 Good morning, and welcome to the 10th meeting of the Health, Social Care and Sport Committee in 2024. I received no apologies for today's meeting. The first item on our agenda is to decide whether to take items 5 and 6 in private and whether to consider in private future meetings a draft report on the Abortion Services Safe Access Zone Scotland Bill. Our member is agreed. Our second item today is consideration of two affirmative instruments. The first instrument is the Alcohol Minimum Pricing Scotland Act 2012 continuation order 2024. The purpose of the order is to continue the effect of minimum unit pricing provisions, which has been inserted into the Licensing Scotland Act 2005 by the Alcohol Minimum Pricing Scotland Act 2012. In the absence of this order, those provisions would expire. The policy notes that minimum unit pricing has had a positive impact on tackling alcohol-related harms in Scotland and should be continued as evidence suggests that if MUP was no longer in effect, then alcohol consumption would increase, contrary to the policy aim of reducing alcohol-related harm. The second instrument is the Alcohol Minimum Price per Unit Scotland Amendment Order 2024. The purpose of the instrument is to increase the minimum unit price currently set at £0.50 per unit to £0.65 per unit. The policy notes states that evidence has found MUP at £0.50 per unit has had a positive impact on health outcomes in Scotland and that in order to derive greater health benefits, the current level should be raised to £0.65 per unit. The Delegated Powers and Law Reform Committee considered these instruments at its meeting on 27 February 2024 and made no recommendations in relation to those instruments. We will now have an evidence session with the Minister for Drugs and Alcohol Policy and supporting officials on both of those instruments. Once we have had our questions answered, we will proceed to a formal debate on both motions. I welcome to the committee Christina McKelvie, Minister for Drugs and Alcohol Policy, Orland O'Hymur Mason, Drugs Policy Division, Catherine Mayant, Health and Social Care Analysis and James Wilson population health strategy and improvement all from the Scottish Government and I invite the minister to make a brief opening statement. Good morning, convener and good morning, colleagues. I'm pleased to be in front of you today to discuss minimum unit pricing and the two draft orders that were laid on 19 February. The Alcohol Minimum Price in Scotland Act 2012 continuation order 2024 seeks to continue the effect of the minimum unit pricing provisions beyond the initial six-year period. The Alcohol Minimum Price per unit Scotland amendment order 2024 seeks to change the level from 50 pence per unit to 65 pence per unit. Scotland is facing a burden of disease in the next 20 years, a growing burden of disease. Non-communicable diseases are the leading cause of death and ill health in Scotland and alcohol is one of the key contributors to this. Members of the committee will know that in September 2023, the Scottish Government published its report on the effect of minimum unit pricing in the first five years of operation. This report drew heavily on the studies included in Public Health Scotland's comprehensive evaluation of the policy and evaluation commended by internationally resowned renowned public health experts, including Professor Sir Michael Marmont and Professor Sally Casswell. During this study period, the Public Health Scotland evaluation estimated that minimum unit pricing reduced alcohol attributable deaths by 13.4 per cent, 156 people a year and was likely to have reduced hospital admissions wholly attributable to alcohol by 4.1 per cent compared to what would have happened if minimum unit pricing had not been in place. Alongside consideration of the impact of minimum unit pricing, the Scottish Government also undertook a review of the price per unit. The decision to lay regulations that would increase the price to 65 pence per unit is underpinned by the modelling carried out by the Sheffield University. Their research suggests that to maintain the value of the price per unit and therefore to continue to achieve the public health benefits at a level estimated by Public Health Scotland evaluation, it should be increased to at least 60 pence. However, it is clear that Scotland continues to experience significant levels of alcohol harm. The Scottish Government is therefore proposing to increase the value of the price per unit to 65 pence to further increase the public health benefits of our policy. I expect and Sheffield University's model and predicts that if this increase is implemented it will save additional lives. I know that some don't agree on minimum unit pricing but we have considered their concerns in reaching this position. Many business stakeholders told us during Round Tables held in 2023 that implementing any price change quickly may be difficult. That was echoed by the regularly review group. They recommended that a six-month implementation period would be necessary to allow business to prepare for a price increase. I am pleased to say that we have listened and should Parliament agree to increase the minimum unit price, that will be implemented from 30 September 2024. I am clear that minimum unit pricing is a vital part of the Scottish Government's approach to tackling alcohol-related harm. However, it is not a silver bullet. No single intervention in issues such as complex as alcohol harm would be. For some findings in the Public Health Scotland evaluation, it was clear that some people who were alcohol dependent had experienced additional challenges linked to the price of alcohol increasing. I know that specialist support and treatment is vital for these people. To this end, the Scottish Government has provided a record funding of £112 million this year for Scotland's alcohol and drug partnerships. That funding supports a critical critical delivery of services for those affected by alcohol dependency, including outreach, psychosocial counselling, inpatient and community alcohol detox, access to medication, alcohol brief interventions, alcohol hospital liaison and alcohol related cognitive testing. In addition, residential rehabilitation offers programmes which aim to support individuals to attain an alcohol or drug-free lifestyle. Public Health Scotland's most recent interim report published in December last year showed that of the 386 ADP-approved residential rehab placements, almost half, 48 per cent were for people with problematic alcohol use and 20 per cent were for people with both alcohol and drug issues. In 2023-24, the Government also provided £13 million in funding through Cora to support a range of projects to help those with substance addiction issues, including alcohol dependency, into treatment and recovery. Minimum unit pricing is an important part of our approach to reduce alcohol harm and improve the health and wellbeing of our population. The decision to continue minimum unit pricing and to increase surprise per unit to 65 per cent will show that Scotland continues to be world leading with our policies to improve the health of people in Scotland. A position recently supported by over 80 third sector organisations, senior clinicians and leading public health academics from Scotland, UK and further afield. I look forward to discussing this further with you this morning and I welcome questions from you and your colleagues. Thank you very much Minister for that opening statement, which pre-empts what was going to be my first question. I will move on. You touched on some of the claims from certain stakeholders that conclusions that Public Health Scotland had reached in its evaluation of MOP, where I am quoting here selective, biased, misleading or flawed. How would you counter that and how would you respond to those claims? As I said, not everybody agrees with minimum unit pricing, convener, but I think the evaluation from Public Health Scotland and the work that we have done and those 80 organisations and front line organisations tell a very different story. If you look at the letter that was sent from a leading number of public health officials to the Lancet, which is a letter including Professor Mycoat, Marmon and Sally Caswell, and they are saying that the concentration of the decrease in mortality in the lowest income groups is particularly welcome and as a narrow one of health inequalities was one of the key intentions of the policy and this has been achieved. I know that some people don't agree with minimum unit pricing but I have to say that the professional judgment and the experience of front line organisations and people with lived and living experience tell a very different story. They see the value of minimum unit pricing and they support its continuation and its operating. Thank you for that and I should please on record my register of interests. I am a registered mental health nurse with a bank contract with Cretogars Conclyde NHS. Can I just briefly about the initial aims of MUP was to decrease the sales of high alcohol ABV, high alcohol volume products, particularly strong ciders, etc. Has the Government done any research into the sales of those products and if it has had an impact on them? I met with the industry partnership group last week to have a discussion about further proposals and working together on this. I am very committed to working with the industry on this but some of the analysis that we have seen particularly around about the academic analysis and public health Scotland analysis is some of those more high potent, very cheap ciders and other alcohol like that. There has been a definitive drop in the use of those and particularly amongst young people. We are seeing young people under the age of 25 and the health study for young people, the health and wellbeing study that is done in schools, the survey that is done tells us that young people are declining quite quickly in numbers of who would access that type of high alcohol cheap price at the time of minimum unit prices in the original debates. It was called pocket money alcohol, it is not that now. If there is any impact on the industry at all, it is on the cider producers in Scotland. They are seeing a real decline on the sales of those types of alcohols. In terms of other products, I am thinking here of things like whisky spirits, have you seen an impact on the sales of those products? There does not seem to be the analysis that we have done, there does not seem to be any impact on alcohol because it was already sitting well in excess of 65 pence anyway. That is in the off-trade and the on-trade, it sits about £2.04 an average per unit. The off-trade, we have not really seen any impact there at all because it was not where the policy was targeted at. It was at those high alcohol, low prices products that were available, so we have not seen that impact on those at all. Thank you Minister. Tess White has a supplementary. Thank you, convener. Public Health Scotland evaluation of MUP is riddled with holes and, as are the conclusions drawn by the Scottish Government on MUP's effectiveness, and that is not my view. The law society said, and I quote, in our view, the study does not provide enough evidence that the introduction of MUP saves lives, and other stakeholders in the Scottish Government's consultation have described the evaluation as flawed, selective, biased and misleading. So, how does this square in your opinion with the robust evaluation that former Health Secretary Nicola Sturgeon promised during the Bill's parliamentary passage in 2012 ahead of the sunset clause expiring? Thank you. So, I wouldn't agree with that characterisation of the evaluation. The Scottish Government tasked Public Health Scotland to undertake an independent evaluation of minimum unit pricing. There was two overarching evaluation questions. One was to what extent has implementing minimum unit pricing in Scotland contributed to reducing alcohol-related health and social harms? First question. The second one, are some people and businesses more affected positively or negatively than others? The evaluation plan for minimum unit pricing contains a portfolio of studies, which are either undertaken by Public Health Scotland, commissioned by Public Health Scotland to external research bodies, and through open procurement processes separately funded and led by academic partners. There was a whole slew of information taken into account on this. Public Health Scotland took a theory-based approach to that evaluation of minimum unit pricing, its implementation and compliance, its alcohol market, alcohol consumption and alcohol harm. The outcomes of the Public Health Scotland evaluation is that it is estimated to have cut alcohol consumption, cut alcohol attributable deaths and likely to have reduced hospital admissions wholly or attributable wholly to alcohol during the study. The minimum unit pricing evaluation also told us that it reduced health inequalities, where we have seen the biggest reductions in men and those people living in the 40% areas where there is the highest inequality. I would argue that Public Health Scotland took a robust approach to this. There are people out there who do not agree with this policy and will have a different opinion, and that is absolutely fine. My opinion is based on the work that Public Health Scotland have done and the work that Sheffield University have done for us. Of course, all the organisations that are working on the front line, including those with lived and living experience who have seen the benefit of minimum unit pricing over the last few years. You said that you were talking about underage drinkers just there. Could you point me to the evidence that shows MUP has reduced underage drinking, please? The impact on underage drinking has been pretty marked and something that we should look in more detail to. It surely demonstrates the benefit of doing that health and wellbeing survey with children at school, because that is where some of this data has come from. The health behaviour in school-aged children survey showed that levels of drunkenness in school-aged children at 15 years had steadily declined, and it is now at its lowest number for 32 years. Some of that has been picked up by Crick and Frexelons in the school, and some is with specific projects. I was along. The Public Health Scotland evaluation did not find that. It did not go into that detail, but the health behaviour survey in schools did. That gave us some of that additional information about young people. Some of the actions that were taken through Crick and Frexelons in the health and wellbeing strand of that work, and also the work that organisations are doing within schools now. Just recently, I was along at Craig Royston High School, who had worked very closely with crime stoppers and their youth wing of that is called Fearless, to look at ways in which young people could seek advice and get support, should they be them or their friends embarking on hazardous drinking habits, and the same with drug habits. That has allowed children to get that support that they need at that age. That is the case, but the quote that you did here was about underage drinking. Public Health Scotland has said that they have found no evidence that MUP has reduced underage drinking. Is that correct? Public Health Scotland has said that, yes. I am interested in some of the other measurements that we might look at around MUP. We have seen strong evidence and reported back about the health harms and the evidence around how it affects industry, but I wonder if you have had any views or if you have saw any evidence around some of the other indicators, both positive and negative, in terms of does it help to reduce crime and reduce other social harms? Is there any evidence to suggest that people have moved to other addictive substances? It was just to see whether you felt there was a need for more evidence in that area or if there is some stuff that you could point to. There are a couple of things there. Public Health Scotland analysis showed us that the biggest impact was on men and people in that 40 per cent category of having the highest inequality, which is a piece of work that we should interrogate further. That is where I will go with that. The other thing is the impact on women. We have seen very different impacts on women, because women generally drink things that are above the £65 or the £50 per unit already. We need to do a bit more work around women. Anecdotally, what I was hearing when I visited the Craig Miller project last week was that many organisations, such as the Bothy and Craig Miller, who deal with drugs and alcohol, have set up women's groups to look at the particular barriers that are faced by women. One of those barriers is stigma. The work that Professor Allen Miller is doing with the National Collaborative on a rights-based approach to this is looking at some of those intersections. Those intersections are sometimes the deepest when they are overlapped with other things. There are areas that we are working on, in particular thinking about women and thinking about what I am hearing anecdotally, but we need evidence to back that up. I know that the analysis has a much deeper, detailed understanding here. I just wanted to add to that to say that the Public Health Scotland evaluation, as the minister said, took a theory-based approach. One of the things that it did was to look at any potential unintended consequences of minimum unit pricing. That included what you mentioned there, the impact of minimum unit pricing on crime, road traffic accidents, switching to higher strength alcohol or illicit substances. It did find that there was not really any consistent evidence of minimum unit pricing having impacted upon those things, with the exception of some negative impacts on dependent drinkers and particularly dependent drinkers on a low income, showing that they perhaps, in some occasions, might not have been able to buy food because of the increase in price in alcohol, but those were a few occasions and were quite difficult to attribute to them up. The thing about dependent drinkers is that they were never the focus for this policy. It was always the harmful and hazardous category, as I said in my open remarks. That category of people need a much more nuanced, detailed approach. Some of the work that we are doing around treatment and access treatment has been pretty successful there, but it is still worth looking at it. Carol, did you ask me about drug use as well? People may be changing to— Yes, it just that there had been some suggestion that might happen, but I think there is some evidence. The front-line organisations that support people had that worry, but it is not materialised and they have been pretty open. They have said it in evidence to this committee in the last few weeks that they have not seen that. We have not seen Public Health Scotland found no evidence that people started to use drugs because of the increased price in alcohol, and that is in that harmful hazardous group. As I said, dependent drinkers have a very different approach being taken to that work. I suppose that one more question is just to be clear, because it is an important policy that we are going to be voting on. The Government is confident that it worked in the area that it should have worked in, but there is some commitment there to look at some of the evidence around it and any work that we need to do in that other area. We are not committed to a huge Public Health Scotland review like the one that we have just done, but I am committed to reviewing much of the areas where we feel that we need a bit more focus. That is why I am focusing in on dependent drinkers and women and some of the other challenges that other people have had around that. The commitment is to keep that under review, essentially. The work of this committee on that is incredibly helpful for that, to inform the work that we are doing, but also to challenge us and where we should be looking as well. I welcome that. I have just a very brief supplementary question. I am going back to the conversation with the question from Sandesh Calhanni. With regard to underage drinkers and the effect of MUP, I think that there is absolutely a great anecdote. There certainly does seem to be a lot less alcohol consumption amongst young people these days in that group. Of course, we do have the opportunity to come on whether that is due to MUP or other factors, but I can understand that we might not know that. Is there any work that has been done to analyse whether the difference in Scotland on the significantly different to trends that we have seen in the rest of the UK with regard to the reduction in consumption of alcohol amongst young people, because that might point to policy choices that are making more of an impact? I think that that would be interesting data if that is available. We have done some analysis of that sort of a cross-border and comparison analysis of what is happening here compared to other parts of not just the whole of England, but England and Wales and other parts of England. You may have seen the letter that came to committee from the Association of Directors of Public Health in North East England and their analysis on this. There is always work that we can continue to do on this area. What we haven't really realised, I think, is the impact of Covid. I think that we have still got a bit of work to do on what the impact of Covid is, and that will play out as we move forward. In Scotland, what we are seeing is that group of under-25s—I mean that I have a son who won't even put processed food in his body, never mind alcohol—and I know lots of families that are like that. That doesn't mean to say that we are not taking the focus of where there is problematic and harmful drinking going on in younger age groups. That is why the health and wellbeing study of 15-year-olds is incredibly important, because that gives us real-time information and data on how we then can target that. That is why organisations such as Crime Stoppers and Give It and others are working in schools now, because I think that education part of it is incredibly important. I am assuming that there is data available on alcohol consumption rates in Scotland versus the rest of the UK, and what does that show for young people? The health behaviour in school-age children's survey is a multi-country survey, so we can compare Scotland with other countries. Those trends are observed in other countries. I am not sure of the extent to which Scotland is showing a greater decline in other countries, and it is not something that, as the minister has said, it is not something that we attribute to minimum unit pricing. There are other interventions and other things happening in schools. Emma Harper Thank you for being here this morning. I am interested in how the pandemic impacted alcohol consumption. I know that I have a wee brief in front of me here from Alcohol Focus Scotland that talks about 156 lives being saved and 499 hospital admissions per year on average that have been averted, but I am interested in how the pandemic affected alcohol consumption and did it impact on the data that was being measured by Public Health Scotland? Public Health Scotland took information from a range of measures. Some of those studies, I think maybe seven or eight, included the Covid years type of analysis, so we can get you more detail on that via Public Health Scotland on some of the deep analysis on that. Is it the blog that you are talking about that was written? Yes. I spotted that as well. I was spotting it over the weekend. I spotted this coming through on the airwaves and had a good look at it as well. Although we realised that there was an increase of harmful drinking across Covid, we have still not been in the position yet of completely analysing that and understanding what that means and what it means for recovery going forward. That has included an uptick in people self-suggesting that they have had an increase in their drinking habits, mostly in the people who were in harmful hazardous, who are now looking for ways in order to reduce that as well. It is an area where we need to keep working on it, because I do not think that we are anywhere near understanding the impact of Covid on many things. I remind people's habits. Social isolation and loneliness, for instance, is a driver for people looking for ways to escape social isolation and loneliness. Some people would become more alcohol dependent in those areas. We treat social isolation and loneliness as a public health issue now. We are treating it as a public health emergency now and looking at the data that is coming through on that. I believe that eight of the studies had info that included the Covid years. We can get you much more detailed analysis on that, unless Catherine, who has been much embedded in all of this work, will be able to pick that up. There are two parts to your question. The first is what is the impact on Covid on people's drinking habits and what might we expect for the future. The other is whether Covid impacts on the evaluation. To reiterate what the minister said about drinking habits during Covid, it is still early days and data takes a while to come through, so we do not fully understand the impacts on that. However, the data shows that consumption changed during the pandemic and that it became a little bit more polarised with people who were already drinking a lot, drinking even more, and people who did not drink a lot, drinking even less. As part of the price review work that Sheffield University did for us on the modelling, it looked at what might happen over the next 20 years with health harms caused by these changes in drinking patterns. Even in the most optimistic scenario, even if drinking patterns go right back to pre-pandemic levels, which we do not know yet if that is what is going to happen, even in that scenario, they expect that there will be increased health harms caused by the pandemic and the drinking during that time. I think that that gives us further impetus to do more work in this area. On the second part of your question on whether the pandemic impacted upon the evaluation and the ability to properly evaluate minimum unit pricing, the public health Scotland adjusted for Covid where it impacted. As the minister said, only eight of the 40 papers actually included data collecting during the pandemic. The method that Public Health Scotland used in a lot of their studies was to compare Scotland with England. Obviously, the pandemic was also happening in England, so that acted as a sort of control for that. We are confident that Covid did not interfere with the ability of the evaluation to determine the impact of them up. We will move to Paul Sweeney, who joins us remotely. I just wanted to ask a question around some of the discussion in the 2018 study. There was a business regular impact assessment on price elasticity of demand, which found that alcohol generally is quite an elastic product, so as price increases, consumer behaviour will not really change very much. That means that there is a rent created that flows to the retailer or the vendor of the product at the expense of the consumer. There were some observations of where the price does become more elastic, such as off-trade cider. I think that we have seen some of the evidence around those particular potent ciders reducing in popularity. There is a minimum unit pricing. It did not seem that the most recent study by Public Health Scotland addressed some of the analysis around price elasticity of demand. I wonder if the minister or some of our colleagues might be able to narrate perhaps what they have found in that regard. I know that the Sheffield model did find that heavier drinkers were more responsive to price change, but nonetheless, people who have an alcohol dependence are more likely to continue to consume alcohol, but will find themselves perhaps in a more financially distressed position as a result. Mr Sweeney, I think that the committee will be keen to know that we have published an up-to-date Bria, which goes into some depth. That was only about three days in the job when these lovely officials presented me with a 70-page document to work my way through. That goes into some detail there, and we are happy to make that available to the committee as we go. Mr Sweeney is right that some of the elasticity and prices have really impacted on those high alcohol, low-priced products. The cider market will tell you that their market has collapsed in Scotland, although we would probably argue that it is not too much. However, that has been where some of the biggest impact of MUP has been noticed from a business point of view. We take the approach of the World Health Organization about accessibility and availability and how you tackle that, and setting a minimum price is one of the tools that the World Health Organization suggests that we use. That, along with the work of Public Health Scotland and Sheffield in our commitment to on-going review, we will keep that under review, because we want to make sure that we are being responsive as possible. The work that was done on analysing what price point it should be set at, the price point that many thought in Sheffield was about £60.62. Tying in with inflation and all the issues, we felt that £65 would be the level in which it would create the circumstances to drive down, again, some of those sales and drive down hazardous and harmful drinking. We are taking into account all of those things, including the World Health Organization's recommendations around that. That is helpful. I was also wondering if there had been any reports back from the on-trade potential that was observed in the Sheffield model, that there was an elasticity observed in spirits being traded on the on-trade bar relative to beer. I wonder if that has been some feedback that might have perhaps come from industry that they have observed a change in consumer behaviour in the on-trade. You have stumped me there, Mr Swinney. I do not have that information either in my head or in this folder about that comparison between spirits and beer, but we can certainly look at the analysis that is being done and provide the committee with an update on that. If it exists, we will get it to you. That is helpful. I also noted, certainly in the 2018 study, the estimated impact of 50p minimum unit pricing on consumer spending. It did highlight that, on average, for the consumer there is a small impact, particularly if they are moderate drinkers, but the largest impact is on those who are most likely to buy the products liable to be affected. Those on low incomes would drink at harmful levels. The dynamic of the minimum unit pricing is to transfer that wealth of the income from the individual consumer who may be a problematic substance user, a problematic drinker, and perhaps poverty to a retailer. Has there been an effort from the Government to look at that particular segment of the consumer and to look at ways to mitigate that, whether it is through money advice or targeted interventions to try and mitigate the impacts on their household income? The beer has got some of that additional detail in it about industry and the impact on industry, but you hit the nail on the head about the reason why we are doing this, and this again is only one tool, minimum unit price is only one tool. It is for that impact on people, not just on minimum unit pricing, but then the cost of living crisis is an impact on everyone. There is additional work, additional support given to ADP. That is a record funding of £112 million this year, and the commitment that we have made over the next whole term of Parliament for the next two years of £250 million contained within that is all of those supports. One of the ways in which we approach this is through a whole family approach. We look at some of the challenges that people have in their life, such as homelessness, debt, all of that. All of that advice is all factored in with the supports on that, and that has proven incredibly supportive and helpful for people who are in the categories that Paul Sweeney has just mentioned. If you look at the managed alcohol programme that has been undertaken in Glasgow with the Simon community, particularly with people who are homeless, we have a wonderful case study that I can make available to the committee of a particular individual who has taken part in the Simon community's pilot project of managed who is now in a test for supported tenancy, has had income maximisation work done because they weren't claiming anything, didn't know they were entitled to anything, and have had all of those other social supports that they need, including being able to access other types of therapy and support that they need. That person has now become a peer mentor, so you can see the real benefit of taking that whole family or person-centred approach. We are really interested in the outcome of the pilot of the Simon community, particularly for a very vulnerable cohort of our population who might find themselves with a harmful use of alcohol, but also unemployed, homeless and with very little family support. That is one aspect of that person-centred, and the other aspect of taking the whole family approach is looking at the whole family and what they are entitled to and where we can engage with them to ensure that they are getting all of that holistic support. We all understand that approaching one thing with one response is never going to work in those circumstances, so it has to be that whole family approach. That is where the third sector, the charity sector, our ADPs and all of the professionals who are working in this field become incredibly important, so we have that multi-agency approach to those individuals. That is important that you have highlighted those particular examples of interventions that are shown promise. Is the minister engaged with local IGBs, integrated joint boards in health and social care partnerships, just to highlight that with potential financial pressures on them in the coming financial year that they do not take decisions that might undermine or impact on these programmes to try to target support to people who are facing these particular problems? Yes, most definitely. I think I have been in this role for about eight weeks now. What I tried to do was to maintain as much of Elena Wittman's diary as possible to maintain continuity so that the regular things were still happening with the regular people. Amongst that, I tried to learn the portfolio, but I also tried to engage with some of the key stakeholders. I have done quite a lot of work over the past few weeks and we have had a number of round tables and other ways of gathering evidence from stakeholders. One of the issues is arising time and again is this worry around about IGBs. When the First Minister pointed me to this post to say that your budget is protected, which I have to say is a very privileged place to be in any level of government right now where your budget is protected. I have got a plan of events over the next weeks and months to discuss with IGBs and boards how that money should be spent. I am absolutely clear that the money that is coming from my budget for ADPs and for front-line services through IGBs and boards is to be spent on those subjects, and I will make that clear when I meet them. It is a very tough circumstance for everybody right now and I want to be as supportive as possible, but I am absolutely clear that that money is to be spent where we have agreed it should be spent. I am conscious not to indulge the convener's patience, but I just wanted to ask— We need to move on. I have lots of other people who are keen to ask questions, and I am going to move to Sandish Gohani. Minister, you said that dependent drinkers were never the focus of this policy. Is that your position? The minimum unit pricing policy was always about hazardous and harmful drinking. We always knew that there would be a nuance to a different approach needed and additional support needed for dependent drinkers, yes. When the Scottish Government was in court and Lord Ordinary was speaking, one of the things that Lord Ordinary said was in contrast that minimum alcohol pricing will target the really problematic drinkers to which the Government's objectives were always directed. To me, that sounds like dependent drinkers. It depends on how you define problematic, does it not? I would define problematic as people who are hazardous drinking, too, and that is the focus of this work. It impacts on the dependent drinkers as well, but there has always been the clear understanding that that group of people, being more vulnerable and more stigmatised and need a nuanced and more detailed support structure around them, and that is the work that we are doing. In addition to this, I said in my opening remarks that this is not the silver bullet, this is not the answer for everyone, but it gives some of the answers for most people and we have developed other answers for some of those other people as well. Certainly when you say problematic drinkers, we could have a discussion about what that means, but really problematic to me, which is what is in the court's findings, that goes further, doesn't it, the word really? In the court's findings? In the court's summary? In the summary, so not the findings. In the court's summary judgment. So my approach is that this is to target all drinkers, but we know that dependent drinkers need a different and more nuanced, supportive approach. So sorry, the Scottish Government's position in court was that this was to target all drinkers. And the analysis for Public Health Scotland over the last six years has demonstrated to us that it's much more nuanced than that. So the approach that we are taking is to ensure that that supports some place. In court, the Scottish Government's position was that this policy was to target all drinkers. Yes. Okay. Now when it comes to problematic drinking, when it comes to people with dependent drinking, we heard from Paul Sweeney about what has happened. They are spending more money on alcohol and often choosing to spend that money on alcohol, not to eat and not to heat their homes. We have seen a cut in Glasgow and Edinburgh for money going into drug and alcohol treatment. So how does this square with your objective to try to help? Yes, please. Could you clarify which financially you're speaking about? Going forwards. Well, then we haven't seen a cut yet, but there's proposals. We discussed closely with ADPs and with Health and Social Care Partnerships about their spending plans, which are in the power of local areas to respond to local need. But the minister has been very clear in her answer just now that the investment that goes to ADPs is earmarked for that purpose, and her expectation is very clear that it's spent on that. And she'll be able to say, I'm sure, the level of investment that's gone to ADPs is at record levels. So we should expect to see a reversal of the proposals by Glasgow and Edinburgh. What should I ask Edinburgh and Glasgow about that? I'm sorry, I didn't catch that. Sorry, those are decisions for Edinburgh and Glasgow, but we're very clear in discussions with Edinburgh and Glasgow that we expect the money to be spent for those purposes for which we're giving them the money. Okay, so there's a proposed cut, and that's going to surely harm dependent drinkers when it comes to treatment services, when it comes to helping them, because we know MEP is causing a problem to them. So how can we ensure that dependent drinkers get the help that they need in what you said was a nuanced approach? So can I just clarify as well, are you meaning the budget 23, 24, 24, 25? Yes. Yes. And the proposed cuts to ADPs? To drug and alcohol services. So I'm absolutely clear that the budget that we have provided for ADPs this year gets spent on ADPs, and it is at a record amount. So the money for ADPs is going up, has gone up this year. And my direction, I think, if I have to go that far, will be that that money is spent on ADPs and the work that they have to do, including the very detailed work they do with dependent drinkers. And that ties into Mr Sweeney's question before about in contact with IGIBs and boards and the work that they're doing, because obviously this is a shared responsibility across health and social care. But my direction is that that money is to be spent on ADPs and the work that they do on the front line. Okay, thank you very much. Emma Harper. Thank you, convener. Can I go back, minister, please, about the targeting of this intervention of minimum unit pricing? I know some people have said that this is a flagship policy, it's a silver bullet, and you've mentioned that yourself. But I'm keen to just clarify about how we support the most vulnerable people in society. And I know that the Association of Directors of Public Health in North East, they did send us a letter and they said that we need to be similarly proactive and enlightened in public health policies in England to reduce alcohol harm and protect the most vulnerable in our communities. So the North East England public health experts support this action that's been taken forward in Scotland because North East England has similar alcohol harm that we were seeing in Scotland. So I'm interested to hear specifically again about how minimum unit pricing is to target a specific group that it's not just a silver bullet for everybody. Yeah, it's never been the silver bullet and it's never been in isolation, the only thing that we are doing. If you look at the letter from the Association of Directors of Public Health in England, the paragraph that jumped out at me was around about positive health impacts, which have a higher proportionate impact on people who are in the deepest health inequalities. So for instance they said the positive health impact of the policy compared to what would have happened without MUP can be seen both in annual death statistics before the pandemic struck and when comparing the rise in alcohol deaths in Scotland and England since. In the first fuel year after MUP was implemented there was a 10% reduction in alcohol specific deaths and a small reduction in hospital admissions for liver disease and one of the key areas of this is the high instance of liver disease in Scotland and how we can tackle that to reduce the harms there. It also goes on to say changing drinking habits during the pandemic combined with reduced stress access to services led to a tragic rise in alcohol specific deaths. We recognise that and we are focusing on that piece of work. They then said however it was substantially lower than the rise experienced in England and particularly the rise in the northeast. So they analysed the difference between not having minimum unit pricing in England and in the north of England and having it in Scotland and have obviously come to the conclusion their professional judgment and conclusion that minimum unit pricing targeted those areas where the biggest inequalities were and particularly around about hospital admissions and deaths. I mean 156. If that's somebody in your family that's precious person so every 156 of those are continued to be precious as well and the points I made earlier in response to the question about the impact on women and the impact on some other groups as well. That's a piece of work that I think I want to pick up and look at too. I forgot to remind everybody that I am a registered nurse former liver transplant nurse and I should remind everybody about that. Thank you. David Torrance. Thank you, convener. Good morning minister and your team. Minister what evidence led the Scottish Government to conclude that the unit price of 65 to go above it was too high for Scotland because there's some up there who would argue if we increased it above 65 per cent at 65 pence per unit that it would increase the harm from, decrease the harm from alcohol and deaths? Can I maybe bring Catherine in on this because that detail around about the analysis and the decision making there was before I was in post. I don't have the benefit of hindsight to remember that so I am but Catherine was immersed in this so she can maybe give you a much more detailed answer. Yes so to come to a decision on the price and to inform that work we commissioned University of Sheffield alcohol research group to do some modelling for us and that was to look at the impact of new price points on alcohol related health harms and also on the industry and what we were looking for was a balance of where we see the impact on health harms that we want to see we see you know that we're saving lives that we're reducing hospital admissions and also that we are careful upon the impact upon industry and that 65 pence was judged to be the right balance that was where we were going to see increased effects compared to if we'd gone for sorry it gets a bit complicated here 50 per cent 50 pence in 2019 would be 60 pence today due to inflation and we wanted to go a little bit further than that and see increased benefits for health so 65 pence was judged to be that point where we saw the benefits for health and we did not interfere too much with industry. Alcohol is cheap relative to the strength so the further up that you go the more you know the clearer it is you start to bring in types of alcohol that might not be recently defined as that so you start to drift away from the policy intention as well. I don't have any questions because the minister answered them in a statement. Okay thank you Mr Torrance. We'll go back to Paul Sweeney for a supplementary. Thank you convener I just wanted to ask about obviously we're discussed earlier some of the challenges about financing public services particularly those targeted to the harm reduction in communities through integrated joint boards and so on and obviously we discussed the dynamics of minimum unit pricing as being basically a rent created by retailers and that creates an extra income for those private sector retailers that kind of that juxtaposition does jar with me and I realised there are some policy limitations here but is the Government looking at opportunities to capture some of that revenue to to bolster the public finances? So Mr Sweeney on that some in the sector have asked for the Scottish Government to look at a public health levy on this and it's something obviously we have considered in the past and certainly in the most recent budget statement the DFM you know intimated a willingness to to relook at that. I think it goes back to the response that Catherine gave to David Torrance about getting the balance right and that's why my conversations with this business sector and the public health sector become really important about getting that balance absolutely correct in a way that you know I don't know if we'll ever be able to negate any negative or positive outcomes on on either either side of the argument but the the commitment is to review again whether a public health levy is something that we should consider whether the very early stages of that because it was only announced a few weeks ago in the budget I'd be happy to give the committee an update in future weeks and months on that work and where our intention is to be you'll know that we consulted on marketing last year and some of this came through in that consultation we're committed to doing more of that work over the next year or so and that's one of the ways in which we will consult with both the industry and the people who are working in the front line and delivering public health measures too but happy to update the committee when we have more detail on that. Yeah, that's a helpful indication for the minister. I'm happy to rest at that point, convener. Thank you. Thank you. Gillian Mackay. Thanks, convener and morning minister. This is obviously the first time we've we've uprated MUP and due to the length of time between it being introduced and and now some people are feeling it's it's quite a jump. Has government considered whether we require legislation for an automatic uprating or something similar of minimum unit pricing going forward? So that's been raised with me already over the last few weeks particularly when the budget statement had included within a commitment to to look again at a public health levy so that's one thing. The other thing is on the uprating and you'll have heard from Catherine the detail work that went into that to set it at the level that we think would be the most effective level. On that some areas of the sector have asked about having an annual uprating for instance so I'm committed to looking at that and again it's an early piece of work we've not really developed much further than making that commitment right now and but I think it's a piece of work that will be valuable to do and if there's a sort of annual uprating or you know that you know we can set into legislation at a future date but we're at very early stages I really want to look at it the work of this committee will be you know really helpful in that and the work and the understanding from the sector will be really helpful in that but it may become a time in the future where we look at you know a regular uprating and having that placed in legislation. I appreciate that it is at an early stage but has the minister and has government considered how that would work in practice would it be linked to an inflationary index or some other index and would we see an implementation period like we're seeing this year between the uprating being brought in or announced and the change on the shelves to reflect the call from industry and businesses that they need that time to make changes? I'll be absolutely honest I'm open minded on the ways in which we can do this we're looking at many ways in which we can tackle this and every official in the department have got different experience so they're coming with all of that information as well so whether inflation is the measure and then we'll have an argument of whether it's CPI or RPI so we can we can work that out but my mind's opened and you're absolutely right about giving a business that opportunity to be ready so that's why we listen to their calls and if this goes through this one 65 pence it'll be September before you know that and that's to be implemented and that's what they thought they needed some we're looking for 12 months which we're stretching a wee bit but we think six months is a good enough time and if it's something that becomes you know almost a regular thing then the opportunity will be there to do that you'll know the First Minister set a new deal with business and that's why just last week I met with you know the business partner the alcohol business partnership group to talk about some of the concerns and the challenges that you've got so again trying to take as much as a balanced view on this as possible and make life I'm not here to make life more difficult for our producers we've got a world leading you know food and drinks industry that's the global impact is huge I wouldn't want to diminish any of that but we do have to get the balance right and on the on the upgrading as well obviously there may be there may be times where inflation is is much higher like we've seen in in recent times and the impact will obviously differ on minimum unit price and depending on that that economic outlook but I'm also quite interested in how we put that lived and living experience that has been so important the whole way through at the heart of any any upgrading and analysis that that we do so that if there is a if there is ever a case and obviously we're speaking in hypotheticals here but if there is ever a case where that that upgrading does have to be higher for for good reason that that experience that has been so integral and useful so far is put at the heart of of what we do yeah I'm a I'm a policy person who doesn't make policy without the people being impacted by the policies sitting at the table and that's the approach that I've taken and all of my ministerial and parliamentary roles I think even in my past professional life I didn't make any policy decisions without people sitting at the table so that lived and lived experience is absolutely key I think my answer to your first question about being open minded is exactly the answer to your question about the process of upgrading because inflation may be a crude measure of a way to do it given some of the economic impacts we had sharp inflation rise and then dropping inflation that may not be the measure that we will use and as I said my mind is opened and if colleagues in the committee have got ideas on how we can maybe do that then please please let me know I'm very keen to work with both parliament across government and with stakeholders to make sure we get that right that's great thanks convener test wait thank you convener minister I do have a question about upgrading but I'd like to just go back to harmful drinkers so the policy memorandum for the original bill if you remember emphasised that minimum minimum pricing would reduce the consumption of alcohol by harmful drinkers um but instead we've actually if you look at the facts we've seen a 25 percent increase in alcohol related deaths over the past three years alone and over the past 10 years the number of people accessing alcohol treatment services has actually gone down by 40 percent so do you agree that harmful and hazardous drinkers are the ones who need the greatest help that's a yes it's straight off it's obviously a yes public health scotland evaluation found that the evidence points to minimum unit pricing having a positive impact on health outcomes for for harmful and hazardous drinking and the work that we have done around that is incredibly detailed so you my answer is yes that those people do need the the most support and I think that point that you made about a 40 drop in people accessing services is something that's confounded us and we're doing a bit of work to understand why that is and from and this is anecdotal but from some of the conversation I've been having across the board there's particularly groups of people who because of stigma will not go in access services women are pretty big in that category as well so that's why my work looking at the impact on women of minimum unit pricing and the support that they need and that's why the work that professor allen millers doing around about stigma and the the work that lots of the organisations are doing around about stigma and because I've got a real concern that if we make like we do with with people who have got a drug dependency and alcohol dependency is basically there's shunned socially then the opportunities from come forward for treatment are much more difficult so because we are taking such a public health approach to this we are hoping we're creating the circumstances where people feel confident about coming for treatment but we are a bit confounded by that 40 drop and we're doing detailed work and analysing that and understanding how we can pivot services to do that and Orlando's been really involved in this work so he can come in and give you more detail early you said it's going to impact all drinkers and and particularly those people who it's going to hit in the shopping basket who are social drinkers so rather than m up targeting harmful drinkers is going to hit everybody in the social drinkers so it's really difficult because of the cost of living crisis whether that's actually completely accurate because some of the biggest impacts for people right now is the cost of living crisis and the impact that's had on them for their shopping for their energy bills and for everything else in in their life too so there's there's there's a bit more nuance than just you know that one approach there's other things that have influenced in some of those issues that that people are facing and the cost of living crisis is a huge influence in that and you do recognise there are massively differing opinions on this many people just think rather than a silver bullet it's a blunt instrument with massive holes in it so another's would argue the complete opposite even in the consultation those those ideas and understanding were pretty polarized even in the consultation so i would take the public health scotland sheffield university front line workers public health directors i'm afraid i will take their expertise and much more um uh to heart in the work that i need to do to make a difference here than maybe some of the people who would be sitting in the sidelines um criticising the policy but have no real ideas and how to do it themselves and i must reiterate again i do not believe this is a silver bullet there is no one who's saying this is a silver bullet it's not it's only one of the tools we have on the box in order to tackle the issues that we face will talk ask a question about rating but it public health scotland's data was based on modelling and we did sort of focus and they they actually agreed that it was based on modeling rather than actual stats calcium yep public health scotland conducted a number of studies where the estimated the impact of what would have happened what would have happened compared to if minimum unit pricing was not in place i will actually go back to the upgrading question so minister you talk about whether it's rpi or cpi in the future is it your intention to come back to parliament when there's a review and for a robust analysis based on facts not modeling thank you so i think we have to call an analysis into account and i think modeling is a you know it's a recommended respected way in which to tackle societal issues and get to getting the information that we need to move a policy forward so i wouldn't underestimate the impact of modeling in the work that's done at sheffield university and public health scotland but i take your point about you know data and facts because that's one of the issues that we all face and have in that information as well as far as coming back to to parliament as i said to jillie mckai my mind is completely open on a process of upgrading we are working across some of that information right now in the best way to do that i will bring it back to this committee if that's what you wish i'm happy to come to parliament and and do that in parliament but i suspect in order to do that we will be another change to legislation so that we'll have to go through the process anyway check so you you're open minded to come back to this committee um hopefully when when you've got some facts rather than models and that would be a good opportunity to come and have another review and discuss it and debate it i'm happy to come back when i've considered all of the evidence including facts and modeling thank you i've got some specific questions but i just want to maybe just round back on a couple of things i mean just to help me understand or just for the record on this facts versus modelling thing my understanding is that the analysis that's been done is based on facts and statistics but it's addressing a counterfactual because there's other variables in the mix so to say there isn't based on facts is incorrect is that a correct analysis yes i mean if we were to look at the statistics the data that we have on alcohol specific deaths and hospital admissions they are impacted by a huge number of different factors across society we've we've already spoken about covid and the cost of living crisis there are two things that have happened in the same time period that MUP has been implemented so what public health scotland needed to do was find a way of disentangling all of that of getting down to the impact of minimum unit pricing and they did that by comparing scotland with a counterfactual so they compared scotland with england which had experienced similar has a similar culture similar economy and has also been through the pandemic and a cost of living crisis and looked at the differences there and that is how they got to the conclusions that minimum unit pricing had led to a decrease in alcohol specific deaths and likely to have led to a decrease in hospitalisations that also has put together with all the other work that public health scotland did the evaluation was a huge portfolio of studies looking at different aspects along a theory of change so it looked at compliance with minimum unit pricing it looked at what happened to the price of alcohol it looked at consumption and then because all the things along that theory of change were met you know there was compliance with minimum unit pricing the price of alcohol increased and consumption decreased therefore that helped increase the confidence around this decrease in alcohol specific deaths and hospitalisations being due to the impact them up thank you so it is based on facts and they've used some robust statistical analysis to isolate the different variables as best they could in the letter to the Lancet from Professor Michael Marmon and Sally Caswell and they said this summary of research on minimum unit pricing is comprehensive including interviews with individuals who fear the policy will be detrimental to them personally or financially public health scotland approach to emphasising population level findings is the right one for assessing population level interventions such as minimum unit pricing so they were absolutely clear about the value of that analysis thanks very much so saying point i want just to touch on just to clarify something for me maybe i missed this but just to be clear if we're talking about up rating then clearly the options you've got are to come back in a similar process that we've done today in a year or two or three and talk about the next the next height or it could be to put in place a process that automatically upgrades to automatically upgrade would that require primary legislation or what would need to be done from a legislative point of view to prevent you having to come back every year or two to walk through this process again i think i think for us as we explore it we need to look at what the right approach was a clear but it's automatic would kind of take legal advice on that and it's obviously the opportunity to upgrade it using regulations as we've done here so i think what we'd be keen to do is continue kind of exploring with a wide range of people what the right approach is what the right measure is and the committee obviously and come back with it by the process so if you decided that you're going to put up by let's say rpi or cpi every year to make it give that effect that would require primary legislation changes that correct which is an amendment to the the act is that correct i mean you can amend the regulations so there's a kind of range of things you could potentially do because the upgrading process changes now allows us to lay in order so that would also be an automatic process so it depends what you mean by automated i suppose but automated means you don't have to come back here every year and argue for another five to ten times it just happens so i think yeah we'd certainly need to take legal advice on that as we move forward but at the moment there's kind of a wide range of options on what that looks like so we'll look for the best option i think that that allows parliament to scrutinise any decisions that are being made but also to ensure that you know we can continue with the benefits of this policy yeah i mean just to be clear because of course the we talk about increasing it but the reality is we're just standing still the decision not to increase it is an effectively in real money a decision to reduce it it's important to recognise that okay yeah and that's why that modelling found that 60 62 percent was maybe 60 pence with 60 62 pence was where maybe where you know it would just bring it up to the level inflation added from 50 pence and that's why we decided 65 because it takes it to that one threshold further and we did look at modelling on 70 and other prices per unit and but we felt that 65 gave us the right balance between impact on industry and impact on public health that's great thanks and of course that'll be based on 2018 not in 2012 when the 50 pence was first proposed yes i think so yes yes which would be much higher inflation over that period accumulatively of course so thanks very much moving on i wanted to unpick a wee bit well first a brief point on time to prepare for businesses if i'm correct it's not an exact analogy but when the chancellor puts up alcohol duty that happens almost immediately is that is that correct whereas in this case you're given quite a lengthy period of time for businesses to prepare is that correct yeah absolutely yeah right okay so if you compare those two then the fact you're given you're given quite a significant period already to businesses in that regard i want to focus primarily on some of the points that pox we need raised and first of all just to recognise that the public health supplement as was obviously was done prior to mup so it's important to maybe separate out those two things is not being dependent on each other but potentially related to each other and i would just like to with regard to the nup issue and this thing that's been kind of dancing round us through the evidence sessions that we're struggling to get our arms round round about whether or not there actually has been an increase in revenue to retailers or producers as a consequence of mup certainly the evidence we took from the cider producers i'm a 300% or there are there abouts increasing the retail price of the product but an 80% reduction in volume of sales we suggest that they've seen perhaps a 20% reduction on increase or reduction in in retail revenues because the reduction in volume sold is outweighed the increase in any price i suppose the question is do you have any data on this other than what we've managed to piece together through some of that kind of ad hoc evidence session i would expect hmrc has got some pretty robust data on that you know the industries are unable to predict this with any data so is this something you've got something on so as we can kind of put this thing to bed once and for all i mean at that moment it's not clear data across the piece on this there's a range of a kind of anecdotal information we certainly follow up with hmrc but i'm not aware that there'll be a kind of clear link on volume versus kind of pricing sales so we've got a lot of information however it's something we're keen to kind of continue working on to look at the differential spread of some of that because we know we know for instance that producers maybe are providing a different view as the retailers where their reviews being held across the supply chain so okay there's different for differences for different retailers so if it's the off trade and it's a you know bottle shop they you know they can pretty clearly see the difference if it's supermarket sales that's become really difficult to separate out in between you know people buying whatever they buy with their shopping so that's been a bit more difficult for supermarkets to separate that out but hmrc might have some of that data so we'll we'll follow that one up yeah i'll have it worked on this out i don't know that hmrc keeps a very close look watch on how much alcohol people are selling they'll know from alcohol duty yeah absolutely on different types of products okay now that might be but if you get anything i'd be helpful just help put this to and i don't know if you've got any other data on we have access to sales data in a general sense but it doesn't provide his revenue right so it gives you volume of sales it doesn't give you the kind of cost of those sales so i think we use those it's certainly useful that's certainly useful on how we look at alcohol purchase rates in scotland across the piece and phs will continue to do that as part of their kind of work around you know alcohol harm and alcohol related statistics yeah because my concern on this is that we're all going to chase this golden pot of money but in reality possibly doesn't exist and it'd be nice to put that to bed once and for all moving on then to talk about the the public health supplement and i think you've already indicated that you're you're having a look at that potentially um so i don't have as any more you can say on on what you might do on that when you might come back with a perspective on that and who it might might impact because clearly i think it was larger retailers before our supermarkets are impacted yeah it was and as you say it was before m up the dfm and you know stated the intention in her statement just recently that we would re-look at this so we are at very very early stages we've had calls from stakeholder organisations like chap and others um in alcohol focus scotland asking us to have a look at this again um from the perspective of if you raise the levy can it be spent um ring fence and spent in those areas which is you know perfectly reasonable um ask however we need to balance that with the impact on business in which you have just illustrated very clearly about um you know how do we measure that and how do we ensure that we direct um any additional monies to to the places where they need to go so that's why i said to jillie mccam very open minded on this okay if your experience in the industry has got anything to tell us please please um please share that um i'm really keen to work across parliament and government to get that right and it might be getting it right is not to have a levy you know um maybe getting it right might be a levy and i think for alcohol focus scotland and others there you know they were suggesting around about 16 pence you know so they've got some ideas already and we'll we'll interrogate all of those in factily i'm into our thinking about how we move forward with that particular point. Thanks very much thank you. I appreciate minister we've already gone over time but i believe sandish gohani has a a question so um if we could have a brief question and a short answer that would be wonderful thank you. Thank you thank you convener minister talking come back to modelling we are clear that when we did our modelling is an estimate of the number of people uh that m up has saved so if we look at the difference of age standardized alcohol specific deaths by 100 people 100,000 people england versus scotland in 2006-07 actually the difference meant that scotland did better than england 2008-09 difference was better in scotland in 2011 and 12 it was better in scotland so the scotland had reduced alcohol specific deaths compared to england there was no m up then and then if we look when m up was brought in in 2018-19 there was again a difference not as good as 2006-07 but it was there was a reduction but then 1920 actually england did better than scotland and 2021 was the same can you explain that to me so that timeline that you've given us is over 17 18 years a lot of time a lot of interventions a lot of work being done to reduce drug related alcohol deaths and hospital admissions i think that we we took the decision to continue and to implement minimum unit pricing because we saw the benefit not just in the short term but in the long term and that's why my commitment is to continue this policy and to up rate it because i think we can see the definite change that's happening there is it long enough to understand that on a population level probably not and that's why the reviews and the work that's being done in the model and that's being done becomes incredibly important in all of that and yes it is estimates it can only be estimates because again disentangling you know the outcomes for people and health outcomes particularly for people who it's it's the don't factor into the the death statistics the factor into the reduction in hazardous and harm it is a bit more difficult to to understand and that's why that modelling is done in the way that it's done and the analysis is done in the way that it's done but also to help us understand how we move forward with this and we want to operate precisely for that reason that that differential has narrowed and we want to make sure that differential it you know increases again and if you look at what the director of public health in north east england are saying they are saying this policy works we can see that it works we've made the comparison between scotland and northeast of england and i think their assumption no their assumption the recommendation is that they they want minimum unit pricing for england and wales and i think that's a really important point there thank you minister just you know you said that it's not in the short term i'm being very cheeky asking another question but would you commit to maybe doing another review in five years time to see what's happened so we're going to keep this under continuous review um whether in five years time we do a full review will be for probably other other people to decide but my commitment is to keep this under continuous review to ensure that we're able to be fleet of foot given some of the changes we may see some of the impact of the pandemic then playing out over the next couple of years on how we can respond to that as well but i think our policy like this we would always benefit from it being reviewed and no doubt there'll be academics and others out there who will continuously review it anyway but i think this government has a commitment to review on all of this work and we will continue to do that an earlier point that the scotch government's court submission described has this in harmful drinkers so when the court was talking about problematic drinkers it was referring to you know the submission that we provided so i think it was taken in that context i just thought i'd be helpful to note that kind of factual correction for the committee thank you we will now move on to agenda item three which is the formal debate on the instruments in which we've just taken evidence can i remind the committee that officials may not speak in the debate minister can i ask you to move and speak to motions sxm one two two two zero and sxm one two two two one lodged by yourself thanks very much convener and i'm happy to lodge both those amendments and i think there's not much more to say really in our position other than you know my key opening remarks about we believe that now is the time following the review to both continue this policy and to upgrade it to 65p and i commend both those regulations to the committee and would hope you would support them thank you minister i've had an indication from a one member of the committee so far that they wish to speak carol mocking thank you convener in relation to today's ssi's i can confirm that scottish labour does support the continuation of m up and the upgrading of the m up to 65 pens and we support the work undertaken by public health scotland on this and the data produced is complicated as we've heard but we believe as clear m up worked for so long as 50 pens was an effective price and lives were received as a result and this is undoubtedly significant and it is only right that we continue the policy and look further at the impacts it has on public health with an upgraded price m up however is not and will never be effective on its own and i welcome the minister's acknowledgement of this point in relation to dependent drinkers and we have discussed this this morning public health scotland concluded there is limited it's just a quote there's limited evidence to suggest that m up was effective in reducing consumption for those people with alcohol dependency those with alcohol dependency are a particular subgroup of those who drink at harmful levels and have specific needs people with alcohol dependency need timely and evidence-based treatment and wider support that addresses the root causes of the dependency and scottish labour supports this statement the long-term underfunding of alcohol and drug partnerships the cutbacks to health services and council budgets and the real-term cuts to investment in this year's budget suggest that the government could become over relying on m up as a unitary method of tackling alcohol harm this will not work experts tell us as such and the government i hope will now move to outline that further commitment they will make to these services which offer support within our communities just one more point further to this we believe we cannot continue m up for much longer without ensuring that profit you know the profit it creates for larger companies is reinvested and publicly funded public health initiatives and then we feel that this is only right and we would seek to work with colleagues to achieve this and concluding convener the continuation of m up is in my view a positive step its continuation has scottish labour support but once again i would urge colleagues to ensure work is undertaken by government to properly fund and support services that will save the lives and commit to vital services in areas of those living in our highest levels of deprivation if we do not do this and act with purpose we will quickly see the benefits of m up fade and this is not something any of us want and i know from today's debate this is the position of the minister and i hope to work with the minister to put these things together thank you convener thank you cattle and test week thank you convener um m up is a blunt instrument to tackle a very complex problem and the public health scotland evaluation is riddled with holes and the alcohol specific deaths are at the highest since 2008 moderate drinkers are being penalized and will be penalized even further by the price increase and other approaches to treat alcohol addiction are underfunded and under resourced thank you thank you sandish gohani thank you convener i'd like to start my remarks by looking at public health scotland's report in which civil servants decided to intervene and change wording so for example wording was supposed to be consistent and civil servants went and decided to write strong and consistent and that was the wording that appeared not in the draft but now in the final report from public health scotland we can see that test white said earlier during committee there's been a 40 reduction in alcohol treatment that's occurred and whilst the minister has spoken many times saying that this is not the silver bullet and it's nuanced and there's lots of other things that need to be done the facts are nothing else is being done this is the government silver bullet this is the only thing that they seem to be doing when it comes it to the area of alcohol and we simply need to see more treatment occurring because that has proven proven to reduce people's dependence on alcohol it's also proven to reduce deaths and improve lives and save lives we need to also look upon the fact that a policy which increases the price of alcohol will affect dependent drinkers disproportionately the whole point of being a dependent drinker is you drink to the exclusion of other things that is your primary focus you are dependent upon that substance and a policy which has increased the price knowing and it the government must have known it would affect dependent drinkers and yet nothing was done for dependent drinkers over the time of mup to help them to ensure that they didn't spend more money on alcohol to ensure that they actually came away from alcohol that to me is absolutely awful because we should have known the government should have known the 25 civil servants working on this policy should have known that that would happen i'd like to speak about profit and the outrageous profits that are being made because of mup by retailers it's simply unacceptable that a policy designed to help people is creating huge amounts of money and that money is not being reinvested into alcohol programs into helping the people that it was designed to be helping in court it's clear that this is not supposed to be a population level approach that was not what the government said in court and yet the minister said to me that it was the point of this so that that doesn't make sense to me either and when we talk about other evidence a Taiwanese group wrote in the Lancet that the modelling that has been done was simply not accurate and that this is not doing what we think it's doing we have the facts are we have increased by 25 percent the number of people who have died because of alcohol that is the numbers and saying that we have saved 156 lives in modelling suggests that had we not had mup we would have had the highest number of deaths ever we've also heard from the minister that we have confounders when it comes to this which are the biggest confounder here is simply the cost of living but also COVID we must see with a full evaluation what happens in five years time when hopefully we don't have these confounders in place and that would be able to give us a really good indication of what's going on and the minister has said that we are looking to have a reduction sorry an increase in the amount of money spent on people who are treated for drug and alcohol and I welcome that and so I would ask the minister to back our right to recovery bill which would give people the right to have this treatment thus forcing our health and social care partnerships to invest in this level so in summary what I would say is this evaluation has not proved that mup is what we set it out to be which was to help those of the heaviest drinkers in our society and we need to ensure that if it does go ahead that we use the money that's been generated to help those people otherwise I think it's an absolute travesty thank you Emma Harper thanks convener so I wanted to have written some notes here based on what we've received in evidence but also just to reiterate what the intention of the minimum unit pricing policy is and I just want to restate some of the content from the correspondence that the committee received from the association of directors of public health northeast on the 20th of march and they said as partners based in the northeast of england which is the region that suffers from the worst alcohol harms in england the public health directors in the northeast have said that they have watched the positive impact of mup in scotland with huge interest and they actually used the word admiration and at the time when alcohol deaths in england and especially in the northeast are at an all-time high adph northeast are asking for similarly proactive and enlightened public health policies to reduce alcohol harm and protect the most vulnerable in our communities and the directors of public health northeast are hugely supportive of the scotland minister's proposal to continue to upgrade mup and agree with the level of at least 65 pence per unit and according to the adph northeast the evidence is clear that the policy has achieved its aim of reducing alcohol related harm by both reducing population consumption and by targeting the consumption of people drinking at higher levels it has also contributed to reducing alcohol related health inequalities and again this is what northeast public health directors are saying and i quote they're saying the evidence from scotland is clear mup works by targeting the cheapest most harmful alcohol and we hope that the scotland Government will see fit to continue and upgrade the mup as part of its enlightened evidence best evidence based approach to public health and additionally we received a letter signed by over 80 organizations medical faith organizations and charities calling for cross party support to continue mup and you know in thinking through some of their data they're saying there's an estimated 156 families each year who have been spared the loss of a loved one and that alcohol can have a serious impact at every stage of life with the impact in pregnancy having a lifelong effect on the child and hospital admissions are down by an estimated 4.1 percent reducing the pressure on our nhs so in the final census from that submission and i've tweaked it a wee bit because i agree now that mup has been seen to work the 80 organizations and myself support the continuation of this policy and to upgrade mup to save more lives thank you convener thank you and jillian mckay we've heard at this committee recently of the impact of mup from lived and living experience and this for me has added real world context the evaluation we've seen something which we welcome in many other areas of this committee's work those voices need to be amplified and continue to be involved in this issue and i'm pleased that the minister has indicated her willingness to continue to put this at the heart of policy development going forward we need to ensure that going forward there is appropriate support and treatment mix for those who require it and that we tackle barriers for those groups who are currently having difficulties in accessing treatment i accept and trust the minister's assertion that this is not a silver bullet and one of the most important things we need to do is tackle the alcohol environment we have here in scotland and for me this includes looking at advertising how this advertising affects children and young people and at risk adult drinkers as well as implementing a public health levy which i'm really pleased was in the budget as a result of discussions between Government and my party tackling alcohol harm has to be a multi-pronged approach and tackle all the barriers that people are facing to services and i'm very pleased to be supporting both SSIs this morning thank you julie mckay minister would you like to sum up and respond to the debate yes thank you very much and convener that that's really helpful can i start thanking both Labour and the SNP members and the green members for the support to the policy the comments that you have all made about work still to be done and the way in which we fund the sector and the analysis and the work we have to do around about looking at a health levy is not lost on me so i will be taking all of them away as actions can i reassure members on funding this is a record 112 million pounds that i will you know i'm absolutely committed to making sure that gets spent in exactly the right places so i can give that reassurance and can i also pick up some of the points around about who supports this policy and so that's in response to to tess white and sandish gohani we have seen the Lancet letter we have seen the association of public health directors in northeast england and Emma Harper's obviously made reference to that work we've seen 80 organisations who work with people on the ground day in day out supporting them we've seen case studies like the work simon communities doing and we've seen those modelling numbers given us 156 people whose lives have been saved that's not an insignificant number that's 156 loved ones and we should never forget that that's people and those numbers and not just numbers and if i can pick up the point on treatment so on treatment the 40 drop that we have experienced here has also been experienced in england and they're also looking at the reasons for that but it's just not true to say that nothing else has been done on this matter and i'll give you a list of things that we are currently taking forward to tackle all of the issues whether it's harmful hazardous or dependent drinkers so we're working on new clinical guidelines on alcohol treatment and we're working with the UK government on that actually so that we've got that whole UK approach alcohol brief intervention review national specifications on alcohol and drugs all adps already offer psychosogeal counselling inpatient alcohol detox services access to medication and most offer community detox abis alcohol hospital liaison so it's just not true to say that nothing is being done because all of that is already being done and as for the right to recovery bill i've been asking for months to have you know a view of this details of it we have not received that at all and even just last week i responded which i generally don't do on government business on social media to a colleague of us annie wells who is saying will you support the right to recovery bill and i'm happy to meet with you and discuss it and when we have got that date in the diary now so i'm happy to discuss this bill but we need to see the detail to understand what it will actually do i'm glad to see that lots of people support the levy i think maybe some of your colleagues might be a bit disgruntled that you're saying you support looking at the levy because many of them don't mr gohani so keen to work with you on all of that and i have to say you know most of those organizations are all of those organizations who have written to us agree that minimum unit pricing works they also agree it's not the silver bill it it has achieved its aim and jillian macaill is absolutely right at the heart of this is those people whose lives will be made immeasurably better and that's why that lived and living experience is at the heart of all of the work that i will do so i would ask the committee today to support the alcohol minimum price in scotland act 2012 continuation order 2024 and to support the alcohol minimum price per unit scotland amendment order 2024 which seeks to change the level from 50 pence per unit to 65 pence per unit and i thank the committee for all of the deliberations none of it is lost on me all of it will be used to inform my work going forward thank you thank you minister the question is that motion s6m-12220 be approved are we all agreed the committee is not in agreement and so we will call a division inviting members to indicate by a show of hands for against or abstention so those in favour of approving the motion please raise your hand those against and there are no abstentions so the result of the vote on this motion one two two two zero is eight votes in favour two votes against no abstentions and the motion is approved the question is that motion s6m-12221 be approved are we all agreed the committee is not agreed therefore we will have another vote can i ask again members raise their hands if you are in favour of the motion those against there are no abstentions everyone's voted and the result of the vote on motion one two two two one is eight for two against no abstentions and the motion is approved and that concludes consideration of these instruments the next item on our agenda is consideration of one negative instrument the regulation of care social service workers scotland order 2024 the purpose of the instrument is with respect to the registration of social service workers to reduce the number of register parts from 23 to 4 by creating only two categories of social service worker rather than 21 the policy notes states that the objective of the instrument is to make registration and being registered straightforward and easy to understand the current register structure has been developed over time since the introduction of registration of social workers in 2003 and it stated the structure of the register needs to change to reflect changing and emerging roles as well as changes in the way services are delivered the delegated powers and law reform committee considered the instrument that is meeting on the 5th of march 2024 and made no recommendations in relation to this instrument no motion to annul has been received in relation to this instrument do members have any comments i propose that the committee does not make any recommendations in relation to this negative instrument does any member disagree no one disagrees thank you and i confirm agreement with my proposal at our next meeting on the 16th of april we'd be considering a negative instrument and a draft stage 1 report on the abortion services safe access zone scotland bill and that concludes the public part of our meeting today