Chamber and committees

I absolutely recognise that we have lost far too many people in our country to wholly preventable deaths.

There have been significant increases in funding for drug and alcohol services as a result of the national mission. Funding for drug policy has increased by 67 per cent in real terms from 2014-15 to 2023-24, according to figures that were published by Audit Scotland last year. Although I recognise that there are funding issues, we should also recognise that, since the year prior to when we traditionally think of the services having a reduced budget, there has been a 67 per cent real-terms increase in funding.

Decisions regarding Turning Point and other such services are not taken by the Government, but I understand why people are afraid of what might happen if such a service closes. I am looking for the health and social care partnership to explain how it will support some of the most vulnerable women, especially those in Glasgow city centre, who have multiple and complex needs.

I am alive to all those issues, and I am determined to ensure that the budget of which I have control goes to where it is needed, so that we get the best results for our investment.

I recognise that, across the chamber, we all want a reduction in drug deaths, and I recognise that each and every one of those people is an individual. So far in my time in this job, I have met several families who have been affected, and I know of far too many people and families who have suffered that loss.

I will remain steadfast. A safer consumption facility is one thing that we can do to support those individuals who are sometimes at most risk of harm in Glasgow city centre and who are injecting in public. We know from the 2016 report “Taking away the chaos—The health needs of people who inject drugs in public places in Glasgow city centre” that they require a safer consumption facility. The Glasgow health and social care partnership is working at pace to ensure that it has staff members in place come the spring. We hope that the facility will be open by the summer months, once we have the infrastructure in place.

Following on from the question that Annie Wells has just posed to me, Jackie Dunbar has asked another really good question. We are committed to expanding access to residential rehab. We are investing £37 million in seven residential rehabilitation capacity projects across the country. Through that and other funding over the course of this session of Parliament, we are working to increase overall residential rehabilitation capacity by 50 per cent, which is an increase from 425 to 650 beds.

We are moving at pace to develop a standardised approach to commissioning residential rehabilitation services through work with Scotland Excel, which has also supported us to create an online service directory, which will be available soon, to allow services and individuals to see what is on offer across the country.

We are providing funding to support residential rehab placements, including £5 million per year to ADPs, and additional funding through our prison to rehab scheme and our capacity programme.

This morning, Public Health Scotland published a report that shows a further increase in the number of referrals in the first two quarters of 2023-24, with a total of 477 statutorily funded placements being approved. That is an increase of 126 placements on the figure for the same period in the previous year, when 812 placements already showed a 50 per cent increase in the number of placements overall. We aim to increase the number of statutorily funded placements by 300 per cent over the next five years so that, by 2026, at least 1,000 people will be publicly funded for their placement in residential rehab.

I thank Gillian Mackay for that question, which is a very important one that has several facets to it.

As per MAT standard 8, the Scottish Government is working with Public Health Scotland and experts across the sector to ensure that people who use drugs have access to independent advocacy and support for their housing, welfare and income needs. The Scottish Government is committed to ensuring that those who use alcohol or drugs are supported to access services and that staff are trained to understand the wider complex needs of people who use drugs.

In order to ensure that those important and complex interlinked issues are recognised, Reach Advocacy has been awarded funding to deliver training on the implementation of MAT standards as part of a wider human rights-based approach. The training allows front-line staff and managers across statutory and third sector services to develop their knowledge of MAT standards and human rights legislation in order to provide holistic and rights-respecting care.

There is also a fundamental part about really taking on the learning when we recognise where things have gone wrong. That learning can then be cascaded to other front-line services. After hearing directly from front-line services yesterday, I am cognisant of the impact that repeated overdose reversals are having on members of staff. We are looking to support members of staff’s wellbeing.

I thank Audrey Nicoll for asking that important question. Buvidal and naloxone are medicines that need to be available everywhere to help to save the lives of some of the most vulnerable people in our communities. It is simply unacceptable for health boards and integration joint boards to single out those medicines and treat them differently from all other medicines. Stigma is pervasive in all areas of our culture when it comes to issues relating to drug use. My officials have met chief finance officers and ADPs to ensure that the costs of those medicines are being provided for appropriately. For boards where there may still be some confusion, we will be writing out shortly to give clear instructions on the need to properly fund the availability of Buvidal and naloxone.

The definitions that are used for drug deaths statistics are consistent across the UK, but there are important differences in data collection methods and in the death registration systems that affect the comparability of the statistics, due to there being different levels of missing data across the UK nations. The same comparability problem that is found with identifying drug misuse deaths applies to the figures for all individual substances and drug categories. The drug misuse death definition is the main headline figure that is used in Scotland, but the drug poisoning death definition is the more accurate comparator with the rest of the UK.

The Scottish Government remains committed to improving our data and surveillance on drug deaths and harms through, for example, our rapid action drug alerts and response—RADAR—surveillance system. That system, which has come into its own recently, assesses emerging threats, shares information to reduce the risk of drug-related harm and recommends rapid and targeted interventions.

There have also been great advances in toxicology reporting in Scotland. Ministers in the rest of the UK have looked towards us for leading on that. The more we can identify the substances, the more we can introduce harm-reduction measures.

I thank Clare Haughey for the question, because it is on the fundamental aspect of ensuring that people who have co-occurring issues with substance use and mental health are not bounced around services, which happens far too often.

We have commissioned Healthcare Improvement Scotland to produce an exemplar protocol, which will build on best practice from across the country and internationally. It will ensure that every area has access to a high-quality document on which they can base their own protocol. Once the exemplar protocol has been made available to the local areas early next year, HIS will offer strategic change management support, which will help local areas to adapt the exemplar protocol to their own circumstances, pilot elements of it and then implement it fully. In addition, we will work with HIS and stakeholders, including NHS Education for Scotland, to ensure that we have the appropriate training and data reporting to support and monitor improvements.

By implementing the exemplar protocol, local areas will also be implementing MAT standard 9, with co-occurring support being provided where it is needed. However, the protocol is not limited to opiates or medication-assisted treatments; it will support many more people in relation to their substance use.

That is a really good point, because we need challenge and scrutiny of, and independent eyes on, some of these things. I will probably pass over to Susanne Millar to help us with understanding the evaluation process from a Glasgow perspective. Obviously, things will look slightly different from a Government perspective, as my scrutiny will be of the evaluation that Glasgow will take forward.

I am happy to hand over to Susanne at this point.

On your first point, the resourcing of any other safer consumption project would be an on-going process between my officials and officials at Edinburgh council. That is not something that I can foresee, but I take your point about how pressed the budgets are.

We need to have a robust evaluation process, which needs to be flexible and agile. At the same time, I do not believe that that should stop us exploring the possibility of other pilots that could be proposed while the initial Glasgow pilot is being undertaken. As is set out in information that I submitted to the committee, we have had conversations with the Crown Office and Procurator Fiscal Service about what it would be willing to consider.

It is clear that the Lord Advocate would consider a robust application from an area, provided that it followed the parameters of the initial Glasgow pilot. An application would need to be precise, detailed and specific, underpinned by evidence from that area and supported by those, such as Police Scotland, that would be responsible for policing such a facility. Any area that sought to make an application for a pilot would need to ensure that it satisfied the Lord Advocate in relation to everything that Glasgow did.

Conversations have already been undertaken in the city of Edinburgh about whether the council there would seek to have such a pilot in the offing. Officials in the Scottish Government are supporting that area to explore what that pilot could look like.

We do not need to wait for the full evaluation of the first Glasgow pilot before applications are put forward by other areas.