Part of the debate – in the Senedd at 3:55 pm on 22 May 2019.
May I thank Janet Finch-Saunders and her committee for this very impressive and important piece of work? I have to say that it's often my experience that the work in the Petitions Committee is amongst some of the most important things that this Assembly does—the way in which our system empowers the voice of citizens to be heard directly. One of the most positive things I think I've heard today is what Janet Finch-Saunders has just told us about the petitioner's response to the whole of this process, because that multiplied many times, of course, grows a faith in this as a democracy that really listens to people and takes their concerns on board.
Reading the report was a very personal experience for me, because many years ago, we had an experience in my own family of a family member who became dependent on medicine that had been prescribed because of mental health issues. We went through a process that felt like taking a family member through the horrible cold turkey that you see of heroin withdrawal. Now, this was back in the very early 1980s and what disturbed me, I think, was to read in the report that some of these problems still persist—that there are still some issues about the appropriateness of providing, that there are some issues about the understanding around the potential of some of these medications to develop a dependency. And it is really important that these issues are addressed. I'm very grateful to the petitioner for her individual courage in bringing these issues to the Assembly's attention, and I'm sure that all of us, including the Minister, appreciate the courage that it must have taken to speak so openly.
I'd just like to respond to a couple of particular points. One is a very important need, which obviously the committee Chair has already touched on, about making a difference between the right sort of services to support somebody who has developed an addiction either to illegal drugs or to alcohol and people who have become dependent on prescribed medications. The paths that people will have taken that have got them into those unfortunate situations will be very, very different and the help that they need and the support that they need will also therefore be different. And I think the important points that are made about not conflating the language—these are things that we all need to take on board. I feel I need to think about that in terms of my own personal discourse and the way I might talk about some of these issues.
Like Janet Finch-Saunders, I want to come to recommendation 6, which the Welsh Government has rejected. I appreciate the reasons that the Minister has given, but I'd appreciate it if he could inform us today about how the concerns that lie behind that recommendation are to be addressed if they're not to be put on the list of drugs targeted for drug reduction. It is really, really important that we do acknowledge that these medications, as Janet Finch-Saunders has said, can make a huge positive difference for people, but they can also, of course, create difficulties, and people must know, when they are having those medications prescribed, what the options are and potentially what the risks are, and they must have support to manage those risks.
I also wanted to make a reference to recommendation 7, which the Minister has accepted in principle, but has said that it should be a matter for local health boards. I think what I would put to the Minister—and it's a point that was raised by Members across this Chamber—is that we're not always very good in Wales about seeing something that works well in one place and replicating it and learning from it elsewhere. Now, I can't claim, as an individual, to be sufficiently familiar with this particular model, though I've obviously read what the report has had to say and I've heard what Janet Finch-Saunders has had to say. But given that the health boards are asking for some strong national leadership on this, I wonder if the Minister can say a little bit more—having accepted in principle, which I take to read that he's accepting in principle that there is a need for some more national guidance—whether he would ask his officials to look again at that model and see if it could be effectively replicated elsewhere. It may be that it isn't suitable. It may be that, for geographical reasons or whatever, it wouldn't work particularly well perhaps in more urban environments, but when we have this level of knowledge, I think it's a good idea to pick up and run with it. And that approach, of course, fits with some of the work that the Minister himself is trying to achieve through the transformation fund, which is all about developing good models that can then be effectively delivered elsewhere.
The extent to which, of course, some of these antidepressants do cause dependency is still a matter of debate, but I think it's very important that we create a culture of honesty around this, and the fact that a medication can create a dependency is not a reason not to use it, it's a reason to use it with care. We use morphine to manage extreme pain relief in hospitals all the time, but when that is being prescribed, the people prescribing it know the potential risks, the people taking it know the potential risks, and the management system around it is there to prevent danger. I really think that we need, with these substances, which were, of course, sold to us as safe antidepressants—well, I think we know that there cannot be a medication that affects one's emotional well-being that is entirely safe, and we need to ensure that when people are making decisions about treatment, they are making them effectively.
I will end, Llywydd, as I can see my time is running out, just by saying that this is in some way reflective to me of the problems we have with our mental health services—that we know that many of the people who are being treated with these medications are being treated with these medications because there are no suitable talking therapies that might actually be much better. I'd urge, therefore, the Minister to look at dealing with this particular issue in that wider context, of which I know he is aware. We know that mental health services across Wales are not consistent; we know that talking therapies are available to some and not to others. Many of the people perhaps facing this difficult situation should never have had to take this medication in the first place if better alternatives had been available. I look forward hearing the Minister's response and to Janet Finch-Saunders's summing up of the debate and others' contributions. Diolch yn fawr.