Born in 1946 and brought up in Cupar, Fife, I was educated at the local school - The First Minister (Mr Jack McConnell): The Scottish Executive is reviewing the place of methadone in drug treatment programmes and we expect a report by the end of the year. The report will include new information from health boards about the level of use and how it is monitored. All treatment and rehabilitation programmes should help people to be free from drugs and to live productive and fulfilling lives with the support that they need.
Mr McNeil: It is certainly time for a review. Given the latest research by Professor Neil McKeganey, which finds that the methadone programme helps fewer than 4 per cent of addicts to kick their habit, does the First Minister agree that we need to review the methadone programme and drug treatment services in general and to ask hard questions about both? Is it not time to replace the open-ended and one-sided commitment that the taxpayer makes to addicts with some form of social contract with a clear programme for drug cessation? Would that challenge the prevailing view that drug treatment services are merely about stabilising addicts? Would it spell out our ambition to move addicts on, not to another form of dependence, but to a drug-free life?
The First Minister: It is important to record the progress that has been made. In recent times, the number of residential services that treat people who have problems with drugs or alcohol has increased by 50 per cent. In 2004-05, we had 33 services, which was up from 22 just three years before; and we had 4,000 admissions to those services, up from just over 1,000. The number of residential beds has doubled from 244 to almost 500. The number of places and the number of times that those residential services are used have been a priority, have increased and are making a difference.
I met Professor McKeganey earlier this week to discuss his research and to learn about how residential services seem to be much more effective in producing drug-free lives for people who are on those programmes. We believe absolutely that everybody who is on a programme should have an end point in sight and should agree to move from a drug-dependent lifestyle to a drug-free lifestyle. That is why the review is taking place. The Minister for Justice will report to the Parliament on the review when we have received the report and analysed its conclusions. I hope that, throughout Scotland, we can move not only to a drug treatment system in which there are more residential places, but in which people who are on drug treatment programmes—even in the community—move quickly and directly away from drug dependency and towards drug-free lifestyles.
Stewart Stevenson (Banff and Buchan) (SNP): I welcome the fact that the Executive has commissioned a report. Its publication will be a helpful contribution to the debate. If only all Executive reports were published.
It has been revealed that England is 10 times more successful than Scotland in treating people on methadone. Will the review that is under way reveal why that is so? The First Minister said that he wants there to be more residential places. Will the review reveal why the existing residential places are not being used?
The First Minister: Stewart Stevenson knows that decisions about who should be placed in residential places are primarily for clinicians and local agencies. A key task is ensuring that local agencies use those places more regularly.
An issue that is raised by the treatment of drug addicts in Scotland is the apparent inconsistency in the approaches of local authorities and health agencies at the local level and of individual practices and treatment programmes. Getting greater consistency throughout Scotland in the treatment of individuals is an issue. Every individual needs an individual programme, but agencies, medical practices and drug programmes should be more consistent and have the clear objective in sight of encouraging people to have a drug-free lifestyle. They should aim to use the residential places in which we have invested a lot of money.
Margaret Mitchell (Central Scotland) (Con): It is almost a year since the tragic death of Derek Doran from a methadone overdose. Derek was two years old. When will the review of guidelines to pharmacists that are issued by NHS Education for Scotland on aspects of methadone prescribing—which were promised for autumn 2006—be published? Are any new measures being implemented, such as a re-evaluation of the assessment criteria that allow addicts to take home three days' worth of prescribed methadone, to ensure that such a terrible accident never happens again?
The First Minister: The review is work in progress. I am certain that I can tell Margaret Mitchell in writing when she can expect the new guidelines to be published. I am also certain that, as part of the review of programmes that I referred to in my first answer on the topic, the guidance that is given and the consistency of the distribution of methadone will be considered.
I think that every member—indeed, everybody in Scotland—was shocked by the death of Derek Doran. We do not know how many families come close to such things happening and are lucky that they have not happened. We need to be clear about what should happen and there needs to consistency throughout Scotland. There should be clear guidelines for people who are responsible for prescribing methadone and on the safety measures that should be in place for families so that children are not put in danger.
