The Scottish Government has made headway in implementing treatment standards and increasing residential capacity, but has been ‘slow to progress key national strategies’, says a new report from Audit Scotland.
These include a workforce plan and reform of alcohol marketing, it states, with the increased focus on drug harm also ‘shifting attention away from tackling alcohol issues’.
While spending on drug and alcohol treatment has increased from just over £70m a decade ago to more than £160m, Scotland still recorded 1,277 alcohol specific deaths last year – the highest figure since 2008 – along with 1,172 drug misuse deaths. ‘Scotland’s drug and alcohol deaths remain among Europe’s highest – despite an increase in spending and better national leadership,’ says Audit Scotland, which is tasked with checking that public money is spent ‘efficiently and effectively’.
Treatment services are coordinated by alcohol and drug partnerships locally but these have ‘limited powers to influence change and direct funding’, the agency states. ‘Most alcohol and drug funding goes to NHS specialist services to treat people at crisis point – this means there is limited money to put into preventing people getting so ill in the first place,’ it says.
As the partnerships are not statutory bodies they are ‘not needed by law’ the report points out, meaning that it ‘needs to be clearer who is responsible for each service’. Funding that happens ‘for a few months or a year makes it difficult for services to plan for what will happen in the future or put money into prevention’, it adds.
A 2022 Audit Scotland report found delivery of services to be ‘complicated’, with lines of accountability ‘not always clear’ – making it difficult to track where the spending was going or what it was achieving (https://www.drinkanddrugsnews.com/clear-plan-needed-to-improve-complex-scottish-services/). The report also called for a ‘clear plan’ to improve service provision.
‘Alcohol and drug services are complex and delivered by a wide range of partners,’ said Accounts Commission member Christine Lester. ‘But there needs to be more collective accountability across the system for how each body is helping people whose lives have been blighted by alcohol and drugs.
Better information is needed to inform service planning and where funding should be prioritised. There is also more to do to tailor services to individual needs, using the experience of service users. Right now, not everyone can access the services they need, and that experience is worse for people facing disadvantage.’
In 2023-24, £63m of funding came from the government’s national mission to reduce drug-related deaths, and ministers needed to ‘understand which alcohol and drug services are most cost-effective’ and plan how they would be funded when the mission ended in 2026, said auditor general Stephen Boyle.
‘That’s especially important at a time of increasing strain on the public finances. With many alcohol and drug workers reporting feeling under-valued and at risk of burn-out, there is also an urgent need to put a timeline against plans to address the sector’s staffing challenges.’
Alcohol and drug services at https://audit.scot/publications/alcohol-and-drug-services