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We work alongside the individuals from the Thistle; Maggie Page might want to come in on that. We also work closely with the organisations that run the Thistle, but it is largely down to them to work with the Lord Advocate to meet the criteria that she might set to ensure that conditions within the unit can change. It is a long process to get those permissions and to persuade that the legislation that covers the rest of the country can be lifted under certain circumstances.

The Scottish Affairs Committee at Westminster recently reported on the Thistle and made some suggestions for different models. The challenge with that is that we have not been able to persuade the Westminster Government to review the Misuse of Drugs Act 1971 and, because of that, what is happening at the Thistle is a one-off situation. Each time the model is modified, it will have to be agreed locally with the Lord Advocate. That means that it is difficult and that careful steps must be taken to make any changes to the model that operates there. Maggie, do you want to say more?

RADAR gives us rapid information that can be disseminated out to exactly where it is needed across the country, and it is making a difference to the harms experienced across Scotland.

RADAR is not perfect. My sense, a few months into this job, is that the longer that it takes to produce the data, the more rich and robust it is. We get early data that tells us something, but, often, the longer we wait for the data, the richer it is. However, we do not have time to wait. We are in a drug deaths crisis and we need fast information, and we need to get that fast information out to the front line—out to the health boards and to the places where people are likely to go to receive treatment for overdose. We need to get it out to the front line so that the paramedics and the alcohol and drug services know what they are dealing with. That is vitally important.

Thank you—that is a really excellent question, and I think that Maggie Page will want to come in with a little bit more detail on it.

We think about three strands when we are thinking about the next steps around treatment and access to residential rehab. We focused a lot on providing funded places, and we are on track to reach the 1,000 funded places that we committed to. We also focused on increasing residential rehab capacity, and we have really increased the number of available beds. I think that we will get a report on where we are with that next November, but, again, there has been a substantial increase in provision.

The bit that will probably require a bit more focus in our strategy next year is the pathways around access to residential rehab, which is about access to stabilisation and detox, and how we get things lined up for people. Your previous panel of witnesses talked about access to abstinence-based residential rehab, for which people are required to go through medical detoxification before they can start. It would be ideal if the residential rehab lined up right at the end of the detox, without a gap or a long wait for detox, when somebody is ready for residential rehab and wants to get in. We are working hard on those pathways to improve access into services, because that is an area where we can achieve real improvement.

I agree that there is an issue with implementation, which is a challenge that all ministers face in all portfolio areas at all times. We often set out great ideas and produce fantastic policies and great legislation, but that is not how it feels on the ground for the people who access our services. As a minister, one of my challenges is to close that implementation gap, so that the reality meets the ambition.

I am the first to acknowledge that there is a gap. For me, one of the crucial ways in which to close it is through the involvement of people with lived experience. If we have the voices of lived experience at the heart of our policy and legislative development, it keeps us right. It means that we are usually on the right track, because we are listening to the right people.

That also holds our feet to the fire on delivery, which helps us to close the gap. The situation is always evolving. Nobody is saying that we get it 100 per cent right. Lived experience, particularly in this area, where there is a huge amount of passion, does not speak with one voice, but that approach helps us to get it right.

We get lots of data coming in, and lots of monitoring and supervision. In fact, some people feel quite overburdened by the reporting that we request from them, but we are pretty keen to understand what is going on out there. My sense is that we are very much aware of the challenges. We are providing support where we can, so that local areas can rise to those challenges.

Maggie, do you have anything to add?

It would concern me if we thought that the only measure of success was referral into treatment. We heard the statistic that more than 50 people have been referred to treatment. That is reasonable if we think about the level of chaos that the people who came through the door in the first six months were experiencing. To have 50 people referred for some form of treatment—not necessarily residential rehab—within six months is a reasonable number.

We have not explored that, because the barriers are not being removed and we have been unsuccessful thus far in removing them.

If I remember rightly, efforts to bring the Thistle to life started in 2015, so that means that it took 10 years until it opened this year. That predates the national mission. Those efforts began at the start of the rise in the number of drug-related deaths, but the reason behind considering whether to have a safer drug consumption facility at that time was to reduce the number of cases of HIV, because there had been an outbreak—a cluster—of HIV in the area, and such a facility was seen as a way of reducing that harm.

You are right that, at the moment, we are in the thick of a drug deaths emergency, and very early data shows that lives have definitely been saved in that unit. Therefore, it is understandable that we recognise that it is a life-saving facility; it definitely prevents deaths. We will do a more thorough evaluation of what happens there and what the benefits and disbenefits are, and we will consider where to go when we have a bit more information.

At the moment, I am not seeing barriers to scalability across Scotland, or even to sustainability, being removed. We had a change of Government in the UK last year, and I thought that there would be an opportunity for a change in approach, but I am not sensing that at all. I have to focus on the here and now and on the emergency that we are in, and find a way forward now.

With reference to the national testing laboratory at the Leverhulme centre, the Government as a whole has been working closely with the University of Dundee since last year on the challenges that it has faced, and the Government has been providing a great deal of support, including financial support. We are pretty close to a resolution on the issues that the Leverhulme was facing in getting the national testing laboratory up and running, so I am confident that things are on track. Maggie, do you have more to say about where we are?

I would like to hope that those efforts will have a positive impact on that gentleman’s life. We heard from the previous witnesses about the outreach work that is going on from the Thistle centre. We heard from the community representatives about the lengths that the staff go to in order to meet people and encourage them to access help and support. I am confident that, if the Thistle is not the place for him, it could help him to access help and support in other places.

We heard from the previous panel that, anecdotally, there are concerns about an increase in the number of people in the area and about faces that are not recognised. It is quite difficult to capture that. As both community representatives on your previous panel said, it is undoubtedly an area where drug consumption was happening anyway. The drug consumption happens close to the market. It is long established that this is an area where people come to buy their drugs, so it is difficult to capture how much change there has been since the Thistle opened its doors in January.

In general, safer drug consumption facilities reduce the levels of crime, drug paraphernalia and street litter in the areas that they are sited in. As well as being a life-saving intervention, part of their purpose is to reduce the harm that is experienced by individuals and by the community because of drug use happening in it.

Again, Richard Foggo can come in on this, but yes, they do tie in. Addictions were identified as one of the key themes in the target operating model. The implementation and embedding of MAT standards is a key part of ensuring that that approach works effectively within the system.

Buvidal is, or should be, available all over Scotland. The Scottish Medicines Consortium has assessed it and has made recommendations about where and how it should be used.

Please indulge me, because I am a pharmacist as well as a Government minister. In some ways, it can be seen as a wonder drug. It is a little bit different to other opioid substitution therapies because it is a mixed agonist-antagonist, which means that it has some inherent, built-in protection against overdose. That is really important for the prison population, given the recognised risk of overdose immediately after liberation from prison.

The generic name is buprenorphine, and Buvidal is the brand name. It is a long-acting injection, which means that it is given by injection at intervals and reduces the need for individuals to present daily at a chemist’s, which can be quite degrading. Some people find that a supportive intervention, whereas others find it degrading and feel that it interferes with their getting on with rehabilitation and resuming caring duties, employment, volunteering or whatever else they need to do on liberation from custody.

The fact that it is a long-acting injection means that it is impossible to divert, which is another advantage. I would not call it a wonder drug, but the inability to divert it is a real advantage when decisions are being made on the best choice of opioid substitution therapy—given that, globally, the evidence is very strongly in favour of opioid substitution therapy and shows that it reduces deaths, harm and criminality and helps people to recover and stabilise. In the most recent detailed interrogation of drug deaths data, we found that 53 per cent of people who died had methadone in their system, but 40 per cent of the individuals who died after taking methadone were not prescribed it. There is a level of diversion in the system that is dangerous and contributes to drug deaths. That is another reason why long-acting buprenorphine, which cannot be diverted because it is injected into the patient, has an advantage over other forms of opioid substitution. The MAT standards make it very clear that individuals who are receiving the medication and accessing healthcare should be a part of the decision-making process around which drug is right for them.