Recommendation 5 requested an update on our actions in responding to recommendation 8 of the Health and Social Care Committee's inquiry into alcohol and substance misuse, which was published in August 2015. I can confirm that the All Wales Therapeutics and Toxicology Centre has produced or contributed to a range of relevant guidance and good practice on prescription-only and over-the-counter medicines since that inquiry. I provided a list of that comprehensive work to the committee. I can also confirm specific action relating to the recommendations of the former advisory panel on substance misuse were included in the substance misuse delivery plan that just ended last year. The recommendations made in the advisory panel's 'A report on: Harms Relating to Prescription Only Analgesics', published in December last year, are being taken into account in the drafting of the new delivery plan for 2019-22.

As you've heard, I don't accept recommendation 6. Depression is a common, recurrent and, in some cases, debilitating illness. For many people with depression, prescribing an antidepressant will be a safe and effective treatment option. We believe that a national prescribing indicator that intends to reduce prescribing could have the unintended consequence of discouraging the appropriate use of antidepressant medication and result in some patients not starting treatment and others stopping prematurely. We know that such medications can have an effective role to play in managing depression. Our interest is in the appropriate prescription and management of medication. I'd be concerned that targeting those for wholesale reduction would not lead to a positive outcome for the person. We remain of the view that improvements to prescribing practice, patient review and safe tapering will achieve the desired outcomes outlined by the committee that we share in terms of the outcome and the impact on the person. Alternative psychosocial treatment options, such as counselling, should of course be available and considered. Our investment to improve access to and the range of psychological therapies in Wales continues to increase. We are also testing new approaches to improve access to non-clinical support to improve mental health through, for example, our social prescribing projects.

And, as you know, I've agreed recommendation 7 in principle. I recognise and applaud the work of the Betsi Cadwaladr prescription medication support service, but I'm not convinced of the need for a national programme based upon that particular service. I continue to believe that that should be addressed at a local level in response to local needs as part of the needs assessments of area planning boards to ensure that the issue is considered including ensuring that local drug treatment services engage with general practice to provide additional support when needed. There are different but positive approaches across Wales—for example, in Aneurin Bevan on tramadol reduction. Rather than endorse one approach across the country, I expect that practice to be shared between different area planning boards to understand what further improvement can be made. Patients should of course in the first instance be supported by their clinician appropriately, whether that is by prescribing medication and indeed the regular monitoring of any side-effects and providing support for safe tapering of the medication.

We of course recognise that sharing information and best practice in relation to drug dependence will improve support for patients as proposed in recommendation 8, and our All Wales Medicines Strategy Group has a key role to play in this, and we'll continue to work with them to share best practice and drive improvements.

Recommendation 9 is for NHS Wales, but I very much support all opportunities for the NHS to benefit more from pharmacists' expertise. We'll have more to say on that in the coming weeks and months. I encourage health boards, trusts and primary care clusters to work more consistently with pharmacists to support patients. Our pharmacists have a vital role in providing medication reviews and professional advice, including crucially, in light of this report, helping patients end prescribed treatment.

In response to recommendation 10, my officials will work with DAN 24/7 to evaluate if further training on prescription-only medication is required for staff and to ensure the website includes content on dependence on these medicines.

I'd like to close by thanking both the Petitions Committee for their work and all those people who gave evidence, but most importantly to put on record my gratitude to Stevie Lewis, whose personal experience has brought to our attention the difficulties that can arise when withdrawing from prescribed medication.