Our amendments 1 and 2 reflect the latest statistics from the Welsh National Database for Substance Misuse showing that only 13 per cent of individuals were deemed substance free by the end of treatment from 6,084 referrals to drug and alcohol agencies in Wales.
The number of deaths from drug-related poisoning and drug misuse hit record levels in England and Wales last year.
Deaths from all drug poisoning were up 65% in England, but 153% in Wales, since records began in 1993 – and whilst drug misuse deaths in England rose 192%, the increase in Wales was 409%.
Alcohol remains a major cause of death and illness in Wales, with around 1,500 deaths attributable to alcohol each year (4.9% of all deaths).
Mortality rates are higher in Wales than in England.
I was pleased to introduce North Wales-based CAIS Drug and alcohol Rehabilitation charity and Living Room Cardiff, the community-based recovery centre for Cardiff and south Wales, and then to speak at their official merger launch to become one of Wales’ largest addiction therapy providers here in 2014.
The Welsh Government’s Substance Misuse Delivery Plan 2016-2018, which we are debating today, does acknowledge that partnership working between the statutory and third sector is at the heart of delivering its key aims – but this will only happen when this is co-produced, designed and delivered with the third sector.
Area Planning Boards were established some 5 years ago to oversee commissioning and delivery of substance misuse services.
The governance for these bodies was never properly established and they have evolved in very different ways - leading to variations in practice across Wales. Latterly the divergence has grown, with some all but disappearing in favour of statutory agency leads. The third sector, by omission, is now largely absent from strategic planning.
The Delivery Plan is fairly silent on Area Planning Boards- and we therefore need to know the Government’s view on the expected governance arrangements, inclusivity of membership, joint commissioning and plans for the future.
The Welsh Government accepted the recommendation in the Health Committee’s 2015 inquiry into Alcohol and Substance Misuse that it maps the provision of detoxification centres in Wales, identifies gaps and sets out who these will be addressed.
The then Minister also said that this Delivery Plan will consider what further actions are needed centrally to support Tier 4 Services nationally.
However, it instead talks only of only Local Health Boards and Local Authorities working with partners to set out a plan on how they intend to address gaps in services, with Tier 4 listed last.
It is 9 years since the Welsh Government commissioned report on substance misuse tier 4 treatment services in Wales was leaked to me and made public after they tried to bury it.
It identified numerous reports of people reoffending so as to be able to be detoxed in prison, and of hospital admissions because of the unavailability of in-patient detoxification and residential rehabilitation.
The report called for a substantial increase in capacity, for a central referral unit for the whole of Wales and for the development of 3 drug and alcohol detoxification and rehabilitation units across Wales working with Third sector providers.
A further report in 2010 reinforced this message and the then Welsh Government stated that it was talking forward work on development of the three units.
Instead, the Welsh Government residential detoxification cuts a decade ago remain in place - and although a Wales Tier 4 Framework was produced after the previous health minister issued a letter advising commissioners to support Welsh facilities, the number of rehab places in wales has significantly reduced over the past 5 years. What is the Minister’s view on this – and, given that 50% of the residential rehabilitation placements funded were in facilities outside Wales – how is the Framework launch in 2015 affected this?
The Health Committee’s 2015 Inquiry described Silo working – and only last week the Chair of the North Wales Safer Communities Board told me that too much is being spent on fire fighting and not enough on intervention and prevention –
where approximately 75% of those with substance misuse problems, include over 50% with alcohol problems, also have mental health problems, but the continuing gaps in dual diagnostic provision I was highlighting a decade ago mean that the revolving door persists, with huge consequent costs for health and social services, and criminal justice.
Unless these issues are addressed at last, this Delivery Plan will remain the latest chapter in a long history of betrayal.