Good morning. Welcome to this meeting of the Scottish Affairs Committee. We are very grateful to all the witnesses on the panel for coming down, I think all from Glasgow, to talk with us about the safer drug consumption room. I hope we said it at the time, but thank you very much for arranging our visit and for the conversations that we had afterwards, which were very useful to our inquiry. I will kick off with the first question to you, Saket. Could you tell us briefly a little bit about the evolution of the plans for the Thistle and what the main barriers were to its opening?

Good morning. Thank you very much for the invitation here. It was great to see some of you at the Thistle a few weeks ago. Thanks for your interest. The Thistle is a result of about a decade’s work. We became operational on 13 January, but the background to the Thistle is that, as you know, Glasgow city has for many years had a very high prevalence of problem drug use and a high rate of drug-related harms linked to that. We have had outbreaks of unusual issues in public health, emergencies in the city such as clostridium novyi, anthrax and botulism in the population involved in injecting drugs, but it was really in about 2015 when we saw a sudden spike of new diagnoses of HIV in people who inject drugs in Glasgow city. We investigated that through a formal health needs assessment about people who inject drugs in public places, particularly in Glasgow city centre because most of the new HIV diagnoses were linked to that population. We did a formal health needs analysis, which was commissioned by our director of public health and by the chair of the Alcohol and Drugs Partnership, called “Taking Away the Chaos”. As well as describing some of the characteristics of the population and their health and care needs, it made a number of recommendations about changes to the current provision of services at that time but also the implementation of new services, new evidence-based services that had been effective in other parts of the world that could have a positive impact for this population. The two new interventions that were recommended were the implementation of a heroin-assisted treatment service. Many of the people who were involved in the HIV outbreak had many years of experience of multiple interventions and treatments and had not benefited from them, so the argument was about trying a new evidence-based intervention that had worked successfully elsewhere. We had the legal framework to deliver heroin-assisted treatment through the licensing processes from the Home Office and for licensing of prescribers as well. The drug consumption room was another recommendation of that report. The drug consumption room at that time was described as a safer injecting facility. There are multiple such facilities across the world, and we had done a literature search and linked in with some of the other services across the world to learn from them. The literature search gave us reasons to believe that such an intervention in Glasgow city would achieve similar benefits to those achieved in other parts of the world, particularly in providing a safer, more hygienic environment for the use of drugs, and that if it was located in the right place people would use the facility. By using the facility there would be improved health outcomes for individuals and those health outcomes would relate to blood-borne viruses as well, reducing transmission of blood-borne viruses in the population, but improve other health outcomes as well such as wounds and mental health and fewer emergencies more widely. Of course, by being able to respond to overdoses and emergencies on site there is also the benefit and likelihood of reduced drug-related deaths. Links using these services have been shown in other parts of the world to support people into other treatment, care and support services as well, particularly drug treatment services. We presented a business case to the Glasgow city IJB, and that business case included not just the benefits for the individuals that we wanted to engage in such a service but also the businesses and the community around such a facility. We were aware for a number of decades of the impact of discarded drug-related litter and visible public injecting on residents, businesses and other stakeholders, even to members of the public coming through Glasgow city centre. In many other parts of the world these facilities have been shown to have a positive effect on the social environment, the social amenity. The final part of the business case was a cost-benefit analysis. There have been some very strong studies; when we were looking at the literature in 2015-16, there were very good peer-reviewed journal publications from Canada and Australia in particular around the cost benefits. The benefit is derived from this intervention, preventing things such as presentations to emergency departments, hospital admissions, fewer ambulance call-outs and even the prevention of HIV, which was really important and remains an important discussion. A lifelong treatment for HIV can run into hundreds of thousands of pounds for one individual. They are very effective treatments, but they are very expensive. I think that at that time, the cost we were given for lifelong treatment was £360,000 per individual. The evidence base from across the world is that if we prevented even a few HIV infections and hospital admissions a year, there would be a very significant reduction in wider costs to the wider health and care services. The IJB approved that business plan and asked us to approach the Lord Advocate for the legal framework that we would require. Drug consumption rooms were not possible at that time without some legal framework, and we approached the Lord Advocate to ask for a statement of prosecution policy or prosecution waiver for us to run this service. As you know, and it is well documented, that was declined at the end of 2017. After that, there were a number of years of trying to find a legal solution to this, which we can get into in more detail—but as that was happening, the drug crisis in Glasgow and across Scotland was steeply worsening, so the case for a drug consumption room became and remains as relevant and prescient as ever. We were, however, able to implement the heroin-assisted treatment service, which we did at Hunter Street Health and Care Centre where you visited and that was done at the end of 2019. Prior to that, we had not yet identified a site for a co-located drug consumption room and heroin-assisted treatment service, but once we implemented the heroin-assisted treatment—and the original business case was a co-located facility—it made sense to implement a drug consumption room on that site as well. It remained relevant in its vicinity to well-known and well-established public injecting sites in the city. It remains close to where we know there are a number of people involved in injecting away from home and it is also a community that is affected by drug-related litter and visible public injecting as well. Moving on, we were delighted when the new Lord Advocate made a statement in Parliament—I think it was in 2021—to say that she would consider a new and specific proposal. We worked on that new and specific proposal under current legislation, so without legislation change, and we presented that to the Lord Advocate. We were delighted when in September 2023 she was able to offer a statement of prosecution policy, after which we then went into an implementation plan that involved the building needing to be worked on to deliver the injecting facilities in the area that you saw. We embarked on an engagement plan with the community, as one of the things the Lord Advocate had stated in her letter to us that she would like to see as part of the implementation plan. We developed a very robust evaluation programme, and I believe some of the research team have spoken to you and given evidence already. We spent a very intense year, as you know, on that implementation plan and we were delighted on 9 January this year when a formal statement of prosecution policy was issued, which allowed us to be operational on 13 January. That, believe it or not, was a summary of 10 years.

It was a very good summary. Did anything change in your proposal between the original application to the Lord Advocate and the one that eventually was agreed?

Yes. In the original application, as I said, we had not identified a site specifically as such and the latest proposal was a much more specific proposal for a site. We also included other information and documents about how we would manage to avoid certain elements of the Misuse of Drugs Act 1971 breaches through our rules and our standard operating procedures. We provided such documents to give the Lord Advocate as much comfort as we could so that our request was now just a specific request around possession of drugs for potential service users in the facility and the site and nature of the facility was described in more detail.

A two-pronged question: have the positions of the Scottish and UK Governments changed over time and are those Governments proactively engaging with you?

I will just start off on that, but I will defer to my colleagues as well who may want to go into more detail. My understanding is that from the initial proposals and the approvals by the IJB, there were votes in the local council and Scottish Government to support these facilities and that support has remained as far as I am aware until now. As you know, there were asks of the UK Government around primary legislation to alter elements of the Misuse of Drugs Act that would allow a facility like this to exist in Glasgow, and potentially in other places as well, or devolving the powers to do so to the Scottish Government. That was declined at that time and my understanding is that that position has not changed, but I will hand over to Councillor Casey who may have more detail.

Thanks and good morning, Committee. As Saket has said, we have had a strong cross-party consensus at Glasgow city council regarding the introduction of a safe consumption room, which has been hugely helpful in that sense. We reaffirmed our support when the Lord Advocate made the intention to release a statement of prosecution policy back in September 2023. We got that cross-party support again at Glasgow city council, which was really helpful. The Scottish Government have been supportive of us introducing a safe consumption room from its inception and from the very early days and have worked really closely with the team in Glasgow and alongside the Lord Advocate’s office as well in taking those different cases through the journey. The Scottish Government supported us in the initial request to submit a proposal to the previous Lord Advocate. However, as we know and as has been explained earlier, that Lord Advocate came to the conclusion not to be supportive. I think it is fair to say that the previous UK Government’s position had been fairly hostile to us opening a safe consumption room in Glasgow and had been actively proposing against us going down that road. Their view was very much that there was no safe way to take drugs; that was their public position on it, and they were less than helpful moving forward. When we got the permission, or the statement of prosecution policy or the intention of that, it was welcome that the UK Government and the Home Office had acknowledged the independence of the Lord Advocate in Scotland and that position and had intimated that, while they did not agree with opening a safe consumption room, they were not going to intervene. That was very welcome, and it was a bit of a shift in the right direction, but still they were not coming out in support. Since we have opened, I am not aware that the UK Government have formally changed their position. The work of this Committee and the discussions that we have in the coming months will be hugely crucial, hopefully, in developing the position in that case. I hope that the UK Government sympathise with the work that we are doing and will look closely at it. As we know, the way in which we have got the permissions now through the Lord Advocate is not the easiest way, to say the least, to open safe drug consumption facilities. We have managed to do it in Glasgow, but we know that more safe consumption rooms are needed, maybe more of them in Scotland and indeed across the UK as well, and we really need to find a better and easier way to do that. To me, the best way to do that is through a change to the Misuse of Drugs Act.

I imagine that the evaluation, which we will come on to talk about later on, will also be crucial in that process. Okay, thank you for that. I will pass over to Stephen Flynn now.

Thank you all for coming down today. I apologise for not making it to Glasgow the other week to see you all in person at the facility. I hope I will get there soon. It is obviously very early days, and I would not expect you to be able to draw any conclusions yet. Certainly, in the last evidence session, it was intimated to us that it would be some time before any conclusions could be drawn; but on the effectiveness up until now, where do you think things are at with footfall and the number of people using the facility? Is that in line with the expectations that you had? Do you believe it is reflective of the number of people in the area who are using drugs? Finally, in that context, there has been significant discussion about the use of the facility by males and by females. Do you feel that the use is reflective of the community as it stands? If not, what more work needs to be done to make sure that those who are perhaps not using the facility who could be using it are doing so in the future? Who wants to go first?

Shall I start? Yes, early days—we are in week eight now, so it is very early days to draw any definitive conclusion. We will be issuing reports to the IJB and will be able to go into more detail about our analysis of reach and effectiveness in due course, but the early experience is very positive and very promising. To date we have been visited by over 140 unique individuals. We have had over 1,000 such visits and the injecting space, the using space, has been used well over 700 times. All that means that we are making an in-reach into the population that we hoped to. Some of that population definitely feels that this service is already meeting their needs, and we have prevented 700 to 800 drug-related items of litter from being discarded in the streets. We find that people are engaging with the whole range of the service model; not just the using space, but the wider service model seems to be, at this early stage, fit for purpose. People are using it as a touch base to go and engage with other treatment, care and support needs such as wound care, housing support, treatment and care as well. Crucially we have already seen, as anticipated and as exists in all other drug consumption facilities, a number of very significant medical emergencies and overdoses that have been reversed and people have been supported. I am fairly confident that some of those in particular, if they had happened behind closed doors or in a public space with no other people in the vicinity, would likely have had very tragic outcomes. At this stage certainly I feel, and we feel quite positive about the experience to date. We have a lot more to do to improve the reach, increase the reach and make people feel comfortable about returning for as many of their injecting episodes as possible into this facility. Lynn is probably able to provide a bit more detail on some of the day-to-day experiences.

Absolutely. Saket has already spoken about the numbers, but I think more than the numbers is the care and treatment that people are receiving. We are getting feedback from other services about people’s experience within the service. They are talking about being made to feel welcome, not feeling rushed and it feels like a safe space to them. To that end, we are seeing new people coming in every day because they are speaking to other people who have used the service. People are prepared to travel and come to the service to make use of it, which is much better than being alone down a lane or whatever. We have managed most of the medical emergencies in-house. Very few have needed an ambulance. Very low numbers of people have needed an ambulance, but all of them have returned to the service after that, so while it is quite a traumatic experience for people, it has not put them off coming back. They have felt they have been well looked after and they are building good relationships with all the staff team within the service. I think that is quite key. There has been a lot of outreach with the staff team in the service and we aim to keep that going. We have been quite targeted with our outreach. We are going to places where we know that there is a lot of public injecting, engaging in the local area and speaking to people about the service. People are reporting when they come in that it is because they have spoken to some of our outreach staff. We have been working with partners to develop that outreach and get the word out there to people that this is a service where you can come, feel safe and have your needs addressed, be that wound care, your physical health, your mental health, have blood-borne virus testing. It is taking care of some of people’s most basic needs. The shower facilities and the clothing store have been used daily. We are really making a wider difference to people. Yes, they can come in and inject, but that is almost a transaction while they are there. A huge amount of other work goes on. We have made a number of referrals to care and treatment services already, including one in the first week, which we did not necessarily anticipate so early on. We have made lots of referrals to housing. The gender split we are seeing is roughly what we see in our care and treatment services. It is similar, but we are quite proactively trying to work at getting more women in because we know that there is a gap across our services. It is difficult for women to access services.

What do you think are the underlying causes for that in particular?

There is a real anxiety with women coming into a service. Sometimes it may be that they are in a relationship and their partner will not allow it, but there is an anxiety, a mistrust. I think overall that there is a mistrust of statutory services. We are aiming to overturn that and allow people to come in and get a different experience within the Thistle from the one they would get anywhere else. We are doing some work with Routes Out, physically going out with the outreach team there, speaking to women involved in prostitution in the local area and trying to talk to them about what will make it easier. A lot of what we are doing is working with people to find out what will make it easier for women to come in. We are working with the Simon Community hub. We have strong relationships there. It is just about going out, asking women what they want from a service and trying to make it as smooth and comfortable as possible. The hook of having a shower, nice facilities and clean, dry clothes has proven quite successful.

I think one of the crucial bits of the development and the design of the facility was the women’s reference group, a group of lived and living experience individuals who had experience of the services that we provide. We changed the early design and concept of what we had. It changed dramatically from speaking to that group to try to make sure it was as welcoming as possible to women who are caught up in addiction. That was a crucial part of designing the service for those specific needs. My colleagues have also touched on the impact the facility is having on the individuals using it. Also crucial is the wider impact on the local community as well and we need to be really clear about that. Part of the Lord Advocate’s statement was about the public engagement element and doing a lot of dedicated work to go and speak to the local community where the facility is. Unfortunately, over the last couple of weeks there has been an element of deliberate misinformation in the public domain from various sectors that are, I suppose, trying to say that the public injecting sites that we know of, and of which there is evidence going back many years, are a new thing because of the safe consumption site. We need to be very clear about the fact that these are not new. We are very well aware of them. The Thistle’s location was partly due to those public injecting sites. The reason I mention that is because we are trying to demonstrate the benefits to the local community as well as to those who are using the service. Anecdotally, in speaking to our cleansing operatives, in the feedback that we have been getting from the teams who regularly go and clean up the public injecting sites, we hear that there is a bit of a reduction in the number of discarded needles and drug-related paraphernalia. Obviously, the academic study on this and the evaluation will go into that in a lot more detail because a lot of mapping was done prior to the facility opening and that will continue after that. Anecdotally, however, the feedback we are getting from the cleansing operatives is that those numbers are reducing. Even in these early days, just eight weeks, that is 700 injections that would have been taking place in public places in the surrounding areas that have taken place away from them. The public-place numbers are reducing, which is really good as well.

Can I briefly add to what my colleagues have said? Going back to the question about expectations, I think we would all say that the numbers that we are seeing, the number of people accessing the service so early on, has probably exceeded expectations. We know that as a population, we are talking about people who do not trust services a lot of the time and have been challenged and struggled to engage with services. As Lynn mentioned, the outreach work is really important. We have seen an increase week on week and that is the bit of the engagement that really pleases us. Another important aspect of the service is that it has allowed people to come in, not inject, spend a bit of time in the service, and then come back. We have seen that happen fairly regularly: people have come, visited a couple of times, and then have felt able to come back and use the injecting space. Briefly to pick up on Lynn’s points, I think we know that women are very much under-represented in addiction services overall, in treatment services and residential services. That is to do with some of the barriers, the stigma and the male-dominated environment that we have. We spoke to a number of facilities across the world about that and nobody has managed to find a solution. As both Councillor Casey and Lynn have said, we have done a lot of work with women with lived experience and continue to do that work. The clothing store and the showers, for example, came from that group of women who said, “If you want to engage with people, you need to offer something more, and probably a safer space away from even the injecting area and the lounge area that the service offers.”

That is really helpful. Thank you. One very quick final point: you referenced the IJB reports. How often are you reporting into the IJB?

We have now said six monthly. There have been a number of IJB reports leading up to the point of implementation, but six monthly.

I am picking up on what Allan said about taking the local community along with you. When we spoke to you last week, the week before, you were due to have your first community meeting. Can you inform us how that went?

I had the pleasure of chairing that meeting so I will kick off, but Lynn and Councillor Casey were there as well and can give their versions of events. It went very well. The attendance was good. We had community reps, but I think it is fair to say that we could have more community representation in future meetings. We would like to have more business representation in future meetings. It was a first meeting, so we are establishing our terms of reference and how we are going to do our work. We also established that evening meetings are difficult for some members of the community, and perhaps for some businesses as well, so we are looking at different days of the week, different times of the day to try to engage people more. It was very interesting, though, that my perception was that we had very positive feedback from a number of stakeholders, particularly those who work with the patient population group who we want to use the service. In fact, we had some good anecdotal reports of outcomes for individuals who had used the facility already. We would like to hear more about the community experience in due course.

I think it is fair to say that there needs to be more representation from local community members specifically. That is crucial. I have to be really honest that it is not through lack of trying. We probably carried out one of the most extensive pieces of engagement work that the HSCP and IJB have ever done on the implementation of a service. We conducted numerous public engagement events and public drop-ins, and we went to public meetings. The vast majority of the local community, the vast majority of the public have not engaged one way or the other and I think that is just generally the case with consultations or engagement events, so it is difficult to gauge public opinion on an issue like this. However, we will do a lot of work. We have some key stakeholders and key community members involved. They let the local community know about the work that we are doing; they spread the word and pass the message on. I am very thankful for the work that they and the community members do. They went above and beyond and have been really helpful in spreading the information, but sometimes it is just difficult for us to get out there. Information spreads by word of mouth sometimes, but it is down to us to make sure that we are getting the right people in the room and having those conversations. The ambition for that engagement forum—albeit Saket is chairing it just now and he is a fine chair—is to transfer the chair and the running of it to the local community so that they have ownership and can determine when the meetings will be, what is discussed there, what feedback is coming through. That is a good bit of best practice that we have seen from other consumption rooms across the world. It drives the narrative and the discussions. As much as we think we know what the community wants to hear or we think we know about the issues that are coming up, if the community is driving those discussions and feeding back to us, it is crucially important for us to get the information that we need. Lynn MacDonald: It is important to note that the community members who are coming to the meetings are not necessarily those who are highly supportive of the Thistle. It is not that we have hand-picked people who will tell us what we want to hear. They very much challenge us, and I think that is very useful because it allows us to hear the reality about the impact of the service in the community and we are very clear that we want to hear that. As well as changing some of the times of the meetings, we are also changing the venue. We are trying a number of things to make sure that we can access as many people as possible.

One final point about this. The meetings themselves are very important but the communication and the partnership working exist outwith them. For example, when we started hearing information that turned out to be misinformation about what was happening with the site, we were able to liaise with a number of relevant stakeholders in a partnership way to investigate and respond quickly. We do not wait for the meetings as such; we are constantly in conversation and responding to issues in a partnership approach.

The figures are very impressive, to my mind, and very encouraging for week eight. Thank you for allowing us to visit last week; I found it extremely beneficial. One fact I took from the figures that we discussed last week and the figures before us today is that perhaps those who are using your facility are doing so, at this initial stage, once a week, so effectively you can keep them safe and help them to be safe when they are there. How do you increase their use? How do you encourage them to come along more frequently and keep them safe every day, rather than just perhaps once every seventh or eighth day?

A lot of it is about relationship building. We are seeing people starting to return more frequently now. We are starting to develop relationships with people. Some people we know are coming in every day and we know roughly when they will be in. We are starting to see people come back more regularly. We have to prove ourselves to people. We have to prove to people that it is a safe place and that they can trust us. Even the response to medical emergencies, making sure we are doing that in a manner that does not put people off returning, has proven really successful. It becomes about your reputation and your credibility within the local community and the word getting out there, with people saying, “Well, actually I have been a few times now”. It is things like having the shower, encouraging people to use the wider parts of the service, and some of the work that we have been doing around referrals and listening to people has been asking what they want from us as a service, speaking to people and saying, “What will make this more useful?” Our plan is that we will be constantly evolving and changing to meet the needs of the people who are coming through the door. It is very much about people’s agenda when they come in, as opposed to us setting the agenda. It is being able to listen. A lot of the people we are working with have a real mistrust of services and have not had good experiences in the past, so it is up to us to prove that this is very different, and so far that seems to be working.

It will supplement that by saying that we have a number of individuals who are the early adopters, so they are coming regularly, not just once a week, but much more frequently than that and there are, as you say, others who are coming twice a week or who have used once and will go away. Some of that is about the dynamic nature of their own situation. It is not just about the engagement with the service. For example, there will be some people who do not use as regularly as others. We have to understand that some people will be more transient about how they come into the city centre and out again. All safer consumption facilities across the world experience this: they are used by a large population, but there is a core population that uses it much more frequently. I think your question is very important and relevant because we will achieve the public health and recovery benefits most if as many people as possible who are injecting around this facility, and into the city centre, use this for as many of their injecting episodes as possible. Our outreach teams, our third sector partners, have been very important and we will continue to work on that. I think over time that trend should go in the right direction, but you are quite right and we are keeping an eye on the frequency of use as well.

Can I come in again, very briefly, to follow up from both my colleagues’ points? The information we presented when you visited was probably from about a week and a half ago and we can already see that gap changing quite significantly. You may remember that there were a couple of days that were outliers in high numbers of presentations, but the numbers are definitely closing now. In a period of probably a week and a half, two weeks, those numbers are starting to follow exactly as Saket and Lynn have said, bearing out that work.

Can I come in very briefly, Chair? I know that the question was specifically about the Thistle service itself and trying to engage people to come back more frequently, but I think there is a wider point that needs to be considered. Saket mentioned the transient nature of people who are publicly injecting in the city. They are not just publicly injecting in that location. They are injecting in other locations around the city centre. I think that makes the case and the argument that one facility is probably not enough; we need to have a network of facilities working in conjunction to make the service as accessible as possible, so that folk who have that transient nature can navigate between different services that we are providing. I think that is potentially a barrier to folk coming back more often. We know that when people purchase their drugs, they want to take them as quickly as possible and that if they are in a location in the city that is further away from the Thistle centre itself—although we think we have the location as best as we possibly can for one facility—there is an argument for having a network of facilities.

Thanks for coming along today. I was very sorry to miss the visit, but I hope I will get there very soon. My question is for Saket. The Scottish Government’s Health and Social Care Minister has said that the facility aims to reduce drug-related deaths. However, I am aware that you have also said that you do not expect the facility to in any way reduce the drug-related death picture in Scotland or even in Glasgow. I think you have given us a slightly different view this morning. However, there appear to be some conflicting views as to the aims of the Thistle. With Scotland experiencing the highest number of drug-related deaths in Europe, it is important that we have some clarity around the expectations and whether the Thistle will have a positive impact in reducing drug-related deaths. Could you clarify to what extent a reduction in drug-related deaths is a rationale for, or an intended benefit of, the facility?

I am happy to try to clear up any confusion. The evidence base from other parts of the world suggests that for the population that uses such a facility, there is improved health and reduced mortality rates. including reduced drug-related deaths, and we hope that that will be realised for the population that uses the Thistle. However, that population is relatively small even in relation to the population of people who use drugs in Glasgow city. We think that in Glasgow city there may be over 10,000 people who use drugs, maybe more than 5,000 people who inject drugs, but this service itself is focused on a particular subgroup. “Taking Away the Chaos” described it as 400 to 500 individuals at that time, which was 2016. The population may be slightly less than that now and the situation is very dynamic. For that population, we hope very much that there will be a reduction in drug-related deaths. As I explained, we have seen some emergencies that have been managed in the Thistle that would almost definitely have led to fatalities outside the service. However, if you build on that and try to get a Glasgow picture to ask about the impact of the Thistle service on Glasgow’s drug-related death figures and the national drug-related death figures, you are talking about a small population within a much larger population. It is very difficult to say that the facility on its own will reduce Glasgow’s figures. However, it is a pilot facility with a view to other facilities potentially coming on board, as you have heard. I am very confident that, were a number of these facilities to exist, targeted at populations that have the highest rates of harm and drug-related deaths, you would see a different picture in Glasgow city and you would see the impact on figures in Glasgow city and nationally as well, possibly. I don’t know if that helps at all.

It does, in identifying the very specific group that it is aimed at. My follow-on from that—and you have just touched upon it in the last part you mentioned—is to ask if that is still the correct focus, given the change in the drugs environment. We know that there is not an inhalation room, and that opens up a whole other set of questions around legislation. But is focusing on the very, very small population who inject where you believe the biggest difference will be made?

The initial proposal did include a smoking/inhalation room, and we are very keen to be able to develop an inhalation room in the facility. You are right that there has been some change in the drug trends in the city, with more cocaine use in particular, which is being used predominantly through inhalation and smoking, although there is still a lot of injection in the city as well. We continue to see cocaine rising in the drug-related death toxicology picture. I think that on its own it will have an effect, but as part of a wider system of care, where this is a touchpoint for harm reduction for the individuals who use it but also access to other treatment, care and support, and as part of a system of care, where it links people who are currently not engaged in the other protective services that we have in the city. We have been working on a whole range of others; I am happy to talk about them as well, but it is an important point of contact for people who are currently very marginalised and not engaged in those. These are important parts of a comprehensive system of care in a city like ours. There is a lot of international evidence to support their roll-out. Most new services in the world include—actually some of them are now predominantly— inhalation rooms rather than just injecting spaces.

I will briefly come in on that point. The question was framed as whether there should be this focus on this facility. It is fair to say that the revenue budget for this is £1.2 million per year. The overall ADP budget in Glasgow is around about £34 million to £35 million. It is a small part of the wider package of service that we are providing. What can be confused here is the wider focus in navigating something that is ultimately controversial. I think safe consumption rooms do attract controversy, and that is why there has been such a national focus on it. It is only a small part of the wider picture of what we are delivering in Glasgow. We have been very clear that the safe consumption room in and of itself, the Thistle, is not a silver bullet, but it has been a missing piece of the jigsaw in the services we provide in Glasgow. As has been said, that will not be enough. There has to be a network of these facilities to really make a difference to the national statistics that we are talking about. We need to because Scotland cannot afford to not make a difference in the drug-related death statistics. We have the worst record anywhere in Europe and the Scottish Government are investing quite significantly in the national mission. We are doing the same in Glasgow. This is only one small part of the wider picture for that investment.

Thank you for that. I appreciate the point that you are making. However, I think, such is the concern around this, that people need to know that public money is being spent in the area that will have the biggest impact. I think it is a valid question to ask. I am not sure we can be looking to networks when we are only a few weeks into a pilot. We need to see the real impact and outcomes before we have further discussion on that. My follow-up question is: to what extent does the facility need to reduce drug-related deaths to be considered successful? You have touched on that, and I think it is a critical point, because the centre opened in the context of a national discussion around the concern of the very high rates of drug-related deaths.

There is a very comprehensive evaluation in place. The business case for the facility was based on a number of intended outcomes. One of those was of course improved outcomes for people who use the service, including reduced mortality and reduced drug-related deaths, but also remember that it was linked to the outbreak of HIV in this population. We want to see reduced HIV transmission, reduced blood-borne virus transmissions and treatments as well. We expect to see better physical health and reduced use of acute services and emergency services. It is a touch base for links to wider support, so referrals and uptake of a whole range of services. Already we are seeing people having support for housing, treatment and care and links to recovery. Our case included a case for recovery for people who use the service. Then there are wider elements, which I described—I feel like I am repeating myself, but I will do just quickly—with the wider community benefit of discarded litter, discarded and visible public injecting, an improved social environment and then the cost-benefit argument, the cost-effectiveness. All of these will be measured by the evaluation. We need to take a holistic and overall view of the outcomes as against the business case that was originally proposed.

When I visited the facility, the quoted yearly cost was £2.4 million. Is it £2.4 million or is it £1.4 million, just for clarity for the Committee, please?

£2.3 million.

It is £2.3 million—sorry.

£2.3 million per year for this facility. Okay, thank you.

Is it clear in your understanding what types of drugs have been consumed in the pilot facility? You said about cocaine use as a rising trend. Are you surprised by what has been happening or what drugs have been concerned?

I will start. It is an injecting facility, and we are not drug checking. Our information is based on what service users tell us that they are using. What we were surprised by initially was just the volume of cocaine in relation to the heroin. We expected roughly equal amounts of presentations for cocaine and heroin use, but in recent weeks we have seen much more equalisation. We have seen an increasing amount of heroin use within the facility and heroin and cocaine use snowballing within the facility. We are getting much more of a picture than we initially anticipated. We are not seeing people describe any other drugs that they are using in the facility, but of course we cannot be definitive about that, because we do not have drug checking to confirm what is in the samples or not.

We have all heard that drug consumption trends are shifting, for example through increasing cocaine consumption. Is the facility equipped to keep up with the evolving drug consumption trends in Glasgow?

I suggest that yes, at the moment we are. The evolving drug use across Scotland, across Glasgow, across the world is something that we all need to be constantly watching. We need to constantly think as services how we evolve and change to meet the needs of people who are coming through the door based on what they are using. That is not just local to the Thistle—that is our whole service—but we have developed a number of treatment options, not just medication for people moving forward. We have launched a cocaine toolkit in Glasgow that we are using and rolling out. We think about how we manage people’s benzodiazepine use. Again, it is linked into the wider system of care. It is about how we access other parts of service via the Thistle as an entry point for that. It will constantly develop and evolve and that we need to monitor. We have a strong training plan in place for staff and we have support from our psychologists. We work closely with Scottish Drugs Forum, who provide a lot of training for us. We are constantly looking at that and reviewing it and we will continue to monitor it.

If I can come in quickly there, we are not able to provide an inhalation space; we know that has been possibly the major shift in the last three to four years in particular. We are hearing from current service users and other people who would use the service and the partner services that work with them that, if we had an inhalation space, some people would use that space. On top of that, the other obvious public health concern in the city has been around whether synthetic opioids become part of the drugs traded in the street. We have data from the last two to three years that tells about nitazenes and fentanyl. We have not really seen much fentanyl and very small numbers of nitazenes, but year on year maybe those small numbers increase. We think that if people are using nitazenes and injecting nitazenes, this environment would probably be the best and safest environment to do that. Nitazenes are very potent opioids, as you know, and could potentially be involved in very significant overdoses and deaths. However, to assist us further, as well as an inhalation space, we hope to have a drug checking service and facility on site in due course. That will help us to understand better what the drug trends in the city are and what people are using in the facility, if they are able to get those checked. That will help us to develop the service and make it even more fit for purpose than it is at the moment.

On that point about drug checking, it is crucial for quickly responding to dangerous or contaminated drugs as well. We all have seen the warnings that came out from an NHS board in Scotland earlier this week about contaminated drugs and how quickly drug checking could, if not address, then put out warnings to citizens in the city. Obviously the application is with the Home Office now, but I hope that it can look at it as a matter of urgency, given the change in drug trends and the dangers of contaminated drugs in the system. Hopefully we can make real progress in getting that open. There are another a couple of practical issues in the delivery of the service. The Misuse of Drugs Act prohibits us from giving people using the service tourniquets, for instance. The other obvious thing, if we are looking at inhalation, is providing equipment for smoking—pipes, for instance. Those are two areas that the UK Government potentially have to look at in providing exemptions for us to assist those who are using the service and indeed want to reduce harm by moving away from intravenous injecting into inhalation through giving out pipes as well.

Turning Point has raised concerns that the facility is already outdated and offers little in the way of support for the growing number of people who inhale drugs or use drugs other than heroin. An addiction campaigner, Annemarie Ward, has voiced her opposition to the suggestion that smoking laws may be altered to have an inhalation room at the Thistle. She then went on and she described the suggestion that we should change these laws to encourage people to stop injecting and return to smoking cocaine as “misguided and disconnected from the reality of addiction”. To what extent do you agree with that characterisation?

I am happy to address some of those points. That statement goes against all evidence that is available on reducing harm. I do not think that is a position that we recognise for the journey through the service. On Turning Point Scotland’s point, it is a fair observation that the facility obviously lacks the inhalation space. We really need to start working quickly on that to make that case, to allow an exemption in legislation. We need to navigate ourselves through the different types of legislation that are required to make that difference. We have already raised the issue informally and verbally with Scottish Government and Government Ministers and we are in the process of preparing a case to put to Government to try to see if there are exemptions within the legislation that would allow us to create an inhalation space. As has been previously said, we have developed the physical aspect of the facility so that it can be retrofitted to allow for inhalation. We know through all the discussions that we have had with our international peers in other consumption rooms that inhalations are a crucial part of the harm reduction service that they provide. We are really keen to model our service on that best international practice. That is a case that we will make to the Scottish Government in the near future.

Annemarie Ward goes on to say that the idea “reflects a fundamental ignorance of the progression of the condition and the nature of addiction. For someone who has progressed to injecting drugs, the likelihood of them willingly switching to smoking is so rare that it’s akin to finding hen’s teeth.” On that basis, to what extent is the facility designed for or intended to reach people who inject drugs multiple times throughout the day?

The purpose of an inhalation room is to engage people who are currently involved in smoking or inhaling drugs often in outdoor spaces at the moment and people who are not engaged in harm reduction and treatment and care and recovery supports. That is one of the key aims of having an inhalation room, just as it is for providing a safer injecting space. The other point around route transition, which is I think what is being described or mischaracterised there, is that inhalation is probably a safer and less harmful way of consuming drugs, if people want to do it, compared with injecting. For cocaine users, we are seeing appalling physical harm particularly with injecting wounds. If we can support people away from that injecting behaviour into a safer route of using, when they are not at this moment ready to stop using those drugs, that is a positive health intervention. That is a very well-established health intervention beyond our discussion here. It is very common practice in Europe and in other parts of world. As far as the wider comment is concerned, I have to say that those are relatively fringe or extreme thoughts in our field. Almost everybody who works with this population in a meaningful way, runs services or supports this population, a lot of the lived experience groups who are involved in our work and the recovery communities, understands the rationale very differently to the one that is being described there. They understand the links that this service may provide for people who are very marginalised and distant from recovery to an improved quality of life and potentially on to recovery as well. That view is not just held by professionals and academics, but by people who work day in and day out with this population and many people who have lived experience of recovery. We employ people with lived experience of recovery who would absolutely counter that depiction of the service.

I will add that one of the benefits of a service like the Thistle, as Saket spoke about, is people not being at that stage where they want to look at the next stage of recovery. It is about engagement and relationship building. This is about people coming in and beginning to feel comfortable talking about what is happening in their lives. If that leads to somebody saying, “I want to access a residential service” and “I want to access care and treatment services”, as we have seen, we will support that, and we would absolutely encourage that if that is what people are telling us they want. A lot of the people were seen as a long way away from being ready to take the next step of going into, for example, a rehab. If that is what people come in and tell us they want, we can support them on that road, but it is a huge amount of work, and are people ready for that at that point of injecting 10 to 12 times a day? Possibly that is too big a leap. There needs to be a stepped approach to that for people. It is just making people feel comfortable that they can go with their own.

Can I just check with Councillor Casey? You mentioned about the application for the licence for checking drugs. Has there been any feedback about when you might get a decision on that from the Home Office as yet?

I do not believe that we have any definitive dates. The Home Office has to carry out a compliance visit. There have been several dates put in the diary and those have been cancelled—not at our end. Hopefully the Home Office can get a definitive date in the diary to come to do that compliance visit and then we can hopefully progress the licence itself. I do not know whether colleagues have any further information on that, because that was the information I had last week.

No, sorry, it is the same information, but it is important to say for Glasgow that there are three sites across the country that wish to pilot drug checking. Because we have a Home Office licence already in place for an enhanced drug treatment service, it is an addition and a change to our licence. As Councillor Casey said, we are still awaiting confirmation of a visit to renew that licence.

I want to add very quickly that we have regular compliance visits because of the existing licence, and there have been cancellations in the past. It is not something that has particularly concerned us from that perspective.

I can start on the second point. Why have the Scottish Government not done it? It is because we have not made that formal request to them yet. It is not like the Scottish Government have said no to that. They have obviously not said yes. We need to present them with a specific case. Saket might be able to go into the history: inhalation was on the initial proposal to the previous Lord Advocate, but they had obviously said no to the overall service at that time. It is fair to say that when we built that case the Scottish Government have not made any decision one way or the other in allowing that exemption. On the other points, I do not know if any of my other colleagues want to say what specific exemptions would be required.

This is where you realise I am not a lawyer, so I will not be able to give you something definitive. My understanding is that they would be exemptions under some of the Scottish Government’s devolved smoking legislations that would allow us to be an exempt premises for certain acts related to the Smoking, Health and Social Care (Scotland) Act 2005, I believe. We are delighted that we will hopefully be able to make a case for that soon because we are hearing already that that is important intervention that service users would definitely use. To give a little bit on the background on this, there were other restraints as well. One of those was around the building and the ventilation requirements for inhalation rooms. We were not sure whether we would have space in the footprint of this facility to be able to implement an inhalation room. When we looked at the potential ventilation required, it was very high-grade ventilation that we might not have been able to source. What has happened in the implementation of this facility is that we are confident that we would be able to find some space within the facility. We had to explore ventilation for the using space itself, the injecting booths themselves, and we made the decision to put in ventilation that would be fit for purpose should we be able to progress to an inhalation space in due course. Some of the conditions required for use are now much more advanced and ready than we thought they would be even six months or eight months ago.

Picking up on one of Councillor Casey’s earlier points around the Misuse of Drugs Act, which prohibits the supply of certain equipment, if we were considering inhalation rooms, we would also need to consider that regarding the equipment. If you are running a service, as we have found with tourniquets, we would definitely want to make a case around supplying pipes, for example.

Thank you for that. I think we could sit and talk to you all day about this, quite honestly, because our private discussion was going in that direction, but I am very conscious of time, and we want to make sure that we cover the range of issues, so before I come to Susan, I ask colleagues and witnesses to be as succinct as they possibly can be.

This is a question for all of you—apologies, Chair. We know that the safer drug consumption rooms work best when there is a system of support in the community. Do you feel that that system of support in the community already exists in Glasgow?

Do you want me to pick up that? As briefly as possible, yes, absolutely. Colleagues have talked very clearly about the full range of harm reduction, treatment and care and recovery services that are available across the city. As Councillor Casey highlighted, the budget for that across alcohol and drug recovery services is just over £34 million and that is across all of that range of services. It is very important that we are able to offer—aligned with the national mission and the medicated assisted treatment standards—same day treatment and choice of treatment, where people require that, but also the wider supports, as Lynn had highlighted. If somebody is in the service and wants access to residential rehab, we would assess them for that. That will not be the case for the majority of people, given the stage of their recovery, but the business case absolutely outlined that this service should aim to look at people’s recovery. As you will know, recovery is different for different people, and it is about those wider supports. The important aspect of this service is the people. We spent a long time looking at the workforce and the skill mix and ensuring that we had a range of staff, including people with lived experience, a range of staff to look at a much more holistic view of people as they come in the door. It is not just injecting. The injection is important, but that is not the most important part of somebody’s visit to the service. It is about that linking, and we have a number of examples of staff supporting people to find accommodation and into treatment and care services. That is very important. We have a wide range of services covering all the harm reduction, treatment and recovery services in the community.

The pilot is for three years and it is funded for three years. Do you know about the funding for the wraparound services? There are significant amounts of money going into this. Are you confident that that money will continue to be available to support them?

The money that funds our alcohol and drug recovery services, and the wider third sector, because we have a huge number of wider third sector partners who support that agenda as well, is funded through a range of funding streams. Some are directly from Government and through the national mission. It is important to say that since 2021 we have increased our budget. We have increased the spend on alcohol and drug recovery services by £2.6 million and that is absolutely in recognition of the increase and access to treatment and care that is required. Some of that has come from national mission moneys, but it is all aligned to the national strategy.

With the Thistle being part of alcohol and drug recovery services in Glasgow, we have taken away the barriers to other services. For example, for us to refer them for care and treatment, we do not have to complete forms or send away forms. We phone our colleagues in the appropriate locality and that is there. We have our own in-patient beds and a crisis outreach. We have seven-day services that are there to do that wraparound.

I am really sorry, Chair, but I need to make a small simple addition to that, which is that this not all about alcohol and drug recovery services. We need wider wraparound supports for this population. We are very lucky to be co-located with Housing First officers. We have a blood-borne virus team from acute services and sexual reproductive health services on site and we hope to have primary care services on site as well. Those are not dependent. They will exist whether the Thistle is there or not. They are very excited about the Thistle because it gives them access to a patient group who they really feel are very vulnerable and who they want to work with. For example, the blood-borne virus team has already instigated an on-site clinic within the Thistle so that they can engage with new diagnoses of HIV or hepatitis C should they arise.

You will be glad to know that my colleagues have covered everything.

Certainly from the visit and from speaking to your people with lived experience, it is good to hear how this approach is working. Is there a need for any one particular service that is being highlighted by you being able to reach this disadvantaged group? Is there any one particular service that sticks out as being needed?

For the service support that we need outside the multi-disciplinary team of the Thistle, the most obvious one is housing and accommodation.

Housing and welfare rights are our highest referrals with the service.

On the housing issue, Glasgow declared a housing emergency because of the acute pressures that we are facing. It is a whole other issue that I am sure you will not want to get into today. The pressures being faced in the city from folk who are coming from other parts of the UK into Glasgow because of specific legislation in England and Wales is causing acute pressure on housing support services. That is probably one of the fundamental challenges that we are facing now.

As my final comment, I will say that you are doing fantastic work. The way that you are able to reach this hard-to-reach group is such a key lesson that we should be trying to extend for other areas.

The Committee, of course, will come to a conclusion about that at a later point, but members are welcome to make their individual comments. I have a quick supplementary from Maureen Burke.

It is fair to say that housing referrals that have taken place have already taken place within the facility. We have already seen that clear pathway of folk coming into the service who have had issues with tenancies or other issues with getting accommodation. That has happened; the journey has already been there. I am not aware specifically of anybody who has been using the service who has refused accommodation or anything like that. There are individuals in the city of Glasgow who refuse accommodation support. I think that would be the case probably across the UK and especially in some of our big population areas. I am not aware that that is specific to any of the services that we have at the Thistle.

It is less that people do not want housing and more that maybe their previous experience of the accommodation has not met their needs. Perhaps it has been in an area where they have not felt safe. Some of the people we know that sleep outwith their homes—they have home addresses, but they are not there—is because they do not feel safe in that area. Some of the work we are then able to do with our colleagues in housing is to work around how we give that person a tenancy where they feel safe and are supported.

The Housing First approach is not unique to Glasgow. We have a Housing First team, but that approach is critical to exactly the points you have made, for people to engage with supports and maintain a house when you have not lived in a house, but also from neighbours and the community round about. We need to acknowledge that sometimes. That is really important.

I would like to come back to my earlier point about the impactful use of public funding. It is an important point to remember, because behind every drug-related death is a family that is in mourning, who have been devastated. We need to make sure that our resources are targeted in the right way. Professor Matheson has said, as we have referenced, that the Thistle is a gold-standard facility. Is this gold standard the most cost-effective use of funding, or do you think there are other alternative formats that could offer similar harm reduction benefits at a lower cost?

All of us will probably have a response to that, and I am probably the non-medical and non-clinician here, so I certainly have a view. First and foremost, the level of service at the Thistle is the right one. Being the first in the UK, we need to be absolutely sure, belt and braces, that we get it absolutely right and we make sure that it does what it should be doing with that service. Models across the world and the globe differ. There are very different models that are delivered by the third sector and that are community based and volunteer run. We need to look at a different mixture of them. Obviously, there will be a real analysis of the work that we are doing in the Thistle and that is great, but there is a potential there to look at other types of models. For instance, could you potentially have a mobile service in the city or indeed in other locations? That may reduce the costs associated with it. There is certainly a need for the level of spend at the Thistle; we will make sure we get that absolutely right and we prove the concept of it. There is certainly room and scope to look at other models that are available as well.

You have answered my question on that point because I was going to ask about mobile units. To what extent is the cost of running a gold standard facility sustainable beyond the current three-year pilot, given the state of local government funding at the moment?

It is fair to say that as a pilot at the moment, and obviously as part of any pilot across the country for any health and social care service, we would review the costs and cost-effectiveness of the service and will continue to do that. While the evaluation will look at the wider impact and the issues that we have discussed today, as a health and social care partnership and an IJB we will need to review and look at the model moving forward. I feel compelled to say that we should be aiming for gold-standard services, whatever services we deliver across NHS and social care. This is a service that is held up, it is multi-disciplinary, but it is aimed at a much wider agenda. As I have said before—I would not repeat myself because of time—this is not just about people coming in and injecting. This is about linking people and particularly individuals who have been a harder-to-reach population. On cost effectiveness, as we have talked about there has been a number of medical emergencies that I fully believe, had they happened outwith the service, would have resulted in fatality. That is what we need to remember. Cost effectiveness is managed across a wide range of issues such as ED presentations and acute hospital in-patient bed days. All that will be picked up in the evaluation.

Can I make one final comment on this? I am really sorry. The cost discussion is very interesting, but you have to have it in the context of the emergency around drug-related deaths. When you have more than 1,000 drug related deaths in a country the size of Scotland, when the burden of disease from drug misuse is as high as it is in Scotland, it is not normal compared to lots of other parts of the world. We have a specific situation that needs an emergency response, and the response needs to be commensurate with the level of the problem. The question is not so much how we justify spending this; it is question of how we justify not doing more and more. It is not just about the drug consumption facility, but about a whole range of services. Lynn has been managing the crisis outreach service, which has been developing an outreach near-fatal overdose response. We have been implementing MAT standards. We have increased our residential services, including stabilisation, crisis and rehab. We want to build as much of a system of care as possible, with multiple points of entry for people, to reduce harms and improve the quality of life for them and hopefully move them on to recovery as well. I would very much argue that we continue with a gold-standard model in the long run and that we recognise that that is actually fit for purpose when you have the level of harm and public health crisis that is going on at the moment.

It is not necessarily that the other models that I said are not gold standard—they are just different types of models. Just because the third sector delivers it does not mean it would not be high class and gold standard either.

My main point was where the funding will have the biggest impact. Everybody knows that public services are under the cosh when it comes to finances at the moment. It is about where the impact is likely to be. I am happy with the answer you have given.

On the back of what Kirsteen was saying about gold standards, we all know that trends move and Governments’ funding moves in different directions. What would happen if the Scottish Government withdrew that funding? Where would the sustainability of the facility be? Would it be on Glasgow city council?

In essence that would come back to the Glasgow Health and Social Care Partnership and the IJB. As with any other funding withdrawal or any funding reduction, we would need to work up a model around how to manage that service, should we manage that service and how that fitted into the wider alcohol and drug recovery services.

You have answered the majority of what I was going to ask, which was about the legal framework and what the limitations might be. In what way do you think the new Lord Advocate taking office would take a different approach from the previous took? Has it been a different approach?

It is fair to say that the case that we made to the new Lord Advocate was different. It was more specific and more detailed. That is not to say, though, that that offer was not made to the previous Lord Advocate. Certainly I had correspondence with the previous Lord Advocate to say that we would be more than happy to make a more detailed case with those site specifications, standard operating procedures and so on. Unfortunately, that Lord Advocate had taken a legal opinion and a legal view on the situation. It was refreshing and welcome that, when the new Lord Advocate came in, they indicated that they would be willing to look at a fresh approach and a fresh case. That question creates a fundamental problem in the way we progress forward, because the fragility of a safe consumption room, in my opinion, should not be based on the opinion or the view of one individual person in post. That is a potential problem, and it makes the case and the argument for having a sustainable framework for how safe consumption rooms can continue into the future and indeed can expand. That has been an opinion all the way through, even when we got the exemption of a prosecution policy, that the most sustainable way to continue safe consumption rooms is an explicit change in the Misuse of Drugs Act to allow safe consumption rooms to operate. You may know my politics, but I think that the laws around the Misuse of Drugs Act, if the UK Government are not wanting to amend them or change them, should be devolved to the Scottish Parliament and the other devolved Administrations to look at their own bespoke issues. Every part of the UK has different specific problems, and we should be dealing with those at a local level. The question points out the fragility of the position where one person ultimately has the responsibility for whether or not the facility gets the go-ahead or continues in the future.

The concern is possibly that, if there were to be another Lord Advocate who perhaps took another view, it still would leave you in a very difficult position. We will move on.

The UK Government have said they will not interfere with the Lord Advocate’s position regarding the pilot. What powers do the UK Government have to interfere with the site’s operation, if they were inclined to? Do you think that the UK Government could close the Thistle if they wanted to?

From my perspective, I do not feel comfortable answering that, as it is a legal question. I would defer that to people who are in a position to answer it.

Yes, that is a difficult question to answer. On the UK Government’s formal position on this currently, as I say, I welcomed the announcement that they were not going to intervene and that they respected the Lord Advocate’s position. It is certainly my hope that that position continues. Part of the work that we are doing is a proper evaluation of the site. There would obviously be a lot of legal wrangling between the Scottish Government and the UK Government regarding any intervention that would potentially happen. Again, as Kelda said, that is not for us to determine. We will operate as best we possibly can under the current situation. The Lord Advocate’s guidance and position is very clear. There is obviously a separation of laws in Scotland from the rest of the UK and the UK Government have respected that. But yes—I certainly hope that that would not be the case in the future.

My next question is of a similar nature. Do you support the decision not to establish an exclusion zone around the pilot facility? What are the implications of encouraging people to use the facility, when effectively there might be no way of getting them there, while they are carrying an illegal substance that they intend to consume, without prosecution?

There are a couple of points in there. Glasgow city council has formally taken the position of supporting decriminalisation of drug possession for personal use. That is my fundamental point. Moving forward, I hope that the Misuse of Drugs Act is amended to allow decriminalisation of that, which would address the concerns that you are raising. The decision not to have an exclusion zone around the facility is right. The community were concerned about whether or not there would be a rise in antisocial behaviour and all of the other problems associated with that. Police Scotland have for a number of years been taking a public health approach to policing on drugs and that is certainly a move in the right direction. Police Scotland largely now carry Naloxone, for instance, and that is really welcome. However, they have been very clear that the policing around the facility will not change. They will not be stopping people simply accessing the facility, unless there is some other reason to intervene in that process—another crime being committed, or whatever. That is the right approach. On balance for the local community, and indeed for the population who are using the facility itself, that is ultimately the right response to opening the facility. It would potentially send out the wrong message if there was some sort of view that there was an area, a buffer zone around the location where there was an exemption in the law, because the law has not changed whatsoever. That needs to be very clear. The Lord Advocate’s public prosecution policy is about possession for use within the facility itself.

Do you think the perceived risk affects the numbers of users that come to the facility at all?

It is hard to tell at this point. We will be looking at that in our engagement with service users who are coming to the facility. I hope that we can find a way to engage with folk who are not using the facility as well. We will be deeply diving into why there are barriers to accessing it. I think that, as Kelda said earlier, the numbers increasing week on week show a bit of confidence that there are not those issues, the worries that people maybe initially had imagined would be the case. There is confidence growing in the service that that is not the case. As I say, the relationship between us and Police Scotland has been very beneficial in the delivery of that position as well.

As I said, it is important to note that as an HSCP, in our business case and in our ask of the Lord Advocate on the prosecution policy, we did not ask for an exclusion zone. It was not a decision made by the Lord Advocate necessarily. It is important, exactly as Allan said, for our community engagement that there is a bit of confidence around that. Very clearly people are quickly injecting anyway within a fairly close proximity to the service and therefore they will be in possession of drugs wherever they are in that vicinity. That does not change. I think that there is a trust in the service and, as Councillor Casey has pointed out, that is increasing and therefore we can see that trust hopefully is building in that community of people.

You are part of a three-year pilot scheme. Will you consider asking the Lord Advocate for an extension on the statement of the prosecution policy?

It is difficult to say at this stage because that would be absolutely predicated on, hopefully, the success of the facility and where we are at that point. As colleagues have highlighted, we would continue to argue very much that a change in the primary legislation, or indeed devolving of that primary legislation, is the most appropriate option for continuing a long-term sustainability, but the service is sustainable in its current form with the current prosecution policy. I know I have avoided the question but, as an organisation, we say that we need to wait until nearer the time to look at it. We are continuing to engage with Crown Office and Crown Office is obviously interested in the facility and, as Councillor Casey said, we work very closely with Police Scotland as well.

I need to double check this, but my understanding is that there is an expiry date on the statement of prosecution policy. The three-year pilot is for the funding from Scottish Government, but I do not understand that there is an expiry date on the prosecution policy. I may be wrong.

The Lord Advocate certainly talked about the pilot. I am not sure whether officially, legally that means there is an expiry date.

I assume they go hand in hand.

Yes, I would think so.

Certainly, when you flashed up on the screen the letter from the Lord Advocate, I do not remember that it had a line that said, “And you must close at such-and-such a point or after the pilot”, but I suppose it makes sense for it to be valid for the period of the pilot. Thank you very much. We have now exhausted all our questions, so I hope we have not exhausted you in the process. Thank you very much for coming along. I am sorry that we had to push it a little bit at the end, but we have Scottish questions this morning, which some people will be very anxious to get to. Thank you again for coming down and for allowing us to come to the facility. Please pass on our thanks also to the lived experience group that we met when we were there for spending time with us. Good luck.