Chamber and committees

Thank you.

I do not dismiss COSLA’s concerns in any way. As we have seen, local authorities across the country are dealing with significant financial challenges, and the funding that goes into a number of those areas has been stretched and, in some cases, reduced over many years.

I believe that that situation is slightly different from the one the bill is about. The bill is about providing a right to addiction recovery using the models through the NHS, integration joint boards and local authorities. Ultimately, however, it will be down to the Scottish Government to decide how that funding is distributed.

Even without the bill—if it does not pass into law—the challenges that COSLA has identified in its submission will still exist. People will still need the support for which COSLA suggests there is not sufficient funding. We come back to the wider question for the Government, the committee and the Parliament about funding for local government more generally.

It is important to recognise that the bill does not seek to replace any other forms of treatment or support. Those will continue, and rightly so. The bill is about ensuring that there is a legal footing on which to give people the option of treatment such as rehabilitation and recovery, and guaranteeing in law that that can and will be provided.

Aberdeen ADP made that point very clearly in its submission to the committee, and I agree that that is crucial. The Highlands and Islands, which I represent, is one of Scotland’s most rural areas, and it makes up 44 per cent of Scotland’s landmass, from Shetland to Argyll and Bute. I am absolutely determined that the bill will have the same impact on people who live in our remote and rural areas and island communities as it will on those who live in urban settings and bigger cities.

Paragraphs 70 to 76 of the financial memorandum are very clear in indicating that we want to ensure that the provision is universal and is promoted accordingly. We set out in some detail how the bill could affect island communities, and we look at some of the issues that could affect smaller communities, such as people’s ability to get a second opinion and how we would ensure that those who made assessments had the relevant training. That is why the bill includes an initial estimated cost of £200,000 for training people to do the assessments. On-going training for NHS staff and others should, I hope, be included if the bill is passed into law, as I hope it will be. If the bill is passed, training will be available throughout urban and rural communities, and the offer will be there for people to get the treatment that they want and deserve.

I go back to the costs in the financial memorandum, which suggest that initial training will cost an estimated £200,000. We have taken the figure from other legislation that the Parliament has passed. If we are to have a universal service, it is absolutely crucial that people in the islands can receive initial training so that they can carry out the assessments that would become the basis of treatment options for the patient.

On staffing, we could look at the wider issue of recruiting people to serve in island communities. I know a number of people who have come to the Highlands and Islands from more urban communities in order to change their lifestyles. We draw people from all over Scotland and, indeed, the United Kingdom, to some of our more remote and rural locations, and they bring their experience with them. We have tried to inform the financial memorandum by putting the training costs up front.

The evidence of how the bill would make savings in the future has come from front-line experts, who have been crucial in informing the bill. They have told us that people would be able to get the treatment that they needed when they needed it, which would allow them to deal with their addiction issues at that point. That would undoubtedly save repeat returns to general practitioners and other medical services, because the problem would, I hope, have been dealt with in the initial phase, rather than getting worse and more complex, which would require repeat visits to GP practices and other professionals.

I go back to what the cabinet secretary said in his letter about hidden demand. Demand is hidden to the extent that people are not getting the treatment, but the demand is still there—there are still people in our communities who are suffering from drug and alcohol addiction. They are accessing some, but not all, services. They might not be accessing the services that are right for them. They need help and support. Some of that will come through the bill if it becomes law, but some of that is already being, and will continue to have to be, delivered.

First, on the issue of employer national insurance contributions, the bill was lodged long before that decision was taken by the new UK Government.

If we adjust the £3.5 billion figure for inflation, it goes up to £4.3 billion. I believe that the savings could be significantly higher. Some people might question Dame Carol Black, but I think that her report for the UK Government was extremely comprehensive. A point that has been used by a number of charities and Governments to encourage more appropriate intervention at an earlier stage is that spending a little now could lead to significant savings in the future. I think that the figure, which in Dame Carol Black’s initial report is given as £4 being saved for every £1 of intervention, could be even higher. A number of organisations continue to cite the figure, because early intervention and a treatment-focused personalised approach can make a huge difference.

The commitment to 650 beds by March next year is one that I have challenged Neil Gray on in the chamber. He believes that he is on course to achieve that number, and I want him to do so. This is not a political point on which the failure of the Government can be seized by opponents. We all want the Government to deliver and achieve that.

If that happens by March next year, what we propose in the bill could ensure that people get treatment, and there will be opportunities elsewhere to look at savings. As more people get treatment when they need it, their issues will be dealt with at that time, instead of their becoming more complex and chronic. Intervention later is far more costly to the Government.

I think that the Scottish Government has been right to seek financial recompense for that to support services here, in Scotland. We can see that there will be a huge challenge for public bodies such as the Government, councils and charities. I agree with that argument, which has been well rehearsed in Parliament and by this committee.

On where we would find the funding, the upper estimate is that the bill would cost £198 million annually. The Scottish Government’s budget is just shy of £64 billion, and I believe that savings can be found within it. In my previous role as a party leader in this Parliament, I often came up with suggestions—not all of which would have found favour with the people in this room—about how to find savings.

The answer is yes and no, if I am honest. Anyone who meets organisations that deal with addiction will find some split opinions. Some people believe that residential rehab is the right and only approach, and others believe that it is not. Therefore, I understand why there will be conflicting views on the bill. Not everyone who is working in the sector will agree with the bill’s approach. That is why I reiterate that the bill would not replace other mechanisms or opportunities that exist to help and support people but would, I hope, complement them.

The people who will be entitled to residential rehab and other forms of treatment that are identified in the bill will be the ones who need it: a medical expert will have determined the right approach for them. Crucially, the bill will ensure that treatment cannot be refused for any reason. It must happen within, at the longest, three weeks of the determination, although we hope that it would happen far sooner. I think that giving the legal guarantee about the treatment that has been determined to be right for an individual, and for that individual to feel part of the treatment, are crucial.