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We are very aware of that issue. Angela Constance and I work closely together, as do our officials. I will perhaps ask my officials to explain just how that works.

We recognise that there is learning from the national drugs mission that we need to apply in exactly the same way to our alcohol services. Some of the criticisms that are made of drugs services—that they are not person centred and do not respond rapidly enough—could equally and easily be made about our alcohol services. We are determined to learn the lessons.

Because of the way that services are structured, treatment for alcohol problems and treatment for drug problems usually happen in the same location. The services are co-located or are often the same services, so investment in one will benefit the other.

One of the pieces of the joint work that we did was the work to tackle stigma, which was quite successful. Stigma is a problem in relation to treatment in both areas, and taking a joint approach on that issue has proved to be quite helpful. Recently, we had an advertising campaign that talked about stigma, which covered both alcohol and drugs. I think that the campaign landed quite well and will make a difference to perception.

We are keen that we have a patient-centred, rights-based public health approach. We want people to be able to access those services easily and for there to be no judgment as they do so. That applies across the board in relation to addiction.

We are also keen to learn lessons. When we have the UK clinical guidelines for alcohol treatment, the work around medication-assisted treatment will be helpful when we think about how to implement the guidelines and ensure that MAT is adopted quickly and used on the ground. Maggie Page is in the drugs team, so I will ask her to come in and say a bit more.

Absolutely. The core purpose of the framework is to prevent disputes through close collaboration between the four UK nations while respecting the devolution settlement. That means enabling policy divergence. The aim of the framework is to avoid, where possible, the need to trigger the dispute resolution process.

In terms of scrutiny, Parliament will engage with the framework through the decisions that it will be asked to take on any change of legislation that is proposed in the policy area. In essence, the framework is a way of working. It sets down the mechanisms for working together with the other Administrations of the four UK nations that share these islands.

You are absolutely correct that the pandemic caused quite a disruption in this respect, as in many others. We have seen a steady reduction in the amount of alcohol that is being consumed. In the first year after the introduction of minimum unit pricing of alcohol, there was a huge decrease in the number of deaths. They reduced by 10 per cent, which I think is the second-largest decrease in any year since records began. In 2020, which was the first year of the pandemic, adults drank an average of 9.4 litres of alcohol per head, which is 18 units per adult, per week. That is the lowest level of average alcohol consumption in Scotland for 26 years, but it is still almost 30 per cent more than the recommended limit.

That does not tell us who was drinking and how they were drinking. There is a real suspicion that people who were drinking heavily before the pandemic consumed more alcohol during it, and that those who were drinking less drank even less.

There was also a big shift in where people drank, because of lockdown. There was much less drinking of alcohol in bars and far more consumption at home. There were also changes in the number of admissions to hospital and an increase in the number of deaths. You might think that, if there was an increasing number of deaths, there would be an increasing number of admissions to hospital, but we actually saw the opposite. That might be about the strain that was being experienced across the healthcare system at the time.

We have a lot to disentangle and to understand about what happened during the pandemic. We also do not know whether it was is a one-off or will alter the trend.

There is one crumb of comfort in all this—although it is really not comfortable at all. Every death is an absolute tragedy; 23 deaths per week is only the tip of the iceberg. Those are the deaths that are directly attributable to alcohol but, in addition, a large number of deaths are related to heart disease and cancer to which alcohol is a contributory factor. It is an absolutely tragic situation. However, the one crumb of comfort is that, although it is recognised that Scotland’s long-standing relationship with alcohol is harmful and that more Scottish people died from alcohol during the pandemic, the increase happened right across the UK and was not unique to Scotland. Actually, our rise of 17 per cent was slightly lower than that of the rest of the UK countries.

That gives me a hope that, perhaps, some of the work and strategies that we have in place were protective during that difficult time. For example, alcohol minimum unit pricing might have meant that, although we had a devastating increase in the number of deaths that year, they were not quite at the level in the rest of the UK.

Minimum unit pricing of alcohol is not the only feather in our cap, however; we have done a lot of work over a number of years. When a nation has such a harmful relationship with a substance such as alcohol, more than one thing has to be done to tackle that. We have therefore taken a range of actions to reduce the availability, attractiveness and affordability of alcohol, in line with the World Health Organization’s recommended approach. We will continue that with a whole-population approach that aims to reduce alcohol consumption and the risk of alcohol-related harms across the population.

However, two consistent threads run through our work; we are keen to focus on two target areas. First, our actions must reduce health inequalities. Secondly, we have to protect children and young people. We are therefore planning and consulting on potential restrictions, as I said, on alcohol advertising and promotion, particularly in order to protect children and young people.

We are keen to give consumers health information on labels, such as through placing on cans the 14 units recommendation. Among the four nations, we are also discussing putting calorie labelling on alcohol. We think that that will be helpful. In addition, over the course of the pandemic, we have twice run our “Count 14” campaign work, to raise awareness of all four CMOs’ lower-risk drinking guidelines that no more than 14 units per week should be drunk. We ran it for four weeks in March 2019, and for six weeks in January to March 2020.

The work that we have done so far—minimum unit pricing for reducing affordability—will help. Young people will see less drinking in society. However, one of the main areas that we need to address is alcohol advertising and promotion.

YoungScot, the Children’s Parliament and the Scottish Youth Parliament did an amazing report a couple of years ago, which made shocking reading. They came to Parliament and presented it: from the mouths of babes, we heard directly how much alcohol they were exposed to. Alcohol is ubiquitous in our children’s lives, and not just through advertising, although that is a big part of it. Children talk clearly about how, when they open the fridge door in the morning to get the milk out, there is a stack of wine there. Think about how our drinking has changed since the 1970s, when I grew up. It was not common to drink at home then; people did not really drink wine with dinner. Nowadays, children see a great deal more alcohol being consumed at home.

Children also see alcohol advertising on transport and on billboards on the way to school. I have previously made the point at committee that we cannot just protect children from alcohol advertising simply by throwing a ring around where they are; we cannot prevent alcohol advertising just around schools. Children are in our society and they see billboards and adverts as they navigate their way to school. They also see advertising in the cinema and on television. A shocking study was done on the amount of alcohol adverts that children were exposed to in sports promotions. I will find the statistic to make sure that I get it correct. However, when children watch sports, they see alcohol advertising literally a couple of times a minute. That is particularly harmful because sportspeople are heroes to them. [Interruption.] I am sorry. I am not sure what that noise is.

I am open to any approach that will work, but there are currently no plans to adjust the licensing laws. I do not think that we can simply say, “If we do this, the problem will go away.” I think we all accept that, given the level of the problem in Scotland and the harmful relationship that we have with alcohol, it is probably going to take multiple measures over a good period of time to shift the culture so that we have a significantly healthier relationship with alcohol.

You are right to say that it is not just about children and young people or impulse buying. The evidence suggests that people who are in recovery struggle when they see adverts for alcohol and will take steps to avoid them. They are another group in our society who find it hard to resist the lure or the attractiveness of alcohol as it is presented to us today.

That is a really excellent question. Last month, SHAAP published some interesting studies on a couple of areas of inequality. One was on LGBTQ+ people. Another, from the University of Dundee, looked at alcohol nurses in deep-end practices, which particularly target socioeconomic deprivation.

The evidence about LGBTQ+ people is that that particular community experiences more alcohol harm than others and uses alcohol in a different way. There are a number of reasons for that, but it is likely that being a minority group facing hostility and discrimination influences drinking behaviour. Historically, safe places for LGBTQ+ people were often bars and clubs. Society must reflect on that learning and think about how we can change that.

Most of the recommendations about making services inclusive were for those who deliver services on the ground. I absolutely support the work that has been done and the recommendations that have been made. I am keen for service delivery to reflect that learning.

I hear from a number of groups—not only from LGBTQ+ people—that services do not look as if they are for them. The study showed that most people perceive services as being for middle-aged heterosexual men. Women and young people feel as if they cannot access services. We must reflect on that. We have a problem with alcohol throughout society and we need our services to be inclusive and welcoming. It is hard for people to ask for help, so we need them to get that when they come in.

You are absolutely right. I represent a constituency in the far north that is quite sparsely populated and has a long history of alcohol harm. I am very interested in that subject.

We definitely need to improve access to alcohol treatment in every part of Scotland, and we need to think about all the health inequalities that play out in our health system, generally. We must consider geographical inequalities, women, poverty and LGBTQ+ people. It is a problem that occurs all over Scotland and perhaps to a greater extent in some of our more rural populations. We are very keen to ensure that services are delivered in rural areas.

Northern Ireland will automatically align with EU regulations, whereas Scotland will make a policy choice to align with EU regulations. I guess that that is the difference.

I think that there will be future discussions about that between Scottish Parliament and Scottish Government officials. We will definitely consider a possible approach to the post-implementation monitoring of frameworks, but I expect Parliament to be fully involved. Individual review processes are currently being developed, and I wonder whether Jennifer Howie wants to say a little more about that.

FSS is responsible for three of those frameworks, and it will collectively involve a number of departments across the UK, alongside consultation with stakeholders, about how to ensure that the process is well informed—cutting down on duplication of effort among all four nations but also making sure that plenty of evidence comes forward to inform decisions. I ask Jennifer Howie to say a little more on that.

Work on reviewing the level of the minimum unit price is under way. That is important work, and we need to carry it out thoroughly to ensure that any change to the level has a robust evidence base.

Just as important as the review of the level of the minimum unit price is the need to ensure that minimum unit pricing continues as a policy. You will remember that, when the legislation was passed, a sunset clause was built in, which requires the Scottish ministers to lay a report before the Scottish Parliament as soon as is practical after the policy has been in place for five years. That will be on 30 April next year. We just passed the four-year anniversary of the introduction of the policy on 1 May. We are doing both of those reviews simultaneously, but the focus has to be on the five-year review, because there is strict legislation in place on the timetable for that.

There are other issues. We know that the pandemic has changed behaviour and the way we drink. We need to better understand that when we think about the minimum unit price.

We also have the cost of living crisis. We are keen that the minimum unit price should reflect affordability rather than simply cost or price, and the World Health Organization is clear that that should happen. Therefore, the fact that people’s household costs have increased substantially will have an impact on how we review the minimum unit price.

Finally, the United Kingdom Internal Market Act 2020 has changed the landscape. There was a lot of discussion as that legislation went through, and the Scottish Parliament did not consent to it. That may well have changed our ability to take public health measures in Scotland that are different from those in the rest of the UK.