Chamber and committees

To ask the Scottish Government what action it is taking to support women with MRKH syndrome to access fertility treatment. (S6O-05589)

Women living with MRKH cannot carry a pregnancy, but they may have children via IVF with a surrogate, as the minister highlighted, or adoption.

Sadly, one of my constituents is unable to access that surrogate option, as she cannot have her embryos developed until a commitment is made from a surrogate. However, to date, surrogates have been unwilling to commit to a surrogacy unless they receive an assurance that embryos are ready to be implanted at the time of agreement. That has made it impossible for her and her partner to start their family.

I understand that, in some situations, women can have their embryos frozen without having a surrogate in place—for example, if the woman has a cancer diagnosis. Given that MRKH syndrome is such a rare condition that provides no chance of spontaneous conception, will the minister commit to considering access to specialised fertility treatment for women such as my constituent?

I am very proud to open the debate on the Criminal Justice Committee’s report into the harm caused by substance misuse in Scotland’s prisons. I thank our excellent clerking team, particularly Lucy Miller, and Scottish Parliament information centre and participation and communities team colleagues for their support during the inquiry.

The inquiry began with accumulation: rising drug-related deaths in custody, escalating use of synthetic substances, repeated warnings from oversight bodies and persistent concern from families and staff that the system is not reducing harm in the way that it should. Over months of evidence taking, prison visits and private engagement sessions, we examined what drives substance use in custody, how effectively it is prevented and treated, and what must change.

The first and most consistent message that we heard was that substance misuse in prisons cannot be understood in isolation from the wider public health challenges in Scotland. The report sets out clearly that people who enter custody are disproportionately affected by poverty, trauma, adverse childhood experiences, unstable housing and poor physical and mental health. Prison does not create those inequalities, but the evidence suggests that it can intensify them.

We heard about the changing nature of drug supply: synthetic cannabinoids, which now dominate seized samples, increasingly potent substances arriving via drones and contaminated items, and the constant adaptation of organised crime networks. We heard that drug-trend testing shows high levels of drug positivity on admission, meaning that many people who arrive in custody are already living with addiction.

Witnesses repeatedly told us that boredom, long hours locked in cells, inconsistent access to purposeful activity and gaps in mental health provision all drive substance use in prison. Where distress is unaddressed, substances can fill the void.

We were struck, in particular, by the evidence around dual diagnoses. Mental ill health and substance dependency are frequently intertwined, yet services are not always integrated in practice.

We also heard directly from people who have experienced addiction in custody. They spoke about withdrawal following arrival, self-medicating anxiety and the difference that it makes when a member of staff treats them as a person rather than a problem. Those contributions were among the most powerful evidence that we received. They shaped our recommendations on trauma-informed care, recovery-focused regimes and continuity of supply on release. I put on record my personal thanks to all those who spoke to us.

Evidence shows that 63 per cent of people in prison have an alcohol use disorder and that 40 per cent report being drunk at the time of their offence. However, specialist alcohol referrals remain strikingly low in comparison to need. Alcohol may be less visible in custody than synthetic drugs, but its role in offending, harm and post-release mortality is significant.

We recognise the exceptional strain on the prison estate. Overcrowding, high turnover and workforce pressures were repeatedly cited as barriers to effective prevention and early intervention. Without protected time for purposeful activity, therapeutic work and consistent staff engagement, progress will always be fragile.

I welcome the Scottish Government and the Scottish Prison Service’s joint initial assessment of our recommendations and the commitment of the Cabinet Secretary for Justice and Home Affairs to continued engagement on the issue. The response highlights important work that is under way, such as the target operating model for prison healthcare, the alignment of the SPS alcohol and drug recovery strategy with the mental health strategy, the implementation of medication assisted treatment standards, recovery cafes, the operational regime and roster review, and action to manage population pressures—all of which is extremely important work.

Those are significant steps, but our inquiry requires us to ask whether the frameworks that exist are delivering consistently across the estate. For example, the Government’s response emphasises that prison healthcare “must be equivalent to” community standards, yet witnesses described variability between health boards in staffing levels, access to therapies and clinical capacity.

On early intervention, the Government notes alignment between strategies. However, our report recommends a custody-focused prevention and early intervention framework that explicitly integrates mental health and substance use services from admission right through to release. Integration is essential.

On accountability, the Government indicates that existing reporting structures will provide updates. The committee’s position is that the Parliament must be able to track measurable outcomes, reductions in drug-related deaths, improved access to treatment and increased engagement in recovery work.

One of the strongest areas of consensus during the inquiry was that substance misuse in prisons is fundamentally a public health issue with criminal justice consequences. If we treat it as a security problem, we will chase supply endlessly. If we treat it as an individual failing, we will ignore structural drivers. However, if we treat it as a health issue that is embedded in a justice context, we have a chance to reduce harm meaningfully.

The committee’s report contains 50 practical, evidence based and cross-party recommendations across six themes. They acknowledge the dedication of staff and recognise financial and operational constraints while being clear that incremental change will not be enough.

Today’s debate is not just about highlighting gaps and shortcomings but about ensuring that custody does not deepen addiction and that release does not mark the beginning of a renewed crisis. The measure of our justice system is not only how securely it confines people but whether it reduces harm, improves health and strengthens community safety in the long term. That is the standard that the committee’s report sets, and I commend it to the Parliament.

I move,

That the Parliament notes the findings and recommendations in the Criminal Justice Committee’s 1st Report, 2026 (Session 6), Inquiry into the harm caused by substance misuse in Scottish Prisons (SP Paper 956).

15:54

Will the member take an intervention?

The point about purposeful activity has been raised by, probably, all speakers in the debate. Over the years, I have had the privilege of visiting HMP Grampian fairly regularly, and it provides some absolutely wonderful purposeful activity. One of the issues and challenges that it faces is access to third sector funding, given that many of the organisations that are involved are external organisations that come in. I put on the record that it is not just the issues around overcrowding and suchlike that are a challenge around purposeful activity.

::Will the member take an intervention?

::I am very proud to open the debate on the Criminal Justice Committee’s report into the harm caused by substance misuse in Scotland’s prisons. I thank our excellent clerking team, particularly Lucy Miller, and Scottish Parliament information centre and participation and communities team colleagues for their support during the inquiry.

The inquiry began with accumulation: rising drug-related deaths in custody, escalating use of synthetic substances, repeated warnings from oversight bodies and persistent concern from families and staff that the system is not reducing harm in the way that it should. Over months of evidence taking, prison visits and private engagement sessions, we examined what drives substance use in custody, how effectively it is prevented and treated, and what must change.

The first and most consistent message that we heard was that substance misuse in prisons cannot be understood in isolation from the wider public health challenges in Scotland. The report sets out clearly that people who enter custody are disproportionately affected by poverty, trauma, adverse childhood experiences, unstable housing and poor physical and mental health. Prison does not create those inequalities, but the evidence suggests that it can intensify them.

We heard about the changing nature of drug supply: synthetic cannabinoids, which now dominate seized samples, increasingly potent substances arriving via drones and contaminated items, and the constant adaptation of organised crime networks. We heard that drug-trend testing shows high levels of drug positivity on admission, meaning that many people who arrive in custody are already living with addiction.

Witnesses repeatedly told us that boredom, long hours locked in cells, inconsistent access to purposeful activity and gaps in mental health provision all drive substance use in prison. Where distress is unaddressed, substances can fill the void.

We were struck, in particular, by the evidence around dual diagnoses. Mental ill health and substance dependency are frequently intertwined, yet services are not always integrated in practice.

We also heard directly from people who have experienced addiction in custody. They spoke about withdrawal following arrival, self-medicating anxiety and the difference that it makes when a member of staff treats them as a person rather than a problem. Those contributions were among the most powerful evidence that we received. They shaped our recommendations on trauma-informed care, recovery-focused regimes and continuity of supply on release. I put on record my personal thanks to all those who spoke to us.

Evidence shows that 63 per cent of people in prison have an alcohol use disorder and that 40 per cent report being drunk at the time of their offence. However, specialist alcohol referrals remain strikingly low in comparison to need. Alcohol may be less visible in custody than synthetic drugs, but its role in offending, harm and post-release mortality is significant.

We recognise the exceptional strain on the prison estate. Overcrowding, high turnover and workforce pressures were repeatedly cited as barriers to effective prevention and early intervention. Without protected time for purposeful activity, therapeutic work and consistent staff engagement, progress will always be fragile.

I welcome the Scottish Government and the Scottish Prison Service’s joint initial assessment of our recommendations and the commitment of the Cabinet Secretary for Justice and Home Affairs to continued engagement on the issue. The response highlights important work that is under way, such as the target operating model for prison healthcare, the alignment of the SPS alcohol and drug recovery strategy with the mental health strategy, the implementation of medication assisted treatment standards, recovery cafes, the operational regime and roster review, and action to manage population pressures—all of which is extremely important work.

Those are significant steps, but our inquiry requires us to ask whether the frameworks that exist are delivering consistently across the estate. For example, the Government’s response emphasises that prison healthcare “must be equivalent to” community standards, yet witnesses described variability between health boards in staffing levels, access to therapies and clinical capacity.

On early intervention, the Government notes alignment between strategies. However, our report recommends a custody-focused prevention and early intervention framework that explicitly integrates mental health and substance use services from admission right through to release. Integration is essential.

On accountability, the Government indicates that existing reporting structures will provide updates. The committee’s position is that the Parliament must be able to track measurable outcomes, reductions in drug-related deaths, improved access to treatment and increased engagement in recovery work.

One of the strongest areas of consensus during the inquiry was that substance misuse in prisons is fundamentally a public health issue with criminal justice consequences. If we treat it as a security problem, we will chase supply endlessly. If we treat it as an individual failing, we will ignore structural drivers. However, if we treat it as a health issue that is embedded in a justice context, we have a chance to reduce harm meaningfully.

The committee’s report contains 50 practical, evidence based and cross-party recommendations across six themes. They acknowledge the dedication of staff and recognise financial and operational constraints while being clear that incremental change will not be enough.

Today’s debate is not just about highlighting gaps and shortcomings but about ensuring that custody does not deepen addiction and that release does not mark the beginning of a renewed crisis. The measure of our justice system is not only how securely it confines people but whether it reduces harm, improves health and strengthens community safety in the long term. That is the standard that the committee’s report sets, and I commend it to the Parliament.

I move,

That the Parliament notes the findings and recommendations in the Criminal Justice Committee’s 1st Report, 2026 (Session 6), Inquiry into the harm caused by substance misuse in Scottish Prisons (SP Paper 956).

15:54

::The point about purposeful activity has been raised by, probably, all speakers in the debate. Over the years, I have had the privilege of visiting HMP Grampian fairly regularly, and it provides some absolutely wonderful purposeful activity. One of the issues and challenges that it faces is access to third sector funding, given that many of the organisations that are involved are external organisations that come in. I put on the record that it is not just the issues around overcrowding and suchlike that are a challenge around purposeful activity.

::Will the member take an intervention?

::I am very proud to open the debate on the Criminal Justice Committee’s report into the harm caused by substance misuse in Scotland’s prisons. I thank our excellent clerking team, particularly Lucy Miller, and Scottish Parliament information centre and participation and communities team colleagues for their support during the inquiry.

The inquiry began with accumulation: rising drug-related deaths in custody, escalating use of synthetic substances, repeated warnings from oversight bodies and persistent concern from families and staff that the system is not reducing harm in the way that it should. Over months of evidence taking, prison visits and private engagement sessions, we examined what drives substance use in custody, how effectively it is prevented and treated, and what must change.

The first and most consistent message that we heard was that substance misuse in prisons cannot be understood in isolation from the wider public health challenges in Scotland. The report sets out clearly that people who enter custody are disproportionately affected by poverty, trauma, adverse childhood experiences, unstable housing and poor physical and mental health. Prison does not create those inequalities, but the evidence suggests that it can intensify them.

We heard about the changing nature of drug supply: synthetic cannabinoids, which now dominate seized samples, increasingly potent substances arriving via drones and contaminated items, and the constant adaptation of organised crime networks. We heard that drug-trend testing shows high levels of drug positivity on admission, meaning that many people who arrive in custody are already living with addiction.

Witnesses repeatedly told us that boredom, long hours locked in cells, inconsistent access to purposeful activity and gaps in mental health provision all drive substance use in prison. Where distress is unaddressed, substances can fill the void.

We were struck, in particular, by the evidence around dual diagnoses. Mental ill health and substance dependency are frequently intertwined, yet services are not always integrated in practice.

We also heard directly from people who have experienced addiction in custody. They spoke about withdrawal following arrival, self-medicating anxiety and the difference that it makes when a member of staff treats them as a person rather than a problem. Those contributions were among the most powerful evidence that we received. They shaped our recommendations on trauma-informed care, recovery-focused regimes and continuity of supply on release. I put on record my personal thanks to all those who spoke to us.

Evidence shows that 63 per cent of people in prison have an alcohol use disorder and that 40 per cent report being drunk at the time of their offence. However, specialist alcohol referrals remain strikingly low in comparison to need. Alcohol may be less visible in custody than synthetic drugs, but its role in offending, harm and post-release mortality is significant.

We recognise the exceptional strain on the prison estate. Overcrowding, high turnover and workforce pressures were repeatedly cited as barriers to effective prevention and early intervention. Without protected time for purposeful activity, therapeutic work and consistent staff engagement, progress will always be fragile.

I welcome the Scottish Government and the Scottish Prison Service’s joint initial assessment of our recommendations and the commitment of the Cabinet Secretary for Justice and Home Affairs to continued engagement on the issue. The response highlights important work that is under way, such as the target operating model for prison healthcare, the alignment of the SPS alcohol and drug recovery strategy with the mental health strategy, the implementation of medication assisted treatment standards, recovery cafes, the operational regime and roster review, and action to manage population pressures—all of which is extremely important work.

Those are significant steps, but our inquiry requires us to ask whether the frameworks that exist are delivering consistently across the estate. For example, the Government’s response emphasises that prison healthcare “must be equivalent to” community standards, yet witnesses described variability between health boards in staffing levels, access to therapies and clinical capacity.

On early intervention, the Government notes alignment between strategies. However, our report recommends a custody-focused prevention and early intervention framework that explicitly integrates mental health and substance use services from admission right through to release. Integration is essential.

On accountability, the Government indicates that existing reporting structures will provide updates. The committee’s position is that the Parliament must be able to track measurable outcomes, reductions in drug-related deaths, improved access to treatment and increased engagement in recovery work.

One of the strongest areas of consensus during the inquiry was that substance misuse in prisons is fundamentally a public health issue with criminal justice consequences. If we treat it as a security problem, we will chase supply endlessly. If we treat it as an individual failing, we will ignore structural drivers. However, if we treat it as a health issue that is embedded in a justice context, we have a chance to reduce harm meaningfully.

The committee’s report contains 50 practical, evidence based and cross-party recommendations across six themes. They acknowledge the dedication of staff and recognise financial and operational constraints while being clear that incremental change will not be enough.

Today’s debate is not just about highlighting gaps and shortcomings but about ensuring that custody does not deepen addiction and that release does not mark the beginning of a renewed crisis. The measure of our justice system is not only how securely it confines people but whether it reduces harm, improves health and strengthens community safety in the long term. That is the standard that the committee’s report sets, and I commend it to the Parliament.

I move,

That the Parliament notes the findings and recommendations in the Criminal Justice Committee’s 1st Report, 2026 (Session 6), Inquiry into the harm caused by substance misuse in Scottish Prisons (SP Paper 956).

15:54