The next item is a statement by the Deputy Minister for Mental Health and Well-being, an update on the substance misuse delivery plan for 2019-22. I call on the Deputy Minister, Lynne Neagle.

Thank you, Deputy Llywydd. It's really pleasing to update Members on the work being undertaken under our substance misuse delivery plan 2019-22, as we continue to tackle the harms associated with substance misuse. The overall aim of the delivery plan is to ensure that people in Wales are aware of the dangers and the impact of substance misuse and know where they can seek information, help and support. Our delivery plan was revised in response to COVID-19 and published in January 2021. Substance misuse services responded rapidly to COVID-19. During the pandemic, huge efforts have been made to ensure that vital help and support is delivered to some of the most vulnerable individuals and families in Wales. I want to take this time to thank everyone involved in this for their continued hard work and dedication. 

The Welsh Government has a strong track record of commitment to this area. We currently invest almost £55 million in our substance misuse agenda per annum. Our draft budget for 2022-23 further recognises the importance of this work and will see our investment increase to almost £64 million. Over £25 million goes to substance misuse area planning boards, and as part of the 2022-23 draft budget, these allocations will increase by £6 million from £25 million to £31 million. This includes an increase of £1 million to both the children and young people and residential rehabilitation ring-fenced allocations to support the rise in demand for these services since the onset of the pandemic. The remaining £4 million will help address waiting times and support service improvements, including developing trauma-informed services. In 2020-21, we also made almost a further £4.8 million available to support our response to COVID-19. Our European funded out-of-work service ends in August 2022. Even though we have not received replacement funding from the UK Government, we will continue to invest in employability support for people recovering from substance misuse and mental health into work, as we know how vital it is to people's recovery.

In August 2020, Office for National Statistics data showed the lowest rate of drug misuse deaths recorded in Wales since 2014. In 2020, there were 149 drug misuse deaths involving illegal drugs, 16 deaths lower than in 2019. However, we will not be complacent with this. In contrast, there were 438 alcohol-specific deaths registered for Wales in 2020, an increase of 70, 19 per cent since 2019. While numbers can fluctuate from year to year, the increase is a concern. Throughout the pandemic, we've continued to work on all of the themes within the delivery plan, to improve the support we provide to those who most need it. One area I'm particularly proud of is how our substance misuse and mental health services have worked tirelessly to support the most vulnerable as part of our commitment to end homelessness. We are now engaged in developing the future approach to rapid rehousing. We already invest an additional £1 million per annum in funding to tackle complex needs, both substance misuse and mental health, for those individuals within homelessness services, and our draft budget doubles this to £2 million to expand support to the remaining areas in Wales, to help them address complex needs in their areas.

A key strand of work that was introduced during the pandemic was the introduction of injectable buprenorphine. This work has significantly reduced the need for service users to attend community pharmacies and clinics, thereby protecting their health and that of key workers. Approximately 1,000 service users are now benefiting from this treatment, and there's significant anecdotal evidence that many are experiencing significantly improved outcomes, including returning to families, work and wider health improvements. I am pleased to update you that, as part of the draft budget, £3 million has been earmarked to continue this treatment alongside a longer term full evaluation. I am proud to say that Wales is leading the UK in this new treatment. Naloxone is a key initiative where we have made excellent progress. An important development with naloxone is the work we're undertaking with the police to enable officers to carry nasal naloxone on duty. We've also funded a pilot project of the peer-to-peer distribution of naloxone, which enables those with lived experience to go out in communities and provide naloxone to those who may or may not be in touch with agencies. This has been highly successful to date and has resulted in all areas of Wales looking at replicating this model.

Our implementation of minimum unit pricing for alcohol is a key focus in reducing the harms of alcohol, the legislation for which came into force on 2 March 2020. Trading standards officers are enforcing the legislation and providing advice to retailers on compliance. To date, no fixed penalty notices have been issued. Our recently published alcohol-related brain damage treatment framework is a key development as we aim to tackle alcohol misuse. The framework is designed for health and social care providers to give guidance on how they should respond to those affected by alcohol-related damage. We currently allocate £1 million ring-fenced annual funding for the provision of tier 4 residential rehabilitation and detoxification services. As part of the draft budget for 2022-23, a further £1 million has been allocated, recognising the rise in demand for support.

In April 2020, we launched our new residential treatment framework, Rehab Cymru, which offers over 30 settings, including three in Wales. There have been 139 placements made to 17 different treatment providers in 2020-2021, and in the current year so far, 95 placements have been made to 21 different treatment providers. I welcome this opportunity to provide this statement on the progress we are making. We will continue to take forward the commitments in our delivery plan, along with our partners, and look at what else can be done as we continue to learn from the impact of the pandemic. I know that the first meeting of the cross-party group on substance misuse, abuse and addiction, sponsored by Peredur Owen Griffiths, was held yesterday. I'm keen to hear the key issues that are highlighted there and look at how these could be fed into future policy development. Diolch yn fawr.

I want to thank the Deputy Minister for her statement. I welcome your commitment into this very important area, and I want to put on the record my commitment to ensure that we do all we can to help people to recover from substance misuse. We need to move to a place where we treat the person, not the offence, where we give everybody a second chance and where treating drug and alcohol addiction, and not criminalising people, will lead to community safety and stronger communities.

Deputy Minister, in your statement, you've laid out the additional funding going into the work of rehabilitation, and I was wondering where this additional money will be spent, and will we be seeing more rehabilitation centres opening across Wales? And with the additional moneys going into this area, how will you be ensuring that the additional moneys are being spent in the right places?

You also raised the point that drug misuse deaths have gone down, and that must be welcome, but I agree with you, Minister, when you say that the number of alcohol-specific deaths is a cause for concern. So, Minister, can you outline any specific strategies that you have for addressing the growing numbers of the Welsh population that are living with alcohol dependencies, because of the wider problems that that causes for their health?

In the statement, you also talked about the link between homelessness and substance misuse. Deputy Minister, with some areas of Wales unable to build houses, how can we ensure that people who need to be housed can get the support they need and that good-quality housing when local authorities and residential social landlords—? Their housing stocks are under considerable pressure, and if we don't have the houses, we can't get people off the streets to get the support they need to recover from addiction.

And finally, Deputy Minister, you mentioned previously about Rehab Cymru, and I wonder if you can outline some of the settings that they're going to offer, and the three settings that are in Wales—can you tell me where they are and are they going to be residential or day care? And to conclude, I want to thank you for your statement today, I think there's some really good progress being made in this area, and I always give credit where credit is due, so congratulations on that, and anything I can do to help you in the future with this, I'm very happy to do so. Diolch, Deputy Llywydd.

Thank you very much, James, for those kind words, the welcome for the statement and the recognition of the positive work, and also for your questions. It's really encouraging to hear you say that you too are very keen to take a person-centred, health-related approach to issues with substance misuse. That is very much the ethos that drives our work in Wales. We don't believe that criminalising people is the right way forward, we want to support people going forward.

In terms of the issues you've raised around funding, it is a very substantial amount of additional funding, as I've already highlighted. The money for area planning boards is rising to £31 million, an increase of £6 million. The money for local health boards is rising by £1 million, and we are also then increasing funding for the rehabilitation services that you've referred to, so that's going to increase by £1 million to £2 million to recognise the demand on services.

In terms of the quality of those services, that is governed, really, by the framework that has been developed, and when someone requires to go into a rehabilitation setting, the framework is—[Inaudible.]—the way of making sure of a quality service that meets their needs, and, indeed, to be placed somewhere outside the framework, there has to be a special case made for that, then.

I'm not in a position to give you the exact settings of where all these places are, but I'm very happy to write to you with further details, and, indeed, you can find that information online, because Rehab Cymru is online. I believe it's accessible to the public as well.

You're absolutely right to highlight the concerns about alcohol, and I think we recognise that that is something that has become more of a problem during the pandemic, and, indeed, research has suggested that one of the groups of people that have seen the higher levels of drinking more alcohol are parents with children, which I think is reflective of some of the stresses everybody has been under.

I mentioned the minimum unit pricing for alcohol. That's a key measure that we're taking to try and tackle not just the harm of alcohol for individuals, but also to reduce admissions to hospital as a result of alcohol. Preventing harm caused by alcohol misuse is a key part of our substance misuse agenda and our overall aim continues to be to ensure that people in Wales are aware of the dangers and impact of alcohol misuse and to know where they can seek information, help and support if they need it. I've also asked officials to explore any opportunities available via things like SilverCloud, because there was an alcohol module on SilverCloud, but, unfortunately, what we were finding was that the people who were trying to access it, their needs were too high for that kind of online cognitive behavioural therapy, so they were then directed to other sources of help. But I am very keen, if we can, to see some sort of universal, accessible online option to help people. And, of course, we do fund Alcohol Change UK in Wales as well, and they've got an excellent website and resources on there.

Just on the situation in relation to housing, just to emphasise that we're very proud of the work that we did across Government to make sure that nobody remained on the streets during the pandemic, and there is further investment in the budget for next year to ensure that that work can be continued and built upon. 

Diolch, Ddirprwy Weinidog. I welcome the statement that's been issued this afternoon and I thank you for the namecheck in the statement and for mentioning the cross-party group that I've helped to set up with the assistance of the fantastic staff at the drugs charity Kaleidoscope. It's also pleasing to be reminded of the reduction in drug deaths in Wales, although I'd like to see the number reduced further because each and every one of those deaths is a tragedy. The rise in alcohol-specific deaths by nearly 20 per cent tallies with the anecdotal evidence that many people were drinking more during lockdown, and it has a huge concern.

There's a strong sense from experts in the field and those who have recovered after a life of addiction that a more compassionate, peer-led approach, that is centred on harm reduction, will be much more effective in combating substance abuse. Waging the war on drugs has been tried for decades and decades without resolution or even an end in sight. This was, by and large, the message that came over loud and clear during the inaugural meeting of the cross-party group on substance misuse. This group was set up to encourage the conversation about life experiences and what constitutes good practice. In our first meeting yesterday, we heard some powerful testimonies from people who had been to hell and back due to substance abuse and addiction. Deputy Minister, I hope we can welcome you to a future meeting to meet and talk with the members of the group.

Plaid Cymru rejects the tabloid-headline-grabbing and draconian drug policies that the Tories in England have. Like many things they announce these days, I suspect it's nothing more than a smokescreen to divert attention from their serious and multiple failings in other areas. In contrast to the reactionary Westminster way of doing things, Plaid Cymru has called for investment into tackling the root causes of drug misuse through innovative programmes and establishing drug-consumption rooms for people to stabilise their drug use. Criminalising people who need treatment is no good for anyone, and it certainly isn't good for society. We can forge a different path here in Wales, even within the limitations of a criminal justice system that is yet to be devolved.

One of the major examples of this has been the out-of-work peer mentoring services running throughout Wales. In my region of South Wales East, this goes by the name of Cyfle Cymru, but it is called something different in other parts of the country. This programme, with a proven track record, was funded by European social fund money that was due to run out in August. I very much welcome the commitment to continue with the funding that is needed to maintain this programme. There was little detail in the statement about the out-of-work peer mentoring programmes, and they will run out in August this year. Can we, therefore, have an undertaking that there will be a continuation of services commissioned by the Welsh Government? The current peer-led model has worked well for the last five years, and experienced staff, who make it the success that it is, need the safeguards that they can carry on with the vital work beyond August in helping some of the most vulnerable people in our communities. Diolch yn fawr.

Thank you very much, Peredur, and I very much look forward to coming to the cross-party group, to one of your future meetings, and I recognise this is an area that you feel passionately about, and I'm very much looking forward to continuing to work with you. I wholeheartedly agree again with your comments about the need not to criminalise people. Unfortunately, the engagement that we've had from the UK Government around the new UK drug strategy has not been as forthcoming as we would have liked and, indeed, I've written to the relevant Minister to raise concerns about that. We are very keen to have an ongoing constructive relationship with the UK Government, but that, obviously, relies on them engaging with us as well.

I'd like to thank you for your recognition of the importance of peer support. I've met some of the peer supporters myself, when I was able to go out and about to visit, and I've heard directly from people affected by alcohol problems just how powerful that support has really been, and I'm very keen to see that work continuing.

We are continuing to fund the out-of-work project. Unfortunately, despite all the promises about not a penny less, there has been no replacement funding made available by the UK Government, but, luckily, because we've had additional funding into the mental health and substance misuse portfolio this year—the £50 million—we are prioritising some of that funding to make sure that these incredibly valuable projects can continue, because it is absolutely vital that people have access to that support so that they can go back into work with the sense of belonging and purpose and everything that those kinds of projects can deliver.

In terms of the arrangements for commissioning the ongoing services, we're continuing to look at those, but what I would say is that we do really recognise in Government that the third sector are doing this work incredibly well, and we would certainly want to build on the strengths of that going forward. Thank you.

I very much welcome your statement today, Minister, and the policy and the approach that we have here in Wales, and the increased investment, I think, is going to be very valuable because, as we all know, there are, sadly, far too many people in Wales, as with other parts of the UK, who have these alcohol and illegal-drug problems. And as well as preventing problems for the future, we need to address, as well as we can, those with those habits at the moment.

You've touched on some of the tensions, Minister, between Welsh Government policy and Home Office policy, and I've heard from service providers that they do sometimes feel that they have to look both ways, as they describe it, and this does bring difficulties if you're trying to have an approach that is logical and doesn't have inconsistencies within it. I hear what you say about writing to UK Government, Minister—I just wonder whether there's anything else that might be done, in terms of helping service providers overcome those difficulties of trying to face both ways, because it does give rise to unproductive tensions and difficulties.

In terms of the funding, Minister, I think some people feel that the money doesn't always filter down to the workforce as much as it might, and this then leads to problems of retention and recruitment, and I wonder if that's something that you recognise and you may take further action on.

Just finally, mental health problems often overlap with these substance misuse addictions, and I think it's sometimes difficult to have joint funding in place for service providers to be able to apply for joint funding from the two sectors. I wonder if there's anything more that might be done to address those issues.

Thank you very much, John, for those points. Just to reassure you, it's not just the one letter that we've written to the UK Government expressing concerns about their approach to partnership with us on these very important issues. Obviously, those discussions are going on on a regular basis with our officials. I attended, on behalf of the Welsh Government, the UK drugs summit, where I also emphasised the need for there to be that very strong partnership, and I think it's something that the other devolved nations would certainly endorse as well, really.

In terms of organisations having to face both ways, I recognise the challenges with that, but I hope that those organisations recognise that we are prioritising funding for substance misuse in Wales, and that's something that hasn't happened in other countries in the UK. We've protected that funding, and we're continuing to increase that funding. We're also very committed to having a strong partnership with organisations, and I've met with the group of organisations that we connect with regularly in Welsh Government to listen to their concerns. So, we're trying to do what we can to make sure that we have that dialogue going forward.

In terms of the issues around funding that you've referred to, obviously we want the funding to reach the front line. Much of the funding, as I've said, goes out via area planning boards, so that that can be targeted to local needs, which is very important. But I would be expecting area planning boards to be having that partnership with the third sector in the same way as we do at Welsh Government level. I've been very clear since coming into post, across the board, really, about how important the third sector is, and for them to have an equal voice, really, in discussions.

You're absolutely right to highlight the challenges with people with co-occurring conditions and dual diagnosis. Just to assure you that we are doing our best to address those challenges. We're working with area planning boards to improve the outcomes for individuals who experience co-occurring conditions, and we've issued a range of guidance on the subject, including a substance misuse treatment framework. All APBs are meant to have a service framework in place to respond to this issue, but, because of the challenges we've been encountering that you've referred to, we are seeking further improvements in this area, and we've established a deep-dive group of experts and practitioners to advise on how we can remove barriers to progress. That group was first established pre pandemic. It meets quarterly over Teams, and the next meeting is on 9 March. It has clinicians and operational staff as well as representation from academia, the third sector and the criminal justice system. Also, in addition to trying to break down those systemic problems, we're also investing more money again in the budget to make sure that we can focus on the needs of these groups.

Finally, Russell George.

Diolch, Deputy Llywydd. Minister, like others I've also seen the good work of Kaleidoscope, so I'll add my own congratulations for the work that they do as well. My question, Minister, is linked to the blood-borne virus element of the strategy. I noticed that other UK nations have their target dates to accelerate the elimination of hepatitis C. In England and Northern Ireland the date is 2025, in Scotland it's 2024, and in Wales it remains 2030. So, my question is—. I'm just wondering, as we move out of the pandemic, I wonder if there's a chance here, an opportunity, to build on much of the good work, I think, that's been done in Wales in that regard. I wonder, Minister, if you would produce a national elimination strategy for hepatitis C in particular, and I wonder if the Government and you would commit to considering eliminating hepatitis C by 2025, in line with the other UK nations. 

Thank you very much, Russell, and can I endorse your kind words about Kaleidoscope as well? We're very lucky in Wales to have some brilliant third sector organisations in this area. In relation to your comments about blood-borne viruses, I'm very happy to have a look at the target. I would need to do that, obviously, in partnership with the Minister for Health and Social Services, but I'm very happy to have those discussions. I would add that some of the things that we're doing already will make a significant contribution to improving things in that area. If you take the injectable buprenorphine, that's leading, obviously, to many fewer people who are injecting themselves on the streets in an unsafe way. So, we are doing things and taking initiatives that will contribute to that. But I'm very happy to have further discussions with the Minister for Health and Social Services about the target that you've referred to. 

Thank you, Deputy Minister. 

The next two items have been withdrawn, so that brings today's proceedings to a close. 

The meeting ended at 17:21.