The following amendments have been selected: amendment 1 in the name of Darren Millar and amendments 2, 3 and 4 in the name of Rhun ap Iorwerth.

We now move to item 6, which is a debate on the substance misuse annual report, and I call on the Minister for Health and Social Services to move the motion—Vaughan Gething. 

Motion NDM6961 Rebecca Evans

To propose that the National Assembly for Wales:

Notes the progress being made in tackling the harms associated with substance misuse, as highlighted in the Welsh Government’s Substance Misuse Annual Report and Forward Look (November 2018).

Motion moved.

Thank you, Deputy Presiding Officer. I'm pleased to open today's debate on the substance misuse annual report 2018. Tackling substance misuse is a priority for the Welsh Government and a significant area to focus upon if we are to meet our ambitions for a healthier Wales. It is a major health issue that affects individuals, families and communities. Our overall aim continues to be to ensure that people in Wales are aware of the dangers and the impact of substance misuse and to know where they can seek information, help and support if they need it. We remain committed to tackling the harms associated with substance misuse.

I'm pleased that we have recently been able to back up this commitment with extra resources. Last month, I announced an extra £2.4 million of funding for the next financial year for our seven area planning boards, who are responsible for commissioning local front-line services. That is an increase in funding of over 10 per cent. This additional funding, at a time of continuing austerity, means we are now able to support the area planning boards with extra money to meet future challenges. This additional investment takes our annual funding for substance misuse to over £50 million. 

In Wales, our approach to dealing with substance misuse will continue to be rooted in health-focused harm reduction. The recently published evaluation of our 10-year strategy, together with the independent health inspectorate review of services, both recognise that overall progress has been made, and this has been achieved against the challenging backdrop of the ever-changing nature of substance misuse. 

That said, we recognise there will always be more to do. We're supporting some of the most vulnerable people in our society and we will continue to face challenge. As we reach the end of the current strategy and delivery plan period, we're turning our attention to the areas on which we need to focus to reduce the harms associated with substance misuse over the next few years. We're currently engaging with area planning boards and other front-line partners and service users themselves to co-produce priorities for the next plan. 

I've already indicated to area planning boards the priority areas to be considered for investment in the coming financial year. These include support work on co-occurring substance misuse and mental health conditions, and work on supporting children and families. In particular, I want them to work with those on the edge of care. There will also be a need for continued focus on work to reduce drug-related deaths, looking at support for those who may be homeless or have housing issues. We have seen real progress on waiting times against our targets. In 2017-18, 90.9 per cent of people starting treatment were seen within 20 days, compared to 86.7 per cent in the year previous. And I would like to take this opportunity to thank those providing these essential front-line services for their achievement.

I'm also pleased to report that we're continuing to see positive outcomes for those in treatment: 86.5 per cent of people reported a reduction in their substance misuse treatment in 2017-18, up slightly from the year before. Whilst these improvements are welcome, there is clearly more work to do across the agenda. For example, the data shows a rise in alcohol-related specific deaths from 388 in 2016 to 419 in 2017. That emphasises how important it is that tackling alcohol misuse remains a priority for the Welsh Government, as both alcohol and drugs remain major causes of death and ill health.

The Public Health (Minimum Price for Alcohol) (Wales) Act 2018 is a crucial part of responding to what is a major public health issue. This legislation will focus on reducing alcohol consumption amongst hazardous and harmful drinkers. It will also help to reduce the negative impact of alcohol misuse on our hard-pressed public services. Minimum unit pricing will form part of and complement our wider substance misuse work. We're already working to tackle the excessive consumption of alcohol through better education, prevention and treatment services to support the most harmful drinkers. We will also continue to support families of those who misuse alcohol.

Turning to drug-related deaths, the small overall decrease in 2017 is welcome, but 185 drug misuse deaths is still far too many people dying needlessly within our communities. I'm particularly concerned about regional variations that exist and I'm clear that we must work with our partners to focus significant effort upon this. My officials continue to work with partners in a number of areas to try and reduce drug-related deaths further. Our groundbreaking WEDINOS—Welsh emerging drugs and identification of novel substances—project continues to play a key role in reducing drug-related deaths, with the analysis of a range of drugs. Testing substances enables us to examine the chemical compound of the substance, but then crucially to disseminate widely the risk factors involved when individuals take them. The distribution of naloxone, a drug that temporarily reverses the effects of opiate overdose, has been a key strand of our harm-reduction approach for a number of years, and will continue. A total of over 19,000 naloxone kits have been distributed throughout Wales since 2009, with 2,186 reported uses. This is available in every community drug treatment service, along with all prisons in Wales. Given its success, we'll work closely with areas of Wales to further expand the provision of naloxone, especially in relation to those who are not engaging in treatment. For example, our officials have been working closely with police custody suites, accident and emergency departments and community pharmacies to ensure that naloxone is available for hard-to-reach individuals who don't normally engage with services. The complexity of this agenda can be seen when we consider the rise in other substances such as image and performance-enhancing drugs. This reflects major pressures that exist in today's society in terms of body image, and where substances are misused to the detriment of the individual's health and well-being.

Information and education are key elements of our strategy, and we continue to support DAN 24/7, a free and bilingual substance misuse helpline providing a single point of contact for anyone in Wales who wants further information or help relating to their drug or alcohol issues. During 2017-18, there were over 5,000 calls to DAN 24/7, which marks a 26 per cent increase on the previous year. Traffic to the website has also increased by 92 per cent during the same time frame, with the DAN 24/7 interactive website receiving over 145,000 hits. DAN 24/7 played a part in numerous information campaigns over the last three years, in line with our continuing harm-reduction approach.

In terms of recovery from substance misuse, and reintegration into society, being able to support employment is hugely significant, but we know that people often face numerous barriers to working, including a lack of education and skills, particular mental health problems and low self-confidence. Our European social fund-supported out-of-work peer mentoring service is a unique approach in Wales, tackling these key employment barriers through a single service. It provides free, long-term support from trained mentors who have personal experience of substance misuse or mental health problems. And since its launch in August 2016, over 4,200 people recovering from substance misuse alone or from substance misuse combined with mental ill health have enrolled in the service.

In total, we’re investing £17.3 million, including £11.6 million of European social fund support, to support the delivery of the out-of-work peer-mentoring service. This will allow us to support over 14,000 people in their recovery journey by summer 2020. I’m keen to build on this work, and my officials are currently liaising with the Welsh European Funding Office to extend the service until 2022 and to provide more support to more people. Substance misuse is a major cause of people being sick, losing jobs, or feeling unable to get into work, and this service contributes to our commitment to supporting people, to break down the barriers that ill health places on employment.

Turning briefly to the amendments, we'll not support amendment 1 by Darren Millar, as the latest statistics on drug-related deaths show they're falling, not rising. Also, on residential rehabilitation, it’s essentially a matter for area planning boards, in line with clinical guidance and input from service users, to decide what is the most appropriate intervention when commissioning services, whether tier 4 provision or, for example, community rehabilitation.

We won’t support amendments 2 and 3 from Rhun ap Iorwerth. It should be recognised that the Healthcare Inspectorate Wales report looked at people’s experiences at the time of the review. However, officials monitor waiting times rigorously through our published statistics, and over 90 per cent of people, as I have recounted, are seen within our target of 20 working days. However, we will continue to focus and work with partners on the issues raised. And, as found in a recent evaluation, we're making progress on issues that are complex and challenging.

We will support amendment 4 from Rhun ap Iorwerth. Substance misuse is regarded as a health matter, and the harm-reduction approach is something that has been a focus of our work on substance misuse for the past 10 years. As opposed to criminalising individuals, there should be a strong focus on rehabilitation with a harm-reduction focus. I look forward to hearing Members contributions during the debate.

Thank you. I have selected four amendments to the motion. I call on Mark Isherwood to move amendment 1, tabled in the name of Darren Millar.

Amendment 1—Darren Millar

Add as new points at end of motion:

Regrets the increase in deaths related to drug misuse and alcohol-specific deaths in Wales. 

Calls on the Welsh Government to address the need for tier 4 residential drug and alcohol rehabilitation in Wales.

Amendment 1 moved.

Diolch. Well, according to its substance misuse annual report 2018, the Welsh Government’s 10-year substance misuse strategy, published in 2008, sets out a clear national agenda for tackling and reducing the harms associated with substance misuse in Wales. It adds that it has commenced work to develop substance misuse priorities going forward from 2019. But the July 2018 Healthcare Inspectorate Wales's 'Review of Substance Misuse Services in Wales: Joint Thematic Report' referred to in amendments 2 and 3 identifies:

'However, people found it difficult to get the treatment they needed from substitute prescribing, detox, rehab and counselling services, because of long waiting times and a lack of capacity in services', adding that

'There can also be long waits (months in some cases) to access counselling and relapse prevention programmes in some areas', and that

'The difference between the national statistics and the experiences people have reported to us need to be further explored'.

We will be supporting amendments 2 and 3 accordingly.

The latest official—the latest official—ONS figures report that deaths related to drug misuse in Wales 2015-17 were up 15 per cent on the previous two years, and 32 per cent since the start of the Welsh Government’s strategy in 2008—not down. Alcohol-specific deaths in Wales were up 8 per cent on the previous year. Public Health Wales also reports an increase in alcohol deaths of over 7 per cent in 2017. I therefore move amendment 1, regretting the increase in deaths related to drug misuse and alcohol-specific deaths in Wales.

Amendment 1 also calls on the Welsh Government to address the need for tier 4 residential drug and alcohol rehabilitation in Wales. As the Healthcare Inspectorate Wales review states,

'The availability of Tier 4 detox and rehab services was inconsistent across Wales…a number of areas do not have their own in-patient detox and/or rehab facilities. Depending on where people live, they may need to travel considerable distances for treatment in another area of Wales or in England.'

During the second Assembly, independent reports on tier 4 residential detoxification and rehabilitation services in Wales were leaked to me after being buried by the Welsh Government. These found that the whole service was underfunded and identified numerous reports of people reoffending so they could be detoxed in prison, and of hospital admissions because of the unavailability of in-patient detoxification and residential rehabilitation. They call for a substantial increase in capacity, and for the development of three drug and alcohol detoxification and rehabilitation units across Wales, working with third sector providers.

A further report commissioned by the Welsh Government in 2010 reinforced this, and the then Welsh Government stated that it was taking forward work on the development of three units at Brynawel, Ty'n Rodyn and Rhoserchan. Well, Rhoserchan and Ty'n Rodyn have since had to close, and Brynawel states that its continued provision of these services is under threat. As Brynawel states, it appears that gaining access to a residential rehabilitation placement for someone living in Wales is a postcode lottery. 

After I wrote to the health Minister about this, he replied that the all-Wales substance misuse residential rehabilitation framework, implemented in April 2015, was developed for use in conjunction with the Welsh Government tier 4 ring-fenced funding of £1 million awarded to area planning boards annually in order to purchase residential rehabilitation placements. Brynawel, therefore, asked whether this £1 million is still ringfenced, what assurance the Minister could give that procedures are in place to ensure that local authorities are complying with their responsibilities in relation to drug and alcohol assessments for residential rehabilitation, and whether the Minister could confirm the number of community care assessments for residential rehabilitation conducted in 2017-18 by local authority, because the experience of providers is very different to the picture painted by the Minister.

Having closed Ty'n Rodyn in Bangor, CAIS has made alternative provision in Lancashire and at Parkland Place in Colwyn Bay, which currently caters for individuals seeking quality residential rehabilitation and who have the means to pay for it personally. They state that although they would be considering statutory referrals shortly, it remains to be seen what the take-up will be. Welsh Government policy has therefore forced charitable providers in Wales into both the private sector and England. These providers tell me that there is acknowledgement across the board that the tier 4 residential rehabilitation framework did not deliver the anticipated benefits for commissioners and providers, that many authorities did not fully engage with the pathway, resulting in referrals to non-framework units, many outside Wales, and that they are not even sure the framework exists at the moment.

Despite blood, sweat and tears over too many years, Welsh Government has returned us to groundhog day once again.       

Thank you. Can I call on Leanne Wood to move amendment 2, 3 and 4, tabled in the name of Rhun ap Iorwerth? 

Amendment 2—Rhun ap Iorwerth

Add as new point at end of motion:

Notes the Healthcare Inspectorate Wales report ‘Review of substance misuse services in Wales’ and calls on the Welsh Government to address the discrepancies between the official statistics on waiting times, and the variable experiences of people highlighted in this report.

Amendment 3—Rhun ap Iorwerth

Add as new point at end of motion:

Notes the long waits for counselling and relapse prevention services highlighted in the Healthcare Inspectorate Wales report.

Amendment 4—Rhun ap Iorwerth

Add as new point at end of motion:

Believes that the criminalisation of some substance misuse adds to the harm caused by such use, increases the stigma and prevents the full recovery of addicts and instead believes that tackling substance misuse should be regarded as a health matter, with harm reduction being the primary objective.

Amendments 2, 3 and 4 moved.

Diolch. I move the Plaid Cymru amendments, but I want to use my contribution today to focus on amendment 4 in particular. 

Now, this debate is timely because just last week, the UK Government announced its intention to conduct a review into drugs policy, including treatment options. Unfortunately, they pre-decided not to consider the questions of decriminalisation or legalisation as part of that review. Now, I'm of the view that limiting their review in that way is short-sighted, and it may well exclude some potentially effective solutions.

Let's take a look at the picture in Portugal, where they've done the unthinkable. Portugal is seen as the trendsetter for switching from the war on drugs to a harm-reduction model, which started in 2001, and, as a result, we now have enough data to evaluate. It's not complete decriminalisation. It's no longer a criminal offence to possess drugs for personal use. It's still an administrative violation, punishable by penalties such as fines or community service. The specific penalty is decided by the commissions for the dissuasion of drug addiction, which are regional panels made up of legal, health and social work professionals. The vast majority of those referred to the commissions by the police have their cases suspended, effectively meaning that they receive no penalty. The commissions' aim is for people to enter treatment voluntarily; they don't attempt to force them to do so—that would be counter-productive.

The main aims of the policy were to tackle the severely worsening health of Portugal's drug-using population, in particular the people who inject drugs. In the years leading up to the reform, the number of drug-related deaths had soared, and rates of HIV, AIDS, TB and hepatitis B and C among people who inject drugs were rapidly increasing. There was a growing consensus among law enforcement and health officials that the criminalisation and marginalisation of people who use drugs was contributing to the problem and that a new, more humane legal framework could be better managed.

As well as decriminalisation, Portugal allocated greater resources across the drugs field, expanding and improving prevention, treatment, harm reduction and social reintegration programmes. The introduction of these measures coincided with an expansion of the Portuguese welfare state, which included a guaranteed minimum income. Therefore, it's likely that decriminalisation alone was not the sole reason for success—it was more likely to be as a result of a combination of policies across all departments, focusing on harm reduction and public health. The Portuguese experiment has been a huge success—levels of drug use are now below the European average; drug use has declined among those aged 15 to 24. Lifetime drug use among the general population has increased slightly, in line with trends in comparable countries. However, lifetime use is widely considered to be the least accurate measure of a country's current drug use situation. 

So, why would we not do this? And why would we not at least make a start on what can be done today? There's a clear public health reason for providing a safer environment for people to use drugs, such as safer injecting zones. These sites allow drug users to inject illicit drugs under the supervision of medical professionals who could intervene in cases of overdose. Providers on site would also be tasked with directing users towards treatment as well as ensuring clean needles and hygiene to prevent infection. This is something that we can do now, and it is something that will save lives. Now, I know the solutions that I've proposed here today will not be supported by everyone, but when we see an increase in problems faced by people who use illegal drugs unsafely, surely this is something we have to consider. 

I'll close my contribution this afternoon by sharing a memory, and it isn't a pleasant memory. During the mid 1990s I worked for the probation service, and, in one year, we lost more than a dozen young people to heroin in a small, local probation office. And I remember one particularly harrowing case, where a young woman who had come out of prison had her toddler cling to her body for a whole weekend when she had died. It was absolutely awful. Now that was before we had this Senedd. We have this institution now and surely it's incumbent upon all of us to make sure that something like that doesn't happen again. We can, and so we should.

I think this is a useful moment to have a look at what we're achieving and what we're not achieving. The threefold increase, nearly, in hospital admissions because of the use of illegal drugs is obviously a cause for concern, and we know that people living in the most deprived areas of Wales are six times more likely to be admitted for drug misuse than in the least deprived areas.

I was puzzled by amendment 1, because it links together drug misuse and alcohol-specific deaths in Wales and there has actually been a reduction in deaths from drug misuse. It's only 4 per cent and, obviously, each death is a tragedy in itself, but, nevertheless, it's important to understand trends.

One of the concerning issues is opioid misuse amongst the older population increasing, and that, if you like, mirrors the use of alcohol in excessive quantities by older people as well. And so there are some clear messages there about things that we're going to need to think about in terms of how we— 

Will you give way?

Yes.

Have you looked at the latest published ONS figures, which do show that the figures, on the latest published figures, go up? That's the Office for National Statistics figures.

I haven't, I'm afraid—I've only been looking at this report. So, I appreciate that you may have better figures, but the figures in this report show that there's been a reduction. If you think that, since then, there's been a massive increase in the number of drugs deaths, then that obviously is a matter that we need to take very seriously.

I think—. The landscape has undoubtedly changed in the last 10 years since we launched the drugs strategy. My constituency in particular has suffered considerably from the rise of county lines—people who target the vulnerable, who use those people in order to make very, very large sums of money. So, austerity has created a vacuum that's being filled by criminal gangs. They're coming in from large cities like London, Birmingham and Liverpool and exploiting children and young adults, often with violent coercion, to get them to deal in drugs. And this is pretty terrifying, not just for the people who are involved but for whole communities who may be innocent bystanders who suddenly become victims.

So, drug-related violence in Cardiff has rocketed. Two years ago, three young men stabbed to death another young man, Lynford Brewster, in broad daylight on an estate in Llanedeyrn, in full view of several witnesses who endeavoured to save this young man's life. A year ago this week, a man was shot in the face in a flat in Roath where three others visited him. Happily, he survived, but it must have been terrifying for all the other people living in this block of flats. And a few months later, just two blocks away, another drug dealer, on this occasion, was stabbed through the heart following a drugs deal that had just been completed. Elsewhere in Roath, another resident got himself involved with a cocaine gang because he'd got himself into debt over marijuana, and he was allowing his house to be used to ratchet up £70,000-worth of deals over a small period of time.

Last June, we had to use the resources of the police to arrest people in raids over five days. Hundreds of police were deployed in something called Operation Red Jet, with chainsaws being used to break down the doors of dealers and hundreds of items, including knives, swords and a machete being confiscated—all that resource being spent by our police forces on attempting to deal with a problem that has, frankly, started to get out of control. So, I want to just use the remaining part of my time to urge people to think about prevention and, in particular, to ensure that schools are adequately dealing with this matter and also that youth services are available, particularly in the most vulnerable communities, so that there are trusted adults that young people can turn to if they start to become involved in being asked to sell drugs, because, otherwise, the consequences for young people are very, very serious and it can generally ruin their lives. So, I think we must emphasise the prevention aspect of this to try and ensure that more young people aren't ruining their lives, either by being drug takers but also being drug dealers.

I welcome the opportunity to contribute to this debate today, and I'm going to focus particularly on alcohol. The report shows some positive changes that have happened over the last 12 months and areas where we certainly could be doing more to help prevent harm from substance misuse, particularly as the report states that the number of alcohol-related deaths rose by 7.1 per cent in 2017, compared to the previous year, and I think that that is a cause for concern. Alcohol is the most widely used substance cited in this report and, arguably, the most harmful on an individual, family, community and societal level. It causes harm through ill health, both physical and mental, it causes accidents, and it is the basis for much violent crime. But I was alarmed to learn recently that Drinkaware, an alcohol education charity that works with public health bodies to raise awareness about alcohol use and responsible drinking, is supported by donations from the drinks industry. Last year, the UK Government's adviser, Sir Ian Gilmore, resigned over Public Health England's decision to work with Drinkaware for their Drink Free Days campaign, and that campaign urged drinkers between the age of 45 and 65 to have regular days off drinking. He said, and I agree, that it was incompatible for a body that is putting out public health advice to be funded by the alcohol industry. And I have to say that I would go as far as to say that I think it's unethical.

Of course people have the right to choose how much they drink, but I do believe that the alcohol education information that they receive should at least come from an independent source, particularly at a time when people already receive so much conflicting advice through social media and other sources. So, I did some very brief research this morning—it didn't take me long—and, on the Drinkaware website, it says, quite clearly, and I quote, that they're:

'funded largely by voluntary and unrestricted donations from UK alcohol producers, retailers and supermarkets.'

I therefore have to ask if the Welsh Government thinks that working with those and taking any of their research seriously is a move that we ought to be taking, particularly in light of what I've just said. And I am aware that they did some research into social norming in relation to drinking practices among students in 2009-10 across universities in Wales, and that research was supposed to be published in 2012. Now, call me a sceptic, and I am in this case, but how are we supposed to rely on that evidence when that evidence is clearly being paid for, and bought, by those people who are actually selling alcohol? I hope, Minister, that we don't rely on evidence that is supported and funded by people who are promoting their industry at a huge cost to society.

I would like to thank the Minister for tabling this debate, and I acknowledge the progress that has been made. However, we have so much more to do.

Substance abuse affects every section of our society; 34 per cent of men and 28 per cent of women drank more than the recommended limits on at least one day during the last week. Adults living in households in the highest income bracket are twice as likely to drink heavily as adults in the lowest income bracket. Older people tend to drink more frequently than younger people. Young people are more likely to take drugs than older people. One in five 16 to 24-year-olds have taken illicit drugs during the last year compared with just over 50 in the 55 to 59-year-old bracket.

Middle-aged males are more likely to be addicted to prescription-only painkillers, and women are more likely to be addicted to over-the-counter medication. The number of people being referred for treatment for substance misuse has continued to rise, and the number of deaths related to drink and drugs are at a record high. Mental health teams are reporting a rise in the numbers of patients taking new psychoactive substances, and NPS use is endemic in the prison population, where up to 90 per cent of prisoners have some form of mental health problem. It is therefore essential that we have the right policies in place in order to reduce the harms associated with substance misuse. We need to address the massive rise in cannabinoid abuse. We need to address the reasons why there has been a drop in the number of people assessed by specialist substance misuse providers. And we need to address the reasons why there are such long waits for counselling services across Wales.

There is a correlation between substance misuse and mental ill health, yet we have increasing waiting times for mental health treatment. The waits for talking therapies have ensured that anti-depressant prescription rates are the highest in western Europe. GPs in Wales prescribe enough anti-depressants to give every member of the population 19 days’ supply. This needs to be addressed as part of the Government's substance misuse strategy urgently.

I will be supporting most of the amendments before us today. There is a vital need for tier 4 residential drug and alcohol rehab in Wales—a need that is underestimated by the official statistics. I will be abstaining on amendment 4, because having worked in the prison service, I can say that we never saw people imprisoned for drug use; they were imprisoned for dealing or for committing serious crimes to feed their habit. I agree with the sentiment behind the amendment, but decriminalising drugs sends out the wrong message. Whilst in prison, drug addicts receive first-class treatment—treatment that should be available outside the prison environment. Prisoners get admitted to a rehab unit, are subject to ongoing support and testing and have one-to-one mental health support whenever needed. Perhaps if that sort of treatment option was available to the wider population, we would not see so many drug-related offences being committed. So, I believe that better treatment rather than decriminalisation is the answer. Diolch yn fawr.

Thank you. Can I now call the Minister for Health and Social Services to reply to the debate—Vaughan Gething?

Thank you, Deputy Presiding Officer. I'd like to thank Members for what has been a largely constructive and considered debate on the substance misuse annual report for 2018. There is agreement across the Chamber that this is a challenging area, with complex problems to address. Our commitment to substance misuse services is critical, and, as I say, has been demonstrated by the additional funding—a 10 per cent uplift in the budget—even in these most difficult financial times; we are faced with continuing austerity.

I do need to deal with the comments from the Conservative speaker in this debate. Yet again, you have Conservative politicians complaining about funding choices made as a direct consequence of austerity. Every Minister in this Government has had to face awful choices; things that we would want to carry on funding, with real value to the public—we had to make choices between them because of a direct consequence of Conservative austerity—a policy that Mark Isherwood and his colleagues have campaigned for in three successive general elections. My message is clear, because we're not going to make progress on this: take responsibility for Tory austerity, take responsibility for what you have done and don't lecture people about budgets, about choices that are made because of your choices.

Now, Mark Isherwood made a few—. I think actually, Leanne Wood's contribution—I didn't agree with everything that she said, but there is a need for a considered and grown-up debate on the issues that she urges; a debate with the police, with the Home Office, with politicians, but above all, with the public as well, about what we expect. Now, we don't have all the powers to do as Leanne urges, but we have had a look at the evidence in Europe and within the UK. We've had a look at medically supervised injecting facilities, and the former independent advisory panel on substance misuse looked at this and it published a report. We published it on the Welsh Government website in 2017. Despite the evidence considered in the report, they recognise that there are still concerns about the compatibility of medically supervised injection facilities with current criminal law relating to the misuse of drugs. This is an area that is a matter for the UK Government and the enforcement is with the police. The report concluded that based on the evidence available, they cannot currently recommend that medically supervised injections are implemented in Wales, but they do recognise that further work needs to be undertaken in this area to look at the potential feasibility within Wales. So, it is not a door that is permanently closed forever, but it is, I think, a recognition of where we are and the different division of responsibilities. We will, though, continue to look—

Will you take an intervention?

I will.

Do you accept that you need to move a bit faster on this to prevent further deaths?

The reality is we don't have the powers to introduce the facilities that I know you genuinely wish to see created here in Wales. I can't create the facilities that I don't have the powers to address. That's why I say there has to be a genuinely grown-up conversation about what we can do, what we will do with our powers, as well as that conversation with the Home Office and the police.

Now, I recognise the comments made by Joyce Watson and Jenny Rathbone—in particular Joyce Watson's comments about the funders of research and how we engage with them. We know from the minimum unit pricing Bill—as it then was—that the value and the robustness of some of that evidence funded by particular actors in this field did not stand up to the most robust scrutiny. But we do need to continue to engage with retailers about their conduct and their behaviour, the way in which they promote alcohol, in particular, and the way in which we have alternative messages about giving people informed choices to make. 

Now, in concluding, I do trust that Members will again join with me in thanking everyone who works on this agenda and the progress that we are still making. Tackling substance misuse requires commitment from across Government and partners who deliver front-line services, to ensure we reach and support everyone in need to get the right and appropriate level of support. [Interruption.] I will briefly.

Thank you very much, and my apologies, I wasn't here for the very opening speech there. Could I ask him—? I've written to him with a series of questions around the support that Brynawel House actually provides. I wonder, in view of the fact that, with some closures now of rehab centres in Wales, Brynawel House is the only Welsh rehabilitation centre on the Welsh Government's all-Wales framework, and the only rehab on the Wales mental health and learning disabilities framework, what discussions, what support Welsh Government and partners—commissioning authorities—can give to Brynawel House to ensure its sustainability.

We've had regular conversations with Brynawel House and with the commissioners of services, to highlight the range of services that are already available, not just in alcohol and drug rehabilitation, but also in the developing area of alcohol-related brain damage. So, there is a continuing conversation for us to have. I do not wish Brynawel to cease to exist. I think it is a useful facility. We need to make sure that its services align with not just our strategy. but that the commissioners actually commission the care that it provides. And all of that care, the services that we continue to fund, will continue to have harm reduction at their core. The additional funding that I have indicated will help to support that work.

In this complicated area, we do need to work closely together. I look forward to working with Members across the spectrum, despite our differing views on a range of subjects, but generally to make sure that we continue to have a positive direction of travel here in Wales to help people in need with appropriate support wherever we can.

Thank you. The proposal is to agree amendment 1. Does any Member object? [Objection.] Therefore, we defer voting under this item until voting time.

Voting deferred until voting time.

I now propose to go to voting time, unless three Members wish for the bell to be rung. No.