Chamber and committees

The figures on drug deaths focus on overdose, and much of our approach has been focused on that. However, it is clear that there are other drug-related issues that can lead to deaths, not least of which are issues such as HIV, hepatitis C, cardiovascular problems and end-of-life liver and lung disease. My understanding is that we do not capture the data with regard to such deaths, so what are your reflections on how we might collect some of that data to ensure that we push the resources to the right places?

Would Dr Gulhane accept that consumption facilities can take many forms and can be based around the community supports that I mentioned? There is a holistic model whereby people can receive different levels of support and use a safe consumption facility.

In rising to close for Scottish Labour, I reflect that today’s debate has been an important opportunity to discuss a range of issues related to the national drugs mission and the progress that we all want in eradicating stigma around these issues. We know that stigma has an impact on the likelihood of an individual asking for the help they need to start the process of rehabilitation following a period of addiction.

As we have heard from so many colleagues across the chamber, it is crucial that we work to eradicate stigma around drug addiction and drug deaths, as well as shifting attitudes to ensure a more meaningful, open and compassionate discussion as we seek to help prevent more drug deaths and to aid more people on their recovery journey.

In doing that, we must recognise at the outset the tragic loss of so many lives. Let us all remember again that they are not just numbers; they are people who lived in our communities, and they are often family, friends and neighbours. We must start with that at the core of our approach. I was heartened to hear so many colleagues mention that. I thought that Collette Stevenson spoke particularly powerfully in that regard.

We must take a different approach when it comes to stigma. We must take a root-and-branch look at where stigma and wider issues around drugs arise. Our approach must be focused on treating the deep-rooted socioeconomic factors that lead to drug use. It should be a holistic approach that is rooted in public health. The evidence is clear that the most deprived communities are those that are most impacted, and that they have many issues to deal with. We heard from Katy Clark and other colleagues from across the chamber about the sense of endemic poverty and the real structural challenge that exists in so many communities. Most public health experts would say that we must tackle those issues at their very root in order to make the most change. Data from National Records of Scotland has shown that people are 15 times more likely to die of a drug-related incident if they live in one of the most deprived areas, compared with the least deprived areas. Tragically, more than 12,000 people have lost their lives to drugs since 2007, leaving thousands of parents, children and friends behind, heartbroken.

We have heard contributions on the importance of services to support recovery, and particularly the importance of rehabilitation that is person centred and flexible in order to meet people where they are. As we have also heard, it can often be contradictory to assert commitments to tackling stigma and to help people access support services. In reality, there is a reduction in the support services that are available, due to budgets in health and social care reducing and budgets in local government being cut.

Claire Baker was right to highlight the need for greater investment and for greater pace of change from the Government. It is indeed the Government’s responsibility to demonstrate that progress, so that everybody can have confidence in the work of the national mission.

Thank you.

In previous discussions of safe consumption facilities, we have talked about the legal barriers that exist, and I think that the minister would contend that that is a significant challenge to the ability to deliver them. I am interested to understand what analysis officials have done of current legislation that might help to overcome that. Have the provisions in the National Health Service (Scotland) Act 1947 been looked at, for example? They put a duty on Government to promote a comprehensive and integrated health service

“to secure improvement in the physical and mental health of the people”,

and the prevention, diagnosis and treatment of illness sit within that. To what extent have officials looked at other legislation that might help us to move forward?

I will come back in briefly. It is helpful to hear about the context of what is being looked at. However, would the minister also be willing to share whatever information she has gathered on, for example, the specific act to which I referred?

I thank Emma Harper for that important intervention. That is absolutely crucial. We know that, over many years, the media have got it wrong, and Emma Harper is right to raise that point about the images that are used around drug use, particularly those of syringes, spoons and so on. There is also an issue around the language that is used. Emma Harper spoke earlier about educating people, about the words that we use and about how we refer to people, trying to look at everyone as a human being, seeing and respecting their innate dignity. That is absolutely important, and it is something that we would all want to reflect on and encourage all parts of our society to move forward with.

We have heard contributions today about the importance of the voluntary sector and the organisations that are embedded in communities delivering vital support to help people with addiction. Alex Cole-Hamilton was right to refer to the many campaigners and community organisations that work in this space, including on the provision of safe consumption.

Stuart McMillan mentioned Moving On Inverclyde, which I know is extremely important to him. He has served on its board for many years. I had the pleasure of visiting Moving On Inverclyde in the summer. It is a community-based support service that helps people who have been affected by problematic drug use. Speaking to people over a cup of tea about their lived experience and their journey was hugely powerful for me and, in many ways, it helped to open my mind to the different experiences that people have. I am sure that Stuart McMillan will continue to work with Moving On Inverclyde for many years, and I hope to work with him in that regard.

It is clear that our third sector needs more support. The Scottish Council for Voluntary Organisations has revealed that third sector and voluntary organisations are facing funding crises when it comes to the support that they can offer, and we need to ensure that they can keep the lights on and the doors open so that they can offer that vital support.

I think that that is true, more broadly, of public services. My colleague Michael Marra spoke powerfully about the need to ensure that people feel respected and valued, that they are met as human beings and that they are not perceived simply on the basis of their frailties or their failures, because they often feel stigmatised in that space. Crucially, we must have public services that are person centred and person focused.

Miles Briggs made an important contribution about housing. The principle of housing first is right, but that cannot be only a headline; there needs to be meaningful support behind that, to ensure that people are not stigmatised where they live. I am sure that we all know from our casework that concerns can be raised about extremely problematic language in that space.

I am conscious of time. If we are all serious about tackling the drug crisis in Scotland, we must take a public health approach. We need a response that meets the need that exists, that mobilises finance and resources quickly to meet the challenges and that acknowledges the scale of the emergency. At its heart, we need a response that puts compassion and humanity at its core.

Primary care is the front door of our national health service. It is the cornerstone that allows intervention as early as possible to ensure that people can be successfully treated in the community. It refers people to the support that they need in the right place, and it should be able to do that at the right time. It is that early intervention that keeps people out of hospital by diagnosing, referring or treating them before their condition deteriorates. It is a vital service that people have trusted over many years.

Our relationship with our GP is crucial in all of our lives, and supporting general practice is crucial to reducing pressure on acute and emergency services. However, a survey from the British Medical Association has revealed that four in every five—more than 80 per cent—of GP practices in Scotland have reported that demand for their service is exceeding their capacity and almost half have reported that the level of demand for their service is substantially exceeding capacity.

As colleagues have said, I am not alone in looking at my mailbox and seeing that it is full of people who are struggling to see their GP and full of GPs who feel at their wits’ end trying to do the job that they love fully. Indeed, Dr Andrew Buist, chair of the BMA Scottish GPs committee, issued a stark warning by saying that the situation in primary care is at a “tipping point” because of the Government’s decision to slash funding for GP practices by £65 million.

The target to recruit 800 GPs by 2027 is short of what is required, and it kicks the issue down the road. The SNP has had 15 years to get NHS workforce planning right, but it has failed miserably year after year.

Of course, it is important that we look at the needs of every community in Scotland, but it is clear that the issues go far beyond that and that we need sustained investment.

For 15 years, there has been a lack of a strategic plan on NHS staffing not only for GPs but across acute settings and all other healthcare settings.

The cabinet secretary did not want to hear that from his colleague.

Our NHS is on its knees and its front-line staff are suffering. They have had enough of the failing health secretary not listening to what they need. That is why the RCN is striking for the first time in its history and why Scottish Ambulance Service staff, including paramedics, are striking for the first time in over 30 years. The cabinet secretary should deliver

“A decent and acceptable pay rise for NHS and social care staff”,

which

“is essential, not just to avoid strikes but to retain and recruit the staff we need to make essential improvements to our health service”

Those are not my words; they are the words of another former SNP cabinet secretary, Alex Neil. Perhaps the health secretary should heed the advice of his former colleague and get back round the table and listen to what staff are telling him, because it is clear that the health secretary had lost the confidence of front-line staff, patients and their families. His record speaks for itself in comparison to those of his predecessors, and he has no idea, plan or support to offer.

Patients and staff deserve so much better than this Government and this cabinet secretary.