Our next item of business is to discuss correspondence that the committee has received recently. I refer members to paper 3. You will see that our clerks have suggested some ideas of how we may want to take forward the various issues. I will open it up to members to raise any points or make any suggestions.
I will take the letters in turn. The first is correspondence from the Scottish Prison Service on the cost of the women’s estate.
This is probably something that we should have asked Teresa Medhurst about while she was here, as there is a budget element to it.
Although Teresa Medhurst has answered our question in her written response, we were not just looking for the numbers. One of the things that came up in our discussion on the topic was about the ability to compare costs across the different estates. I have no idea whether £5 million is good value or poor value for money. Given what those premises are doing—we have seen them—I am sure that that is all very worthwhile. However, we know that they can facilitate quite a substantially lower number of people. Are the £5 million costs for housing 10, 30 or 100 women? How does that compare with the estate historically or to other types of custody units?
It would have been helpful to get more detail around that to make that comparative analysis. That was the reason for the question; we did not just want to know about the numbers.
When we visited the Lilias centre, I think that it was mentioned that an evaluation process was potentially going to be undertaken. I suppose that that would be to monitor outcomes and to look at the effectiveness of the unit. Jamie Greene raises a good point. I am certainly keen to understand the cost benefits arising from the two new units.
I was just saying to Rona Mackay that things could not be any bleaker. I have never heard anything like that in all the time that I have been here.
On the evidence that we have from the Crown Office and Procurator Fiscal Service—
We are discussing correspondence to the committee. If you do not mind, just park that thought and we will come back to it.
Sorry.
You are very enthusiastic.
We are discussing correspondence that the committee has received. The first piece of correspondence relates to the update on the women’s estate. As there are no other queries, are we content to write back to the prison service to thank it for its correspondence and to take forward Jamie Greene’s suggestion in doing so? We will monitor developments around the benefits and evaluation of the unit.
Members indicated agreement.
The second letter is from the Wise Group on the issue of medical prescriptions on liberation. Would members like to make any comments?
At face value, the Wise Group is saying that things have got better. The matter does not seem to be as much of a problem as it was when the committee visited the group’s offices in May. I am not sure where we can go from here.
Throughcare is another issue. I do not have anything constructive to say about that.
It is worth noting that the committee has done well, particularly Pauline McNeill, who identified the issue during the visit, and pushed to raise it, as did Rona Mackay. It shows that simply by our asking questions and intervening, we can make a bit of a difference.
Towards the end the letter, the Wise Group talks about former prisoners who do not have a fixed address and cannot register with a general practitioner. What might be done about that? I am sure that there is no easy fix, but it is certainly a significant matter that probably requires a bit of attention.
12:15
When I read that, it made me think about how challenging it is to get an appointment with a GP within five days these days. My concern is that, if the approach is rigid, some people will fall by the wayside. What happens also depends on what day people are released from prison and what system their GP has. I wonder whether there is some flexibility around the five days.
I was not going to comment. However, I am currently dealing with a lot of casework from constituents who have not been released from prison, who do not have addiction issues, who are not prescribed methadone and who are waiting three or four weeks for a GP appointment.
What will happen when that five-day prescription runs out? That is the crunch point. After they pass those five days, a person’s medical issue might become an emergency. At that point, if they cannot be seen by someone and they cannot get a prescription, where do they go? My fear is that they will revert to illicit drug taking, rather than continue with a prescribed methadone programme, as they will have done while in custody.
We need more detail. As we know, the NHS runs the service; the prison service no longer provides that service. Therefore, the matter has moved from the justice portfolio to the health portfolio. The health secretary needs to respond on the issue.
The Wise Group has said that people who are unable to get a GP appointment within those five days are presenting at accident and emergency. That is putting additional pressure on to A and E. Recently, the message has been that, unless it is an emergency, we are not to present at A and E.
I know from making inquiries into recent casework that, as part of the health secretary’s winter resilience plans, letters will be sent to all GPs asking them to open up appropriate appointments again. I am getting a lot of casework in which people are saying that they are unable to get GP appointments. The issue affects more people than those coming out of prisons.
All of us can get a prescription online quickly or a repeat prescription with a phone call. Is there not some provision that could be made for released offenders to do that as well? As you say, the issue is critical, otherwise people might be left high and dry after five days. We do not have to suffer, as we can get a repeat prescription by going online or phoning, so why would they be excluded from doing that?
I was quite heartened to read that it sounds as though the release process has improved. However, as the Wise Group articulates in its letter, the difficulties outwith prison gates seem to be the challenge and, as you have all articulated, access to GPs is an issue.
I am aware through contact with NHS Grampian in my constituency role that there is an endeavour to encourage the general public to embrace new ways of working in terms of their not necessarily always requiring to see a GP for a health concern. There are other options, such as nurse practitioners, that the public can be signposted to and can access. In the context of this issue, might that be considered so that people who are vulnerable, have addiction issues and are on release from prison can similarly be signposted elsewhere?
On that note, as per the recommendation in the committee paper, should we write to NHS Scotland? We could copy the Wise Group’s letter to it and raise some of the concerns that we have discussed this morning.
In addition, we could keep the Parliament’s Health, Social Care and Sport Committee abreast of what we are doing. It might be something that it wishes to consider quickly in its agenda.
Absolutely. We could perhaps also keep Angela Constance, the Minister for Drugs Policy, informed as well.
Do members agree to that approach and to share the information with relevant committees?
Members indicated agreement.
That completes our public business for today. Our next meeting will be on Wednesday 9 November, when we will continue taking evidence as part of our pre-budget scrutiny process.
12:20 Meeting continued in private until 12:54.Air ais
Pre-Budget Scrutiny 2022-23