Chamber and committees

Work on renewing the level of the minimum unit pricing is under way, as the impact of MUP is connected to the unit price. It is important that we have a robust evidence base to support any decision on the change of the level of the MUP. As outlined in the programme for government, we will publish our final report on the operation and the effect of MUP later this month in Parliament, alongside a consultation on the MUP’s future around both its price and the continuation of the scheme.

It is important to point out that, in my response to the member’s question, I outlined that there has been no reduction in the funding that has been made available to alcohol and drug partnerships. Indeed, the funding that has been made available to them has increased year on year. Last year, £106.8 million was available to alcohol and drug partnerships, and this year £113 million was made available to them. We asked them to use their reserves appropriately and then draw on the funding. However, that funding is then moved forward and used in other ways in the alcohol and drug partnerships themselves, so there has been no overall reduction in funding.

I will bring back to the chamber a debate to discuss a cohesive plan, because I recognise that members across the chamber are looking to understand what the Government is doing to tackle alcohol-specific deaths and alcohol harm.

The proposals that the Glasgow partnership will put before its integration joint board will include some of the details that Dr Gulhane asks about. The consultation with the community will be vital, because we need to ensure that there is no stigma associated with it and that communities definitely feel as though they have been part of the decision making. We know that between 400 and 500 people are injecting in alleyways in Glasgow city centre, so I anticipate that the proposals will include a city centre location. That is for the Glasgow partnership to set out, and we wait to see what it takes to the integration joint board.

I confirm that we identified 425 beds from the “Pathways into, through and out of Residential Rehabilitation in Scotland” report that we commissioned in 2021. Since then, we have had two rounds of funding for the rapid capacity programme, increasing the number of beds across the country by 172. That represents a 40 per cent increase on the figures that we started with. By the end of this parliamentary session, I anticipate that, through other means, including further money going to ADPs and third sector organisations, there will be an increase to the 650 beds that we have asked for. That will result in a 50 per cent increase in the number of beds available.

It is important to recognise that we need to think about the placements as well as the beds. We anticipate that the 650 beds that we will get to will allow us to have 1,000 publicly funded spaces available every year for people in Scotland to access residential rehab treatment. In the past year, 812 people accessed that service, and the past quarter saw the highest number of referrals to date.

It is important that local areas publicise their residential rehabilitation pathways, and they are on the majority of ADPs’ websites. We are working with Scotland Excel to see whether we can create a directory that would give people choice and scope as to where they could go in Scotland to access the treatment that they need.

I thank Jackie Baillie for her question, but I will point out, before I answer the substance of the second part of her question, that the position that the Lord Advocate took yesterday concerned a very specific proposal that was placed in front of her by us and the Glasgow health and social care partnership. That varies hugely from the original proposal that went to the Lord Advocate previously. Although the law has not changed, we needed a very specific proposal for the Lord Advocate to look at.

Regarding the budget that we have in front of us, I must ensure that people understand that there are no cuts to the budget. Those claims are based on a misrepresentation of a recent answer to a portfolio question, not the total budget available to alcohol and drug partnerships or the third sector, and do not represent the full drugs and alcohol budget. In 2021, the total drugs and alcohol budget was £140.7 million; in 2022-23 the total budget was £141.9 million; and there has again been an increase in the budget, to £155.5 million, for 2023-24.

It is important to point out that no one has proposed any reduction in funding for our community justice response within settings, including in Glasgow and Turning Point Scotland’s 218 service.

It is now for Glasgow’s health and social care partnership to take the proposal to the next meeting of its integration joint board, which I understand is scheduled for 27 September. To proceed, the partnership will need to provide an update to its integration joint board and be instructed to undertake public consultation work, as requested by the Lord Advocate, to establish the evaluation framework for the pilot. That public consultation work is so important.

We have been clear in our commitment to establishing a safer drug consumption facility in Scotland. Following the position from the Lord Advocate, we will continue to work closely with colleagues in Glasgow to agree the next steps and review options around implementation, including funding.

We have engaged Public Health Scotland to do an evaluation and to look at the national mission, where the moneys have reached, and the impact of that, because we need to have a clear picture of where resources are best having effect. I believe the policies that we have put in place, which are evidence based, are helping to turn the situation around, but I recognise the concern that Michael Marra shares with me about the increasing use of cocaine and crack cocaine.

It is interesting to see the rapid switch that has happened in Dundee. I have a close eye on that, because I think that that will mean that the services in Dundee will have to pivot to reflect that cocaine use.

In my travels across Scotland, I have met a number of young people who have presented to services for support and to reduce their cocaine habit. Perhaps that will have started off as recreational and quickly spun out of control.

There are a lot of issues around cocaine. I will work with local areas for them to communicate to me what they are putting in place to ensure that we can respond to that.

Following the publication of Scotland’s drug deaths figures for 2022, my officials are developing a programme of targeted engagement in the areas where there has been an increase in drug-related deaths and, in particular, difficulties in delivery, which includes Inverclyde.

We should take a moment to reflect on the fact that people who live in poverty are 16 times more likely to experience a drug-related death. It is incumbent on me and all ministers in our cross-Government response to consider how we can intervene as early as we can. The whole-family approach that we have embedded is about getting alongside families at the earliest opportunity to try to disrupt any propensity for somebody to use substances.

In 2023-24, more than £112 million has been allocated to local areas for delivery partners and local alcohol and drug services to support them to tackle the challenges in their area. I look forward to engaging with the delivery partners in Inverclyde to better understand their challenges and requirements and to tackle any barriers that they have to improving services and the outcomes for people who use drugs.

I recognise Sue Webber’s intense focus on this area. Indeed, I welcome that focus from members across the chamber, as we all have to work together on this issue.

On justice settings and the medication-assisted treatment that we are pushing and for which we are providing support in local areas, including to healthcare teams in prisons, we need full implementation to be achieved by 2025, as previously announced. We know that there are specific challenges in justice settings, as was highlighted in the benchmarking report. However, we have already announced our intention to improve healthcare in prisons through new models of care. HMP Perth is now an improvement site for medication-assisted treatment standards, and the learning from that will be cascaded through the entirety of the prison estate.

Peer naloxone workers are working within the prison estate to cascade life-saving naloxone treatment to people in prison. This year, the MAT standards implementation support team will be supporting health teams in prison settings in embedding MAT standard 3, in particular. That involves assertive outreach, which can also happen in prison settings. There are a lot of recovery communities and recovery cafes in prison settings, which is important, too.

A lot of work is on-going in prisons, and I will be happy to have a meeting with Ms Webber to keep her updated on that.

I absolutely welcome the cross-party Westminster Home Affairs Committee report that was released last month, which recommends a review of current drug laws. Multiple committees, experts and independent organisations—including the independent drug deaths task force—have already called for an urgent review.

We have been clear that Scotland faces a public health emergency in relation to drug deaths, and we cannot rely on only one route to change. We are working hard with the powers that we have but, although there is more that we need to do, the fact remains that the legal framework in which we operate undermines our public health approach.

We are open to a full range of options and have set out policies that could be implemented through the devolution of further powers to Holyrood, including powers to change the criminal law on the use of drugs, or wider constitutional changes, such as Scottish independence. Clearly, the fastest and simplest way forward is for the UK Government to review and change the Misuse of Drugs Act 1971 to support a public health approach across the entire UK. The number of drug deaths is increasing across the whole of the UK, despite the welcome decrease that we saw in 2022, and we will experience the increasing prevalence of really strong synthetics and even stronger street benzodiazepines, so we need to have all the weapons in our armoury to be able to respond to that.