 I welcome to the third joint meeting in 2022 of members of the criminal justice, the health, social care and sport and the social justice and social security committees to consider the progress being made in implementing the recommendations of the Scottish drug deaths task force. We have no apologies this morning, and I welcome Alex Cole-Hamilton to the meeting, and Faisal Chowdry should hopefully be joining us online shortly. Our first item is to decide whether to take item 3 in private, which is consideration of our forward work programme. Are we all agreed? Our next agenda item is our third oral evidence session on reducing drug deaths in Scotland and tackling problem drug use. I refer members to papers 1, 2 and 3. I welcome to the meeting Angela Constance, Minister for Drugs Policy, Orlando Heimer-Masson, Deputy Director for Drugs Policy and Ross Currie, team leader with the drug death task force response in the Scottish Government. Thank you very much indeed minister and colleagues for joining us and also minister for forgoing your opportunity to make some opening remarks. So we'll just move straight into questions and I will jump straight in if I may. First of all, thank you for keeping the committees informed of the development of the national mission plan and the oversight group and also keeping the Parliament updated on a range of developments relating to drugs deaths, standards, substance misuse and the justice system and other areas of on-going work. If I may, I would like to open up this morning's session with just a couple of questions around ADPs. In the changing lives report, the report sets out some of the challenges experienced by specific populations, including women and young people. I was quite disturbed to understand the correlation between deaths of women with substance use problems in the perinatal period and child protection proceedings or having children taken into care. In respect of young people, drug-related deaths among people under 25 have risen sharply in recent years. Related to that particular issue, action 30 outlines how ADPs and services must ensure specific pathways are developed to ensure that young people can access the support that they need when they need it. As a former member of the Aberdeen City ADP, I'm interested to hear any update that you can provide on those two actions, the action 29 relating to pathways for women and action 30 relating to young people. Specifically, the progress that is being made by ADPs in developing local pathways to services and support, given their crucial role in ultimately reducing drug harm and drug death numbers. Thank you very much, convener. Good morning to all your colleagues. I very much appreciate the opportunity to come back to this tripartite committee session and as we embark on the national mission and particularly on our work to respond to the vital final recommendations of the task force, which is essentially about ensuring that all aspects of a public sector and all parts of government are aligned. It seems fitting to me, although it's not for me to tell committees how to proceed with their scrutiny of government. It does appear a very fitting approach indeed for scrutiny also to be joined up. You raise two crucially important aspects in terms of our drug death challenge. When we look at the annual report that was published this summer, we know that while more men die, by a significantly so, that there is a disproportionate increase in the number of women that are dying and that has been a trend for some years. The annual report will show a small decrease in the number of men who are dying, but it shows a continued increase in the number of women that we are losing. We know that that is complex, but it is in relation to trauma and past life trauma, but it is also in relation to women who are mothers. If we think that people who use drugs are stigmatised, that in my view is even greater for women and particularly women who aren't our mothers. We know that the removal of children has a huge traumatic impact and is a contributory factor to deaths. Obviously, in the same way that we are working through task force recommendations, we will be supporting alcohol and drug partnerships to do likewise and indeed to develop pathways. You may have noticed earlier this week that we published the first annual report on both the national mission and the alcohol and drug partnerships. We need to make more progress with very specific care pathways for women. Obviously, some of our investment in residential rehabilitation and residential services has been prioritised to meet that need. The annual report that was published this summer shows that, while for 2021, the number of young people under 25 who had died at that figure had reduced, but it still remains too high, it is always important not to look at one-year figures in isolation, because we do know that the three years preceding that were showing concern and increases. You will see in the annual report that, while they all have services and support available for young people, there is much more that we need to do in terms of being clear about the types and range of services that should be available in each area. That, in part, is why we have a stream of work, specifically on young people. It is about the co-design of standards of care and treatment and the range of services in that work as preceding, and I will endeavour to keep committee and Parliament up to date on that. Following on from that, I will not ask questions just now on it, but it is the lived experience and living experience in how important that will be to inform those specific areas of work. Other members will touch on that later. I will open up questions to members. I will first bring in Alex Cole-Hamilton and then Katie Clark. I appreciate the offer of allowing me to come and sit with you today. I have a couple of questions on ADPs and mat standards, but I would like to come immediately in on deaths in young people. This is quite topical given that there was a death in my constituency a couple of weeks ago at a festival or as a result of taking drugs out of a festival. I have had meetings with the festival organisers, who I have met beforehand, who are exemplars in terms of providing a safe space in terms of the state of the art medical facility on-site, their security, their healthcare staff. This young lady very sadly died having ingested substances before she attended, so there was nothing, zero tolerance approach could have done to protect her. However, there is a perverse reality in the way that we are policing our festivals in Scotland at the moment, as opposed to England. We have a zero tolerance approach to drug use at festivals. On paper, I understand that that sounds compelling, but in England we have pill testing and a recognition that some people will just get high at festivals and we want them to be able to do so in safety. What I would like to ask is whether you consider discussions with the Lord Advocate around the policing of these events so that we can allow young people, or any people of any age, to attend these festivals as safely as possible in the recognition that you are just not going to stop people choosing to take substances on occasion and we need to allow them to do so in safety as they do in England and Wales. First of all, my condolences to the family of Mr Coe Hamilton's constituent. I think that any deaths are tragedy and we all feel that. I think that the death of young people is always particularly sore. To the need for drug checking facilities, I have discussed this matter fairly extensively with the UK Government and the various ministers for UK crime and policing. I think that Mr Coe Hamilton has a slightly different understanding of what the position is in England. My engagement with UK ministers is that they are really resistant to drug checking facilities at festivals. I am aware of one licence in recent times being made available on a short-term basis to support festivals, but it is fair to say that across the UK we do not have enough drug checking facilities at these times. Drug checking facilities require a home office licence and there is the postal service that operates in Wales and has operated in Wales for a number of years where people can get substances tested. The important thing about drug checking facilities is how they are layered with other harm reduction methods. I am very in favour of extending drug checking facilities. I do not think that we are doing enough of that across the UK. It does require a home office licence. There is work going on in Scotland on three projects. Research has been done at the same time that projects have been developed. One of those projects is nearing a position where they will be able to make an application to the home office, but they are geographically specific. The Lord Advocate will, of course, engage with all his colleagues on that if there are different approaches that are required based on experience and on tragedy. If I can move on to mat standards, despite recent implementation and some success of the implementation of mat standards, it is still proving difficult to access same-day services in areas of rural reality, where clinics are few and far between. Can I ask what your plans are to increase provision of same-day services in those rural and hard-of-reach areas? It is a fair point, Mr Cole-Hamilton. I am not going to sugarcoat where progress has not been good enough or fast enough. You are right to allude to that, although the majority of the red amber green status in the benchmarking report by Public Health Scotland was in amber, there wasn't enough greens and there was too many reds, particularly in and around mat standard one, which is that crucial life-saving same-day treatment. That is why, for the very first time, we have a ministerial direction that places certain requirements on chief officers and chief executives of health boards, IGBs and local authorities. I am due to update Parliament very imminently, maybe the next fortnight or so. It is certainly next month on the progress since my last update to Parliament. That is based on the improvement plans that we have received from every area. For some areas, they are now in a cycle of quarterly reporting in other areas where the challenge is greater. They are subject to monthly reporting, but we are beginning to see some good and innovative practice in and around rural areas. Perhaps we should share some case studies with the committee on that. If I can point to borders—borders are rural areas—that were the one area that were able to secure green across mat standards 1 to 5. If we can do it in borders, we can do it elsewhere. That is not underestimating the challenge, but this can be done and it should be done. If I can come back to you, I have a lot of questions and members to come in. I will bring in Katie Clark, and then we will move on to some questions around statistics, and I will bring in Natalie. Minister, as you are very well aware, the drugs deaths in Scotland are significantly higher than other parts of Europe. From the work that you have been involved with so far and all the work that is being carried out, have you been able to come to any conclusions as to why that is and what evidence there is to show why we fare so badly? I always distill this into three very important factors. It is, of course, complex. We have some deep-rooted challenges in Scotland, the task force and various other academics have written extensively about the acute poverty in particular areas of the country. We all know the research in and around the relationship between substance use and past trauma and poverty, but in terms of your specific point about why Scotland. Factor number one is that in terms of the information that we are able to gather on prevalence, there is a higher prevalence of problematic drug use of Scotland. Now, there is quite an existential question as to why that is. The second point is the prevalence of heroin and benzodiazepines in drug-related deaths. We are not always able to do direct comparisons because the drug misuse deaths in England are a bit different in terms of the underlying work and the proportion of cases that go through toxicology and forensic screening. However, we know that there is a much greater implication of benzodiazepines in our deaths significantly more than England and Wales, although I noticed some reporting and recording that is beginning to indicate a rising benzodiazepine problem south of the border. There is a higher implication of opioids in heroin in our drug deaths, which speaks to higher risk behaviours, more injecting, lethal combinations and poly-drug misuse. People with very multiple complex needs. The third reason is about treatment, and I have been utterly frank about this time and time again. We do not have enough of our people in the protection of treatment. That means that we need to get more people into treatment and then when they are in treatment, if people fall out of treatment, we need to follow up. That speaks to the importance of MAT standards. It speaks to the importance of not just investing in services but also reforming services. There are other aspects that I have opinions on in terms of misuse of drugs, etc. In terms of treatment, co-party of the national mission is investing and reforming our treatment services, but crucially not in isolation from the other cross-government work that is so important. The First Force contains 20 recommendations and 139 actions. Can you put on record whether you accept all those recommendations and those actions and whether the Scottish Government is going to pursue them all? I appreciate that 20 recommendations and 139 actions, and of course the task force was an iterative process. There were other recommendations that came out earlier. I hope that I have demonstrated through the information that the committee gave that progress is already underway. We did not sit back and just wait on the final recommendation of the task force. I gave a very warm welcome to both the challenge and to be frank, the criticism that the final report contained for the Government. As you will appreciate with all those actions, we have a lot to work through, but I will be endeavouring to give a very positive response when, at the turn of the year, we come back with the cross-government action plan and the stigma action plan, when we come back to Parliament with that, that we will be able to demonstrate an overwhelmingly positive response. Will we implement every recommendation in the precise way? You will appreciate that it is the role of organisations and people who are making recommendations to make recommendations. Government then have to quite often work out the how. You will indeed. Thank you for letting me join this morning and good morning to the minister. Looking at the statistics, 93 per cent of all the drug deaths there was more than one drug present, and I know in the report that there is little reference to alcohol. I wonder if we know how regularly that was present with another substance. From my own experience both in personal life and dealing with constituents, alcohol is often something that leads on to other things. In terms of preventative and early intervention measures, can the minister advise what research has been done on the part that alcohol plays in drug misuse or equally the statistics that we have got in front of us? The member is probably aware that there are separate statistics produced in and around alcohol-related deaths that relate to deaths by alcohol-related illnesses or health conditions that can be traced to problematic use of alcohol. For the record, I know that we are now getting into talking about statistics, but we are also talking about lost lives in people. I will try to do that as sensitively as I can as opposed to getting into too much of a dispassionate discussion about statistics. Our annual drug-related deaths are in relation to illicit substances and controlled drugs. That is the purpose of those statistics, how many deaths are as a result of the use of controlled drugs and illicit substances. We are right to point to the 93 per cent of the people who will lose more than one substance in their system. In those deaths it is 11 to 12 per cent of those who will lose will also have alcohol in their system. That has actually went down from previous years, where it would have been around in some years up to about 30 per cent. That speaks to the growing problem with other substances as opposed to necessarily a reducing problem with alcohol. The other thing that we need to distinguish between is that, although an aspect of the national mission is absolutely focused on those who are at risk of dying, we are focused on developing treatment options further and in and around opiates, benzodiazepines and cocaine. I think that when you speak to organisations, for example, Scottish families affected by drugs and alcohol, they will tell you in terms of their families and the people they are supporting the number one concern remains alcohol. If you look at some of the work that was done by David Nutt, he published some work in the Lancet that details harms caused to individuals and society and to others with various substances. Alcohol is at the top of the list. Drug misuse deaths have increased in recent years in all age groups except those under 25, although, as the minister stated earlier, that is still too high for that group. Does that offer any hope that preventative or early intervention measures are working or are starting to work? Do we have any data on drug use among this 15 to 24 age group in terms of the drugs that are being used in comparison to other age groups? Does the minister feel that there is enough work being done to distinguish between the different age groups the kinds of drugs that are being used and equally the frequency of those drugs, which is vital for education and those early intervention measures that we have been speaking about? There is, through some of the surveys that are done in education, what we know about young people that is different from other age groups and I refuse to use the term older. What we know about young people is that they are less inclined to be using heroin. That cannabis and cocaine are a bigger factor in the drug use patterns of young people. The point about your question earlier that I did not address is therefore what are we doing in and around education and prevention. That is why we have a national mission. We cannot have drugs policy or our work to deal with the hearing now and prevent people from dying in isolation from that longer term and very necessary work. I am not going to overread the reduction in the number of young people dying in one year's statistics because it is always important that we get underneath the headlines. The work in schools, for example, is crucial. Of course, there is work going on with young people that is about substances overall. I do not think that we need to over fragment that. We need to be engaging with young people within the curriculum around tobacco, alcohol and illicit substances. We have published some research because one of the asks in the cross-government plan is to review what we are doing and to... I think that there are strong arguments on the need to up data. We published research on that last year. Interventions have to be about increasing the resilience of young people and increasing their confidence and their knowledge. While young people want to have particular information so that they are equipped to reduce the harm that is associated with different substances, there is a broad approach that is upskilling. Young people and their resilience. There is a whole larger agenda outwith education about diversion from our criminal justice system. I am very interested in how some areas are looking to adapt, not do a shift and lift, but how some areas are looking to adapt the Icelandic model or aspects of the Icelandic model. That is much more about not just treatment and diversion from the criminal justice system. It is about investment in young people and their resources in their past times and their broader health and wellbeing as well as having other purposeful activities. I wonder if I can ask about the figures in terms of drugs death. Obviously, the figures we have focussed on overdose and much of our approach has been focused around that. I think that it is clear that there are other issues that can lead to death that are related to drugs, not least issues such as HIV, PCE, issues around cardiovascular problems, end of life, liver and lung disease. I wonder to what extent my understanding is that we do not capture that data in terms of those deaths. What would your reflections be on how we might be able to do some of that to ensure that we can push resources to the right place? That is a fair point. It is important to remember that our focus on the national mission and drug deaths sits in the context of wider efforts to improve the population health as a whole. My understanding is that there is some information and there is some data collected in and around specific deaths. Whether it is HIV, there is information that is published in and around wound care, bloodborne and viruses. I will go back and look to see whether enough of that is routinely published. Where does it sit in terms of management information, experimental information? There is an appropriate, regular cycle of that. I think that that very much sits in the context of improving the population health overall. I will come back to the member on that. That is very helpful. I was keen that the minister was able to go away and review that because I did not try to catch the minister or add to what is a very important piece of work. I just think that it is important that we capture those other aspects so that we can ensure that all of our resources are focused. I think that particularly in terms of the resources that are available to communities in that space, where they do work on the broader issues that are associated, also issues like accidents related to drugs and personal safety. I do not know if the minister wants to add anything in that space. I agree that it is important that we have a wide and appropriate dashboard of information where we can understand all of the harms, as well as the contributing factors to drug-related deaths, but it is important that we have that information about all of the harms. I hope that I have managed to demonstrate, at least to some extent, the publication of our national mission plan in September and the publication of both the national mission annual report and the ADP. The annual report is that we do very much have an outcomes framework. You will see in the national mission plan and in our national mission annual report the information that we are currently using that feeds in so that we can capture harms. If the committee came to the view that we were not capturing all of that, we would certainly endeavour to address that. We will now move on to some questions around lived experience. I will bring in Julie Martin and then Miles Briggs. Thank you very much, convener. I would like to ask the minister quite a few times on this particular subject about those who need to access treatment but who have caring responsibilities, particularly mums and dads. The framework for families that was published last year had a lot in there about that. I would like to ask what progress there has been. I know that this week there were significant announcements around that in terms of facilities but progress around helping those who access treatment of whatever type when they have caring responsibilities. I will give you one example. I spoke to a woman yesterday at a recovery-oriented systems of care event for women, 200 women in Glasgow with lived and living experience, all putting the world to rights and certainly holding my feet to the fire. It was a fabulous event, and it was a Glasgow ADP-lived and living experience reference group. It will also be one of the reference groups for the national collaborative. I met a woman who told me that when she was embarking upon in the earlier stages of her own recovery journey, that social work was involved with her and her children. They were of the view that she couldn't take her child to a fellowship meeting, a recovery meeting. In my view, I may not be making judgments about cases, but I begged the question whether we understand enough about the recovery community and the recovery opportunities. That meant that the lady was constrained in the time that she could spend going to meetings and investing in her own recovery. There are sometimes quite simple things that can be done in practice that really speaks to that more personalised care approach and acknowledging the challenges that parents with care and responsibilities have. Of course, there is a really great day on Monday with the official opening of Harper House and Soul Coats. It has been open a few weeks now and it has begun to take the first families coming in. It opened for referrals last month and we are now beginning to see more referrals and some families enter those great facilities. It is a national specialist facility that is available for families all over Scotland. It will be a leading therapeutic facility and there will be services and areas across the country that will be able to learn from it as well. There is other work that we are doing in terms of working with Aberlawer, the children and mother houses, our work with the River Garden in Ock and Crew in Ayrshire. We are increasing their facilities for women as well. In terms of the whole family approach, the family's framework, there is a stream of work that is led by multidisciplinary experts in this area. They are working to support and share best practices but they will also be doing an audit of how that framework is being implemented. We are gathering and publishing more information so that we can support and scrutinise what is happening on the ground. You have pre-empted my second question about auditing what has happened before. All of us will have heard situations where you have maybe had a mother who has had a child taken away from her and then falls pregnant again and there is an expectation that that is going to happen. Is there going to be drilling down into that kind of situation to see where that support could have been in place to help somebody when they find themselves in a situation where they are pregnant again and are worried about their child being taken off them and to support them to have a better outcome? We have made a cross-government commitment to all government to keep the promise. That is about our work to keep families together and to prevent unnecessary separation of children from the appearance and how that is in everybody's interest. It also speaks to the additional stigma that women and mothers experience if they are mothers who have a problem with substances and the fear that many women have in coming forward and seeking help. I know that we will be debating and discussing stigma much later today in the chamber. Therefore, as well as early intervention, there are cultural changes that are needed to ensure that women feel safe in coming forward and that they can build trusted relationships. There is a gap in what we are looking at, and I think that that is to do with housing and homelessness. I know that I have raised with the minister a few times now, but it still is not being addressed. Government, quite frankly, is also not talking about the housing crisis that we have. Given the statistics this week of the 222 people who died who were homeless, a half of those people died because of drug deaths. What is the Government going to do about this? Clearly, we need to see supported housing models put in place. What are the Government doing on this? It seems to be an area that ministers have taken their eye off the bowler. It is most certainly not forgotten, because again, all the evidence and all that lived experience tells us that if we were to distill all of this down, what people need as a home, relationships and to feel valued and to have a purpose in life, whether that is through supporting people into volunteering opportunities or employment. People's accommodation needs are absolutely fundamental and basic. What we have seen with the homelessness death statistics, and again, I hope not to be in any way de-personalise the loss of life in the talk of statistics, but this information is crucial. Mr Briggs is absolutely correct to say that homeless deaths are too high, and he is absolutely correct to say that more than half of those deaths are also drug-related deaths. There is a very close association with homelessness and drug-related deaths. What we have seen, and again, I say this by way of information, and I am most certainly not one for over-reading one set of statistics, but the drug-related death aspect in those figures reduced from 151 to 127. Within the homelessness death, there has been a reduction in the numbers of people who had a drug-related death. They are still too high, but it points to some movement. I am a big proponent of the housing first approach. Mr Briggs will be well aware of the Government's ambitious record in building social housing, but it cannot be housing without support. That is why Ms Robison and her team are taking forward the housing first approach and other approaches to providing care for people as well as their accommodation. Obviously, I shadow Ms Robison, and part of the problem is sometimes the housing first model. Let's be honest about that. Often people who have chaotic lives are not able to hold down a tendency, but that is setting people up to fail. I have also discussed why we do not fund more supported accommodation and get that built and in place. We should have been doing this years ago. There is a charity rare in Alba here in Edinburgh, which I hope the minister will come and visit with me at some point if she has not already seen them. They provide accommodation for individuals who have alcohol brain damage. That is supported living, which stops them being homeless. There is a waiting list here in Edinburgh for another 50 people who could be in these sorts of accommodations. Nothing is happening to take that forward. Here in the city as well, there are 1,095 children living in temporary accommodation. I know from my case work that the substance misuse issues that they are developing are very acute. That is where we really need to see a shift. Housing first is a good policy, but it is not delivering for this group of people. We need to see a rethink on that. I will say something that is, I hope, positive, but perhaps a bit defensive. I think that the housing first model is good. In that, it is meant to have enough flexibility to meet the needs of individuals in recognition that because of the chaos and the trauma that some people are living with, sustaining their own tenancy on their own, it is undefined. I think that we should not step back from the housing first model. I think that there is a point about other models of care. I recognise that in the drug treatment aspect. We have very strong clear commitments around residential rehabilitation and that abstinence-based recovery model not stepping away from that. There is a need for other models of care. Supported accommodation is clearly part of that. That links not just with the work on homelessness but with the work in and around mental health. There will also be an opportunity for Parliament, particularly when the homelessness prevention duties are refreshed. I think that there is something very powerful and cultural about the ask and act. There are too many people in inappropriate temporary accommodation. I certainly, as a constituency MSP, do not represent a city but I have encountered young people being put in inappropriate accommodation and that is not keeping the promise or doing their best by every child. I appreciate that there are some particular challenges in and around cities and part of our thinking in and around the cross-government action plan that will bring forward is what specifically will be able to do more to scrutinise and support cities. Bear in mind that Glasgow, Edinburgh and Aberdeen all had rising drug deaths. Again, we know that from the annual report. I'll maybe come back to you if that's okay. We've still got a number of members to bring in, so I would appreciate as succinct questions and answers as possible. I'm going to move on to Russell Finlay to ask some questions around funding. Good morning. I've got a lot to ask, but of course everyone else does, so I'll stick to probably what I think is the most important issue just now in front of me, which is the new report published yesterday by Favour UK. I'm sure you're aware of its contents. It's quite critical, the Scottish Government. It talks about a phenomenon that identifies as pretend rehab services. What it means by that is that beds that are categorised as being for the purpose of rehab aren't really for rehab. They are for stabilisation as helpful and as important as that is. Do you accept that criticism and how would you respond to that criticism from them? How I would respond is the Government and the Residential Rehabilitation Development Working Group is very clear. In Scotland we have a very clear definition of what residential rehabilitation is and what it is not. Residential rehabilitation is structured residential therapeutic programs that are supporting people towards alcohol and drug free lifestyle. There are other models of residential services, whether that is in and around crisis care or stabilisation. They are important in ensuring that we have a wide spectrum of treatment opportunities and services in getting the right people into the right treatment at the right time. I would dispute the claim that we are investing in pretending residential rehabilitation. I think that that is unfair personally. What we are counting, if I can put it that way, and what we are funding, is that traditional residential rehabilitation model that has historically been undervalued and underinvested in. I think that it's worth noting that they didn't use the word pretend, they used the word pretend. Talking of counting of rehab beds, I've seen an email that was just from this month, in fact, from one of your officials, a senior policy officer in the Scottish Government's residential rehab team. This official says that there was an error in a Scottish Government report about rehab beds. After publication it became clear that wrong information about 40 rehab beds had been published. Those, in fact, were stabilisation, not rehab beds. What it meant was that this document wrongly said that there were 218 rehab beds when, in fact, there were 170, so it was a fall. I suppose the question is how could something like this happen in an official Government report? Does this not perhaps speak to favours concerns that there is a blurring of the lines as evidenced by this mistake between rehab beds and stabilisation beds? Firstly, Mr Finlay, that was not a Government report, it was a Public Health Scotland report. You're quite right to say that an error was established in the information that Public Health Scotland had received from Glasgow, and therefore the quarterly figures had to be revised down. There was transparency in and around that. In terms of the quarterly figures that you're referring to, 170 residential rehab placements, the highest ever for any quarter, have been funded due to Government funding. Part of the reason that we are publishing information is so that we can scrutinise what is happening in every local area. I know for a fact that we have in the last financial year supported the funding of over 500 residential rehabilitation placements, and over the lifetime of the national mission we have supported the funding of over 700 residential rehabilitation services. It is important to distinguish between residential rehabilitation and stabilisation services. I am talking of transparency. The Auditor General's report of March says that there is a lack of transparency as to where the spending is taking place. I met him last month and he says that it is much the same still. The £250 million, why is there no transparency around that? At the start of this week, I published, in part, due to the recommendations from the Auditor General, an annual report that is detailing the spend and the location of the national mission monies. I am determined to get as much transparency as possible on this, Mr Finlay. I am determined to follow the money because I want to ensure—I think that this is where I am on the same page—that the Auditor General is. I want to ensure that the additional resources that the national mission has secured, that it has maximum effect and that, for example, if this Government has taken the decision to allocate specific resources, to residential rehabilitation, I want to ensure that it is used for pathways into residential rehabilitation, residential rehabilitation beds and, of course, associated aftercare. I want to satisfy myself, because I am accountable to Parliament, that money has been spent on what it was destined for. I am going to bring in Gillian Mackay now just to pick up some questions in and around safe consumption rooms and then I will bring Paul O'Kane back in. The minister will know my interests in the progress of safe consumption rooms, so could the minister give an update on the work in this area? Ms Mackay will know that I am firmly in support of safe drug consumption facilities. I had the opportunity to visit a facility in East Harlem in New York, and I was in the States on my own time at my own cost before there were any questions in that regard. The evidence shows that safe drug consumption facilities work to save lives. They are not the silver bullet, but they have a role to play, and we have worked very hard with our partners in terms of Glasgow Health and Social Care Partnership, the Crown Office and Police Scotland and others to develop a proposition, a service specification, and that has been submitted to the Crown Office. In terms of our more specific update, the Crown Office has been gathering some further information, as I understand, from Police Scotland and are nearing a position where they can give advice to the Lord Advocate. You will appreciate that I cannot speak on behalf of the Crown Office or our independent Lord Advocate. We have a debate on stigma this afternoon, and we are not wanting to pre-empt anything there. What work is being done in communities where safe consumption rooms could be placed to ensure that the stigma around the service is reduced, that people know the potential public health benefits and that communities understand the purpose of the safe consumption rooms? In terms of tackling stigma and understanding of drug and alcohol issues as a public health issue and attitudes towards various treatments, I think that there is a role there because sometimes communities can have views about the location of any service within their community. Therefore, it is important that local services are engaging and having a very open dialogue with local communities. In previous discussions around safe consumption facilities, we have discussed the legal barriers that exist. I think that the minister would contend that that is a significant challenge in being able to deliver them. I am interested in understanding what analysis has officials done of current legislation that exists that might help to overcome that. For example, has the National Health Service Scotland act been looked at in terms of the provisions within that, which puts a duty on Government to promote in Scotland comprehensive and integrated health service to secure improvement in the physical and mental health of people, prevention, diagnosis and treatment of illness. I wonder to what extent have officials looked at other legislation that might help us to move forward. I think that there are two broad points that I wish to make. We are still waiting on the Lord Advocate to give us a view of whether the service specification and operational procedures are within our powers and whether that rests within her powers to determine prosecution policy and what is in the public interest. That is a core consideration to that. There is, of course, Mr Acain's right to point to other health-related legislation, the other bit of legislation that we cannot ignore is the issues of the Drugs Act. We have worked hard with partners to devise a proposition that is within what we can currently do in Scotland, but I am not the final arbitrator of that, hence the role of the Lord Advocate. I think that you also alluded to a point that Ms Mackay made that there are other models here. There are other ways to implement safer drug consumption facilities. There is a fixed model, a fixed premise. There are clinically-led models, and there are other models where there are more voluntary sector-led models. Of course, there are mobile models of safer drug consumption facilities as well. Although, ideally, I would rather have been starting from the position of which model will best meet the needs of our people, where we are right now because of the misuse of the Drugs Act, we are framing a service in relation to our powers. That is being detailed, it is difficult, it requires very precise work, but it is not the ideal way to do this. There are other models there, so we are framing our proposition around what we hope is within our powers, but I am not the final arbitrator of that, as you would appreciate. There is health in terms of what has been looked at in terms of context, but I wonder whether the minister would be willing to share what information she has gathered on, for example, that specific act that I referenced for the committee's information. I am going to bring in Sue Webber. You have a follow-up to Paul and then I will bring in Alex Cole-Hamilton. What correspondence have you had from Police Scotland, the Crown Office and other justice authorities regarding the proposal for the safe consumption rooms, and can you make those public as well? The proposition could change depending on the feedback that we get from the Lord Advocate and the Crown Office in due course. Our work has centred around one service in one city, but there has been a broad range of work. The correspondence in the work is not all mine. You will appreciate that there is a very central role here for independent Police Scotland and the integrated joint board. My approach within Government has been to facilitate that and to support that and to enable people to build from the ground up a proposition that is framed within the powers that we have. I will look at what would be appropriate for me to share, because I appreciate the great interest in that. I also appreciate that there is strong parliamentary support for safe drug consumption facilities. While I know that some Conservative members have reservations, I also take them at their words that they are not looking to stand in the way of a pillar. The minister knows my party's long-held support for safe consumption rooms, and it speaks to the approach that we discussed in our earlier exchange about the understanding that people will always consume, that zero tolerance does not work and that we need to help them to consume as safely as possible if that is their choice. We know from yesterday's events that the Lord Advocate has been very busy. Is the Lord Advocate working to a timeline on that? Do you have an expectation of when she will come back to you with it? With every week that goes by, it is potentially lives that are not saved? I appreciate that point, Mr Cole-Hamilton, that time is of the essence. You will appreciate that I will not help matters by stepping into other people's duties and terrain, but your point is well made that time is of the essence. Those services work. They are not the only solution, but they work, and I have seen them for myself. The core issue of the national mission is to get people into the treatment that is right for them. While I hope that I have conveyed my conviction in and around abstinence-based intervention and the traditional residential rehabilitation, we also need to be fearless, absolutely fearless about harm reduction because lives depend on it. I know that there are some aspects of harm reduction that will feel counter-intuitive to many people, but we have to do what works, follow the evidence and do what we can to reach people where they are, to build relationships and to begin that journey to connect them with other services. It is part of us that is saying that we care and we want people to live and survive and thrive. I will come back and bring in Sue Webber to pick up some questions around early intervention and then we will move on. The task force has recommended that the Scottish Government prioritise intervention at an earlier stage, tackling the root cause of drug dependency and that links between work on poverty, structural inequality, education, children and young people, and work on drug policy should be clearer. I think that these are things that we hear across all committee portfolios about early intervention. Can the minister outline what early intervention should look like in this situation? What steps will she be taking to ensure a more joined-up approach to tackling all of the root causes of drug dependency? I think that there are a lot of things that we need to do to ensure that the Scottish Government prioritises intervention at an earlier stage, tackling the root cause of drug dependency and that links between work on poverty, structural inequality, education, children and young people, and work on drug policy should be clearer. I think that these are things that we hear across all committee portfolios about early intervention. Can the minister outline what early intervention should look like in this policy area and what steps will she be taking to ensure a more joined-up approach to tackling all of the root causes of drug dependency? I know that Mr Briggs has mentioned earlier about housing as well. The reason that we have a national mission is to join the dots so that drug policy does not sit in isolation. In terms of, more specifically, Ms Weber asks a fair question about what early intervention should look like in terms of drug policy, our work with families, the work with communities, the work with housing and homelessness, and how all of that needs to be absolutely aligned. Of course, the purpose of the cross-government action plan is to ensure that all of those actions—there is a breadth of action, there is huge investment despite these trying times across government—how do we make all of that a line better and work better together for better outcomes? In terms of our support to alcohol and drug partnerships, it is very clear that we need alcohol and drug partnerships not to be in isolation, that they need to be very much connected. The work that they do needs to be central to children's services plans and to that broader community planning. All public authorities have a fairer Scotland duty to put on them. I introduced that number of years back, Mr Kohamel might remember. That is about the fact that every strategic decision needs to be thinking about how the decisions that we make here and now have an impact on child poverty and reducing poverty and inequality. Our work with ADPs is driven by the fact that, quite often, the work that they have been done has been separate from other work done by IGB's community planning partnerships, and it has to be front and centre. I am glad to hear about joining the dots and the intention and ambition of what we are doing. I know that we have had a discussion around a constituency case where the individual found it very challenging having first tried to access services in February but not gaining a space in rehabilitation until September. I think that what we hear again and again is that those people looking and seeking services are treated like a pinball in a pinball machine. They are pinged about and they are following the route that the service wants them to follow. It is not censored around them and we hear about pens and person-centred care often, but I do not get a sense that this service is really delivering for those in that way. In terms of that no-wrong door approach, we are not getting a sense that what is happening on the ground is what is being said and stated in documents and by ministers and by civil servants. What can we do to address that implementation gap to make sure that there is no wrong door for those people to go to and that they get the help quickly and not having to wait six or seven months before they can access that help? There are a number of layers to that, convener. I can go back to a point that I made earlier. The reason that we are publishing lots of local information about what is happening with additional investment is so that it can be scrutinised and where there are issues it can be addressed. The member will be aware from our previous discussions but I will not rehearse that every area now has a pathway into residential rehabilitation. What I hear 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 task force that has made some very strong and challenging recommendations, not just about no-wrong door, that there is to be no closed doors. It is the biggest frustration that people have about being bounced around between services. The things that will help will be to ask and act homelessness prevention duties. That is not just about people being passed from pillar to post and key posts in the public sector. I think that the work around mental health and substance use services is critical here. Our response to the task force will also align with our response to the Mental Welfare Commission. The recent reports to reports this year and the rapid review into mental health and substance use services. Some of that is about services on the ground being really, really clear that you cannot deny somebody a service on treatment until they are, for example, abstinence from drug or alcohol. There needs to be much clearer understanding on the ground about who the lead service should be, whether it is mental health or substance use, and when the other partners are brought in. We will be coming back to Parliament on that. I just wanted to ask about accountability on that. Where does it lie? I can ask for a succinct answer. We have still got a number of areas of questions, about 15 minutes left. I think that what I will say about accountability is that it is accountability at each and every level. I am stepping up accountability for local areas, but I stress that I am not asking other people to do anything that I am not prepared to do myself. Accountability and leadership are at a local level, but senior levels such as IGBs, local authorities and the Government are crucial. Accountability is at each and every level. We are accountable to ourselves and to each other. We need to challenge ourselves and each other. Thank you for that, convener. Thank you very much indeed. We will now move on to some questions around the national stigma action plan. I am going to bring in Voisel Chowry and then I will bring in Julian Martin. Thank you very much, convener. Good morning, minister. My question is on people from minority ethnic background are often hit harder by cultural or community stigma and may find it harder to seek help when they need it. What can be done to address that? It is a very important point and it is reflected in our national mission plan. You will see that in terms of our outcomes framework and the importance of not just tackling poverty and inequality but focusing down on equalities and different groups. I have spoken today already about women and young people. My concern is that we are not doing enough to reach into other communities. I am conscious that sometimes services can have stereotypes or misconceptions about other communities. I can assure Mr Chowry that we have begun to make better contacts with groups. Some of that is about the visibility of the recovery community and that has encouraged other groups. I recently made contact with a lady from a Scottish Women's Muslim group for example. I am conscious that while across our society in general drug and alcohol problems can be hidden, they can be even more hidden within some communities and some of that can be related to our false perceptions of other communities. We really need to be thinking more sharply. It is fair to say about how we reach out to other communities. If members or Mr Chowry wish to engage further than that, I would be delighted to do so. Mr Chowry, would you like to come back in? No, thank you very much. I am very happy to get involved in future. I am going to bring in Julian Martin and then I will come across to Natalie Dawn. I have one question that surrounds the stigma of medically-assisted treatments. Even in the last 10 years, there has been a lot more nuanced conversation about the way that medically-assisted treatments are a pathway for a lot of people to prevent them from getting into crisis and prevent drug-related deaths. Would the minister like to outline how any stigma around medically-assisted treatment might cause massive harm to people and the discourse that we have in politics and in the media around people who have access to methadone? It is fair to say that stigma exists in some quarters about certain types of treatment. Some of the discourse that you read or hear about in and around methadone, for example, is unhelpful. Time and time again, I am not interested in supporting harm reduction or medicated 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. People need to have informed choices and options. There is a big international evidence base around different strands of medicated assisted treatment, but medication should never be a lonely offer to people, hence the importance of implementing mass standards. That is essentially about treating drug and alcohol issues on a par with other health conditions. If any of us sitting around here trip up to a doctor or any other health condition, we are given information, we are given choices, we have a bit of a discussion about what is best, and it is that ethos that we need. People should always have choices and options in the space to engage and to make informed choices about what is best for them. I am not interested in false arguments around harm reduction versus abstinence. We have to dump our own ideological perspectives. My views on many things have changed over the years and we need to follow the evidence, but we need to be listening to what each individual wants and needs. I am going to move swiftly on. We have about seven or eight minutes left to some questions around public health approaches in the justice system, and I will bring in Natalie Donne and then Katie Clark. I know that the task force's final report states that they found, I believe, the tentative support for decriminalisation or regulation of the market. This has been shown to reduce drug deaths in some other countries. It would allow resources to be better focused, and finally it could work to reduce stigma around the general population. Can I ask the minister if this is something that the Government would pursue if it was possible and advise of any discussions that have taken place with counterparts at Westminster in relation to this? Equally, the more punitive approach that the UK Government has recently suggested that they will be following, which could work against the public health approach that we are taking here in Scotland? I am going to do my best, convener. My focus on this job has always been first and foremost on what I can do. My endeavours are focused on the powers and resources at my disposal. Ultimately, I am a pragmatist at heart and I want to crack on and do things now. I do not, however, ignore the implications of powers elsewhere. I am not looking to enter into any kind of constitutional debate here and now, but, of course, the misuse of drugs act has an implication in what we can and can't do. It impairs, in my view, some of our approaches to harm reduction or certainly makes that journey towards improving harm reduction interventions harder. The issue of decriminalisation or drug law reform is complex, and I think that there is a debate—I would frame it—about drug law reform more generally. Decriminalisation means different things in different countries. In terms of going back to principles and basics, what is going to work? What is going to make folk safer, if not safe? I am very clear that we cannot punish people out of addiction. The international evidence that we have looked at—we published a paper last March, last May—was looking at international responses to drug law reform. In broad terms, it showed that the public health approach was more effective at reducing harm. Some of people's fears about drug law reform more broadly are that people often worry about increasing drug use, but the evidence does not appear to show that. In my view, we need to have a review of drug law across the UK Government. It is fair to say that I am not inclined to do that. I will be meeting the new minister at the beginning of December. It is a frequent discussion point. I will come to Katie Clark, and then we will bring the session to close. On the dialogue that you have with Westminster, it is quite clear that there is a different approach from the UK Government in the issues of a far more punitive approach to the public health approach that is being discussed here today. What scope do you think there is to genuinely be able to do some different things in Scotland? On the basis of the discussions that you have had so far, I appreciate that it has been a changing scene down there. It may be a different person that you will be meeting in December than before. Where are you in terms of those discussions in terms of being able to have divergence in Scotland and go ahead, for example, with some of the things that are within our competence round about consumption rooms but looking at other initiatives as well? How do you feel you are getting on with that and are you able to focus on specific proposals in your discussions? Despite differences of opinions in terms of Kit Mawthouse, who was the first UK Government minister I met in relation to this job, we had some well-documented differences. Nonetheless, we had a lot of engagement. The quick succession of ministers in recent times that has coincided with recent changes of Prime Minister means that there are two ministers that were in office for such a short period of time that, while I wrote to them, welcomed them to their role and with all of the issues that I wish to discuss with them, time did not permit actually meeting them. In terms of where there is some agreement around issues on things such as leadership, investing in reform and services, the importance of treatment, we have some agreement in and around the need to legislate for the regulation of pill presses. That is very important in terms of tackling. We will see where we get to with home office applications in and around drug checking. We are on a completely different place in terms of safe drug consumption facilities, but I will see where the new minister is. That is a gentleman called Chris Philips. In my mind, the UK Government has a white paper on swift, tough consequences. That is misguided. It will potentially cause more harm. It is based on an outmoded punitive approach. I continue to seek urgent clarity of if and how. How that would apply to Scotland? The White Paper said that tier 1 and tier 3 could, potentially, apply to Scotland and Northern Ireland, and I would have grievous concerns about that. I am conscious that I have written to committee about that, too. Time is against us. I will have to bring our meeting to a close. I know that members will have some outstanding questions, and we will write to the minister with some follow-up points if members would like. A big thank you minister. That has been a really interesting and helpful session to your officials as well this morning. I will now bring the public part of our meeting to a close, and we will move into private session. We will pause briefly to allow our witnesses to leave. To colleagues all the time, I am sure that people will be shying, seeking more information on more dialogue here appropriate.