Seòmar agus comataidhean

Thank you, and good morning. As members know, I have attended all the public meetings that the committee has held on the bill and have listened to the evidence that you have received in the past two months. Although I might not agree with everything that has been said, I take the opportunity to thank those who have made contributions. Should the bill pass stage 1, I will work with the witnesses you have heard from to address their concerns where I can, and I extend that invitation to committee members and to Parliament as a whole.

The specifics of the bill are not before the committee at this stage. Instead, the question is simply whether the bill and the issues that it seeks to address are worthy of further consideration and whether this committee and Parliament should continue considering further measures to tackle drug and alcohol deaths in this country.

I know that the committee is aware of the statistics, but I believe that they bear repeating. The number of drug deaths in Scotland has more than doubled in the past 10 years, and the rate of deaths is 15 times higher in our most-deprived communities than in the least-deprived ones. Alcohol deaths in Scotland are at the highest level since 2008 and are four times higher in our most-deprived communities than in the least deprived. Both of those death rates are the highest in the United Kingdom. This is a crisis made in Scotland and one that can, and must, be fixed in Scotland.

Members might disagree about the solution to this crisis, and we might have a range of views on the content of the bill, but we can all agree that the current approach is not working. That is not a view—it is a fact. Currently, a Scot dies every four hours because of drugs or alcohol. None of us can consider that a success. No one can look upon that fact with complacency. Put simply, we are not doing enough. Those are not statistics—those are real people who are being failed every day.

Deborah had struggled with addiction for more than a decade and was facing sentencing for shoplifting, which is a crime that she committed to pay for her addiction. At her drug treatment and testing order assessment, she begged to be put into rehabilitation, as she did not want to continue with methadone treatment. Her lawyer argued for her request to be met, but that was rejected as being out of scope of the DDTO and she was put back on to methadone. Deborah died of an overdose only a few months later.

Liam had a history of childhood trauma, homelessness and severe mental health issues. He asked for rehab after multiple arrests for drug offences but was placed on a four-month waiting list and told to engage with community services. It was while on that waiting list that Liam overdosed and died.

If the Right to Addiction Recovery (Scotland) Bill helps just one person to survive—if it helps just one more person live life to the full and not die a needless death—I will consider it a success, but I believe that it can do much more than that.

The bill sets out a procedure for a health professional to follow in determining what treatment is appropriate following diagnosis of such an addiction. That includes explaining the treatment options to the patient and encouraging them to contribute their views during the decision-making process. It also sets out a process and a right for a second opinion when a health professional considers that the treatment that the patient wants is not appropriate for them or when the health professional concludes that no treatment is appropriate.

The bill requires that, once a determination is made as to treatment, that treatment must be made available as soon as is reasonably practical and no later than three weeks after the determination is made. One of the key issues that was identified during the policy development process was the number of people who are referred for treatment who do not get that treatment or for whom receiving it takes far too long. The bill seeks to ensure that, in the future, they will receive that treatment—because it is provided at the right time for them and it is the treatment that suits them—and that the treatment they are referred to will be provided irrespective of cost and other considerations. The bill also requires the Scottish ministers to publish and lay an annual report on progress made towards providing the treatments for drug and alcohol addiction recovery.

Finally, the bill requires the Scottish ministers to prepare a code of practice that sets out how the duty to fulfil the right to treatment will be carried out by health boards and others, such as integration joint boards. As the financial memorandum states, the bill would increase funding to alcohol and drug services by up to £38 million annually.

Crucially, the bill takes nothing away. It does not seek to change existing services; it only seeks to add to the treatment options available.

In the Parliament, we say time and time again that drug and alcohol deaths are a tragedy. Every year, the figures are published and the language gets stronger and stronger—there is talk of “crisis”, “scandal”, “shame”, “national mission” and “priority”—but, beyond those words, the sad reality is that we are not doing enough.

The issue has not been given the attention that it warrants, but, by passing the bill at stage 1, we can give the legislation and other proposals the due consideration that they deserve, we can give some of the most vulnerable people in our society hope that their cries for help have been heard by their Parliament, and we can ensure that the deaths of Deborah, Liam and thousands of other Scots were not in vain.

There is no doubt that there are considerable challenges within the NHS workforce. With a couple of NHS staff members sitting around this table, you will hear that on a regular basis. However, in the financial memorandum there is specific funding for additional training of medical professionals for what will be an additional workload—I am in no doubt about that, which is why the cost is included in the financial memorandum’s considerations. That puts the onus on the Scottish Government to deliver that training through its partners. I know that the Convention of Scottish Local Authorities raised concerns about finance, but the COSLA representative also said that he was absolutely supportive of the bill’s intentions.

Our taking the bill to the next stage and the Parliament’s ultimately passing it would indicate to the various bodies and the workforce that we must focus on the issue in Scotland, which I hope would start to drive down the appalling figures of drug and alcohol deaths in the country.

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.

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.

I really believe that it does, because it would give people an opportunity to have their voice heard. First of all, a person’s voice is heard in the deliberation on the best treatment option for them. I welcome the fact that, last week, the cabinet secretary said to Ms Mochan that we need to

“go further ... in a co-ordinated way that works for individuals and how they wish to access services”—[Official Report, Health, Social Care and Sport Committee, 20 May 2025; c 31.]

and that we need to do that in a way that works for them.

There is a gap in the individual element of care that Ms Mochan was getting to and the cabinet secretary was agreeing with. Empowering people to be involved in their own treatment options helps. We have also heard from others that they hope that the bill will support compliance with individuals’ human rights. It would allow them to feel that they have a voice in their own decision making and treatment options, and, crucially, if they disagree with those, they would have the right to a second opinion.

They might still disagree with the second opinion if it says that no treatment is right for them or if the treatment that they have asked for is not appropriate for them, but that is left to medical professionals. I am sure that we will get into that later on. I hope that that will further destigmatise those who are struggling with drug and alcohol abuse, because they will be empowered to get the treatment and support that they believe is right to get them on the road to recovery.

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.

As Ms Fraser said, we chose that definition because it comes from section 11 of the Road Traffic Act 1988. Neither nicotine nor caffeine would cause a person to lose control, which is the issue here.

No. That is what I was going to come on to. I know that the use of the term “diagnosis” has come up quite a lot, and I would be keen to look at that, depending on what your committee decides about whether elements of the language could be exclusionary. I think that the cabinet secretary even said that it would never be my intention, as the member in charge of the bill, for it to be exclusionary. So, if that is an unintended consequence, I will look to address that at stages 2 and 3.

At the moment, the bill is drafted as it is because any treatment starts with a diagnosis—that is why it was put in that way. However, given the evidence that I have heard, I am certainly willing to consider the point.

I should have mentioned to Ms Whitham, on her point about families being included that elements of that could be strengthened in the code of practice, which is also mentioned in the bill. The bill also allows for Parliament to consider the draft code of practice before it is published. I hope that that reassures those who have concerns relating to Ms Whitham’s final point.

I am relaxed that the former chair of the Royal College of Psychiatrists and Dr Chris Williams from the Royal College of General Practitioners are relaxed and comfortable that there would be existing sound governance arrangements in place for that. That is why we have come up with the term “relevant health professional”.

I suppose that that goes back to the narrow focus of a member’s bill. I can look at only one element of the drug and alcohol issues that people face. However, the bill does not step on the toes of any other issues. It does not supersede anything else that has gone before it or will go after it; it looks specifically at the treatment element. Anything around trauma-informed diagnosis or support would continue and would in no way be affected by what is in the bill that is in front of us. It is an extremely important element of the overall package to help people to overcome their addiction issues.