Chamber and committees

Staffing pressure is one of the biggest issues facing hospitals, and Brexit has worsened matters. Dr John-Paul Loughrey, who is vice-chair of the Royal College of Emergency Medicine said yesterday that

“across the whole acute system, [we have] lost staff members who would have come to work in the UK, or who have had to leave the UK, because of the situation with Brexit.”

Does the First Minister agree that this has been a time when the NHS has faced, and continues to face, unprecedented pressure, and that Brexit, which Scotland overwhelmingly rejected, has made the pressures so much worse? Can she outline how the Scottish Government and NHS Scotland are working together to address the situation?

To ask the Scottish Government what discussions it has had with the Scottish Funding Council in light of the reported on-going governance concerns at South Lanarkshire College. (S6O-01166)

Minutes from meetings of the college board of management refer to allegations of systematic bullying and intimidation of a number of staff, and potential financial irregularities. They also show that South Lanarkshire College failed to comply with the code of good governance. What steps is the Scottish Government taking to resolve those on-going issues with South Lanarkshire College and to address the issues that the Educational Institute of Scotland—Further Education Lecturers Association has raised around the governance structure?

To ask the First Minister what the Scottish Government’s response is to the finding of the Royal College of Emergency Medicine’s report, “Beds in the NHS”, that, since 2010, 4,227 hospital beds have been taken out of active service in the national health service in Scotland. (S6F-01175)

Yes, I will do that—I will try to anyway. Earlier, we touched on the issues of services and intersectionality. Everyone on the panel has expertise in different areas. Perhaps I should direct my question to Claire Sweeney. Given the increasing cost of living, what would you point to as one of the biggest interventions that we could make on health and poverty?

Do witnesses have a view on whether universal basic income or a minimum income guarantee is an effective method of tackling health inequalities?

As I begin this speech, my thoughts are with everyone who has lost a loved one to a drug overdose. I pay tribute to Collette Stevenson for her powerful speech.

When we have these debates, we often focus on policy and reform, but it is important that we also take time to reflect on the lives lost and the terrible pain felt by those who have been bereaved. For too long, our criminal justice system and drug treatment services have robbed people of the dignity that they deserve. Our focus must be on restoring that dignity while preventing further deaths. The Misuse of Drugs Act 1971 is outdated and obsolete, and it further erodes the dignity and safety of people who use drugs. In its 2021 report on drug law reform, the Scottish Drug Deaths Taskforce stated that it was

“unequivocal that the Act in its current form creates barriers to the implementation of a public health approach.”

When the case for reform was put to the Minister of State for Crime and Policing at the joint committee meeting, however, it was clear that he did not have a good grasp of either the situation in Scotland or the root causes of drug use. When asked whether he recognised that poverty was an underlying cause of drug use that needed to be tackled, he answered no and said that he believed that drugs and violence drive poverty.

I have spoken before in the chamber about the fact that Scotland’s drug deaths crisis can be traced back to 1980s deindustrialisation and the subsequent economic and social impact. According to the Royal College of Physicians of Edinburgh, some of those experiencing the highest levels of drug deaths and drug-related harms grew up in the post-industrial 1980s, when unemployment levels were high and the heroin market expanded into deprived communities. That group suffers multiple, complex disadvantages, including poor physical and mental health, unemployment, unstable housing arrangements, involvement with the criminal justice system and family breakdown.

The UK Government is so far behind in this conversation, it should worry us all. How can we hope to tackle the crisis effectively when UK ministers are espousing such ill-informed views, which further stigmatise people who use drugs? Kit Malthouse refused to entertain the prospect of drug-checking facilities here in Scotland. As we heard in the chamber last week, there are now plans, and a licence issued by the Home Office, to operate a facility in Bristol. Such services can save lives. I wish the Loop, which will operate the facility, the very best. I hope that it will have incredible success and, hopefully, once and for all, provide evidence that the UK Government will listen to. It is nonsensical and hypocritical to rule out drug-checking services in Scotland and allow them in England. We need those powers to save lives.

The varying purity and strength of illicit drugs makes it impossible—

I was reflecting on the questions that we had asked Kit Malthouse. One of the questions that we put to him was whether the UK Government would back drug-checking facilities in Scotland; the answer was no. If it is something that we were able to introduce, I would be more than happy to chat to the member about all the measures that he has just mentioned.

Safe consumption rooms are another life-saving intervention, and they must be allowed to operate in Scotland. Mr Malthouse said that he needed more evidence on safe consumption rooms. Considering that they have been operating in Europe for around three decades and have proved effective in a range of countries from around the world, including Australia, Canada, Spain, Switzerland and the Netherlands, I am not sure what further evidence he requires. Those facilities could be saving lives now.

I found the minister’s focus on enforcement particularly disturbing. In Scotland, there is a general consensus that a public health approach is needed to solve the crisis. It is clear that the UK Government does not share that view but instead sees it as a criminal justice matter, despite all the harm and stigmatisation that the war on drugs has caused.

I was also disappointed by the minister’s use of stigmatising language, which I will not repeat. We do people a disservice when we label them. It robs them of their dignity and humanity and it others them. If we want treatment services built around human rights, we must dispense with such language and speak about people as if they are human beings deserving of our respect and compassion.

We need a person-centred system that views people as whole beings, rather than various conditions that need to be categorised and dealt with separately. Above all, we must seek to reduce and prevent harm wherever possible. We must maximise every opportunity to connect people with services. The more we embed stigma-free treatment and life-saving interventions in the community, the greater the chances of connecting with those who need the help the most. For example, I was pleased to see the roll-out of naloxone to some taxi drivers in Edinburgh, which will surely result in more lives being saved. I applaud all those in the scheme, which has also been implemented in Glasgow. I hope to see it being implemented in more of our cities and towns.

The Scottish Greens also support the roll-out of heroin-assisted treatment across Scotland. According to NHS Greater Glasgow and Clyde, there is high-quality evidence to suggest that HAT can improve individual and societal outcomes when provided as a second-line treatment for people with chronic opioid dependency. It is yet another area where meaningful progress is being blocked. Stakeholders have reported to the Drug Deaths Taskforce that the process for submitting an application for a licence for HAT is overly complicated and resource intensive. The ability to offer HAT alongside other medication-assisted treatment should be more widespread, and any remaining barriers to the provision should be removed.

Despite the fact that HAT is a well-evidenced intervention, with clear health and social benefits, roll-out has been hindered by an overly bureaucratic process. I have heard the Minister for Drug Policy say on more than one occasion that we need to turn expressions of interest from health boards into commitments. At the moment, health boards must apply to the Home Office and the Scottish Government and could be approved by one and rejected by the other. That may discourage some boards from applying.

It is vital that HAT licensing is devolved to Scotland in order to reduce the administrative burden and to facilitate its roll-out across Scotland.

To ask the Scottish Government how Historic Environment Scotland ensures that communities are adequately consulted when considering whether a building should be listed. (S6O-01135)

A number of constituents have contacted me in despair at the news that Historic Environment Scotland is currently considering whether Cumbernauld town centre should be a listed building. Just when it looked as though plans to redevelop the site were progressing and there was an opportunity to replace the current town centre with something fit for a town the size of Cumbernauld, the HES proposal threatens those plans.

Can the minister assure me and my constituents that Historic Environment Scotland will not approve a proposal to list such an awful building if that will put at risk plans to develop a modern and accessible town centre?