Chamber and committees

There are a number of layers to that. I return to a point that I made earlier: the reason why we are publishing lots of local information about what is happening with additional investment is so that it can be scrutinised and so that, where there are issues, they can be addressed. The member will be aware from our previous discussions, which I will not rehearse, that every area now has a pathway into residential rehabilitation.

What I hear about most from my engagement with people on the front line and people with real-life experience is the fragmentation of services. That is why we have a national mission and a Drug Deaths Taskforce, which has made some strong and challenging recommendations, and not just about no wrong door—there should be no closed doors to people.

The biggest frustration that people have is being bounced around between services. The ask and act homelessness prevention duties will help. It is not just about people being passed from pillar to post. In key posts in the public sector, people have duties to ask and then act.

The work on mental health and substance use services is also critical. Our response to the Drugs Deaths Taskforce will align with our response to the two reports that the Mental Welfare Commission for Scotland published this year and the rapid review into mental health and substance use services. Some of that is about services on the ground being really clear that they cannot deny somebody a service or treatment until the individual is, for example, abstaining from drugs or alcohol.

There needs to be much clearer understanding about what the lead service should be—whether it is mental health or substance use—and when the other partners should be brought in. We will come back to the Parliament on that.

It is fair to say that stigma about certain types of treatment exists in certain quarters. Some of the discourse that we read or hear about methadone, for example, is unhelpful. Time and time again, I have said that I am not interested in supporting harm reduction or medication-assisted treatment at the expense of residential rehab and abstinence. Neither am I interested in supporting abstinence over harm reduction. The only thing that I am interested in is supporting people, and they need to have informed choices and options.

There is a large international evidence base on different strands of medication-assisted treatment. However, medication should never be our only offer to people, hence the importance of implementing MAT standards that involve treating drug and alcohol issues on a par with other health conditions. If any of us sitting here were to trip up to our doctor with any other health condition, we would be given information and choices and we would have a bit of a discussion about what is best. The same ethos should apply here: people should always have choices, options and the space in which to engage and make informed choices about what is best for them.

I am not interested in false arguments around, for example, harm reduction versus abstinence. We have to dump our own ideological perspectives—my views on many things have changed over the years—and we must follow the evidence, but it is crucial that we listen to what each individual wants and needs.

The proposition could change depending on the feedback that we get from the Lord Advocate and the Crown Office in due course. Our work has centred on one service in one city, but there has been a broad range of work. The correspondence around that work is not all mine; the committee will appreciate that there is a central role for the independent Police Scotland and the integration joint board.

My approach in Government has been to facilitate and support that work, and to enable people to build from the ground up a proposition that is framed within the powers that we have. I will look at what it would be appropriate for me to share, because I appreciate the great interest in that aspect.

I also appreciate that there is strong parliamentary support for safe drug consumption facilities. Although I know that some Conservative members have reservations, I take them at their word that they are not looking to stand in the way of a pilot.

There is accountability at each and every level. I am stepping up accountability for local areas, but I stress that I am not asking other people to do anything that I am not prepared to do myself. Accountability and leadership are crucial not only at local level but at senior levels in IJBs, local authorities and Government. Accountability is needed at each and every level. We are accountable to ourselves and one another and we need to challenge ourselves and one another.

That is an important point and is reflected in our national drugs mission plan. You will see in our outcomes framework the importance of not only tackling poverty and inequality but focusing on equalities and different groups.

I have already spoken about women and young people. My concern is that we are not doing enough to reach into other communities. I am conscious that, sometimes, services can have stereotypes and misconceptions about other communities. I assure Mr Choudhury that my officials and I have begun to make better contacts with groups.

The visibility of the recovery community is a factor as well. That has encouraged other groups. I recently made contact with the lady from the Scottish women’s Muslim group, for example. I am conscious that, although drug and alcohol problems can be hidden across our society in general, they can be even more hidden in some communities. Some of that can be related to our false perceptions of other communities. We really need to think more sharply about how we reach out to other communities. If members, especially Mr Choudhury, wish to engage further on that, I would be delighted to do so.

You will indeed.

That is a fair point. I will not sugar-coat instances in which progress has not been good enough or fast enough. You are right to allude to the fact that, although the majority of the red-amber-green statuses in the benchmarking report by Public Health Scotland were amber, there were not enough greens and there were too many reds, particularly in and around MAT standard 1, which is that crucial, life-saving, same-day treatment. That is why, for the very first time, we have a ministerial direction that places certain requirements on chief officers and chief executives of health boards, integration joint boards and local authorities.

I am due to update the Parliament imminently—maybe in the next fortnight or so; certainly in the next month—on progress since my last update. That is based on the improvement plans that we have received from every area. Some areas are in a cycle of quarterly reporting. Others, where the challenge is greater, are subject to monthly reporting.

We are beginning to see some good and innovative practice in and around rural areas, and perhaps we should share some case studies with the joint committee. I point to the Borders, which is a rural area and is the only area that was able to secure green status across MAT standards 1 to 5. If we can do it in the Borders, we can do it elsewhere. Let us not underestimate the challenge, but that can and should be done.

I have discussed that matter with the new leadership of the task force and the task force membership more broadly, and I am confident that it will produce its vital recommendations by the summer. The Government is actively supporting the task force’s work with, for example, a team of civil servants who support it with secretariat tasks and so on.

It has always been the case that we will need to look after the legacy of the task force’s work. Some tests of change will not be completed, but they would not have been completed by the end of this year, which was the original timescale in the task force’s recommendations. Arrangements will therefore have to be made, and we will do that in consultation with the task force and others to ensure that we continue to learn from the evidence as it emerges.

I have made it clear that I am committed to evidence-based policy, but I am also clear that we cannot wait for evidence to be complete, because that will never be the case. We have to take what we know, implement it and be prepared to adapt and change as we move forward.

I very much concur with the view that it is for the Government and this country’s institutions to implement changes, and it is imperative for our democracy that we are guided and scrutinised by the Parliament and parliamentary committees.

Notwithstanding that, there is a role for external organisations and experts in various fields, in particular people in the lived and living experience community, academics and people who provide services on the ground.

The terms of the task force’s remit changed when I came into this post. The task force had been in operation for 18 months when I became the Minister for Drugs Policy, and, at that time, I was very clear that two things were missing or needed to be corrected. Drugs policy should not be seen in isolation and must be connected with every other Government portfolio. Drugs policy needs to be joined at the hip with justice, housing, homelessness, mental health, primary care, education, prevention, poverty and inequality policies, and that is a far bigger job than that of the task force.

I was aware from my early engagement with stakeholders and various party spokespersons and MSPs that there was concern about how the Government was performing in relation to tackling drug deaths and that there were concerns in and around the task force. My view was that the Government had outsourced its responsibilities and that I would not do that. I wanted to support the evidence-led work of the task force. My view was that any criticism of the task force should rest, rightly, with the Government and not the task force, which comprises individuals and citizens who give their time and talents to work with the Government. Therefore, there was a refocusing of the role and remit of the task force.

It is, of course, not for a Government minister to indicate to committees how they should proceed with their business. I will say that I very much embrace scrutiny; although it is not always comfortable, it is absolutely necessary, and I assure you that it always leads to better outcomes.

I welcome the joined-up approach that is being taken by the three parliamentary committees that are involved today, because it reflects the work that we are embarking on in the Government to ensure that drugs policy is joined at the hip with other crucial public policy areas and is not seen in isolation. We are trying to get our services to take that joined-up approach in communities.

There is a role for parliamentary scrutiny of the Government on the Drug Deaths Taskforce, the residential rehabilitation group, how we implement MAT standards and the national implementation group, and I am sure that people will be interested in the new national collaborative, too. The national mission is bigger than any one group. There is a lot to scrutinise and a lot to engage with.