A clear plan is needed to improve complex drug and alcohol services in Scotland, according to a report by Audit Scotland – the body tasked with making sure public money is spent effectively.
Drug-related deaths in the country are the highest in Europe and have been increasing for almost a decade, while alcohol deaths also rose steeply in 2020 (DDN, September 2021, page 4). Delivery of drug and alcohol services, however, remains complicated, with lines of accountability ‘not always clear’, the agency states. This makes spending difficult to track, including how the money is distributed and ‘what it is achieving’.
The Scottish Government has committed to spend £250m to tackle the country’s drug deaths crisis after years of falling investment, with £50m a year to be made available over five years (DDN, February 2021, page 4). However, details of how the money will be distributed across local areas have still not been published, says Audit Scotland. There were also persistent data gaps around referrals, waiting times and outcomes, alongside a ‘considerable time lag’ in public reporting. The range of organisations working across different sectors meant that clear accountability was needed from all partners.
Audit Scotland acknowledged that the government had provided additional investment for evidence-based treatments and establishment of the Drug Deaths Task Force, but said it was too early to assess their effectiveness.
‘We’ve recently seen more drive and leadership around drug and alcohol misuse from the Scottish Government,’ said auditor general Stephen Boyle. ‘But it’s still hard to see what impact policy is having on people living in the most deprived areas, where long-standing inequalities remain. Drug and alcohol data is not good enough, and there is a lack of transparency about how money is being spent and allocated. The Scottish Government needs to set out an integrated plan, with clear measures showing how extra spending is being used to reduce the tragic loss of life we’ve seen over the last decade.’
‘No one’ should be comfortable with what the report had to say, stated Scottish Drugs Forum CEO David Liddell. ‘We face huge challenges in Scotland with inter-related issues that demand a policy approach covering early years support to children and families, poverty, health, criminal justice and employability. What we have currently is confused.
Even with a narrow focus in the drugs field we have a recent strategy, Rights respect and recovery; we have the national mission [to reduce drug-related deaths] and later this year we will have the final report from the Drug Deaths Task Force with their own recommendations. As Audit Scotland recommends, there should be a process that shows how the aims and actions in these link together.’
There were far wider policy issues that related to problem drug use, he stressed. ‘Large numbers of people with a drug problem have been in care and have been parented by the state,’ which made delivery of the Scottish Government’s ‘the promise’ – to drive changes recommended by the Independent care review – a key element in preventing problematic drug use, while delivery of better outcomes in preventing and addressing homelessness was also crucial.
Drug and alcohol services: an update at www.audit-scotland.gov.uk