Chamber and committees

Thank you, cabinet secretary, for coming along today, albeit virtually. We hear at length from everyone about how much pressure everyone is under with their workloads, so I am hoping that you might be able to help. Do you get a sense that the framework will reduce duplication in the likes of the scientific advisory and expert groups that we have across the four nations? Also, are there any plans to develop greater consistency in how data is collected, analysed and presented across the UK?

We have heard, at length, that there is a challenge in accessing services because of the scale of the issue, as well as the challenges that our young people are facing. We have received evidence that

“The number of referrals continues to rise year on year”,

which resonates with what the witnesses have said this morning. Why do you think that more children and young people require specialist services for their mental health? Dr Stark has just intimated that poverty might be one of the key factors, but is there anything else that might be driving that?

Shelley Buckley stated that we look at everything through an adult lens; specifically, she was talking about looked-after children. Bearing that in mind, I declare an interest as a corporate parent and councillor in the City of Edinburgh Council.

Last night, we met a lot of young people who were in care or were looked-after children. We were talking earlier about a single point of access to services, but many of them struggle because they do not have a parent behind them, pushing. What could and should be done to inform children, young people and their parents and carers of the services that are available to them and to make those services easier to navigate? I can see Shelley Buckley nodding, but I will ask Sam March that question first, given his position with South Lanarkshire Council.

There are a number of people in hospital who have missed their vaccination appointments. In her answer to my colleague, Rachael Hamilton, the First Minister stated that that was for clinical reasons. Could the First Minister investigate the possibility of reviewing the policy and protocols in acute hospital settings in order to give those patients—and anyone else who wants it—an in-patient vaccination?

I draw members’ attention to my entry in the register of interests—I am a councillor on the City of Edinburgh Council and a member of the Edinburgh alcohol and drug partnership.

I welcome the chance to speak in such an important debate. I want to do all that I can to look for the positives and to reflect on the cross-party ambition and willingness to work together to tackle and reduce our country’s shocking and shameful drug-related deaths. Today, we are asked to consider the first year and next steps. I know that we all want to see evidence of real improvements in services and support for those who desperately need help, and we want to save people from dying needlessly.

However, in Scotland today, people are still being denied access to the addiction treatment that they need, while the drug death rate has almost tripled on the Scottish National Party’s watch. The SNP’s devastating handling of the crisis has been thrown into further chaos by the recent resignation of members of its Scottish Drug Deaths Taskforce. I acknowledge and welcome the appointment of Mr David Strang.

Annemarie Ward, who is the chief executive officer of Favor UK—Faces & Voices of Recovery UK—has said:

“We have stood by helplessly while friends become more traumatised by the day. We have witnessed friends and family die, watching the slow car crash as each reached out for help that more often than not wasn’t there.”

The absence of hope in our treatment systems is damaging not only to service users but to those working in services. As I asked yesterday in the debate on mental health—and it is just as valid today—

“how can a workforce that has reached burn-out deliver compassionate care when they face periods of stress and anxiety?”—[Official Report, 12 January 2022; c 41.]

How can they do so when they watch people’s lives destroyed by substance misuse daily?

As my amendment states, the next phase of action must also include preventative measures and policies that ensure that, as Mr Whittle said, those who are helped with their recovery are not replaced by more people who fall into the cycle of addiction. To do that, we must understand why Scotland has the crisis that it has. What is unique to Scotland that causes so many drug-related deaths? Only when we understand that can we create a preventative agenda that will work to save lives in Scotland.

That is one of the reasons why the Scottish Conservatives have launched our right to recovery bill, which will ensure that those with addiction issues are able to access the necessary treatment that they require. I have had the invaluable opportunity to speak to stakeholders and those with lived experience, who will have submitted responses to the call for consultation. I thank them all for taking the time to engage with the bill and for sharing the issues that they still face, 12 months on.

Right now, the treatment system in Scotland lacks the quality, the diversity and the capacity to fulfil its potential in protecting people from harms related to substance use, including drug-related deaths.

Stephen Wishart said:

“the proposed Bill does address this. It ensures equal funding must be provided to allow local authorities/NHS health boards to perform its duties. It also”—

importantly—

“shifts the balance of power from the opinion of individual decision makers and to the right of the person to choose what their plan is.”

Yes, we welcome the £250 million to tackle drug deaths. It should not have taken 14 years to finally realise that the drug policies had failed, that families had been failed and that entire communities had been let down and broken. That is why the Scottish Conservatives are pushing forward with our proposals for a right to recovery bill. With the consultation now closed, it was astounding to see the level of interaction and submissions from across the country. We have received overwhelming support and, again, I acknowledge and thank everyone who took the time to submit their views on the right to recovery bill.

As I said, the £250 million of funding is welcome but, sadly, the SNP Government has refused to sign up to the United Kingdom-wide scheme to help tackle drug dealing. Project ADDER—addiction, diversion, disruption, enforcement and recovery—would have provided investment designed to tackle addiction and the supply of illegal substances.

I thank the minister for her intervention, but surely the SNP should be doing everything possible, and taking any approach possible, to tackle our national crisis, rather than playing party politics, yet again, and refusing to engage with Westminster. That is tiresome and unnecessary, when we all know that we must work together to save lives.

Across the country, alcohol and drug partnership meetings have taken on a more upbeat and positive feel for the first time in years. More funding has helped, as they strive to have the new MAT standards embedded within their areas by April 2022. However, that is where things start to go wrong. April 2022 is only four months away, yet ADPs across the country are starting from very different places. Some have already admitted that they will not be able to establish and embed all the standards by that timeline, including Edinburgh Alcohol and Drugs Partnership, which has an established pre-existing service that includes many of the standards.

Half of the ADPs that did not respond to the Public Health Scotland survey said that they had yet to set up a pathway to residential rehabilitation. When it comes to other reasons for ADPs not responding to the survey on residential rehabilitation, 42 per cent said that it was because no referrals were received, and 8 per cent said that no staff were available to complete the template. That is astounding. Such a variation in services across the country underpins the inequalities that we face. We need to wake up.

It is for that very reason that people need the right to recovery, as it is clear that the SNP has failed to support residential rehabilitation. The SNP Government funded only 13 per cent of residential rehab places in Scotland in 2019-20. Furthermore, the number of Government-funded places in residential rehabilitation declined throughout 2021, from 47 placements in March to 36 in September. That is a long way from reaching that figure of 1,000.

I will take time to acknowledge the invaluable work that is going on across my city of Edinburgh. The violent offender watch—VOW—project is led by Police Scotland and consists of four police officers and three peer mentors.?It aims to empower young people who are involved in the criminal justice system to break the cycle of offending, by providing support to people who are deemed to be at significant risk of drug-related harm in the community. That assertive outreach relies on the unique experiences of the peer mentors, who have lived experience, and on the police officers, who offer access to a wide professional network of contacts who can provide opportunities for training and employment.? There is no doubt that the project has saved lives, but funding is an issue.

Tackling drug-related deaths should always be a priority, which is why the Scottish Conservatives launched our right to recovery bill. There has been criticism. Some say that there are flaws in the bill, but those working with us have hit back. Annemarie Ward, the chief executive officer of Favor, said today:

“enshrining people’s rights in the law will ensure access and choice to a plethora of services over and over again ... it is nothing short of incredible.”

She continued:

“This legislation is a starting point to people being able to access services that at the moment are not even available.”

I hope that the Parliament continues to demonstrate consensus and collaboration in tackling the complex issues involved in drug-related deaths. It is our national shame. We should all support the proposed right to recovery bill, making a recovery a legislative certainty—that is the very least these people deserve.

I move amendment S6M-02761.2, to insert at end:

“; acknowledges the valiant efforts of the third sector in ensuring that targeted funds successfully reach frontline service users; believes that it is vital that a right to recovery is legislated for, in order to safeguard the future of funding and focus beyond the current parliamentary session, and calls for the next phase to also include preventative policies that ensure those who are helped with their recovery are not replaced by more people who fall into the cycle of addiction.”

Primary care services are often the first point of contact for people who are experiencing mental health problems, but, as we have heard today, improving mental health and wellbeing is a major public health challenge. That is partly because the underlying issues are complex and people’s needs are different. All public services have an important role to play in supporting wellbeing and tackling the social and economic factors that contribute to mental health problems.

In 2021, mental health issues were the primary reason for time off work, outstripping Covid. Poor mental health accounted for 19 per cent of all lost working time across the country, while confirmed cases of Covid represented 16 per cent. In addition, mental health troubles were the most common cause of lost working time in nearly every industry in the UK, with the length of absences averaging at least three times longer than that of Covid-related ones.

Evidence suggests that mental health problems in childhood and adolescence have a significant impact on people’s physical health and education and on their ability to find and sustain employment. The Covid pandemic has had a detrimental effect on children’s and young people’s mental health and wellbeing, with some evidence showing that it will also affect their attainment.

Thirty-six per cent of children and young people with learning disabilities have a diagnosable psychiatric disorder; 40 per cent of looked-after children in Scotland who are aged between five and 17 have been assessed as having at least one mental disorder; and 95 per cent of 16 to 20-year-olds in custody have at least one mental health problem. As we have heard, children who live in low-income households are three times more likely to suffer mental health problems than their more affluent peers are. Despite those alarming statistics, more children and young people are waiting more than 18 weeks to start treatment in specialist CAMHS—up from 26 per cent in 2017-18 to 33 per cent in 2020-21—while the number of those waiting more than a year for treatment trebled between March 2020 and March 2021.

The national improvement framework is the Scottish Government’s key plan and it sets out four priorities for education, which include children and young people’s health and wellbeing. However, data is lacking to assess the wellbeing of children and young people who are learners at school. If we cannot assess whether a national priority is achieved, it is impossible to know what is working and what needs to change.

We heard from Mary Glasgow, the chief executive of Children 1st, at the Health, Social Care and Sport Committee yesterday. She spoke at length about the challenges that families face when their children need support, and we heard about the importance of having good person-centred services, which the Scottish Government frequently mentions but rarely delivers. Good person-centred services should provide a space in which to really listen and understand the needs of the family and the young person; they should not be about what the agency can spare to offer.

Mary Glasgow told us of family wellbeing teams and of the success that those services have had when social and family relationships are fractured and young people suffer anxiety, self-harm tendencies and eating disorders. Young people who get their GP appointment are often told that CAMHS services are the only option, but those family wellbeing teams offer quick and early help, often remove the requirement for CAMHS assessment and provide a safe space in which families and young people can be heard. Those teams are effective and allow the time that is needed to build relationships between the professionals and the families. Unfortunately, funding issues often make it difficult to, in Mary Glasgow’s words,

“replicate the family wellbeing teams across the country”.

As we heard from Ms Mochan, the language that our professionals use often contributes to the stigma. We must start using human language. Often, those who need assistance feel shame and guilt, and the use of the term “being referred” to a service contributes to that feeling. Shame, stigma and guilt must be removed. Those who need assistance have done nothing wrong. They are entitled to support and help, and that must be delivered with respect, kindness and compassion. However, how can a workforce that has reached burn-out deliver compassionate care when they face periods of stress and anxiety? Patients and carers are at the end of their tether.

I want the SNP Government to accept, for once, that things were bad long before Covid. We must stop using Covid to justify our poorly performing services. We need to start making changes now. Our parents and young people deserve better mental health support. There is so much good practice going on across the country; let us find it, fund it and replicate it.

Yes.

Okay—I think that I have got that now. The language is very subtle, is it not?

Is it acceptable that long-term care is not reimbursable under the scheme if such care was required because of the original mesh surgery? I am talking about the implantation surgery, not the removal.