Scotland's drugs minister aimed her guns at local authority bosses after the nation’s response to our drug death crisis was labelled “a disaster”.
Angela Constance is issuing Ministerial Directions to bosses in charge of drug treatment agencies, including local authorities - putting their jobs on the line if they continue to miss vital targets.
Constance read the riot act in the Scottish Parliament after a damning report by Public Health Scotland revealed that Medically Assisted Treatment (MAT) Standards, due to be fully in place by April this year, have not even started in many health areas.
The standards, trumpeted as the solution to our European-worst death rate - are properly implemented in just 17 per cent of key services.
And the founding pillar of the standards - the promise of same day treatment for addiction issues - is available at just one of Scotland’s 29 local authority Alcohol and Drug Partnerships, in the Borders area.
Campaigner Annemarie Ward, of the FAVOR charity, said the group has represented scores of people who have been fobbed off for up to six months instead of being offered treatment.
She said: “It’s a disaster, a sick joke. Scotland has a death rate four times worse than England yet down there they are delivering much of what is contained in the much trumpeted MAT Standards.
“We have a postcode lottery, where some people have zero improvement from three years ago and a small few might actually get the treatment they were promised.
“The treatment system we have in Scotland is not fit for purpose and it’s being run by the same people who got us into this mess in the first place.”
The PHS report focuses on the first five of ten MAT Standards that were laid down as benchmark policy by the Scottish Drug Deaths Taskforce last June.
These promise same day access to treatment, support in making treatment choices and dosages and a commitment to keeping them in treatment for as long as it takes to get better.
Scottish Labour’s health spokesperson Claire Baker slammed the Scottish Government’s performance, telling Constance: “The publication of the benchmarking report today as welcome but its content is not - it as a disaster.
“This is a flagship policy that is now in disarray and it is appalling that, after promises made, only one ADP is fully delivering same day prescribing while only 60% are making real progress.”
Scottish Lib Dems leader Alex Cole Hamilton accused Constance of blaming the workers for her own shortcomings.
He said a whistleblower had come forward to say cash promised to ADPs was not getting through.
Scottish Tory health lead Sue Webber said: “This report shows that the target was nothing more than a pipe dream.
"Just 17% of the standards have been fully implemented, and shamefully MAT Standard 1 has only been implemented in one ADP area, the Borders. That’s a 97% failure rate.
“So what’s the new recommendation for Public Health Scotland? To push back the target by a year and water it down.”
The standards are properly implemented in just 18 per cent of relevant services and 65 per cent of them are only partially up and running.
The PHS report lays bare how Scotland the spectacular failure of the government’s Scottish Drug Deaths Taskforce to make any real dent on the death rate which makes us the shame of the world.
The Taskforce, which is being quietly disbanded next month, devised the ten MAT Standards last May. It is soon due to make a report of final recommendations.
Angela Constance took the “warts and all” report by PHS on the chin and admitted that same day treatment is the most fundamental pillar of the MAT Standards.
She said: “I want to make clear to Parliament the pace and the scale of change are good enough nor quick enough.”
But she unleashed a stark warning to top executive officers, telling them they will personally receive letters that compel them, by law, to do as they are told with cash assigned to hitting MAT targets.
She said: “This ministerial direction has been issued to all health boards, integration authorities and local authorities spelling out for must be achieved and the oversight arrangements I am putting in place to hold local leaders to account for implementing the MAT Standards fully.”
Improvement plans will be signed off by all chief executives and chief officers, with quarterly reports essential.
Drug death blackspot areas will be forced to file monthly reports to prove targets are being hit and vulnerable people are getting into treatment on Day 1.
The PHS report also pinpointed damaging variations in implementing the standards, patchy provisions being made and a lack of adequate systems to deal with data flow.
It also highlights that funding streams are potentially clogged and staffing levels are too low to keep the plans on track.
A total of 1,339 Scots died last year from overdoses - 15 times the European average and four times that of the rest of the UK.
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