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Official Report: search what was said in Parliament

The Official Report is a written record of public meetings of the Parliament and committees.  

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Dates of parliamentary sessions
  1. Session 1: 12 May 1999 to 31 March 2003
  2. Session 2: 7 May 2003 to 2 April 2007
  3. Session 3: 9 May 2007 to 22 March 2011
  4. Session 4: 11 May 2011 to 23 March 2016
  5. Session 5: 12 May 2016 to 5 May 2021
  6. Current session: 12 May 2021 to 3 April 2025
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Displaying 987 contributions

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Criminal Justice Committee, Health, Social Care and Sport Committee, and Social Justice and Social Security Committee (Joint Meeting)

Reducing Drug Deaths in Scotland and Tackling Problem Drug Use

Meeting date: 2 February 2022

Angela Constance

I have recently had some meetings with Ms Robison on strengthening the homelessness prevention duties. There is something very simple, powerful and fundamental about the ask and act duty, because it should not just be a case of asking somebody and then acting by referring them on somewhere else. That might be appropriate at times, but the whole ask and act philosophy is also about how you can act before you refer someone on. It is culturally important in giving a sense of ownership and ensuring more collegiate working across the different workforces.

I am looking closely at the work that Ms Robison is leading, because it contains something important that we might be able to learn from and implement in our drugs policy, and which also connects with the MAT standards. It is all about how we make people’s rights real in reality.

Criminal Justice Committee, Health, Social Care and Sport Committee, and Social Justice and Social Security Committee (Joint Meeting)

Reducing Drug Deaths in Scotland and Tackling Problem Drug Use

Meeting date: 2 February 2022

Angela Constance

I really appreciate that question, because there are a number of issues around residential treatment, and I am committed to taking a balanced approach to securing a whole system of care. Residential rehabilitation is an important part of that. It has historically been supported and funded less, and this Government is now seeking to address that.

When I made my statement to Parliament in November last year, a whole suite of information was also published, some of which was meant to shine a light on where things were not operating as they should be. Some of it was also about the work that is being done to improve access to funding and improve access pathways, and some of it was about how to improve accountability, within the Government but also at a local level, so that people could see where the funding was going and how many places were being funded by alcohol and drug partnerships in each area.

I know that the pandemic had an impact on some services. I am not sure whether I picked up correctly what Mr Choudhury said, but I am not certain about any on-going concerns. The residential rehabilitation working group continues to liaise very closely with residential rehab providers, and where there are issues to iron out, they will be proactive about it. There is a housing support fund to ensure that people do not have to choose between maintaining their tenancy at home and going into residential rehab. That was set up to mitigate some issues in which the rules for housing benefit were implicated.

I hope that that answers Mr Choudhury’s question.

Criminal Justice Committee, Health, Social Care and Sport Committee, and Social Justice and Social Security Committee (Joint Meeting)

Reducing Drug Deaths in Scotland and Tackling Problem Drug Use

Meeting date: 2 February 2022

Angela Constance

Absolutely. International evidence is crucial, because many other countries around the world have a far higher drug deaths rate than that in Scotland, and we should be looking at the very best practice not only in Scotland and across the UK but internationally. We have a lot to learn, and I make no bones about that.

Criminal Justice Committee, Health, Social Care and Sport Committee, and Social Justice and Social Security Committee (Joint Meeting)

Reducing Drug Deaths in Scotland and Tackling Problem Drug Use

Meeting date: 2 February 2022

Angela Constance

I am sure that Mr Findlay will have discussed in detail with the justice secretary things such as Rapiscan scanners. The safety and wellbeing of prison staff and prisoners is of the utmost importance.

It is reflective of what we know about the wider community that we cannot arrest our way out of a drug deaths crisis. It has to be about addressing the root causes of people’s substance use and the bigger and broader agenda of homelessness and poverty. It is also about ensuring that people have access to the treatment that is right for them. Access to treatment and support in prison is crucial when it comes to healthcare. An important survey of prisoners’ health and social care needs will be completed by the spring, if I recall correctly.

Really important work is being led by the recovery community in our prisons. I have visited a number of recovery cafes. We must be focused on addressing the needs of individuals.

There are also broader issues about overcrowding in prison. I think that most commentators would be of the view that our prison population is too large.

Criminal Justice Committee, Health, Social Care and Sport Committee, and Social Justice and Social Security Committee (Joint Meeting)

Reducing Drug Deaths in Scotland and Tackling Problem Drug Use

Meeting date: 2 February 2022

Angela Constance

Yes, I am. Sorry, Ms Mackay, but I do not think that I caught all of your question, but I am sure that it is about safer drug consumption rooms and the evidence that Mr Malthouse gave to the committee yesterday.

It is a matter of public record that work is being done on a pilot for a safer drug consumption facility in Glasgow. A proposition for that pilot has been made by the health and social care partnership in Glasgow. Very extensive work is being done between the Crown Office, the police, us—the drugs policy division—and our local partners in Glasgow.

Mr Malthouse and I come from different positions on this. I am strongly of the view that there is no disputing the evidence that safer drug consumption facilities can save lives. I refer members to the evidence paper that the Government produced not long ago and that I am sure that we shared with the Criminal Justice Committee at the time. I have also shared an exchange of correspondence between Mr Malthouse and me. He sees more problems than I see. There are undoubtedly issues that need to be resolved, and that is what we are actively engaged in doing.

There are three avenues to pursue with regard to drug consumption facilities. The UK Government could introduce primary legislation, perhaps in the way that Ireland did a number of years ago. It could devolve powers to Scotland and enable us to introduce legislation. The third option is for us to pursue what we can within our powers to bring forward a proposition that is clinically and legally safe for those who use and work in the service.

It is delicate and detailed work, and it has its difficulties, but it is progressing. We are absolutely committed to doing everything that we can, where possible within our powers, to implement evidence-based interventions that save lives.

Criminal Justice Committee, Health, Social Care and Sport Committee, and Social Justice and Social Security Committee (Joint Meeting)

Reducing Drug Deaths in Scotland and Tackling Problem Drug Use

Meeting date: 2 February 2022

Angela Constance

There are three aspects to that. I will deal with the devolved aspect first; there is also a reserved aspect.

The point about the recommendation on single records needing to be addressed is well made. I have met Community Pharmacy Scotland and the Royal Pharmaceutical Society, and they rightly point out that, with better linkage of records, they could do more. My officials have raised that issue with the chief pharmacist and the health division. I absolutely accept the point. The pharmacists are absolutely correct to raise it, and I want a resolution to be found, because I think that pharmacy services can bring much more to the table.

That links to the issue of naloxone being registered as a controlled drug, on which our engagement with the UK Government is important. If naloxone was classified differently, different options would be available. It could be provided as part of a pharmacy service. People can have an individual consultation with a pharmacist about a range of medications; they could do that in relation to naloxone and kit that involves a needle, in particular.

The pharmacists also make the argument that if nasal naloxone was reclassified, it could be sold in chemists in the same way as decongestion products are sold. That would require changes at UK level, but it would help in widening distribution and acceptance of naloxone.

Over and above that, the task force has done really good work. The reach of naloxone is up to about 59 per cent. If you would like a technical explanation of how that is worked out, I will hand over to Morris Fraser. As a result of our naloxone campaign, 4,000 kits have been distributed. The work of Scottish Families Affected by Alcohol and Drugs on the click and deliver service is first class, as is the work of the police. The Scottish Ambulance Service has given out 1,000 kits. As well as distributing take-home naloxone kits, its work in connecting people to services is also relevant.

The task force has done good work in and around naloxone—naloxone is also becoming available to people in prisons, prior to their release—but there is more to do on pharmacy. There is also much more that we could do on mental health services. There are areas in which there can be improvement; the point about pharmacy was well made.

Criminal Justice Committee, Health, Social Care and Sport Committee, and Social Justice and Social Security Committee (Joint Meeting)

Reducing Drug Deaths in Scotland and Tackling Problem Drug Use

Meeting date: 2 February 2022

Angela Constance

On the latter point, we are on track in developing our public health surveillance system, which builds on existing warning systems and is broader than a traffic-light system or distribution of naloxone. We are also waiting to hear the results of the UK-wide consultation on naloxone. We will certainly endeavour to keep Mr Briggs and the committees informed about what is happening.

With regard to treatments, I say that it is crucial that they be based on evidence. That has to be a priority. On NET, we have corresponded with Mr Briggs about it and we have pointed people in the direction of the chief scientific officer with regard to pursuing trials.

Mr Briggs made a fundamental point about informed choice, which is a core part of the medication assisted treatment standards. All patients who receive a healthcare service make informed choices and are supported in that by clinicians and practitioners. People should be able to make informed choices around medication assisted treatments and other types of treatment. The whole purpose of MAT is to make the connection between the options and possibilities in pharmaceutical interventions and those in psychosocial interventions. Mr Briggs’s point about the need for a balanced approach and for implementation of what works, based not only on the evidence but on what meets individuals’ needs, is important.

Criminal Justice Committee, Health, Social Care and Sport Committee, and Social Justice and Social Security Committee (Joint Meeting)

Reducing Drug Deaths in Scotland and Tackling Problem Drug Use

Meeting date: 2 February 2022

Angela Constance

I am very much aware of Ms McNeill’s work in the area; I frequently meet stakeholders who talk about her work and events that she has hosted in the past.

With regard to Mr Malthouse’s comments about services such as safe drug consumption facilities sending out the wrong message or encouraging drug use, I point out that there is simply no evidence for that. We hear people verbalising that concern, but there is no evidence for it, whereas there is evidence to show that safe drug consumption facilities reduce overdose deaths and save lives. They reduce transmission of blood-borne viruses, reduce infection in wounds and improve wound care, and they help in reaching people who inject drugs and who might not otherwise engage with, or be visible to, services.

12:15  

Ms McNeill is a Glasgow MSP. Much of the campaign that is coalescing around safe drug consumption facilities came about because there is also a community benefit from reducing drug-related litter and drug use in public places. There is evidence that such facilities work and about their benefits. They are not a magic bullet—nothing ever is. However, in Scotland, we need all the options. I have views about the Misuse of Drugs Act 1971, but we want all the available options to help us to address this national scandal and crisis.

Criminal Justice Committee, Health, Social Care and Sport Committee, and Social Justice and Social Security Committee (Joint Meeting)

Reducing Drug Deaths in Scotland and Tackling Problem Drug Use

Meeting date: 2 February 2022

Angela Constance

Some of the work that we are actively engaged in is on updating prevalence information. We need to update our understanding of the extent, or prevalence, of drug use in our society. There is some existing data; just before Christmas, I announced funding to update it. We need to understand more about prevalence in Scotland. That information is important because it is crucial to introducing our treatment targets.

In direct answer to Gillian Martin’s question—I think that this is a fair critique—I will say that we do not have enough of our people in treatment and we do not do enough to retain them in treatment or to follow them up if they fall out of it; hence, our investment in, for example, non-fatal overdose pathways and outreach. The new treatment target and the indicators that underlie it will therefore be crucial in improving and scrutinising the number of people who are in treatment. As I said to Parliament, we will announce that in the spring

12:00  

With regard to capacity, much of our work on MAT standards and residential rehabilitation is about not just improving our ways of working but increasing capacity. Workforce capacity is important, so right now we are mapping the shape and size of the workforce in order to identify gaps and to look more at training needs.

The issue of stigma is very pertinent to the workforce; workers, too, often feel quite stigmatised. We will consider a recruitment campaign, but that has to be joined up with other big national workforce strategies across the Government.

Criminal Justice Committee, Health, Social Care and Sport Committee, and Social Justice and Social Security Committee (Joint Meeting)

Reducing Drug Deaths in Scotland and Tackling Problem Drug Use

Meeting date: 2 February 2022

Angela Constance

I am really excited about the national collaborative. I was committed to bringing it forward—in part due to my experience in social security and the work that we did around lived experience with experience panels, and in part because of my days in education, where I saw the benefits of the early years collaborative.

I think that it is absolutely crucial that there is a vehicle that is owned by the voices of the experienced—that it is theirs. I am delighted that Professor Alan Miller, who is Scotland’s leading human rights expert, has agreed to chair the national collaborative. He comes with independence. He is well placed to understand the impact of trauma and has worked with survivors of in-care abuse, through which he brought forward a programme of work that amplified their voices and ensured that change happened. I am thinking in particular of the redress scheme.

I am very confident about the national collaborative. Professor Miller is now involved in a series of engagements—introductory and one-to-one meetings with the sector and with people with lived and living experience. He will work with them to develop a programme of work, including milestones and timescales.

The national collaborative is a very important part of the national mission, because we need to ensure that voices of experience are plugged in to every aspect of that mission. It is also about enabling those voices to inform and drive change, and about what we do being informed by a human rights approach.