Chamber and committees

That is a very good question. Indeed, it was one of the questions that I was asked quite often when the bill was formally launched last May. We already have targets on, for example, cancer treatment times, but what happens if we do not meet them?

The annual reporting to the Parliament will, I think, put greater onus on ministers. They will have to be accountable to the chamber and to representatives, and therefore, if the bill goes through, it will be for members in the next session of the Parliament, whoever they might be, to hold Government ministers to account. Some, depending on who is in Government and who is in Opposition, might demand that ministers resign over that. I am not in any way saying that that should happen—I am just saying that we have put in the bill an opportunity for the Parliament to scrutinise delivery against its aims, and I think that that will be an important role for the Parliament, as we move forward.

Yes, I believe that we can say that with some certainty. As I said in my opening statement, the number of drug deaths is 15 times higher in our most deprived areas than it is in our least deprived areas, and the number of alcohol deaths is almost four times higher in our most deprived areas than it is in our least deprived areas. The legislation will make the biggest impact in those communities.

We have spoken about the hard-to-reach areas and the unmet demand. I hope that people will come forward to get the help and support that they need, because we can see that theirs are the communities that suffer the most from drugs and alcohol, so they are the communities that can benefit the most from the proposed legislation.

I cannot do that with the bill. As I said to the convener, non-Government bills must sometimes be quite narrow in focus. There are issues that we have not touched on yet, although we probably will with the lead committee, around housing and homelessness and suchlike, which are very often associated with addiction issues, which we cannot get into with this legislation, despite many of the front-line experts being keen that we are able to do so. I do not think that we can extend the scope of the bill. It will be for others to look at that, and I encourage them to do so.

The bill deals with people who are diagnosed with an addiction, but I understand that that is not everyone who suffers from alcohol misuse. However, by stipulating a diagnosis of addiction, we can get the required medical intervention and the treatment that is needed to deal with that addiction. That is why that is stipulated so clearly in the bill.

With that caveat—that is, in the manner that we are proposing—my answer would be no. That is my understanding. We have looked at that, and we have also—

I have learned a lot from Ms Smith’s bill and the discussions that Mr Greer, Mr Mason and I have had on our committee in that respect. It is important that we look at alternatives.

Going back to Mr Hoy’s point, I think that the bill continues to raise awareness of this issue. Indeed, we have seen the submissions that you and the Health, Social Care and Sport Committee have received and which shine a light on a number of these areas.

Moreover, as I said in my opening remarks, I think that what we have come up with—and I have specifically mentioned the non-Government bills unit, Stephen Wishart and Annemarie Ward—is very good. I also like the fact that the cabinet secretary, in his letter in response to your call for evidence, has said that he agrees with

“the intended outcomes of the Bill”.

However, I am also willing to look at and accept any amendments that are lodged.

Ultimately, though, I do not want to say that I would accept far less than the bill, because that would allow ministers and others to aim for that something far less rather than what is in the bill, which I think is crucial. We need more availability of rehab beds and forms of treatment that can help and support people with addiction issues. That will require further commitments from the Government, which is why we have put in an increased budget. The Government needs to continue to prioritise the area and back it up with the funding that is required.

This has been my first committee appearance on the bill. It has been useful to tease out some financial and data issues at this point. I am sure that those will also be considered by the lead committee. I take on board the points that members have raised and will seek to come back to you with that additional information.

If there is a surge of people coming forward because of awareness of the proposed legislation, and, hopefully, its becoming law, I believe that that will be a good thing. You will note that, although I do not specify this in the bill, in the financial memorandum, I encourage the Scottish Government to take part in a publicity campaign to raise awareness of the right. I believe that a surge would be a good thing. If people who need treatment, support and assistance are aware that it will be made available to them and that there is no option for someone to say, “You cannot have that because it’s too expensive,” and if that ultimately saves lives and deals with the shocking number of deaths that we have, that will be a good thing.

On your point about the varying costs of public and private residential rehab, it is not just about the weekly costs. You are right to highlight those, but the financial memorandum also specifies at paragraph 38 the time that some people spend in residential rehab, which can go from just a few weeks to potentially years in some cases. We have to look at those significant costs.

We mention in the financial memorandum that there is a tipping point. At some stage, as more people are treated and get help and support—which we believe needs to happen—that will reduce costs elsewhere in the public service. I go back to Dame Carol Black’s point that, for every £1 spent on intervention, we can save £4 elsewhere in the public services. It is important to bear that in mind.

You also asked whether the Government would use private providers more. Clearly, that is an option, and it is up to the Government—we state that very clearly—to decide how the treatment is delivered. However, as the Government provides more beds in the national health service, that will hopefully reduce some of the need to go to the private sector. I do not want to use the word “competitive”, but there will be more opportunities for people to go to the private sector or to the NHS to get their treatment. I hope that we would see some of the costs at the higher end stabilised and brought down.

Of course, people will get the treatment that a medical expert believes that they should get. It is not a self-referral process; it involves someone going through an assessment with a medical expert, and that medical expert—or, if this treatment is initially refused, the medical expert who gives a second opinion—deciding that this is the best course of treatment for that person to get over their addiction issues.

Those are on-going costs that will occur regardless of whether the bill is passed.

Again, as you will know, convener, the range of £28.5 million to £38 million is the additional cost.

I think that we are, but it is taking too long to get and the data is clearly still not complete. As I said to the convener, annual reporting to the Parliament will significantly improve that data because the Government will be duty bound to include it in a statement to the Parliament and will be held accountable for that. The Government will have to work with integration joint boards, health boards and others to get that data.

I make this point sincerely: I have had constructive meetings with a number of drugs ministers, the cabinet secretary for health and the First Minister. I had a joint meeting with the First Minister and the cabinet secretary last autumn and I think that there was agreement at that meeting that we need to focus on data and to improve the data in the future. When I get such reassurance from the top of the Government, that is encouraging and it might have been facilitated by the bill.