Hansard

We carry a national shame of thousands of heartbreaking drug-related deaths. It is my job as the Minister for Drugs Policy to lead the national mission to turn the tide on that crisis.

When I speak to people in recovery, I am often reminded that preventing somebody from dying is only the beginning of the recovery journey. Recovery is not something that happens to people; it happens when the system of services and resources facilitates individuals to build recovery capital and social connections, and to pursue their recovery goals safely. The system of services needs to be based on hope and trust to meet people where they are and not leave them there.

I come before Parliament today with the word “hope” in mind to provide an update on our progress on residential rehabilitation and to set out our milestones for the road ahead. Our national mission to tackle the drug deaths emergency is focused on a public health response to save but also to improve lives, whether that is through harm reduction services, medicated assisted treatment, abstinence programmes, or support for mental health, housing and welfare. It is about supporting people to access the treatment and recovery that is right for them. We are therefore working to ensure that all the component parts of a recovery oriented system of care operate effectively with good links and pathways between them to reduce harm and promote recovery.

Residential rehabilitation must be part of the range of evidence-based prevention, treatment and recovery services. That will ensure that there are options and choices for those who seek an abstinence-based recovery. There are three parts to our national approach to achieving that: improving pathways into and from residential rehabilitation, in particular for those with multiple and complex needs; investing in a significant increase in the capacity of residential rehabilitation; and developing a standardised approach to commissioning residential services.

Today, we have published a suite of reports that detail the current state of pathways into, through and from rehab. The research that the Government has undertaken has highlighted areas that do not have clear pathways. That has enabled us to tailor and target our interventions to the areas where it is hardest to access rehab. Pathways into and between all types of services are important, but they are even more vital for residential rehab, because it is all too often not part of the range of options available.

We know that the transition from rehab back into the community is a higher-risk phase, so it is important to get it right, with reintegration into other services, such as housing and employability services. Pathways to residential rehab and aftercare should be clear, consistent and easy to navigate, no matter what area of Scotland a person lives in. We want to ensure that people feel supported and have more choice in their treatment journey, and that a no-wrong-door approach means that they can ask for help through a variety of services, including housing, criminal justice and community outreach. The tragic statistics that were published today on homelessness deaths, more than half of which are linked to drugs, make that an ever-greater priority.

We will be ensuring a rights-based approach by applying the PANEL—participation, accountability, non-discrimination, empowerment and legality—principles in the development of pathways in all alcohol and drug partnership areas. By summer next year, we will ensure that each ADP has a published pathway document to share with clinicians, social workers and outreach workers, as well as individuals and their families.

We have responded to calls for more transparency and accountability by working with Public Health Scotland to track the number of residential rehab placements that ADPs have funded. That will provide the Government with a clear line of sight on how the residential rehab money is being spent. So far, in the first six months of this financial year, ADPs have funded 212 placements with an investment of around £1.4 million from the £5 million that was allocated to be spent on residential rehab and aftercare this year. That is almost the same as the number of placements funded annually in 2019-20.

Let me be crystal clear: it will be unacceptable for any area not to be investing in residential rehab. We aim to increase the number of publicly funded placements by more than 300 per cent over the five years of the programme so that, by 2026, at least 1,000 people every year are publicly funded for their rehab placement. We will work with ADPs to support the delivery of that ambition and to facilitate regional approaches, especially in those areas where the rates of drug deaths are highest and access to residential rehab is most challenging. Regional hubs overseen by Healthcare Improvement Scotland will ensure that the local system of treatment and recovery services, including residential rehab, is operating to the highest of standards.

In order to facilitate the increase in publicly funded placements, we are working to increase capacity. That builds on the recommendations from the residential rehabilitation working group—to which I am very grateful—to ensure equal access across Scotland.

The total estimated number of rehab beds that are available in Scotland just now is 425. Our aim is that, by 2026, there will be 50 per cent more rehab beds in Scotland, giving a total of 650. We have established a rapid capacity programme as part of the recovery fund, which will expand existing services and establish new services. Our surveys highlighted a gap in provision that meets the needs of women and those who require childcare facilities, so we have made that a focus for the programme.

We have already committed to just over £8 million of funding over the next five years to support a new national family service, to be delivered by Phoenix Futures. The service, which will be up and running by summer 2022, will support up to 20 families at any one time.

I am pleased to announce to Parliament today that we are providing funding to expand the capacity of the Lothian and Edinburgh abstinence programme—LEAP—by 40 per cent. That funding will enable the detox capacity in the Ritson clinic to increase by 50 per cent. That will enable more people to safely detox before going into the LEAP service. The project will be delivered in partnership with the Lothian ADPs and will act as a blueprint for a regional model of delivery to address inequities of access across Scotland.

I can also announce to Parliament today that, in recognition of the fact that one size does not fit all, and given the need for a diversity of residential rehabilitation options, we are funding River Garden so that it can scale up its innovative residential therapeutic community and social enterprise. Based on the experience of international models in Italy, Sweden and the USA, River Garden offers a three-year residential programme for people in the early stages of recovery. The service currently supports seven residents, and the funding will enable it to realise its vision of supporting 56 men and women in recovery.

That brings us to a total of £18 million of investment so far from the recovery fund, which will increase capacity and ensure choice.

In order to transform more fundamentally the way in which residential rehab beds and placements are funded, we are developing standardised approaches to commissioning rehab services. Subject to the outcome of the national care service consultation, the Government may take a national approach to commissioning specialist addiction services. However, although the national care service has the potential to reform how services such as rehab, detox and stabilisation are commissioned and procured, we do not need to wait until the more systematic changes are made. That is why we have asked Scotland Excel, as the centre of procurement expertise in local authorities, to undertake market analysis and further engagement with ADPs now to consider the different routes that are available to the Government.

When the First Minister and I recently visited Bluevale Community Club, we emphasised that no ideas are off the table, as problems and solutions belong to us all. We want to build a political consensus around what works—for example, we welcome the recognition across the Parliament that safer drug consumption facilities have a role to play in saving and improving lives.

I have outlined today the work that we are undertaking over the next five years to ensure that everyone who wants residential rehabilitation, and for whom it is considered clinically appropriate, can access it. My priorities are about making people’s rights real by funding and shaping new services, supporting the development of clear pathways and reforming the commissioning model. The national mission is not about prioritising residential rehabilitation over medication assisted treatment standards or abstinence over harm reduction—it is about supporting people, and getting more people into the treatment and recovery that is right for them. By doing so, we can help people to flourish and feel hopeful about their futures, and we as a country can see through this crisis to a better time.