 The next item of business is a statement by Angela Constance on pathways to recovery, update on progress and milestones for expanding access to residential rehabilitation in Scotland. The minister will take questions at the end of her statement, and so there should be no interventions or interruptions. I call on minister Angela Constance up to 10 minutes, please. We carry a national shame of thousands of heart-breaking drug-related deaths, and it's my job as Minister for Drugs Policy to lead the national mission to turn the tide on this crisis. When speaking to people in recovery, I'm often reminded that stopping someone from dying is only the beginning of the recovery journey. Recovery isn't something that happens to people, it happens when the systems of services and resources facilitate individuals to build recovery capital, social connections and 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. It's with that word hope in mind that I come before Parliament today to provide an update on our progress on residential rehabilitation and 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 improve lives, whether that is through harm reduction services, medicated assisted treatment, abstinence programmes or support for mental health, housing and welfare. This is about supporting people to access the treatment and recovery that is right for them. Therefore, we are working to ensure that all the component parts of a recovery-orientated system of care operate effectively with good links and pathways between them to reduce harm and promote recovery. Residential rehabilitation must be part of this range of evidence-based prevention treatment and recovery services. That will ensure that there are options and choice for those who want to seek an abstinence-based recovery. There are three parts to our national approach towards achieving this. 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 also. Today, we have published a suite of reports detailing the current state of pathways into through and from rehab. The research undertaken by the Government 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 that is even more vital for residential rehab because it is all too often not part of the range of options available. We also 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. Pathways to residential rehab and aftercare should be clear, consistent and easy to navigate no matter what area of Scotland you live 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 are published today on homelessness deaths, more than half of which are linked to drugs, make this an ever-greater priority. We will be ensuring a rights-based approach by applying the panel principles of participation, accountability, non-discrimination, empowerment and legality in the development of all pathways in all ADP 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 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, an investment of around £1.4 million from the £5 million 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. However, let me be crystal clear, it will be unacceptable for any area not to be investing in residential rehab. We are aiming 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 this ambition and to facilitate regional approaches, especially in those areas where the rate 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, are 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 that I am very grateful to to ensure equal access across Scotland. The total estimated number of rehab beds available in Scotland just now is 425. Our aim is that by 2026, there will be 50 per cent more rehab beds in Scotland, 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 service 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. This 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 today to Parliament that we are also providing funding to expand the capacity of the Lothian and Edinburgh abstinence programme LEAP by 40 per cent. The funding will enable the detox capacity in the Ritsyn clinic to increase by 50 per cent. This 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 that there is a need for diversity of residential rehabilitation options, we are also funding Rivergarden to scale up their innovative residential therapeutic community and social enterprise. Based on the experience of international models in Italy, Sweden and the USA, Rivergarden offers a three-year residential programme for people in the early stages of recovery. The service currently supports seven residents and this funding will enable them to realise their 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 more fundamentally transform the way 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, Government may take a national approach to commissioning specialist addiction services. Whilst 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 to consider what the different routes available to government are now. 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, and, for example, we welcome the recognition across this Parliament that safer drug consumption facilities have a role to play in saving and improving lives. Today, I have outlined 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 on 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 residential rehabilitation over max standards, it is not about giving priority to abstinence over harm reduction. This is about supporting people, and it is about 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. The minister will now take questions on the issues raised in her statement, and I intend to allow around 20 minutes for questions after which time we will move on to the next item of business. It would be helpful if those members who wish to ask a question were to press the request to speak buttons now. I call on Sue Webber. I thank the minister for advance sighting of her statement and the many attachments that came with it this afternoon. In October, the Scottish Government held a debate on a person-centred approach to mental health and substance abuse. Today, we have heard again about the importance of getting more people into the treatment and recovery that is right for them. The problem with the idea and ideology of person-centred care is that, in reality, the care that people receive is system-centred or organisation-centred. Patients generally get what the system or organisation is willing and able to deliver, not what they want or need. What guarantees can the minister give us that person-centred care will be centred around the person and not around the ability of providers to deliver a service? I very much appreciate Sue Webber's contribution. I also understand that there was a wide variety of attachments and publications that have underpinned the statement today. There is a wealth of information that we have published with Ms Webber or, indeed, any other MSP. I am happy to engage further in the detail in and around that. Boring into the detail is absolutely crucial here if we are to redesign systems of care, whether that is community services or, indeed, residential rehabilitation services that meet the needs of individuals and not providers and not local authorities and not government. We have to have the person at the absolute centre of that. Although I appreciate that much of what I have published today might be less than politically sexy if I can put it that way, it is important to bore into the detail of where the money is being spent to understand where the gaps and provision are, to sort out pathways so that they are clear and consistent and easy to navigate across the country, as well as invest in services to use existing capacity but also to build that capacity. Much of our work around national commissioning and our regional approach will help us to change the systems, not to be meeting the self-perpetuating needs of the system but to meet the needs of our people who need treatment and its treatment that is right for them, not right for us. I welcome today's report on an advanced site of the statement. It shows that some progress has been made and that is to be welcomed. However, I want to introduce a note of caution and how we frame this discussion. I welcome that the minister mentions harm reduction. We must not stigmatise people who use opiate substitutes as a way to address their addiction. It is a legitimate treatment option, and if we are serious about bringing Scotland's fatalities to an end, it is part of the response. I have a few questions about the statement. Although the increase in placements are positive, the residential rehab monitoring funded places' recent report shows significant differences by ADP, so when will the postcode lottery come to an end? I also ask about fatalities of those under 25, for which we have seen an increase. There is also recognition as a lack of access to specialist treatment for young people, including rehab, so what facilities are planned for young people. The final question is to ask the minister if she is confident that the resources in place are sufficient and is she monitoring whether there are any increased changes in the cost to residential rehab? I will try to cover all of that as quickly as I can. I am grateful to Ms Baker for her recognition of the progress that we are making. I absolutely endorse what she is saying about not stigmatising opiate substitute therapy or harm reduction. That is one of the reasons why we are taking a whole systems approach and we are talking about that wider system of care where all the parts need to complement and fit together. She will also note that we are increasing placements significantly. I hope that that will be welcomed across the chamber in terms of phase 1 of the rapid residential rehab recovery programme. We are investing £18 million and that equates to at least 77 beds. It will increase capacity by around 18 per cent and is a significant step forward. However, she is right to say what is next. While we have had a particular focus on families and women and our work there is far from done, we need to think much more about where services need to be, particularly for young people, because what we have seen over the past few years is a growing amount of young people either being admitted to hospital or tragically losing their lives. The homelessness statistics today and those tragic deaths, which are also preventable, means that we need to, with even more haste, think about how we support those with multiple and complex needs. The £18 million investment is a great boost to services across the central belt of Scotland and our investment in the Lothians in particular will give us a blueprint for expansion elsewhere, but we need to have a really close and look at the acute needs that also exist in our rural communities. The expansion of residential rehabilitation is welcome. However, the minister has outlined the importance of a range of different types of treatments that are required and available. Can the minister give an indication of what role community services will play as access to rehab is expanding? I am particularly aware that that period after residential rehab is particularly crucial. Over the piece, it is important that we do not consider residential rehabilitation in isolation. We need to remember that community services are key to the success of residential rehabilitation. That is about the need to provide continuity of care. That is about the preparation that people need prior to entering rehab. That is also crucially about the aftercare that people receive. We need to be thinking about that aftercare and a much more long-term basis. That is not people coming out of residential rehab and receiving a little bit of support for a wee time. We need to be thinking about the longevity of that on-going support. The active outreach and referral to the lived experience recovery organisations is also important in that regard. In terms of improving aftercare, the £5 million improvement fund, of which £3 million was allocated to improve the quality of existing rehab services, includes improvements in preparation, outreach and aftercare. Before I call the next speaker, I remind all members who wish to ask a question to please press the request-to-speak button—not looking at anybody in particular who is not looking at me, so we will see what happens there. Craig Horry to be followed by Audrey Nicolle. The minister conceded that one size does not fit all. As the Government considers yet another structural overhaul of drug and alcohol support through the creation of a national care service, what assurance can she give that a further review will not simply result in more cuts and bad outcomes for those who require access to residential rehab and aftercare services? Improving access and the capacity to residential rehabilitation is a key part of our national mission to tackle the drug deaths crisis. It is not the only part, as we have heard from others, that there is an important in terms of harm reduction and community services. What I have done in this post with the support of the First Minister is to make long-term funding commitments, both to ADPs and to the voluntary sector, who are often at the front line with the four new funds for people to apply to, whether that is the recovery fund, the local improvement fund, the service improvement fund or, indeed, the family and children's fund. I absolutely concur with the point that this can never be about one size fits all, but we have a national emergency that requires national leadership. It does also require good partnership working on the ground and some bespoke arrangements. However, Mr Hoy could equally criticise us if we were devolving or outsourcing decisions by government where we need to set an example and lead and fund in show direction, but also raise the bar about what is expected in every part of Scotland. The proposal to increase capacity for residential rehabilitation and recovery is welcome and timely. However, what provision will be made to include access so that the highest risk individuals do not face barriers to access arising from preconditions for being alcohol or drug free prior to their admission? As is set out clearly in the good practice guidelines that we published today, there is much more that we can do to remove the barriers that exist in referral criteria, admission criteria and where that is most acutely felt is, of course, people with the most complex of needs, whether that is because they have a history of homelessness, mental health problems as well as issues with addictions. While it will always be the case that services need to make judgments about entry criteria based on safety and efficiency and cognisance to the needs of other residents, it is therefore also important that, as well as our expansion of residential rehabilitation, which is for those who seek an abstinence-based recovery, we are also looking at other models of care, whether that is other models of residential care or accommodation with support. It is also one of the reasons that we are actively committed, and you have heard the announcement today in terms of the extra funding for LEAP and NHS Lothian about why we are increasing funding to improve access to detox, but there is much more that we can do in terms of that different range of services that can accommodate people safely who are not pursuing an abstinence-based recovery. In the wake of the developing situation surrounding the Omicron variant, could the minister inform Parliament how many individuals in residential rehabilitation have received both doses of the Covid-19 vaccine? How many residents in rehabilitation centres have adequate testing and vaccination services available to them? Finally, what has been put in place to make sure that residents get the booster in good time? We published a status report maybe six to eight weeks ago. I will send that information to Ms Mocken, but as a result of that information that demonstrated that vaccination levels within people who were accessing residential rehabilitation were not as great as the general population or in accordance with various clinical priorities and age groups. As a result of that, we undertook a range of actions. New guidance has been issued to health boards. We have been proactive in arranging for guidance and testing kits to be sent to residential rehabilitation. We have also provided some training and support for people to access via webinars and such. However, it is an area that we are taking, and I can assure you, a very active interest, because this is about access to healthcare. All NHS boards as part of their bigger vaccination programme have, as part of those plans, how they will reach people that are harder for services to reach, and we are taking a very close interest in that. Indeed, this is about people's rights to access the same healthcare that you and I have the absolute right to get as well. As you know, Phoenix Futures plans to open a national drug rehabilitation centre on the set of the former Sea Gate Care Home in Solcoats in my constituency, backed by the Scottish Government. However, it will not consult the local community. Instead, it will contact neighbours and elected representatives to help them to understand what they do. I, for one, am still waiting. Does the minister agree that a new development of this nature and scale must be consulted on, not least to ensure that any local concerns are taken on board and addressed, scotch any misunderstandings and ensure that such a project becomes part of the Solcoats community and not just located in it? I appreciate those points, Mr Gibson. As I said earlier to Mr Hoy, we have a national crisis that requires a national mission, and that does indeed require national leadership and decisions to be taken at a national level. I think that I would always be the first to recognise that we can all work harder to improve our partnership working. In that vein, I recently met councillors from North Ayrshire and also Phoenix Futures who will deliver on this project to discuss the plans for consultation as well as community engagement. It is important to recognise that there are local opportunities and local benefits of having a national service in your facility in your area. That was a huge focus of our discussions with the local councillors. I am confident that Phoenix Futures has a well-established approach to carrying out things such as community impact assessments and consultations for projects such as this. They have been running a very similar family service in Sheffield now for 25 years, and I would expect this new national centre in Scotland to follow in this example. If I can assist in any further way to Mr Gibson to reassure his constituents, I most certainly will, but I was very proud that this new national service was the first project that we announced as part of our rapid residential rehabilitation increase in capacity programme because we all have obligations to keep the promise. There was a gap in services for families, and we know that fear of what will happen to one's children is very much a barrier to women in particular to come forward in seeking the assistance that they need. This is a real good opportunity for us to start a breaking cycle, but also to keep the promise. Before I call the next speaker, I remind the minister that I am very well aware of the importance of the subject and the comprehensive nature of the detail that the minister wishes to provide to the chamber in responding to questions. We have very limited time and still quite a few people who wish to ask a question. I thank the minister for advance sight of her statement and she knows that she carries the good wishes of this entire chamber towards the end that she has described. We still face a problem of global proportions. We are still the worst in the world, and as such our response to it needs to be equal to that. I am very grateful to see the Government commit to increasing our rehabilitation places to 1,000, but I am very concerned that it will take us till 2026—five years—to get to that number. People are dying today. What is keeping us? Why is this going to take so long to deliver? For the sake of brevity, perhaps I could emphasise to Mr Cole-Hamilton that we have taken significant steps forward without attracting always from the need to do more and to go further and faster. However, as the first stage of our residential rehab programme, we have committed £18 million. That will add an additional 77 beds, it will increase capacity by 18 per cent and will provide 450 more placements over time. That is an important first step. I do not demur from the fact that there are other steps that we need to take quickly, and part of that is about the whole systems approach. Within the next fortnight, I come back to Parliament to make a statement in and around progress around, for example, medication assisted treatment standards. Emma Harper, to be followed by Gillian Mackay. I would like to commend all the parties' work across chamber for taking a united approach to tackling drug-related deaths in Scotland. We have to use every opportunity at our disposal to identify those at risk and, meaningfully, signposting people to support services. Is the minister in a position to provide an update on engagement with her UK Government counterparts on proposals to introduce safe consumption facilities in Scotland? I continue to take two approaches. On the one hand, I continue to engage with the UK Government on the evidence, not on the politics. I recently attended the UK Drugs Summit and, at that time, published an evidence paper in support of safer drug consumption facilities. Recently, on the back of comments from Douglas Ross and the Conservatives' shift in position, I took the opportunity to write back to the minister, Kit Malthouse, to see if that could encourage a similar change in heart from the UK Government. I am also determined to do as much as we can within our own powers. The Lord Advocate's statement with regard to safer drug consumption facilities is helpful, as it is to be welcomed. We are working through the detail of a proposition to pursue within our own powers. Gillian Mackay, to be followed by Brian Bitto. Public Health Scotland published statistics today that state that 12 alcohol and drug partnerships, including North and South Lanarkshire in my region, did not provide data on the numbers of people entering residential rehab and that one of the reasons for that was patients not meeting the abstinence requirements. Can the minister advise what other treatment options are provided to individuals in those circumstances so that they are not being turned away with no follow-up support? Let me repeat again that it will not be acceptable for any part of the country not to be invested in residential rehab. I also recognise that residential rehab is not for everyone, and that is why we are taking a whole systems approach that we need treatment and recovery services, both different models of care within a residential nature, but also within community settings. As the minister suggested, Scotland has a shockingly high number of drug deaths, so it can come as no surprise that it also has a similarly high proportion of deaths within the homeless community, with more than 50 per cent of homeless deaths being drug related. I can ask the minister what the Scottish Government is doing to tackle drug deaths within the homeless community, to reach out to the community and ensure that they have access to rehabilitation services. Mr Whittle is absolutely correct when he says that this is about how services reach out to people who have more complex needs. Some of the work that is started in Dundee that is overseen by Health Improvement Scotland was focused on, for example, the integration of addiction and mental health services. We know the connection between problems with addiction, mental health and homelessness, so we really need that full spectrum of services, but it also needs to be far better connected. As a result of that work that started in Dundee, an additional four health boards have taken that approach. There is a 2.2 million project that has expanded that work that is essentially about the better integration of services, so that services can reach those most in need and to remove barriers where they exist. I remind the chamber that I am a member of the Moving One Inverclyde, the local addiction service. The minister will be aware of some of the issues that I have raised with in the past. On this, there will be many individuals who have an addiction to prescription drugs, such as benzos, as well as many others who have addiction to street drugs. Will any increase in the residential rehabilitation spaces ensure that there are sufficient spaces for those with an addiction to prescription drugs? The guidance on good practice pathways emphasises the need to facilitate access to residential rehab for all individuals, no matter what type of substance they are engaged in. Research shows that there are particular barriers around the use of benzodiazepines that have specific risks around detox. The germane issue in relation to drug deaths in Scotland is the polydrug use, but people's use of substance should not be a barrier to access and rehab. Thank you, minister. That concludes the statement. I will allow a very short pause to enable front benchers to move seats if they wish to do so.