Chamber and committees

I am grateful to Mr Findlay for that question, because it highlights the important role of the police in upholding the law. He might be aware that there is a serious organised crime task force, and much of what he describes is firmly in the remit of the Cabinet Secretary for Justice and Veterans. Nobody would demur on the importance of interrupting the supply of drugs or bringing to justice those who pose the greatest risk to individuals and our communities.

Again, looking at evidence from around the world, we know that more punitive approaches—those in which a criminal justice system is focused solely on enforcement—can result in additional harms and barriers to treatment. I do not know whether the member is aware of the work of the Conservative Drug Policy Reform Group, which recently produced some interesting findings and spoke about how it is important that different policies do not work against one another. It is important that policing and how our criminal justice system operates do not become a barrier to people’s access to treatment, and that they do not add to the harms that people are already experiencing.

There is more work to do on engaging communities on what will make them safer. Ensuring that people have access to better and quicker treatment is a huge part of that. Again, all the evidence points to a public health approach as being better for smarter justice in our community and for making communities and individuals safer.

I am not going to contradict the cabinet secretary for justice. However, I routinely provide challenge to my colleagues on what more we can do to ensure that people have access to treatment and support to address their use of substances. For example, I am very clear that, as we work to implement the medication-assisted treatment standards, they must apply in prisons, too. A key and fundamental part—although not the only part—of improving and saving lives is ensuring that our prison population gets better access to healthcare, and that includes drug treatment.

I have recently had some meetings with Ms Robison on strengthening the homelessness prevention duties. There is something very simple, powerful and fundamental about the ask and act duty, because it should not just be a case of asking somebody and then acting by referring them on somewhere else. That might be appropriate at times, but the whole ask and act philosophy is also about how you can act before you refer someone on. It is culturally important in giving a sense of ownership and ensuring more collegiate working across the different workforces.

I am looking closely at the work that Ms Robison is leading, because it contains something important that we might be able to learn from and implement in our drugs policy, and which also connects with the MAT standards. It is all about how we make people’s rights real in reality.

I really appreciate that question, because there are a number of issues around residential treatment, and I am committed to taking a balanced approach to securing a whole system of care. Residential rehabilitation is an important part of that. It has historically been supported and funded less, and this Government is now seeking to address that.

When I made my statement to Parliament in November last year, a whole suite of information was also published, some of which was meant to shine a light on where things were not operating as they should be. Some of it was also about the work that is being done to improve access to funding and improve access pathways, and some of it was about how to improve accountability, within the Government but also at a local level, so that people could see where the funding was going and how many places were being funded by alcohol and drug partnerships in each area.

I know that the pandemic had an impact on some services. I am not sure whether I picked up correctly what Mr Choudhury said, but I am not certain about any on-going concerns. The residential rehabilitation working group continues to liaise very closely with residential rehab providers, and where there are issues to iron out, they will be proactive about it. There is a housing support fund to ensure that people do not have to choose between maintaining their tenancy at home and going into residential rehab. That was set up to mitigate some issues in which the rules for housing benefit were implicated.

I hope that that answers Mr Choudhury’s question.

Absolutely. International evidence is crucial, because many other countries around the world have a far higher drug deaths rate than that in Scotland, and we should be looking at the very best practice not only in Scotland and across the UK but internationally. We have a lot to learn, and I make no bones about that.

I am sure that Mr Findlay will have discussed in detail with the justice secretary things such as Rapiscan scanners. The safety and wellbeing of prison staff and prisoners is of the utmost importance.

It is reflective of what we know about the wider community that we cannot arrest our way out of a drug deaths crisis. It has to be about addressing the root causes of people’s substance use and the bigger and broader agenda of homelessness and poverty. It is also about ensuring that people have access to the treatment that is right for them. Access to treatment and support in prison is crucial when it comes to healthcare. An important survey of prisoners’ health and social care needs will be completed by the spring, if I recall correctly.

Really important work is being led by the recovery community in our prisons. I have visited a number of recovery cafes. We must be focused on addressing the needs of individuals.

There are also broader issues about overcrowding in prison. I think that most commentators would be of the view that our prison population is too large.

Yes, I am. Sorry, Ms Mackay, but I do not think that I caught all of your question, but I am sure that it is about safer drug consumption rooms and the evidence that Mr Malthouse gave to the committee yesterday.

It is a matter of public record that work is being done on a pilot for a safer drug consumption facility in Glasgow. A proposition for that pilot has been made by the health and social care partnership in Glasgow. Very extensive work is being done between the Crown Office, the police, us—the drugs policy division—and our local partners in Glasgow.

Mr Malthouse and I come from different positions on this. I am strongly of the view that there is no disputing the evidence that safer drug consumption facilities can save lives. I refer members to the evidence paper that the Government produced not long ago and that I am sure that we shared with the Criminal Justice Committee at the time. I have also shared an exchange of correspondence between Mr Malthouse and me. He sees more problems than I see. There are undoubtedly issues that need to be resolved, and that is what we are actively engaged in doing.

There are three avenues to pursue with regard to drug consumption facilities. The UK Government could introduce primary legislation, perhaps in the way that Ireland did a number of years ago. It could devolve powers to Scotland and enable us to introduce legislation. The third option is for us to pursue what we can within our powers to bring forward a proposition that is clinically and legally safe for those who use and work in the service.

It is delicate and detailed work, and it has its difficulties, but it is progressing. We are absolutely committed to doing everything that we can, where possible within our powers, to implement evidence-based interventions that save lives.

There are three aspects to that. I will deal with the devolved aspect first; there is also a reserved aspect.

The point about the recommendation on single records needing to be addressed is well made. I have met Community Pharmacy Scotland and the Royal Pharmaceutical Society, and they rightly point out that, with better linkage of records, they could do more. My officials have raised that issue with the chief pharmacist and the health division. I absolutely accept the point. The pharmacists are absolutely correct to raise it, and I want a resolution to be found, because I think that pharmacy services can bring much more to the table.

That links to the issue of naloxone being registered as a controlled drug, on which our engagement with the UK Government is important. If naloxone was classified differently, different options would be available. It could be provided as part of a pharmacy service. People can have an individual consultation with a pharmacist about a range of medications; they could do that in relation to naloxone and kit that involves a needle, in particular.

The pharmacists also make the argument that if nasal naloxone was reclassified, it could be sold in chemists in the same way as decongestion products are sold. That would require changes at UK level, but it would help in widening distribution and acceptance of naloxone.

Over and above that, the task force has done really good work. The reach of naloxone is up to about 59 per cent. If you would like a technical explanation of how that is worked out, I will hand over to Morris Fraser. As a result of our naloxone campaign, 4,000 kits have been distributed. The work of Scottish Families Affected by Alcohol and Drugs on the click and deliver service is first class, as is the work of the police. The Scottish Ambulance Service has given out 1,000 kits. As well as distributing take-home naloxone kits, its work in connecting people to services is also relevant.

The task force has done good work in and around naloxone—naloxone is also becoming available to people in prisons, prior to their release—but there is more to do on pharmacy. There is also much more that we could do on mental health services. There are areas in which there can be improvement; the point about pharmacy was well made.

On the latter point, we are on track in developing our public health surveillance system, which builds on existing warning systems and is broader than a traffic-light system or distribution of naloxone. We are also waiting to hear the results of the UK-wide consultation on naloxone. We will certainly endeavour to keep Mr Briggs and the committees informed about what is happening.

With regard to treatments, I say that it is crucial that they be based on evidence. That has to be a priority. On NET, we have corresponded with Mr Briggs about it and we have pointed people in the direction of the chief scientific officer with regard to pursuing trials.

Mr Briggs made a fundamental point about informed choice, which is a core part of the medication assisted treatment standards. All patients who receive a healthcare service make informed choices and are supported in that by clinicians and practitioners. People should be able to make informed choices around medication assisted treatments and other types of treatment. The whole purpose of MAT is to make the connection between the options and possibilities in pharmaceutical interventions and those in psychosocial interventions. Mr Briggs’s point about the need for a balanced approach and for implementation of what works, based not only on the evidence but on what meets individuals’ needs, is important.

I am very much aware of Ms McNeill’s work in the area; I frequently meet stakeholders who talk about her work and events that she has hosted in the past.

With regard to Mr Malthouse’s comments about services such as safe drug consumption facilities sending out the wrong message or encouraging drug use, I point out that there is simply no evidence for that. We hear people verbalising that concern, but there is no evidence for it, whereas there is evidence to show that safe drug consumption facilities reduce overdose deaths and save lives. They reduce transmission of blood-borne viruses, reduce infection in wounds and improve wound care, and they help in reaching people who inject drugs and who might not otherwise engage with, or be visible to, services.

Ms McNeill is a Glasgow MSP. Much of the campaign that is coalescing around safe drug consumption facilities came about because there is also a community benefit from reducing drug-related litter and drug use in public places. There is evidence that such facilities work and about their benefits. They are not a magic bullet—nothing ever is. However, in Scotland, we need all the options. I have views about the Misuse of Drugs Act 1971, but we want all the available options to help us to address this national scandal and crisis.