Chamber and committees

With regard to the whole-family approach, there very much is a presumption in the MAT standards that family involvement is, by and large, a good thing. Of course, individuals will have different circumstances in which that might not be appropriate, or it might not be what the individual who is in treatment or recovery desires.

However, even in cases such as, for argument’s sake, that of a son who does not want his mother fully informed, there are actually reasons for some involvement, and some residential establishments do that very well. The Lothians and Edinburgh abstinence programme, which is led by Dr David McCartney in Edinburgh, has a families group. On a week-by-week basis, the staff do not necessarily go into the care of individual loved-ones but they will say, “This is the shape of the programme—this is what we are doing this week and this is what you might expect.” There are always ways to engage and be helpful and support a family member, even if consent has been withdrawn to share private medical information. Scottish Families Affected by Alcohol and Drugs is also doing some work just now, which is much more focused on models of care and service delivery and standards in and around that. I think that that will be very important moving forward.

As I indicated in my last update to Parliament on MAT standards, we are on a journey to really bear down on people to get the standards, as they stand, implemented. However, at some point, we need to come to the question of how MAT standards evolve. MAT standards will need to be more explicit about treatment in and around different substances, and they could be more explicit around things such as leadership, how we better support women and how we work better with families, because working with families is core. It should be core not only to what we do in drug policy but to what we do in the early years, education and housing support. That is not a nice extra—it has to be our core business, and we have to get the core and the foundations right.

All of us are at one on that, I think. I do not need to repeat to this audience the worldwide evidence about safe drug consumption facilities, which is irrefutable. They are not a silver bullet but they save lives, and the scale of the challenge in Scotland is such that we need all solutions at our disposal.

There would have been an easier way to do it. I will happily answer questions on that, if required. However, I and my party made a commitment that we would leave no stone unturned.

It is not all in my gift. We have an operationally independent police force, and the Lord Advocate and the Crown Office are independent; nobody here needs me to give a lecture on why that is. However, it is encouraging that the proposal that was submitted to the Crown Office was supported by Police Scotland and Glasgow City Health and Social Care Partnership.

It will be for the Crown Office and the Procurator Fiscal service to take matters forward. They are continuing to work well with Police Scotland and it is important that they continue that work, which, as the committee will know, is around the policing of any facility, should it be required. It is imperative that clarity exists on that point for both the public and police officers.

I have done everything that I can up to this point. As everybody else here is doing, I am waiting on the conclusion of those vital discussions between the Crown Office and the police and on any forthcoming decision from the Lord Advocate. I will have to respond to that decision—whatever it is—in due course, and I give you my absolute commitment that I will do anything that I can within my gift, because safe drug consumption facilities work.

Ms McNeill raised important pragmatic issues. After having put £10 million into the implementation of MAT standards, we have closely monitored recruitment. It is a mixed picture—some areas have done very well with recruitment and others have struggled more.

We have always provided continuity of funding and I have continuity in my budget. People can apply for multiyear funds through the Corra Foundation. Some of that resource has been accessed by services as well as by the third sector. We give alcohol and drug partnerships clarity and continuity.

I understand the argument for simplifying funding routes. We may get to that point if we have a simpler, whole-system approach. However, I wrestle with the need to ensure that investment that has been earmarked and allocated to support families has gone to support families, or that money that I have earmarked and allocated to improve access to residential rehabilitation is being spent on residential rehabilitation and after care.

I am not unsympathetic to that point about a simpler process, but the position that I have arrived at is that, in order to tackle the drug deaths crisis here and now, I have to follow the money and ensure that resources get to where they are needed. I appreciate that that will require a level of monitoring and that we will need some bureaucracy to scrutinise that. We may be able to change that when we get to wider reforms, perhaps of the ways in which alcohol and drug partnerships, or wider drug and alcohol services, function. At the moment, I am absolutely following the money and will not apologise for that.

That is why we should not look at the whole-family approach in isolation. It is why our response to the task force came from Government as a whole, although individual work to tackle poverty and inequality is being led by Shona Robison and there is work to reform our justice system and an investment in housing. All those things are connected.

The idea that drug policy must not be seen in isolation lies at the heart of the national mission. The social determinants of good or poor health must be tackled. The cross-Government approach means that we are making commitments not just for this year but for future years.

Our equalities framework has six outcomes and six cross-cutting themes, one of which is recognising equality. That includes the particular needs of women but is also about how we can better reach the black and minority ethnic community.

As well as the Aberlour work that you outlined, and the work of Phoenix Futures at Harper house, which I will touch on in a moment, it is also really important to look at the perinatal mental health work that Kevin Stewart and Clare Haughey are involved in. There is substantial investment in refreshing and updating that work to support women who have mental health issues or use drugs. Much work has been done to change generic, universal and specific health services.

I had the great pleasure of visiting the first of Aberlour’s mother and child recovery houses in Dundee a month or so ago. It was quite an experience. The initiative is part of our work to keep the Promise. As a former social worker, I know the impact of families not being kept together.

We also know that, although significantly more men than women die, the rate of increase among women has been faster in recent years. Ten or 15 years ago, the ratio of deaths between men and women was wider; now, it has narrowed. To take, as you suggest, a gender-informed approach, there are many reasons for that, but at the heart of it are the trauma and grief that women experience when they lose their children. We need to work harder to keep families together—to keep mothers with their babies.

Aberlour will open another mother and child recovery house in the central belt. I await an update on that and I hope that we will have more to say on it in the not too distant future.

The work that Phoenix Futures is doing in Harper house will also be revolutionary. It is a national family service for mums, dads and children aged up to 11. Not just as a minister but as an MSP, I take very seriously my obligations to keep the Promise. Families should not be parted due to a lack of support and a lack of service. The evaluation on Harper house will inform us all for many years to come.

Sorry—would you repeat that?

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.