24 June 2022
The Minister for Drug Policy, Angela Constance, made a scheduled statement in Parliament yesterday afternoon and announced that she is invoking Powers of Direction available to Scottish ministers under the Public Bodies (Joint Working) (Scotland) Act 2014 to give a Ministerial Direction that will compel Integration Authorities, Local Authorities and Health Boards to implement the Medication Assisted Treatment (MAT) Standards. This is the first time that these powers have been invoked by a Scottish Government minister. Ms Constance’s approach was summarised in her statement that she was “not asking; and not taking no as an answer.”
Local bodies will produce local improvement plans to implement the Standards. These will be drawn up and signed by all local Chief Executive and Chief Officers who will have ‘shared and visible’ responsibility for implementing the Standards and who will name a local officer responsible for driving necessary change and reporting on progress to the Minister directly. This reporting will be done every three months – and every single month in areas where deaths are concentrated and MAT Standard 1, same day prescribing, has not been implemented (e.g. all Scotland’s major cities).
Ms Constance’s announcement came after Public Health Scotland published a national benchmarking report on implementation of the MAT Standards which showed that no area had implemented all the Standards and only one area, Scottish Borders, had implemented Standards 1 – 5 by the original deadline of April this year.
Many areas have struggled to make demonstrable progress – the ‘traffic light’ system used in reporting showed that on Standard 1 – same day prescribing – 59% were stuck on red. Some form of progress towards implementation was widely reported but a lack of comparable data meant that the extent of such progress was unavailable.
David Liddell, CEO of Scottish Drugs Forum reacted to the Minister’s statement,
“This announcement shows a level of concern that is shared by Scottish Drugs Forum and our members about the capacity of local bodies to reform themselves and of cultures that are resistant to change. It will be crucial that adequate resources, both financial and human, are deployed to implement change at the pace required. It is clear that the Minister sees improvement in community-based treatment as key to reducing drug related deaths as well as wider outcomes required by the National Mission. We have previously insisted that there is a need for leadership and clarity of accountability. Invoking this Act is a bold move and shows that Government is serious and realises the importance of implementation – the MAT Standards must be implemented.”