Health and Sport Committee, 10 Dec 2008

Meeting date: Wednesday, December 10, 2008

Official Report 87KB pdf

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Petitions

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Methadone Prescriptions (PE789)

Our next item of business is consideration of petitions. I refer members to the briefing papers. PE789, by Eric Brown, calls on the Parliament to take a view on regulation to ensure that a patient takes their methadone prescription while supervised by a suitably qualified medical practitioner. The committee is invited to consider closing the petition on the grounds that the Public Petitions Committee and this committee have extensively explored the issues raised by the petitioner and that the Scottish Government is introducing measures to investigate the link between prescribing policy and methadone-related deaths. Alternatively, committee members might wish to recommend another approach on which we might agree. I seek members' views.

This issue has been extensively explored. Given the Minister for Community Safety's assurances in his letter to the convener, I think that we can close the petition.

I am concerned that the Government's response does not really address the issue. According to the minister's letter, the Government has not commissioned any research and does not propose to do so. The minister draws attention to the work of the national forum on drug-related deaths and the piloting of a national drug-related deaths database. However, the minister qualifies what he says by noting that statistical comparisons of small local areas may not be possible because of the small sample size. The matter is not being addressed in a serious way. We need to think more about the issue and write back to the Scottish Government to say that we are not happy with its response.

I am sorry to disagree with my friend Helen Eadie. Eric Brown petitioned us on a topic that has been widely debated. The minister's response is good and gives us much more than we have previously had. There is undoubtedly serious concern across Scotland about the issue that the petition raises.

The minister states in his letter:

"A cross-analysis of this data could highlight if there are any links between methadone-related drug deaths and dispensing".

We have never had such an analysis before. The minister also states that the Government is

"piloting the national drug-related deaths database in Lanarkshire, Dumfries and Galloway and Ayrshire and Arran."

I am not sure what the timetable is for rolling out the database, but it is a major step forward in the right direction. Certainly, my party has serious concerns about the lack of choice in using methadone and so on. We will welcome the information that will come from the database pilots. I welcome, too, the Government's response on the issue.

The minister states in his letter that the Government hopes to

"roll out the first stage of the database in early 2009".

Yes, and he continues that that

"will be followed by the IT element".

I hear what Helen Eadie says, but I disagree with what she proposes. Surely the first thing to do on the issue of methadone prescribing is to get the necessary data, which we do not have at present. Initial research can simply be about getting the data. It is interesting that the database will consider whether there are links between deaths and taking methadone, record the deaths of people who were taking methadone that they were not prescribed, and record whether clients have topped up their prescription. The database may not be conclusive and all-embracing, but it will include those three categories. It is important first to get such information.

That point does not address the qualification in the minister's response, which is highlighted in our briefing paper:

"statistical comparisons of small, local areas may not be possible due to the small sample size."

I agree that having the database is a good step forward, and I acknowledge that it will record information, including whether methadone was prescribed to the deceased. However, at the end of the pilot, we could still not have all the information that we need. I feel that we should have further reassurances from the Government that, in fact, it will address that issue.

There are two issues here. First, I agree with Mary Scanlon that things have moved on substantially since the petition was lodged. There is now far greater recognition in Government and in the medical profession of the need for supervised dispensing of methadone, which is not universally practised. Helen Eadie is right that there are issues in that respect. Nevertheless, it is clear that the policy direction, which is the only area that we can affect, is to get back to a situation whereby unsupervised dispensing of methadone is simply not the norm—I think that we are moving to that. Secondly, in giving effect to that, the minister's letter is to be welcomed because it recognises that, unless we have the data, all sorts of unsupported claims can be made in Parliament.

I am in no doubt that drug misuse remains a matter of great concern not just to the committee, but to the Parliament as a whole, so I cannot conceive of a situation in which the Parliament will not want to bring the Government regularly to account on the delivery of its new drugs policy. To that extent, I believe that the petitioner has achieved a lot. He has not been unique in highlighting an unintended drift in the previous policy, which has had substantial unintended consequences.

My judgment is that the Parliament will never lose sight of the issue now that it has an active interest in bringing the Government to account on the delivery of its policy, and that it will concentrate on the change in policy, whereby the prescription of methadone must be supervised and there must be a database against which achievement of that aim can be measured. We should accept that the petition has gone as far as it can go, but that does not in any way prevent the Parliament from engaging in the normal process of putting the Government's drugs policy under scrutiny.

I have a final point. According to the minister's letter, the information technology element of the drug-related deaths database is due to be rolled out

"towards the end of 2009."

I accept what Helen Eadie says. It is difficult, particularly in the islands, to provide supervised consumption of methadone on a Sunday, given the public transport situation and the fact that many island pharmacies are simply not open on a Sunday. A major step forward has been made, but I would like us to return to the issue, perhaps at the end of next year. The petitioner has successfully secured a commitment from the Government.

I notice that the pilots are due to conclude shortly. It is open to any member to ask parliamentary questions on the issue to keep the minister on his toes.

I put on record that not all practitioners necessarily agree with what Ross Finnie said and Mary Scanlon implied—that all methadone taking should be supervised at all times. There are very good reasons why that does not have to be the case, despite the very bad cases that we know about.

In addition, the petition, which was submitted in 2004, requests that people who take methadone be supervised

"by a suitably qualified medical practitioner".

I know of no one in the field who thinks that every dispensation of methadone should be supervised by a medical practitioner, because that would be totally impractical.

Such supervision is often done in pharmacies.

Helen Eadie has a final point.

Mary Scanlon made an important point. I agree with Ross Finnie that some progress has been made, but we should be mindful of the caveat about not raising unrealistic expectations. That is why I am keen that we pursue Mary Scanlon's almost throwaway suggestion that we revisit the issue in a year. We have the option to close the petition or to call for a progress report from the Government in a year's time. Given that the issue has been of continuing importance for the past nine years, I am not minded to agree to close the petition. I think that we should revisit it in a year's time, when we can consider an analysis of what progress has been made. The petitioner has brought a vital issue to the Parliament's attention.

Indeed, but it is not necessary to keep the petition open to revisit the issue. The committee can decide to fit that into its work programme. I see that the Government hopes

"to roll out the first stage of the database in early 2009, followed by the IT element of the project towards the end of 2009."

I am not swayed one way or the other; it is up to the committee to decide. I am just saying that it is not necessary to keep the petition open, as we can decide to come back to the issue when we think about our work programme.

But the converse is also true—it is not necessary to close the petition. It is neat and tidy to do so, but if we keep the petition open, that will place an obligation on us to revisit the subject.

There are conflicting views.

I totally accept Helen Eadie's good intentions, but I agree with Ross Finnie. The Government's drugs policy will attract the attention of the whole Parliament on many occasions, so I do not think that it is necessary to keep the petition open. The petitioner has succeeded in his aim and the petition has taken on a life of its own.

We could close the petition but write to the minister to say that we intend to review the position in a year's time, at the end of 2009. Individual members can monitor the situation in the interim.

I would be prepared to accept that suggestion with the caveat that we should ask the minister to provide us with a report to consider by this time next year.

That is absolutely fine. It will not be a problem to do that once the pilots have finished.

Are members content for us to close the petition and to write to the minister using words to that effect?

Members indicated agreement.

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Sports Facilities (PE1205)

In relation to PE1205 by Chris Gallacher on the provision of local, regional and national sports facilities, the committee is invited to consider whether to deal with the issues that the petition raises as part of its pathways into sport inquiry and to close it on that basis or to adopt a different approach. I invite members' views. This is the Meadowbank petition.

I apologise for my late arrival, which is due to the cancellation of trains.

As we are moving into stage 2 of our pathways into sport inquiry, I would like to consider the issues that the petition raises as part of that inquiry. The petition makes a good point. We should move forward on that basis.

Are we agreed?

For clarification, it would be difficult for the inquiry to examine the specific issue of facilities at Meadowbank, because I suspect that that would result in our being inundated by requests from across the country. The petitioner should be aware of the fact that we will consider general issues around the provision of facilities at local level.

Yes. I suspect that the committee might take the same principled line if other petitions about facilities are referred to us.

If we wind back to the letter to the minister—[Interruption.] I am getting confused because of my glasses.

The committee kept open the two previous petitions that it considered that related to the pathways into sport inquiry, so I suggest that it might be worth while keeping open PE1205 for the duration of the inquiry.

Do members agree?

Members indicated agreement.

That is fine; I was going astray.

That concludes our formal business. We move into private session for consideration of items 4 and 5.

Meeting continued in private until 12:31.