Well, as our report states:

'An issue that kept being raised was the difficulty for rough sleepers to access integrated substance misuse and mental health services' and

'we have concerns on the level of integrated support for rough sleepers with co-occurring disorders.'

Although we noted that:

'There may be some small pockets of integrated services such as the work of the Community Care Collaborative in Wrexham', referred to by the Chair,

'these appear to be the exception and not the norm.' 

Briefing us on her research into priority need and rough-sleeping, Dr Helen Taylor from Cardiff Metropolitan University, told us that just making someone a priority would not address the issues that they were experiencing. She said that it won't solve the problems—giving them somewhere to live and giving them help; they have to want to do it. You have to give them that chance. Dr Taylor also told us that many spoke of their experience in schools, which did not know how to deal with their conditions and behaviours.

In accepting our first recommendation, the Welsh Government stated that it has

'established a Welsh Government Co-occurring Substance Misuse/Mental Health Deep Dive to consider progress in the development of co-occurring mental health and substance misuse and the challenges that remain.'

Perhaps it could tell us in plain language what that means, how and when this will report, when things will be done differently, and how performance will be monitored. 

The Welsh Government only accepts in principle our recommendation 4 calling on it to take

'a lead role in working with organisations across sectors to drive forward the necessary cultural change', and dodges our statement that it should

'update the Committee on the actions it has taken and timescales for future actions to deliver this recommendation at six, nine and twelve months.'

And we thought long and hard about that, and that was an important recommendation for us. It instead states that:

'Implementing the Housing Support Grant will be the key mechanism through which we will achieve this objective.'

Despite this, as we've heard, the Welsh Government played fast and loose with this grant in its draft budget by giving it a cash-flat settlement—a cut in real terms—with Cymorth Cymru, Community Housing Cymru and Welsh Women's Aid warning that services preventing homelessness and supporting independent living have now reached tipping point. As a supported-living service provider in north Wales told me, and I'll say it again, the consequences will be increased pressures on the NHS, A&E and blue-light services, adding that this, combined with the Welsh Government's planned redistribution of housing support grant, will be 'devastating to north Wales'.

The Welsh Government accepts our recommendation 7, and says that it is currently undertaking further work to understand the barriers faced by rough-sleepers with co-occurring disorders and neurodiverse conditions, and that this,

'will form part of developing future services which better meet the needs of vulnerable individuals.'

Several witnesses with experience of rough-sleeping referred to their own Asperger’s or autism or that of loved ones. What has the Welsh Government been doing all these years, despite being told repeatedly that, too often, autistic people are being treated as the problem by public sector officials at senior levels, who have failed to establish and meet their communication and sensory processing needs?

In accepting our recommendation 9, the Welsh Government states that it remains committed to ensuring that residential rehabilitation and in-patient detoxification services are available and that it allocates £1 million ring-fenced annual funding to area planning boards for the provision of these tier 4 services and that it is currently tendering for a contract for an all-Wales substance misuse residential rehabilitation framework, which will provide a list of approved residential rehabilitation and detoxification service providers. What they don't say is that it’s still unclear whether the £1 million is ring-fenced; that their previous framework, which resulted in referrals to non-framework units outside Wales, has expired; that, following damning reports, a previous Welsh Government stated that it was taking forward work on three units in Wales, but two of these have since closed; or that the latest ONS figures show that Wales saw an 84 per cent increase in drug-related deaths over the previous decade and that, across England and Wales, Wales comes second only to the north-east of England for the highest mortality rate for drug-related deaths.

As the Wallich's chief executive told us,

'we definitely need to improve access to tier 4, but, at the moment, my services can't get people through the assessment.'

As the chief executive of Kaleidoscope told us, tier 4 is chronically underfunded and there's very little funding for anyone with a drugs issue to get into a tier 4 service.