Seòmar agus comataidhean

Gosh! How to answer that succinctly? I will do my best, convener.

My focus in this job has always been, first and foremost, on what I can do; therefore, my endeavours are focused on the powers and resources that are at my disposal. I am a pragmatist at heart, and I want to crack on and do things now. However, I do not ignore the implications of powers that exist elsewhere. I am not looking to enter into a constitutional debate here and now but, of course, the Misuse of Drugs Act 1971 has implications for what we can and cannot do. In my view, it impairs some of our approaches to harm reduction—or certainly makes the journey towards improving such interventions harder.

The issue of decriminalisation, or drug law reform, is complex. I would frame the issue as drug law reform more generally. Decriminalisation means different things in different countries, but in terms of going back to principles and the basics, the question is what is gonnae work—what is gonnae make folk safer, if not safe. I am very clear that we cannot punish people out of addiction.

We published a paper last March or May that looked at international responses to drug law reform. The international evidence that we have looked at shows, in very broad terms—I am summarising, convener—that the public health approach has been more effective at reducing harm. Some people have fears around drug law reform more broadly and often worry about increasing drug use, but the evidence does not appear to show that that happens.

In my view, we need to have a review of drug law across the UK, but I think that it is fair to say that the UK Government is not inclined to do that. I will meet the new minister at the beginning of December—that is a frequent discussion point.

Despite some well-documented differences of opinion with Kit Malthouse, who was the first UK Government minister I met in relation to this job, we nonetheless had a lot of engagement. The quick succession of ministers in recent times that has coincided with recent changes of Prime Ministers means that two ministers were in office for such a short period of time that, although I wrote to them welcoming them to their role and raising all the issues that I wished to discuss with them, time did not permit us to actually meet them.

There is some agreement between us and the UK Government on issues such as leadership, investing in the reform of services and the importance of treatment. We have some agreement in and around the need to legislate for the regulation of pill presses, which is very important for tackling the illicit marketing of benzodiazepines. We will see where we get to with Home Office applications in and around drug checking. We are at a completely different place on safe drug consumption facilities, but I will see where the new minister—a gentleman called Chris Philp—is on that.

Uppermost in my mind just now is the UK Government’s white paper on “swift” and “tough” consequences. That approach is misguided. I think that it will potentially cause more harm and that it is based on an outmoded punitive approach, and I continue to seek urgent clarity as to whether and how it would apply to Scotland. The Home Office white paper states that tier 1 and tier 3 interventions could potentially apply to Scotland and Northern Ireland, and I would have grievous concerns about that. I am conscious that I have written to the committee about that, too.

As you will appreciate in the context of those 20 recommendations and 139 actions, the task force was an iterative process; other recommendations came out earlier. Through the information that I have given to the committee, I hope that I have demonstrated that progress is already under way. We did not sit back and wait for the final recommendations of the task force. I gave a very warm welcome to the challenge, and to the criticism—to be frank—that the final report contained for the Government.

Given all those actions, we have a lot to work through, but I will endeavour to demonstrate an overwhelmingly positive response at the turn of the year, when we come back to the Parliament with the cross-Government action plan and the stigma action plan.

On whether we will implement every recommendation in the precise way that is envisaged in the report, you will appreciate that it is the role of organisations and people who make recommendations to make those recommendations, and it is for Government to work out how they might be delivered.

First, I offer my condolences to the family of Mr Cole-Hamilton’s constituent. Any death is a tragedy. We all feel that, and the death of young people is always particularly sore.

That points to the need for drug-checking facilities. I have discussed the matter fairly extensively with the United Kingdom Government and UK ministers such as the Minister for Crime, Policing and Fire. Mr Cole-Hamilton may have a slightly different understanding of the position in England. In my engagement with UK ministers, they have been really resistant to drug-checking facilities at festivals. I am aware of one licence having recently been made available to support festivals on a short-term basis.

It is fair to say that we do not have enough drug-checking facilities at those types of events across the UK. Drug-checking facilities require a Home Office licence. For years, a postal service has operated in Wales whereby people can get substances tested.

The important thing about drug-checking facilities is how they are layered with other methods of harm reduction. I am very much in favour of extending drug-checking facilities. Across the UK, we are not doing enough of that . In Scotland, there is work on three projects, and research is going on at the same time that those projects are being developed. One of those projects is nearing a position at which it will be able to make a licence application to the Home Office. The projects are geographically specific.

We will, of course, engage with all colleagues, including the Lord Advocate, on whether different approaches are required, based on experience and such tragedies.

There are a number of layers to that. I return to a point that I made earlier: the reason why we are publishing lots of local information about what is happening with additional investment is so that it can be scrutinised and so that, where there are issues, they can be addressed. The member will be aware from our previous discussions, which I will not rehearse, that every area now has a pathway into residential rehabilitation.

What I hear about most from my engagement with people on the front line and people with real-life experience is the fragmentation of services. That is why we have a national mission and a Drug Deaths Taskforce, which has made some strong and challenging recommendations, and not just about no wrong door—there should be no closed doors to people.

The biggest frustration that people have is being bounced around between services. The ask and act homelessness prevention duties will help. It is not just about people being passed from pillar to post. In key posts in the public sector, people have duties to ask and then act.

The work on mental health and substance use services is also critical. Our response to the Drugs Deaths Taskforce will align with our response to the two reports that the Mental Welfare Commission for Scotland published this year and the rapid review into mental health and substance use services. Some of that is about services on the ground being really clear that they cannot deny somebody a service or treatment until the individual is, for example, abstaining from drugs or alcohol.

There needs to be much clearer understanding about what the lead service should be—whether it is mental health or substance use—and when the other partners should be brought in. We will come back to the Parliament on that.

It is fair to say that stigma about certain types of treatment exists in certain quarters. Some of the discourse that we read or hear about methadone, for example, is unhelpful. Time and time again, I have said that I am not interested in supporting harm reduction or medication-assisted treatment at the expense of residential rehab and abstinence. Neither am I interested in supporting abstinence over harm reduction. The only thing that I am interested in is supporting people, and they need to have informed choices and options.

There is a large international evidence base on different strands of medication-assisted treatment. However, medication should never be our only offer to people, hence the importance of implementing MAT standards that involve treating drug and alcohol issues on a par with other health conditions. If any of us sitting here were to trip up to our doctor with any other health condition, we would be given information and choices and we would have a bit of a discussion about what is best. The same ethos should apply here: people should always have choices, options and the space in which to engage and make informed choices about what is best for them.

I am not interested in false arguments around, for example, harm reduction versus abstinence. We have to dump our own ideological perspectives—my views on many things have changed over the years—and we must follow the evidence, but it is crucial that we listen to what each individual wants and needs.

That is a fair point, and it is important to remember that our focus on the national mission and on drug deaths sits in the context of wider efforts to improve the health of the population as a whole. My understanding is that some data is collected with regard to deaths for specific reasons, including deaths as a result of HIV. Information is published on issues such as wound care and blood-borne viruses. However, I will consider whether enough of that information is routinely published—it is a conversation that I have with Ms Todd—as well as where that sits with regard to management information and experimental information and whether there is an appropriate regular publication cycle. That issue sits very much in the terrain of improving overall population health. I will come back to the member on that.

I agree that it is important that we have a wide and appropriate dashboard of information so that we can understand all the harms as well as the contributing factors to drug-related deaths. It is important that we have that information about all drug-related harms. Through the publication of the national mission plan in September and the national mission annual report and the ADP annual report, I hope that I have demonstrated, at least to some extent, that we have an outcomes framework. In the national mission plan and the national mission plan annual report, you will see the information that we are using and that feeds in so that we can capture those harms. However, if the committee came to the view that we were not capturing all that, we would endeavour to address that.

I will say something that, I hope, is positive but is perhaps also a bit defensive. The housing first model is good in that it is designed to provide enough flexibility to meet the needs of individuals. It recognises that it is unrealistic that some people, because of the chaos and trauma that they live with, will be able to sustain their tenancy on their own, so we should not step back from the housing first model.

However, you have a point about other models of care. In relation to drug treatment, we have strong and clear commitments on residential rehabilitation and the abstinence-based recovery model—we are not stepping away from that—but there is a need for other models of care. Supported accommodation is clearly part of that, and that links with the work on homelessness and mental health.

There will be an opportunity for the Parliament to consider our approach when the homelessness prevention duties are refreshed. There is something very powerful about the ask and act approach. Too many people are in inappropriate temporary accommodation. As a constituency MSP—although I do not represent a city—I have encountered young people being put into inappropriate accommodation, and that is not keeping the Promise or doing our best by every child.

I appreciate that there are challenges in and around cities. Through our work on the cross-Government action plan that we will produce, we are thinking about specific things that we can do more of to scrutinise and support cities, bearing in mind that, as we know from the annual report, Glasgow, Edinburgh and Aberdeen all had rising drug death rates.

First, Mr Findlay, that was not a Government report; it was a Public Health Scotland report. You are right to say that an error was established in the information that Public Health Scotland had received from Glasgow. Therefore, the quarterly figures had to be revised down, and there was transparency around that.

Regarding the quarterly figures to which you refer, 170 residential rehab placements have been funded by the Government, which is the highest-ever number that has been funded in any quarter.

One reason that we publish information is so that we can scrutinise what is happening in every local area. I know for a fact that, in the past financial year, we have supported the funding of more than 500 residential rehabilitation placements and that, over the lifetime of the national mission, we have supported the funding of more than 700 residential rehabilitation services. I accept that it is important to distinguish between stabilisation services and residential rehabilitation.