Chamber and committees

That is an area that we have given considerable thought to, and I understood that the committee was raising the issue because there could be a gap in information. Part of the underpinning evaluation of our national mission to save and improve lives is to ensure that we have the right measurements in place.

I will not repeat what I have said about MAT standards, but ultimately issues such as these are resolved through the delivery of MAT standards.

I will just take a slight step back from the question to introduce some context. Public Health Scotland already publishes a range of information about OST, such as the number of people who are in treatment, for example. The committee is also well aware of the information that is held on the prescription of healthcare at the local level. The information that we are talking about is available, but it is held in Police Scotland’s national custody records. We are giving some thought to that. The task force has made more broad recommendations about ensuring that our healthcare and justice systems speak to each other, and other important recommendations about information sharing.

On information that is held by a statutory organisation such as Police Scotland, there are particular complexities around unravelling that. I am aware that His Majesty’s Inspectorate of Constabulary in Scotland has access to a range of information that is held by Police Scotland, so I am contemplating whether that is a potential route and whether I, as minister, should engage with the inspectorate.

I do not know whether the committee has considered that. The information is available to the inspectorate through the inspections that it has done. Indeed, this time last year, it did an inspection that involved the Elgin custody suite and it made a number of recommendations. I am informed that that led to increasing nursing provision in custody so that there is now full-time nursing cover in that centre.

There is a lot of work to do, and a lot of work is on-going. Members will be aware of the ministerial direction that I issued in June because I was not content with the scale and pace of progress. Part of the purpose of the statement that I will make to Parliament next week is to reflect on the information that all areas have provided on their improvement plans. All areas are subject to regular reporting on progress. For most areas, that will be done quarterly, but for areas that have particular difficulties, it will be monthly.

The other purpose of my statement next week is to inform Parliament of the Government’s view not just of the task force’s recommendations but those of Public Health Scotland’s benchmarking report, which was published in June.

I very much welcomed the task force’s report, as I had been looking forward to receiving its vital recommendations. The task force has made a comprehensive suite of 20 recommendations with 139 action points, and we will issue our full response to those at the start of the new year.

We have given an initial response to the report to the Health, Social Care and Sport Committee, the Criminal Justice Committee and the Social Justice and Social Security Committee. We gave some indication of our direction of travel, but the culmination of our response will be presented to Parliament at the turn of the year.

Like you, Mr Ewing, I am not a clinician. You have, however, heard the evidence from Dr Carole Hunter, who is a senior pharmacist of many years’ standing.

This is one of the issues that I have written to NHS Grampian about. On the specific point about dihydrocodeine, while prescribers can make judgments on a case-by-case basis, based on clinical judgment and health and safety, the bottom line—as I understand it as a non-clinical person—in accordance with the United Kingdom guidance that Dr Hunter referred to and the guidelines for Police Scotland and healthcare professionals, is that the routine use of alternatives such as dihydrocodeine does not meet the required level of support for MAT standards, and they should only be used in exceptional circumstance, not routinely. That is what I have stated in my correspondence with NHS Grampian. Essentially, it is a reiteration of the guidance.

For information on the broader context of my correspondence with NHS Grampian, convener, I have written in fairly direct terms to say that it has come to my attention and I am aware that, despite the longstanding nature of the issue, it still does not routinely provide OST in all circumstances. The issue is around the routine nature of the provision. Yes, Dr Hunter spoke about exceptional circumstances but the health board should be in a position to provide OST routinely and it should not be disrupting people’s medication. I have therefore asked NHS Grampian if that is the case, and if it is, what is it going to do to remedy it, and when? I would be happy to share that letter and any response I receive in due course with the committee, if it would be helpful.

Good progress has been made in increasing the distribution of take-home naloxone kits. Quarterly figures were published on either Monday or Tuesday that approximately 6,500 take-home naloxone kits have been distributed. Members can refer to those published figures at their leisure but they give a breakdown of the settings from which they come, including prisons, community pharmacies and the Scottish Ambulance Service.

There are 13 alcohol and drug partnerships that have a prison within their catchment area, and 85 per cent of those have made specific arrangements with their community justice partners around identifying risks, part of which is the issuing of naloxone. In some cases, good use is also being made of peers, peer networks and people with lived experience who are now in recovery going into prison settings and supporting people with training on the take-home naloxone kit.

There is another statistic that we monitor. I hate talking about statistics in this fashion, convener, because, at the end of the day, we are talking about lives, but the reach of Scotland’s national naloxone programme continues to increase, and it is estimated that 66 people out of every 100 who are at risk of opioid overdose have been provided with a take-home naloxone kit.

Naloxone is very important but it is just one part of the solution, which is a whole system of care, treatment and support. I believe that we are making progress but we need to continue on our trajectory.

That is a feature in the Bail and Release from Custody (Scotland) Bill, which is at stage 1. I have been a longstanding advocate of ending Friday liberation. It just does not make sense to me. I appreciate that there are significant operational issues for the Scottish Prison Service to consider in all of this, but when I think of my time as a prison social worker—admittedly that was a long time ago now—I know that releasing large numbers of people on a Friday because people cannot be liberated on Saturday or Sunday can often lead to people not being liberated until later in the day. Although people’s care arrangements should be in place before they are liberated, which is part of the proposed justice legislation that the cabinet secretary is taking through Parliament, people have practical issues to contend with on the first day of their release that mean that it does not make sense that it should be on a Friday. If they face any challenges, it can mean that they have to wait until Monday.

We have to follow the evidence that shows that any period of transition and change comes with its risks. We know that people being released from custody means them going through a period of elevated risk, so we need to plan to mitigate that risk. At a commonsense level, Friday liberations do not make sense.

Mr Sweeney knows of my enthusiasm for safer drug consumption facilities, and we are doing everything possible, within our powers, to leave no stone unturned to achieve the goal of a pilot site in Glasgow.

The short answer is that the Crown Office is now in a position to advise the Lord Advocate. As you know, I cannot speak on behalf of either the Crown Office or the Lord Advocate but, along with our partners in Glasgow, we have done an extensive amount of work on the matter and pursued it to the nth degree. It is not a silver bullet, but it is one piece of the jigsaw and, given the scale of the challenge that we face in Scotland, we need all the bits of the jigsaw.

Thank you, convener, for inviting me along this morning. This is my first appearance at the committee in my capacity as Minister for Drugs Policy.

I want to start by thanking the committee and the petitioner for the work that they have done on this matter. Access to the right treatment at the right time for each and every person is at the very heart of the national mission. I support the aims of the petition and agree that the people who are detained in police custody must have access to their prescribed medication, including medication assisted treatment such as methadone.

Mr Sweeney’s broader point, whether it is in relation to safer drug consumption facilities or any other service, is about the connectivity between services. To go back to the petition, one of the improvements made by the Elgin custody suite was to put in place systems whereby the local service is informed when people are brought into custody, when they are on an OST prescription, and when they are to be released. The issue that we are all concerned about is what happens while someone is in custody and whether they are getting the medically prescribed treatment to which they are entitled and which should, under no circumstances, be disrupted unless there are exceptional health and safety issues.

I will give you one example. Yesterday, I was at a recovery-oriented systems of care event for women, where 200 women in Glasgow with lived and living experience were putting the world to rights and certainly holding my feet to the fire. It was a fabulous event with the Glasgow ADP lived and living experience reference group, which will also be one of the reference groups for the national collaborative.

I met a woman at the event who told me that, when she embarked on the early stages of her recovery journey, social work were involved with her and her children, and they were of the view that she could not take her child to a fellowship meeting—a recovery meeting. In my view, although I am not making judgments about such cases, that begs the question whether we understand enough about the recovery community and recovery opportunities. That meant that that lady was very constrained in the time that she could spend going to meetings and investing in herself and her recovery. Sometimes, quite simple things can be done in practice that involve taking a more personalised care approach by acknowledging the challenges that parents with caring responsibilities have.

Monday was a great day with the official opening of Harper house in Saltcoats. It has actually been open for a few weeks now, and the first families have begun to come in. It opened for referrals last month, and we are now beginning to see more referrals, with families entering the great facility. Harper house is a national specialist facility that is available to families from all over Scotland. It will be a leading therapeutic facility, and services across the country will be able to learn from it.

We are doing other work, such as our work with Aberlour. On child and mother houses, we are working with the River Garden Auchincruive in Ayrshire, which is increasing its facilities for women.

In relation to the whole-family approach, the families framework is a stream of work that is led by multidisciplinary experts in the area. They are, of course, working to support and share best practice, but they will also do an audit of how the framework is being implemented. Again, that is about gathering and publishing more information so that we can support, but also scrutinise, what is happening on the ground.