Chamber and committees

I absolutely recognise that, as we heard again from members of the people’s panel today, many of the MAT standards are directed towards opioid dependency. However, many of the standards are applicable to people regardless of their substance dependency. In particular, those that relate to access to mental health support and treatment are in place regardless of the type of dependency.

I recognise in my written response that we need to look at what we can do to provide medicated assisted treatment that goes beyond opioids. Colleagues have had questions about the fact that, as the people’s panel observed, we are seeing a growing level of polysubstance use and, in certain parts of the country, a growing level of use of cocaine, benzodiazepines and other drugs including nitazenes. Clearly, we need to ensure that we are responding to the use of those drugs, too, and that is part of our consideration.

We accept that there needs to be improvement, as I said in my written evidence. In the evidence from the people’s panel, we heard that, although the services exist, we need to explore, with regard to co-ordination and consistency, why they are not being referred to. We will work with the court service and other statutory organisations to ensure that there is awareness of the services that are available and that they are referring people to those pathways. Every encounter should be utilised as an opportunity to ensure that people are made aware of the support that is available to them and to encourage uptake of that support. We will explore that further and see what more can be done to ensure that the recommendation can be fulfilled.

Yes. I heard that evidence. I can reflect on the situation in my constituency; I know that the local support cafe is looking to work much more closely with the justice system so that there is a supportive element through somebody’s release from custody and they go into a supportive environment that means that they are supported in the community in a much better way. I know that that is being considered more widely. I heard that from the panel this morning, and we are absolutely looking to do better on it.

First of all, services absolutely should be doing that. Mr Doris raises a very challenging case in his constituency, and I pay tribute to him for trying to ensure that co-ordination is provided. He suggests that it has not been and that, as we have discussed in response to previous questions about referrals between statutory bodies and community and voluntary organisations, there should be better co-ordination.

As he was speaking, I was thinking about what the Thistle is seeking to provide. It is a safe space for drug consumption, but it is also part of a pathway for people to be able to get access to services—that was a critical part of the Lord Advocate being willing to provide her letter of comfort—because there are statutory services within it, including housing, social work and various other services.

The evidence that is coming through from the Thistle’s early work is that people are able to engage with those statutory services in a way that has not been seen before. The Thistle is speaking to people who services have not spoken to before. The early evidence suggests that the intention in relation to that pathway, which was critical to the Lord Advocate’s willingness to provide her letter of comfort, is working. However, we have more work to do—I have already acknowledged that—to make sure that there is more joined-up communication between services and that referral pathways are being put in place.

The specific example that Mr Doris gave relates to the need to make sure that there is co-ordination and that every organisation seeks to provide a supportive environment to resolve issues. That should be what we all expect to take place.

Absolutely. I would welcome that.

We support alcohol and drug partnerships to deliver some of those services. Obviously, our health services are there to deliver, and we have provided increased funding to our health boards and our local authority partners to ensure that they are providing services.

We have already referenced the support that is provided through the Corra Foundation to ensure that community and voluntary organisations are able to respond. The organisations in the community and voluntary sector are trusted and have a wide reach—they can reach much deeper into communities than statutory services can—and the role that they play has to be acknowledged. I certainly acknowledge that, and my commitment to funding those community organisations is clear.

If there are examples of where we need to do more in local areas, or if there is more that we need to do at a national level, I want to hear about that. We would always consider funding for services where the evidence is clear that they are helping to meet a particular demand.

There is not a huge amount of greater detail that I can go into. The work that the improvement hubs will deliver is obvious, but I note that Healthcare Improvement Scotland’s co-ordinating role and its work on ensuring that the pathways are working well are well established, too. As I have said, I do not have a huge amount of detail that I can go into or anything that I can go into in any greater depth—I do not know whether Laura Zeballos or Maggie Page wishes to add anything.

I thank Ms Haughey for raising the issue and the people’s panel for its work on illuminating this as an issue that needs to be addressed. I heard the gentleman on the previous panel make the point that he had not been aware of the naloxone programme but that, when he did become aware of it, he wanted to be involved. That speaks volumes about not just the powerful effect of the naloxone roll-out itself, but the need to ensure that we are not complacent and think that everybody has an understanding of the roll-out, as colleagues around the table do, and the fact that it has gone to various statutory organisations as well as others.

We will consider what more we can do to have an awareness-raising campaign and what might be effective in that respect, and I am happy to come back to the committee with our consideration of how that could work. The very illumination of the issue through the work of the people’s panel will be helpful, as will, I hope, our discussion here. I believe that all of us around the table have agency in being able to raise awareness. Mr Sweeney and the convener said that they had gone through training—indeed, Mr Sweeney was able to say how quick that training was. If we use our own agency as local leaders, that will be just as important as any Government or Public Health Scotland-led campaign in this space.

I am grateful to Mr Sweeney for raising the issue. It angers me greatly to see misinformation being spread about a service that seeks to address an issue by using a method that international evidence demonstrates works and that is part of a toolbox to support people to reduce the harm and deaths that are associated with their substance dependency. That is shameful. The evidence can be challenged—of course, we can have a debate about the efficacy of the approach and whether it works, which is why we are piloting the measure. However, to blatantly spread false information is wrong.

All those claims are false. That particular location was chosen for the Thistle because community injecting was already happening there. I have seen no evidence—nothing has been reported to me or anybody else—to suggest that there has been an increase in injecting in the community or, indeed, an increase in the discarding of paraphernalia in the community. That claim is false. It is also not true to say that the drugs that Mr Sweeney mentioned are being provided at the facility. The individuals who are seeking to use the safer drug consumption facility bring their own.

I find it deeply distressing, disappointing, frustrating and upsetting that people are seeking to spread misinformation about a group of people who are incredibly vulnerable and are seeking to use a service in order to reduce the harm that their substance dependency is causing to them. I also find it deeply distressing that the people who work around the facility are being exposed to that type of misinformation and that there is misinformation about the contribution that has been made by those with lived and living experience and by family members of those who have lost their lives, who say that this is the right thing for us to be investing in.

Unfortunately, it is not surprising that people are spreading such misinformation, but I find their doing so deeply concerning. I know that Mr Sweeney shares my frustration about that, which, I suppose, is why he has raised the issue today.

It is for the Scottish Affairs Committee to carry out its investigation. I hope that it will do so with the sensitivity that the people’s panel and the joint committee have brought to this emotional issue. I hope that the Scottish Affairs Committee will explore the evidence and the efficacy of the approach, as well as hearing the testimony of those with lived and living experience who have fought so hard for the facility to be established and who have shaped the way that the service is being run and those who work in it. I hope that those views are taken into consideration and that we have an evidence-based outcome. Obviously, it is for the Scottish Affairs Committee to conduct its business as it sees fit, but that is my hope for its inquiry.

As I said, it is right that we are having a debate—and I think that we have had a very healthy debate in the Scottish Parliament—about the efficacy of the approach and the evidence for why we would want to establish a safer drug consumption facility. It is critical that we keep the debate to those points of evidence and take into account the views of those with lived and living experience, to ensure that we can make progress for the people we need to do better by and to save lives.