Chamber and committees

This is an area that the Liberal Democrats want the Government to succeed in. People are dying. I remember the widespread acclaim that accompanied the appointment of Dr Matheson to lead the task force. It is very dispiriting, then, to hear the concerns that she has raised about the Government’s approach.

We want evidence-based solutions. I visited the Thistle centre in the early morning one day in the October recess. Since that facility opened in January, it has prevented or reversed 60 overdose events through its pharmaceutical interventions. That is 60 people who are alive today who very likely would not be if they had been on the street, so I utterly reject Annie Wells’s assertion that the Thistle is not working. [Interruption.]

With that weight of evidence, why can we not extend that pilot to other parts of the country that are equally struggling with the scourge of drug deaths? [Interruption.]

Will the cabinet secretary give way?

We need to consider provision for expectant mums in the round, so I welcome Douglas Ross’s intervention.

There is also the case of Shelley Mowat, who in 2018 developed a potentially life-threatening blood clot as a result of the protracted journey that she faced to get to Raigmore. In her remarks, Jackie Baillie was right to touch on the many mums who, when they have completed that arduous journey, are turned away at the doors of Raigmore because of staffing and capacity pressures at the hospital. That sometimes increases their journey time to up to 12 hours, which comes with excessive waits and complications.

All that Willie Rennie’s amendment asks for is that mums in the far north be offered the same consideration that was offered to those in Moray who, following an independent review of the kind that we are calling for, have now seen their access to a full spectrum of maternity services begin to return at Dr Gray’s hospital.

Today, we are witnessing a welcome departure from the refusal and denial that traditionally come from SNP ministers. I welcome that. It has been a long time coming—nearly a decade. By agreeing to our amendment—as I am so glad that the cabinet secretary has signalled the Government will do—he will hand a victory not to the Scottish Liberal Democrats but to the campaigners, the patients, the mums and the midwives in the far north who have been crying out for an independent review for many years. I hope that, as the Government concludes the debate tonight, it will give us some detail on that review. It is clear that the Parliament will, by a majority, vote for our amendment. By so doing, it will instruct and commission an independent review into maternity services in the far north.

I have never accepted that this issue presents a binary equation of either leaving mums unsafe in the far north or forcing them to come to Raigmore. There have been many examples of effective models that work in other remote and rural parts of the country, such as in Orkney or other parts of the Highlands and Islands.

In agreeing to the amendment, the Parliament will have a responsibility to hold the Government’s feet to the fire. If we agree—as it seems we will do—to commission that independent review, that cannot be the last that we hear of it. The Government must, in short order, explain to the Parliament when the review will be commissioned, when it expects it to report, and how and by what means the campaigners and the communities of the far north can feed into it. It should be the case that only those with lived experience can feed into it—the lived experience of the mums who, right now, might be travelling that treacherous 100-mile journey that takes more than two hours to cover, as they do battle with sightseers on the north coast 500 on the most important day of their lives. We should not expect them to face such a journey, which they sometimes do alone.

I am grateful to the Government for supporting our amendment. It is a victory for the campaigners in the far north. It has been a long time coming—it has been far too long coming.

I am very grateful to the Labour Party for giving its time to this important debate this afternoon. I rise in support of the amendment in the name of Willie Rennie. It speaks to one of the most geographically punishing health inequalities in the British Isles.

The maternity services at Caithness general hospital were downgraded in 2016—the year that I, and many others, entered the Parliament for the first time. That decision has forced pregnant mums, who are sometimes in active labour, down the arduous and treacherous stretch of the A9—the 100 miles that it takes them to get to Raigmore—sometimes through the snow or the dark, and sometimes dealing with deer on the road and attendant concerns about vehicular crashes. Every day, from that day to this day, my party has stood with community campaigners—in particular, the Caithness Health Action Team—in support of restoring those services.

That decision to downgrade denies expectant mums fast access to obstetric expertise and care in the event of rare or serious issues. It demands arduous travel and delay, heightening risk and stress on what is perhaps the most vulnerable day in that person’s life. It is a situation that has commanded the attention of the United Nations, which regards the situation as an abject failure of the right to health for mums in rural parts of the country.

That denial of human rights is measured in near misses and negative health outcomes. We have heard from Jackie Baillie and Rhoda Grant about the split-site twins who were born at either end of the northernmost leg of the A9. There was also a newborn who suffered brain damage in October 2022 as a direct result of the three-hour journey that it took to get the mum to Raigmore. That is a concrete example of an adverse neonatal outcome if ever there was one.

On a point of order, Presiding Officer. My app froze. I, too, would have voted yes.

The stacking of ambulances outside our A and E departments and the long, protracted waits inside A and E are not a result of a deficiency in emergency care. Instead, they are a result of the fact that, on any given night in Scotland, 2,000 Scots are stuck in hospital who are well enough to go home but too frail to do so without either a care bed or a care package to receive them into the community. That is because this Government has failed on social care.

Does the cabinet secretary recognise that the situation in our communities is getting worse, particularly in the Highlands, which is seeing care homes close? Will he instruct an urgent inquiry into all preventable deaths caused as a result of the crisis in emergency care?

The lack of notice to, or involvement of, elected representatives at all levels in Inverness is unforgivable. Had they been consulted, they would have told the UK Government that it is simply moving asylum seekers from one kind of unsuitable and costly accommodation to another. Compassion must guide our approach, but so, too, must common sense. Inverness is a welcoming town, but the centrality of the barracks will give rise to the same concerns—particularly about the impact on local services—that are leading the Government to end the use of asylum hotels in the first place. Does the cabinet secretary agree that alternative space must be found and that, with urgency, the UK Government should recruit 2,000 new casework officers to clear down those asylum claims?

Does Douglas Ross recognise that treatment for drug addiction and chaotic lifestyle factors is often about more than only rehabilitation? It is about harm reduction and stabilisation. Comprehensive, trauma-informed recovery work needs to go alongside that.

I congratulate Douglas Ross, not least on the work that he and his staff have done alongside the non-governmental bills unit, but on the work that he has done across the chamber to bring us to a space where the Liberal Democrats will offer our cautious support for the principles of the bill at stage 1. This is the last opportunity before this Parliament rises for the election for us to use our legislative framework to deal with one of the worst crises in our public services and way of life.

I listened with interest to what I thought was a compelling speech from the minister, who very bravely took us through some personal examples of addiction in her family, for which I commend her. However, I fundamentally disagree that rehabilitation and harm reduction are in any way mutually exclusive. I fundamentally believe, as Liberals do, that harm reduction is something that we need to have everywhere. We do not. We have called for the Thistle pilot to be expanded across the country, not least to our metropolitan areas, but also to those areas of rurality where harm reduction is so badly needed.

Rehab has its place, too, however, and people deserve a right to rehab. Therefore we will support the bill, because we cannot turn our backs or close the book on the last opportunity in this session of Parliament to make meaningful change in this area, before a new Government, potentially, is sworn in next spring.

We owe it to every family who has lost a loved one to addiction to explore every possible solution, because this is a crisis and a scandal that can blight every part of life’s journey. I have talked many times about my experience in my journey to Parliament through organisations that provided addiction services, not least to babies who were born addicted to substances and have to go through withdrawal in their first days of life. I was proud of the Liberal Democrat influence on the Scottish budget that allowed an increase in the budget for Aberlour Children’s Charity for its provision of services for babies experiencing neonatal abstinence syndrome.

The bill’s aim is to give everybody the right to timely person-centred treatment. We should all be able to get behind that. I do not understand why people are fixated on the gravity of where the bill is now, as opposed to where we could get it to. That is why we are not going to give up on it today.

Too many people who are seeking help are still turned away, told to wait and sometimes simply lost in the system. The bill creates a legal right for people who are diagnosed with addiction to receive a treatment determination and to begin treatment within three weeks.

I have concerns about bringing in a guarantee to be covered by the funding envelope that we currently provide for drug and alcohol services in this country. I am concerned that such a legal imperative will lead to alcohol and drug partnerships, social care partnerships and health boards diverting resources away from crucial trauma-informed and harm reduction services in order to meet that guarantee. However, that need not be the end of the story. I have had discussions on the issue with Douglas Ross—I am grateful for his time—and I believe that he supports an expansion of that funding envelope so that we can accommodate both types of services, because they should not be mutually exclusive.

I am also concerned that, at current workforce levels, we do not have enough people working in addiction services to make the bill’s proposals a reality. That does not mean that we should not try. It does not mean that we should not seek to expand that workforce, because whatever Parliament decides this afternoon, we should expand the number of people who join addiction services and help others to stabilise their lives and get clean of substances.

That statement of intent for the bill is powerful, but, without that capacity, it is, potentially, not realistic. I look forward to working with the member in charge, if Parliament passes the bill at stage 1 today, to get it to a place where we can answer those criticisms and, by so doing, respond to committee’s reflections on the financial memorandum and the deficiencies that it sees therein, of which we heard from Clare Haughey.

The bill might be far from perfect, and I am not entirely convinced that it provides all the answers to this crisis—in fact, I know that it does not. We need to recognise that, often, substance use is a response to unresolved childhood trauma. In every measure that we deploy—whether it is a right to rehab, stabilisation or harm reduction in the corridors of the Thistle or in centres like it, which I hope will be rolled out across the country—we have to recognise that trauma-informed practices are key to not just helping people to conquer their addictions at that moment in time, but to addressing and resolving the underlying trauma that led them to that space in the first place. We need to wrap around a range of additional services, once people are stabilised, to help them to conquer problems in their lives that are unrelated to substance use but that underpin that use in the first place. That includes providing access to a safe, warm and stable home; ensuring that they have a trajectory and purpose in life, through education, training or employment; and understanding, at every stage, the trauma that underpins the decisions that they have taken up to this point.

I do not believe that the concerns about staffing or capacity are good enough reason to reject the bill. It is up to the Scottish Government to work with parliamentarians to say that, if it is the will of Parliament—and I believe that it should be the will of Parliament—we will make a funding envelope around the bill that accommodates the needs of the services that now exist for harm reduction and stabilisation, but that also offers the crucial right to recovery and rehabilitation that Douglas Ross has rightly put in his bill.

For those reasons, the Liberal Democrats will support the bill’s general principles at decision time. Every life lost to addiction is one too many. We cannot afford to let the conversation pass us by and close the book on legislative change for the rest of this parliamentary session. Therefore, we will support the bill at decision time.