Chamber and committees

I appreciate the opportunity to join the meeting and I commend the three committees that are involved for joining forces and ensuring that there is joined-up scrutiny of our national mission, which aims to be joined up throughout every tier of Government and across Government.

Members will be aware that our work in response to the task force pre-dates the publication of its vital final recommendations. Work on the implementation of MAT standards and on our national naloxone programme has preceded the task force’s final report. Committee members will also be aware that, in January, we published a full response to the task force’s 20 recommendations and 139 action points. As well as holding a debate in Parliament, I shared our response to the 139 action points with the relevant committees. Since then, we have endeavoured to keep the committees and Parliament fully informed about where we are.

Colleagues, particularly those on the Criminal Justice Committee, have been following the Bail and Release from Custody (Scotland) Bill since January. That bill is of particular interest to me because it will put an end to prisoners being released on Fridays or before a public holiday, which will improve standards of throughcare. The bill will also change how we use bail.

Members will recall that I gave an update yesterday on the Government’s response to the rapid review of better ways to join up healthcare for people with co-occuring mental health and substance use conditions. As you would expect, I have met the Minister for Transport to work through some of the finer detail of the pilot of concessionary travel. We also continue to be very focused on the implementation of MAT standards. The committee will be well aware of the ministerial direction on that and of the monthly and quarterly reporting that different areas are subject to. I will update Parliament on that again in June.

We continue to make progress on access to residential rehabilitation, which is another pillar of the national mission. The monitoring report that Public Health Scotland published yesterday shows that, in the quarter from October to December last year, we had 228 statutorily funded residential rehab placements, which is the highest-ever number. That means that, over the lifetime of the national mission, we have funded more than 1,100 residential rehabilitation placements.

Our national mission reporting arrangements underlie all of that, and members will be aware of the outcome framework that we are working to. We also publish an annual report each year. The most recent one was published in August last year and there will be a further report later this year.

I have had many conversations with people over the piece in different formats. When I came into this post, I had a lot of introductory meetings but, given the independence of Police Scotland and the Crown Office, it is better to have a lot of the discussion at official to official level. The last thing that I would want to do would be to derail any plans or progress because it was perceived that I was interfering with the operational independence of Police Scotland or the Crown Office.

Do you mean every single project?

I appreciate the committee digging into the issue. Because drugs policy can rarely be considered in isolation, the debates in the chamber or during other committee appearances that I have been obliged to make have often been very wide-ranging. It has therefore been useful for me to take a specific issue in a specific locality and bore down into the detail. Thank you for that.

Thank you.

There are two points there, Mr Torrance. One is a more global point about the implementation of MAT standards. They are vital and they are a big part of the Government’s reform programme. They are about ensuring that people have quick access to and informed choice about their evidence-based treatment, and that services are planned and operate in a way that they anticipate people’s needs. All of that is connected to mental health and primary care, and the MAT standards are therefore crucial and not optional. Members will be aware of the statement that I made to Parliament earlier this year, and I will make a further statement next week.

On the specific issue of the prescription of medicine or opiate substitution therapy in police custody settings, MAT standard 3 requires people’s treatment to be provided to them irrespective of their setting. OST needs to be routinely available to those for whom it is prescribed in custodial settings if MAT standard 3 is to be met. All health boards, alcohol and drug partnerships and integration joint boards have accepted the importance of that and our shared agenda for implementation of MAT standards.

We have been engaging on the issues raised by the petitioner in committee with various police and healthcare networks, such as the Police Care Network and, to the best of my knowledge, the only place where there appeared to be an issue was in Elgin. However, I want to be clear—and the guidance and MAT standards are clear—about what should happen.

In my view, as Minister for Drugs Policy, any interruption of a person’s medical treatment is utterly unacceptable because of the consequences that the committee is well aware of. The interruption of someone’s medical treatment is discriminatory and not acceptable. Ultimately, the implementation of MAT standards will resolve the issue where it exists, and as I said, the issue appears to be specific to Elgin.

I hope to convey to the committee in the strongest terms that the practice, where it exists, is discriminatory and that we treat drug and alcohol problems as a health condition, so drug and alcohol treatment has to be on a par with any other treatment for any other condition.

On the broad point, health boards and IJBs should monitor that. Through their routine reporting structures, they can and do raise workforce issues with the Government and NHS Scotland.

On the work that I and my drug policy officials are pursuing on the implementation of MAT standards, a financial resource is attached to that implementation. When I spoke to the committee before the summer recess, I said that approximately 100 posts were going to be funded. That figure has increased. To be specific and more helpful, I know that Moray, where Elgin custody centre is, has been successful in recruiting staff to work in and around MAT standards. Similarly, NHS Aberdeenshire has sought a number of staff and has largely been successful with that.

I am not disputing that there are issues with the workforce but there are examples of where those have been overcome, either through additional resource to help with recruitment or through the redesign of services.

It is not so much about a gap in the information as the availability and transparency of the information at the national level. More information is gathered about what happens with the prescription of OST in police custody settings than in other settings. That goes back to the nub of the issue. We have lots of information about where OST is dispensed, whether it be from a hospital or pharmacy, but we have much less information about where it is administered. The amount of information that is gathered in the police custody setting is much greater than that gathered in, say, homeless settings, where there are in-reach medical provisions.

That is an accurate summation about the information that is currently gathered by Police Scotland. In terms of me satisfying myself about what is happening on the ground, the major stream of work on that is around the implementation of MAT standards. We have a lot of granular information about what is happening at the local level. Colleagues might be aware of the supplementary information that was published in August that gives an area-by-area breakdown of where individual areas are with their MAT standards. The MAT standards implementation support team—MIST—is providing practical, hands-on support to local areas on how to gather information better and how to change the ways in which they are working while being fully cognisant of the need to challenge stigma, discrimination and culture. We have improvement plans in from all areas. We also have quarterly—or monthly, in some cases—reporting.

Through the serious and significant endeavours to implement MAT standards, we have much more information at the local level, which gives us a real connectivity between government and communities that we have not had previously.

In general, I agree that community pharmacies are an underused resource. The task force has made some interesting recommendations about an enhanced service contract, and there are some parallels with that around arrangements with general practitioners and primary care.

There are 1,250 pharmacies in Scotland. That is quite an extensive network that we could be tapping into. There is innovative, progressive and helpful use of pharmacist services in different parts of Scotland, but there is a network and expertise there that we need to make more use of. It is imperative that we use all the assets that are at our disposal and community pharmacies are very much part of that.