20/08/2012 Newsnight Scotland


20/08/2012

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Assange. I wanted to go to Sweden and so we can find out if he did

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those things and whether he is Tonight on Newsnight Scotland. Why

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are we no longer shocked by the ever spiralling numbers of people

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on illegal drugs? Treatments like methadone or abstinence can help

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tackle the medical addiction. But they don't tackle the underlying

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social issues. Do we need to rethink the way we approach this

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intractable problem? Methadone was one of the great

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hopes in the so called war on drugs. The theory was that it could be

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used to stabilise addicts, get them off heroin, and help them towards a

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drug-free life. But what was intended to be a staging post on

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the road to recovery has instead for many become a permanent way of

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life. And at the same time, the number of drugs deaths in Scotland

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continues to rise, with methadone often implicated as one of the

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contributory factors. Here's David I have been on methadone, on and

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off, for 15 years. Perhaps more. I have had jobs. If I was not on

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methadone, I would make sure I got out that every day for many drug

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users, methadone has become a way of life. The might are no longer

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inject heroin, but many end up stabilised in a pharmaceutical

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prison. Their annual bill for methadone in Scotland is now �36

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million. There are now 22,000 users. They could put you into a three

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clinic and Divya after-care. Make sure you have after-care for at

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least a month. -- and give you after-care. At the moment, I am

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like a ghost, just walking about. People do not recognise me. Well as

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a methadone users have their doubts, for some chemists methadone has

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become big business. Some pharmacies like this one are well

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paid for dispensing methadone. But is it an expensive way of parking

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the problem? For the wider community, methadone can make a

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welcome difference. There used to the needles on the pavement,

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needles everywhere. People were walking into the middle of the road

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and not knowing where they were. It was just a mess. But I have to say

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that in the last eight or nine years, it has been a better and

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safer place. There is still a lot of drugs. In fact I have heard that

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a lot of readers have started back again. But it has been more

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peaceful. -- a needles. Pharmacies are on the front line of

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distributing methadone. The aware of the need to do more. The lead

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fairly chaotic lives. We need to stabilise them and work with them.

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We to help them take their addiction. Is that second-stage

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happening enough? No, it is not. I think we do quite well in his

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stabilising patients, maintaining patients, helping them to lead and

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relatively normal lifestyle. But we do not then make the next step.

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the meantime, they point out that methadone it does help the wider

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community. A drug user not on treatment can cost almost �60,000 a

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year in terms of crime. The cost, for a drug user on methadone, drops

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to �23,000 in the first year, then a �15,000 after that. But are we

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failing to see the big picture? There are obvious things. The loss

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of the industrial economy, the loss of purpose and meaning that comes

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from employment. But added to that his individualism, materialism, the

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type of culture we create for ourselves where you always have

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meaning of life if you are able to spend and make your way as a

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consumer. Many people are denied that, and in being denied that, and

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in being denied the more traditional forms of life such as

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family life, you deny them a future. Methadone helps you so much. Most

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of the time, if you take it early in the morning when the shop opens,

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by 9 o'clock at night, it wears off. You do not fear that. What are you

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going to do? You want to go and have a charge. If you have the

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money it, that is. We wonder what to do. Drug-related deaths in

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Scotland are on the rise. 584 drug I'm joined this evening by Dr Neil

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McKeganey, the director for the Centre for Drug Misuse Research at

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the University of Glasgow. And by the Chair of an Independent

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Drugs Enquiry, John Matthews. And finally Dr Peter Cawston, a

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Drumchapel GP who runs a methadone John, from your years as a minister,

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what did you meet in your parish that was drug addicted and what

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could have problems have led to that situation? When I first

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started my ministry in rough hill, -- Ruchill, the hospital there

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distributed lidos and methadone. That was 20 years ago. -- needles.

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It was brought him because of fares over HIV and Aids. This was seen to

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be a stabiliser and a civic protection. Over the 20 years that

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I was a parish minister there, I conducted over 1300 funerals, a

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quarter of which were young people who had died as a result of drugs

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misuse and it just general wear and tear on their bodies. You can see

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why methadone was seen to be something that saved it lives,

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stabilised people, but we did not bring along the panoply of other

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things a were promised. The goal rather used to stabilising people.

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-- we got rather used to bus stop in a way, the report suggests that

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I was, I have a small clinic practice and over seven years I

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have had 45 people come through it. Eight of them are in full-time

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employment and quite a number have been in significant employment over

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that time. To my mind, these are eight people who I suspect their

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taxes have paid for their treatment. There are many people who have

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moved on to feel that their lives are what they want them to be. Some

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of those people work around methadone and some are not and I

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think to focus entirely on the medication rather than on people's

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lives and letting people move on is a mistake. That is precisely what I

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do not want to do tonight. But when you look at the extent to which we

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are drug-addicted in Scotland and the UN very recently said that we

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had the 6th worst problem in the world, is it a particularly

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Scottish problem and why should that be? Perhaps I should say that

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the centre for drug misuse is entirely independent of Glasgow

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University so it is important that I -- you understand that I am not

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here as a member of the university. The scale of the problem eclipses

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any other country. It surprises us because it is a problem that

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started in the late 80s and nobody expected that the drugs problem in

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Scotland would reach anything like the scale which we are now seeing.

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That presents us with a massive challenge. It was always

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unrealistic to expect the methadone would be the answer to that problem.

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It is part of an answer but it was never designed to be the main

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answer to Scotland's heroin problems. Let's get back to

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methadone in a bit but I am trying to understand how we got here in

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the first place. The film talked about the de-industrialisation as a

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major factor. The parish I had was very poor. When I first went there

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it was in freefall in terms of the lack of employment, the state of

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the housing where young men ducked and dived and young girls saw it as

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attractive to start a family, and young people were generally

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rubbished and if you are rubbished every day and told you are rubbish

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then you start to believe that and then you do not care how you live,

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what to swallow, who you go with. To that extent we were trying to

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give young people the sense at which they were valued but I would

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have to say that drugs and alcohol do not happen in a vacuum. They

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happen in a culture and our culture has moved that way and we are

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parties are baiters, all of us, you and I are participating as in that

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culture. Is it a culture that has now become embedded or is it

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changing? I think it is certainly a major part of many people's life

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experience. We know lots of people who do use drugs or come across it

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at school so I suppose it is embedded in some respects. Scotland

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is a very unequal society and in a sense this is simply one facet of

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that inequality. As a society, are we becoming immune to the 500 plus

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drug deaths that are reported? Are we shrugging our shoulders and

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saying, that is how it is? Sadly we are. If in Scotland we had a jumbo

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jet crashing every year, we would be shocked by that to a degree much

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greater than we greet these figures. They are shocking for a few number

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of days that the figures come out and then they recede in interest

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and we somehow have become attuned to the level of drug mortality in

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Scotland. That is a shocking situation to find ourselves in.

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do now have recovery at the heart of government policy but do we know

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what we mean by that, John? Differ in people mean different things by

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yet. There are those who say recovery is about total abstinence

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and what Peter were saying was that they are right people who can

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stabilise their lives and enjoy a certain quality of life by obeying

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the rules in terms off taking methadone. What we see it in these

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figures that were released are people who are messing about with

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other things which is a very dangerous thing to do with

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methadone. You are not supposed to mess about with other substances if

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you are on the methadone programme? It is not a requirement and we have

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to understand that for many people who are not as I described working

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or feeling that their lives have some meaning, life can be very

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meaningless and boring on methadone and it is a huge problem for me to

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try and help people deal with other problems. A significant number of

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my patients take alcohol as well as methadone. There is a lack of help

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for people on methadone and who have mental health problems. Many

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are psychologically traumatised by their experience of drugs and also

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many people are physically carrying these bars in terms of their bodies,

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so a lot of my time at the clinic is spent treating heart, liver,

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lung problems. A I was quite struck by the methadone user in the film

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who talks about the need for going into an intense clinic based

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programme and then having help and support thereafter. I'll be good at

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continuing to support people who may be do manage to become drug

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free? No, we do not do that well at all. The research shows that

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addicts who have managed to come off drugs were those who were able

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to move into a reservation -- residential programme. That will

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not be successful for everybody but those who have secured that period

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in a presidential we have, they did better but it is a worried that we

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have a drugs policy in Scotland that is committed to recovery but

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we still do not know how many people on the methadone problem are

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actually coming off a drug-free. That was a criticism of the Labour

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government in the past but it is a situation that persists. We do not

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have accurate numbers of drug users on the methadone programme or

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accurate information about those recovering from it. Do you see

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methadone as continuing to be a part of our drugs strategy or do

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you think it could be replaced altogether? I think we have a

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fantasy that they can be a short, sharp solution where people come

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off drugs and I think there are significant risks associated with

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coming off. People lose their tolerance to opiates and then go

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back on to drugs and die. Their run risks associated with both

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rehabilitation and methadone treatment. Icy methadone as

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continuing to be part of the picture. I think what people need

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more than anything his people that work with them who are committed to

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helping them move on in their lives, whether that is three about the

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Dome or other means. How hopeful are you that we can make some

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headway? The smoking situation in terms of improved health to 20

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years. The independent inquiry used a metaphor of the iceberg. It

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exists because the temperature of the water is too cold and this

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iceberg that we have is continuing to grow and will do so unless we

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have raised the temperature of the water, and the temperature of the

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water is the culture of Scotland of which we are all participants in.

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Until we decide to help and do something about it, then I fear

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that we will continue in the way that we are doing. Thank you. Let's

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take a look at tomorrow's front pages. Let's start with the

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Scottish Daily Mail. It goes with say no to students from the middle

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classes. Scots are being frozen out of universities in favour of

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children from poorer areas. There is a picture of Prince Harry. The

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Scotsman goes with my mum's killer was just like a brother to me in.

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The paper says the sun cannot forgive the friend or family it of

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the Nadal of Jenny. The Independent has an interesting front page story

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on the NHS in England. Global that work of NHS hospitals to exploit

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the brand and there has been confirmation that this is to be

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