unintended consequence of my trying to give an individual as much support as possible through having that in-person meeting if people from the islands or the more remote and rural areas were then excluded.

To go back—because I jumped ahead with Ms Whitham—there has been a strong theme throughout Ms Harper’s questioning about the impact in our rural communities, which is why I looked again at the Auditor General’s report of just last year. It says:

“Progress in providing person-centred services is mixed. Not everyone can access the services they need or is aware of their rights.”

That is what is currently happening—it has nothing to do with the bill. The report goes on:

“People face many barriers to getting support, including stigma, limited access to services in rural areas, high eligibility criteria and long waiting times. People who already face disadvantage experience additional barriers to accessing services and there is more to do to tailor services to individual needs.”

That sums up what I am trying to overcome through the bill. However, I accept and acknowledge that the stipulation that a meeting must be “in person” would exclude certain people, which is why I would readily seek to change that at stage 2.

I know that that has come across quite a lot from the witnesses. In section 1(5), there is a list of treatments, but there is also a catch-all at the end that states “any other treatment” that is deemed “appropriate”. Although I can understand why some people think that the bill is heavily reliant on an abstinence-based approach, it is not exclusively so. Any other form of treatment could be added at any point—section 1(6) allows Scottish Government ministers to add to that list. I hope that that will reassure you that, although that may be a perception, it is certainly not the intent, and, in the detail of the bill, more options are available, and there may be further options in the future.

The point is very well made. I would not say that I had a dilemma, but I had the option of saying nothing in section 1(5) apart from the last point—that is,

“any ... treatment the relevant health professional deems appropriate”.

The worry was that such an open approach would make scrutiny at this committee and the finance committee difficult, because it would not be specific enough. How would you then budget for the treatments and hold the Government to account for it? Reporting is extremely important, and the bill will deliver that, but it would have become far more challenging with a very open-ended section 1(5).

Therefore, we looked at a list of options, and those are the ones that I included, but I am very willing to look at amendments that add some of the points that you have suggested. If a strong case can be made that including other treatments would provide more balance—if that is the concern—we could add them to the list in section 1(5).

As for whether that makes the bill less clinical and more political, I do not believe it does. There are reasons for having the list of treatments as drafted—the treatments that have been included—and there will be reasons why people will wish to lodge amendments to add to the list. Ultimately, there is the catch-all of

“any other treatment the relevant health professional deems appropriate”,

which takes away the political element.

That said, I go back to the point that I made in response to Mr FitzPatrick: there is already a political drive to increase the amount of rehab beds in Scotland, which I think we all support. When we get the increase in rehab beds that the additional funding coming through the bill will help to deliver, I want people to have the right to get them. At the moment, people are being recommended for rehab and are being told that it will take weeks, months or, in some shocking and unacceptable cases, years for them to get into the rehab facilities that they need to access.

The bill must have an influence on the types of service that receive investment. As we know, not enough money has gone into rehab facilities in the past, which is why some of them have closed. That is why, in the national mission, the Government has increased the amount of money going towards them.

As for your concern about debating particular treatments, so that we include some and do not include others, and about whether that takes away from the clinical decision, I would say that, no, it does not. I trust the doctors—indeed, one is sat next to you—to make the clinical decision that they think is right for the patient in front of them. They have to adhere to the orange book guidelines, and they will still have to adhere to them, regardless of what is in the bill and any future amendments.

They also have the option of choosing no treatment at all. Despite all the options being listed in section 1(5), the doctor could say that none of them was appropriate or suitable for an individual, and therefore no treatment would be provided. The doctor, medical expert or nurse practitioner would have the opportunity to say that no treatment was suitable for the patient.