– A series of blogs about families and substance use by our Policy and Research Assistant, Rebecca McColl.
The Right to Recovery Bill was launched for consultation by Douglas Ross, MSP for Highlands and Islands (Region) in October 2021. Scottish Families responded to the consultation in January 2022 after discussions with our team and our Family Reference Group (which includes family members impacted by someone else’s substance use).
The reasoning behind the proposed Bill is to “enable people addicted to drugs and/or alcohol to access the necessary addiction treatment they require” by enshrining the right to access “necessary addiction treatment” in Scots law (Right to Recovery Bill, 2021). The Bill proposed a statutory right to a range of treatment options, such as short and long-term residential rehabilitation, community-based rehabilitation and medical assisted treatment. Furthermore, the Bill seeks to prevent individuals from being refused treatment from alcohol and drug services for reasons such as medical or criminal history, and allow for individuals to choose a preferred treatment option “unless it is deemed harmful by a medical professional” (Right to Recovery Bill, 2021). Having carefully considered the Bill, Scottish Families welcomes any discussion to improve treatment, support and recovery in Scotland, however, we shared concerns regarding if the legislation would achieve real change on the ground, and noted there was a stark absence of any mention of rights for families.
How We Responded
We know that individuals and families constantly face barriers and challenges when trying to access services and support, and there are persistent issues around the quality of treatment when accessed. We believe the sentiment and intentions of the Bill align with the experiences of families and individuals across Scotland, however, the decision to propose a legislative right brings a number of concerns.
Firstly, there is a range of policy changes happening in Scotland right now, such as the likely implementation of a National Care Service and developments to Human Rights Legislation. Both have the potential to completely change the landscape in Scotland, and changes to Human Rights Legislation could secure stronger rights regarding access to alcohol and drug treatment than what is currently being proposed by the Right to Recovery Bill.
The language used within the document (such as ‘addiction’ and ‘drug user’) can be stigmatising and may exclude people who may not identify with such terms. We would suggest using ‘people first’ language in order to be respectful and inclusive, which is especially important when proposing change.
It is deeply disappointing that rights for families were completely omitted from the Bill, aside from a brief mention in the foreword. As stated in the national alcohol and drug strategy ‘Rights, Respect and Recovery’ (2018), family members were given the same rights as individuals using alcohol and drugs. Furthermore, the Scottish Government published a new framework, in December 2021, further solidifying the commitment to whole family approaches and family inclusive practice. It must be said that the absence of families in the Right to Recovery Bill ignores this commitment and that families have the right to support in their own right, regardless of the treatment or other status of their loved one. If the Bill is to progress, there is significant room for improvement and a need for clarity throughout, particularly regarding what the Bill could mean for families.
What Would Legislation Mean?
Families tell us constantly that they are often excluded from their loved one’s care and nor are they updated. We understand restrictions around GDPR, however, it is of concern that legislation would only add another barrier for families. We know there are already multiple issues experienced by families whose loved ones also have mental health issues. Change has been needed here for a significantly long time, and it is of concern that adding legal processes to an already complicated situation for families may make matters more difficult.
It is unclear what sort of right the Bill is proposing, how that would be achieved, or what type of action it would allow for. It is difficult to comment on what this would mean for individuals and families when much of what the Bill is proposing is uncertain. The Bill also suggests individuals should be able to choose a preferred treatment option unless deemed harmful by a medical professional. It is unclear what circumstances would give a medical professional the right to deny a treatment option, and the final decision would still be beyond the individual seeking treatment. This proposal would therefore allow for little to no change, and could potentially damage therapeutic relationships by creating a power imbalance. There is no mention of families, causing questions surrounding family involvement in this process and what support families should have in their own right.
We agree that no one in Scotland should be refused treatment when seeking help, no matter their circumstances. We have the right to healthcare, but there is an existing accountability gap. The Bill is specifically proposing the right to a service, as opposed to the right to a desired outcome (for example, highest attainable health). An approach based upon human rights would focus on the quality of services and ensure outcomes were being met. We need a commitment from the Scottish Government and all political parties that the Human Rights Bill, which states that the ‘right to health’ includes those who need access to alcohol and drug services, is adhered to. Although we understand the sentiment behind the Bill, we believe other avenues, such as human rights, would create a more robust pathway to long-lasting cultural change.
What Happens Next?
The Bill is the first step in introducing a Member’s Bill in the Scottish Parliament. The consultation period ended on 12 January 2022, and responses will be analysed prior to a final proposal which will be submitted to the Scottish Parliament by Douglas Ross MSP. The proposal must achieve the support of at least 18 MSPs from at least half of the political parties or groups represented in Parliament. If the Scottish Government does not intend to legislate the Bill, Douglas Ross MSP will then have the right to introduce a Member’s Bill. A Member’s Bill must then pass three stages where it may be amended or rejected. If passed at the end of the process, it becomes an Act. This can be quite a lengthy process, meaning it takes a couple of months to find out the outcome of the proposed Bill. At the time of writing, Scottish Families submitted our full response to the Bill on 12 January 2022 and are awaiting the publication of the final proposal.