Part of the debate – in the Scottish Parliament am ar 12 Ionawr 2023.
Every life lost to drugs is as tragic as it is unacceptable. As we enter a new year, we continue to face a public health emergency, and we must not underestimate the scale of the crisis.
Last July, the Scottish Drug Deaths Taskforce published its final report, “Changing Lives”. The report was the culmination of three years’ work examining the drivers of our drug deaths crisis and providing evidence-based recommendations for change. I again thank all those who were involved in the work of the task force for their dedication and commitment.
We have not waited for that final report to act. Since the formation of the task force, we have announced our national mission and we have taken a wide range of actions to save and improve lives. Many of those actions were informed by the task force as its work developed, including the medication-assisted treatment standards and the roll-out of naloxone.
The task force’s message was clear: change is needed and change is possible. The “Changing Lives” report set out 20 recommendations and 139 action points, reflecting the complexity of the needs of people who are at risk of a drug death and the scale of the challenge that we face. Meeting that challenge requires a whole-Government response. Indeed, a truly national mission requires an approach that involves us all.
Today, we have published our cross-Government response, which is underpinned by two transformative principles. First, we will treat problem drug use as we do any other health condition. Taking that approach across Government will help to ensure that every area considers what adjustments are needed to ensure that people who are affected by problem drug use are included and not discriminated against. The second principle will also help to ensure that that happens, by including representatives with lived and living experience of problem drug use in the co-production of policies and strategies in any and all areas of policy or service delivery that affect them.
Our cross-Government response sets out more than 80 actions. Although there are significant challenges in tackling the drugs crisis, we are determined that a lack of investment should not be one of them. Despite the huge fiscal challenges that we face, today’s action plan is supported by spending commitments totalling more than £68 million for the remainder of this parliamentary session.
Drug dependency is a health issue with undeniable roots in poverty. Therefore, our response highlights the work of the Scottish Government to tackle poverty and inequality, the social determinants of health, as well as actions on early intervention and family support.
I know that of particular concern, across the chamber, are the testimonies that we still hear far too often of people seeking help and being turned away or told that a service cannot support them, particularly when a person has a wide range of needs. The task force and the Government are clear that no door should be the wrong door and that there should be a more personalised and joined-up approach to support. Getting it right for everyone—GIRFE—is about providing a more personalised way to access help and support when it is needed, by placing the person at the centre of decisions that affect them. People who are accessing addiction services have been identified as one of five key themes for the new GIRFE pathfinders, which will test that approach using a co-design method.
We will also invest a further £2.4 million over three years to implement the recommendations from the rapid review of care for people with co-occurring mental health and substance use conditions. We know that people often need to travel to access services and support, which can be a barrier to treatment, particularly in rural areas. We will therefore work to update the referral process for access to the concessionary travel scheme and will explore the feasibility of expanding the scheme to people with a substance dependency, with £500,000 being made available for an initial pilot.
The successful implementation of MAT standard 7—which is all people having the option of MAT shared with primary care—will see better joined-up working, which will help to address the wider health needs and inequalities of people who use drugs. To enable that, from April 2023, we will ring fence £30 million—£10 million a year—for the remainder of this parliamentary session from the Scottish Government’s enhanced services allocation for primary care services to support specific services related to drug treatment.
We will continue to embed a whole-family approach and family-inclusive practice, building on the framework that we published in December 2021. I am particularly pleased to announce £4 million in funding to expand Routes—a programme for young people who are impacted by substance use in their families that is supported by Scottish Families Affected by Alcohol and Drugs.
Recognising the breadth of needs that people with problem drug use often have, there are also actions on dentistry to develop a programme to meet the oral health needs of people who use drugs, actions on education to ensure that provision for our children and young people reflects the latest evidence on what works in drugs education, actions on employment to maximise access to and the impact of our existing employability services, and actions on housing including the introduction of new duties to prevent homelessness.
The actions that are set out in the cross-Government response also include prioritising early intervention in the criminal justice system, using custody for remand as the last resort, ensuring that people with problem substance use in the prison estate can access the support that they need, and removing barriers to people accessing services and treatment on release from prison. For example, the Bail and Release from Custody (Scotland) Bill will end liberations on Fridays or in advance of public holidays, which have presented a significant barrier to many people accessing services on liberation.
As I set out in my statement to Parliament last month, we know the challenges that our workforce faces and we have brought together an expert group to develop a longer-term workforce action plan, as the task force recommended. I confirm today the provision of £0.5 million per year to deliver that plan and a further £480,000 per year for additional recruitment to the very successful addiction worker training programme. Recognising the importance of having a trauma-informed workforce and services, today’s publication also includes investment of up to £1.1 million per year in the national trauma training programme.
Section 2 of today’s publication outlines our response to the task force recommendations that relate specifically to drug services and policy. Alongside that, we have published a supporting document that provides our current position on each of the task force’s 139 actions. We have regularly discussed in Parliament the importance of stabilisation and crisis services as part of a suite of options that need to be available for people. I am therefore pleased to announce that our task force response includes an £18 million commitment to develop stabilisation and crisis care services, over and above our investment of £100 million in residential rehabilitation. We will better align crisis stabilisation, detox and rehabilitation to reflect the full range of recovery pathways.
All the actions that are outlined in today’s publication can and will make a difference, but we know that stigma too often prevents people from seeking support or puts barriers in their way when they seek it. Stigma kills, and actively fighting it is a crucial component of a human rights-based response to Scotland’s drug deaths crisis. Section 3 of the publication includes our stigma action plan, which I committed to in the debate on stigma last year.
As a Government, we will lead by example by reviewing our policies to remove barriers for people who are affected by substance dependency. However, we also recognise the need for broader change. We will develop and implement a national programme of activity, including an accreditation scheme for organisations, to improve awareness and challenge stigma across public life. That will challenge public stigma, encourage individuals to examine their unconscious assumptions, educate people on the harms that are caused by stigma and celebrate the positive outcomes of recovery in all its forms.
I will conclude, Presiding Officer. Today’s publication of our cross-Government response to the task force marks the next, even more ambitious phase of our national mission. It demonstrates the actions that we will take to ensure that people who need support for their drug use, and their families, can access both that support and any other public service that they need—