Chamber and committees

I am asking what level of dialogue you had with your workforce.

I will come to the detailed reasons as to why I will not take that path and why I do not think that it would be the right decision.

In opening, I also want to express the hope and the confidence that Jackie Baillie was not intending to imply that anyone treats the topic as a game. We all take it with extreme seriousness, and recognise that Scotland has a wildly unacceptable number of drug deaths and that there is a significant degree of frustration about the pace of change. Even though there is broad support for the direction of travel of the Government’s policy of investing in services and innovating, there is frustration about the pace at which that is happening. We know that those things take time.

With a small number of passionate exceptions, most of the evidence that was heard at stage 1 was broadly critical of the bill. A long list of concerns has been raised. Absolutely nobody has been in denial of the problem, but many have argued that the bill is the wrong answer to it. A number of changes would need to be made to the bill if it were to progress: it would need to be made consistent with the current policy and legal framework, rather than being in conflict with it. The current framework is regarded as being more collaborative and less medicalised. The bill would need to address the concern that the legal right to treatment in some areas would result in the deprioritisation of investment in prevention and early intervention.

There is a concern that the bill will create a precedent for the creation of legal rights to treatment in specific health areas. I do not think that it takes much imagination to think where we could get to in a relatively short space of time if the allocation of resources in healthcare were determined not by clinical need but by whether individual bills had passed through Parliament.

It was suggested that the bill needs to give more clarity on how the support that is given by carers, family members and others could be brought into the process. It is unclear how or whether that could be addressed at stage 2. It has been argued that the bill does not embed a trauma-informed approach and that, although that needs to be addressed, there is a lack of clarity about what changes could possibly achieve that.

The bill’s requirement for a medical practitioner to make the treatment determination risks overmedicalising the process, and it fails to recognise that other routes to accessing services are often hugely important. There is a concern that the costs, including for staff training, would go far beyond those estimated in the financial memorandum, and that that, in itself, would have a detrimental impact on the provision of services.

There is also a concern that, by creating a legal right to treatment within a fixed timeframe, when capacity in services takes time to expand and be developed—

I begin by acknowledging the work that Douglas Ross has put into lodging the bill in the Parliament. Any member’s bill, whether it is consensual or controversial and whatever the topic, takes a significant amount of work, which we should acknowledge. I also acknowledge the work of the Health, Social Care and Sport Committee. I joined the committee part-way through the scrutiny process, so I acknowledge the work that was done before I joined it. I took the time to watch and read the evidence that I had not been present for and I express my thanks to all the witnesses who contributed to and enriched the scrutiny process.

We should also all recognise the shared commitment to the issue. Respectfully, I disagree with Douglas Ross’s point about optics. Whether we pass a bill on one subject and do not pass a bill on another does not tell us how much we care or do not care about a topic. The Parliament has a responsibility to pass what we believe is good legislation. I do not think that it is about sending signals.

I recognise the sincerity with which Douglas Ross speaks, but does he accept that the situation regarding the bill is not as simple as he presents it? Does he acknowledge, for example, that the submission that we have all received from Turning Point Scotland—front-line experts, to use his words—raises the possibility that not only does the bill require improvement but that it could have harmful, unintended consequences by increasing the risk of relapse?

I will come to the detailed reasons as to why I will not take that path and why I do not think that it would be the right decision.

In opening, I also want to express the hope and the confidence that Jackie Baillie was not intending to imply that anyone treats the topic as a game. We all take it with extreme seriousness, and recognise that Scotland has a wildly unacceptable number of drug deaths and that there is a significant degree of frustration about the pace of change. Even though there is broad support for the direction of travel of the Government’s policy of investing in services and innovating, there is frustration about the pace at which that is happening. We know that those things take time.

With a small number of passionate exceptions, most of the evidence that was heard at stage 1 was broadly critical of the bill. A long list of concerns has been raised. Absolutely nobody has been in denial of the problem, but many have argued that the bill is the wrong answer to it. A number of changes would need to be made to the bill if it were to progress: it would need to be made consistent with the current policy and legal framework, rather than being in conflict with it. The current framework is regarded as being more collaborative and less medicalised. The bill would need to address the concern that the legal right to treatment in some areas would result in the deprioritisation of investment in prevention and early intervention.

There is a concern that the bill will create a precedent for the creation of legal rights to treatment in specific health areas. I do not think that it takes much imagination to think where we could get to in a relatively short space of time if the allocation of resources in healthcare were determined not by clinical need but by whether individual bills had passed through Parliament.

It was suggested that the bill needs to give more clarity on how the support that is given by carers, family members and others could be brought into the process. It is unclear how or whether that could be addressed at stage 2. It has been argued that the bill does not embed a trauma-informed approach and that, although that needs to be addressed, there is a lack of clarity about what changes could possibly achieve that.

The bill’s requirement for a medical practitioner to make the treatment determination risks overmedicalising the process, and it fails to recognise that other routes to accessing services are often hugely important. There is a concern that the costs, including for staff training, would go far beyond those estimated in the financial memorandum, and that that, in itself, would have a detrimental impact on the provision of services.

There is also a concern that, by creating a legal right to treatment within a fixed timeframe, when capacity in services takes time to expand and be developed—

I saw Mr Whittle first.

The bill seeks to create a legal right to treatment within three weeks of a treatment determination that would be actionable and challengeable, at a time when we all agree that we should expand the provision of services. I worry that money would end up being spent on lawyers’ fees instead of providing services.

The requirement for a medical diagnosis has also been mentioned. Many people require support but do not have a clinical diagnosis of addiction, and they would face additional barriers.

I am aware of time, so I will finish by saying that recovery means different things to different people. In the debate today, we have already heard a member conflating recovery with residential rehab leading to abstinence. That is one route to recovery for some people, but it is not going to be the path that everyone takes or that everyone is ready for.

There is a real risk that the bill would see resources shift away from other services that work well to reduce harm and prevent deaths. Scotland is investing to expand the services that are needed and to innovate with new provision such as the safer consumption facility, which is already saving lives. We also need the reform of the Misuse of Drugs Act 1971, which is wildly out of date and inhibits such innovation, making it harder to provide services.

Continuing that work is the way to make progress in cutting drug deaths, reducing harm and giving people the support that they need on their own terms. That is the direction of travel that Scotland should continue taking, and we should all continue to put pressure on the Government to do that at pace. However, I do not believe that the bill would help us do that.

—the bill creates significant risk of litigation, and that that would generate additional financial costs to service providers at the expense of investment in services.

I will give way if there is time in hand, Presiding Officer.

With the best will in the world, I cannot remember many bills that have gone through the stage 1 process and led to a committee report that shows quite so many extensive changes being required. [Interruption.] If members will permit me, I will continue. Does the member accept that, if those changes were made at stage 2, we would arrive at the final day of stage 3 with a bill that was so fundamentally different that it would be a piece of legislation that had not been consulted on and on which witnesses had not had the opportunity to comment?