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.