EXTRAORDINARY powers have been used by the Scottish Government to speed up sluggish progress on implementing key measures to tackle the drugs deaths “emergency” in Scotland, it has been announced.
Angela Constance, the minister tasked with curbing Scotland’s rates of deaths caused by drugs, admitted that progress on implementing a key plank of its plan to bring down drug death numbers has been “too slow” but told MSPs she has ordered local partners to move faster.
She also confirmed that a proposal to kickstart the introduction of safe injection rooms in Scotland - blocked by UK drug laws - was now in the hands of the Crown Office.
The new proposal is hoped to circumvent legal hurdles facing the establishment of safe injection facilities which are proven to reduce drugs deaths.
The Scottish Government has missed its deadline to implement medication assisted treatment (MAT) standards across the country by April 2022 and this has now been downgraded to a deadline of April 2023 for just half of the total number of standards.
MAT standards refer to the provision of opiates and other medications used to help kick addiction in conjunction with other forms of therapy to reduce the risk of death and illness caused by drugs.
Of the 10 standards, progress was limited with the first five measured in depth. These can further be divided into 145 separate performance indicators.
A report published by Public Health Scotland today, which the minster admitted did “not pull its punches”, painted a grim picture for progress on tackling the crisis, which just 25 fully implemented (17%), 94 are partially implemented (65%) and 26 not implemented at all (18%).
Constance said: “Overall, the pace and the scale of change are nowhere near good enough nor quick enough.
“These are not standards that should be considered nice to have, or nice to do.
“My view is unequivocal: these must be delivered.”
The first five standards are:
- Patients being given the option to start MAT on the same day as they enquire about it
- Patients being supported to make informed choice about the medications used in MAT and appropriate doses
- Proactive identification of people at “high risk” of dying from drugs and offered support
- Provision of other harm reduction methods alongside MAT
- Provision for patients to remain in treatment for “as long as requested”
Constance added: "I cannot stress enough how vital it is that ADPs fully implement the MAT standards, in particular, standard one on same day treatment.
“We all want people to have the right to treatment but that will be for nothing if the services are not in place.
“That is why I am today using powers of direction available to Scottish ministers under the Public Bodies Joint Working Act 2014 to compel local partners to implement these standards.
“This ministerial direction has been issued to all health boards, integration authorities and local authorities, spelling out what must be achieved and the oversight arrangements I have put in place will hold local leaders to account on implementing the MAT standards fully."
Alcohol and drug partnerships (ADPs) across all parts of the country will now be required to produce plans – signed by their senior managers – to improve the rollout of the standards, Constance announced.
Areas where drug deaths are exceptionally high and the local ADPs have not implemented the first “crucial” standard of same-day access to MAT, such as problem spots Glasgow and Dundee, will be required to publish monthly progress reports.
Other areas will need to do so on a quarterly basis.
New oversight arrangements, Constance said, would strengthen “accountability to communities” affected by the crisis.
Opposition parties rounded on the minister for failing to meet the deadline for implementing the full range of standards, with Borders having the sole ADP to fully implement the first five standards.
Borders ranked 24 out of 32 for drug-related deaths between 2016 and 2020.
Sue Webber, the Scottish Tories’ shadow minister for drugs policy, said: “Once again, this Government’s have fallen short and families continue to be let down.
“Despite setting a target last year to ensure that MAT standards would be fully embedded across the country by 2022, this report shows the target was nothing more than a pipe dream.”
LibDems leader Alex Cole-Hamilton responded to the minister’s statement by saying he had been contacted by a whistleblower who said that the rate of progress was so low because funding was only delivered to those tasked with implementing the standards “very recently”.
She said she had “signed off letters” confirming payment and pledged to tackle “any blockages” in the funding system but did not clarify when money reached ADPs.
The Scottish Government was approached for comment.
