Question mark looms over Scotland’s busiest needle exchange whilst HIV outbreak continues

Scotland’s busiest needle exchange for people who inject drugs is currently under discussion to be shut, despite warnings that the move could “exacerbate” the worst HIV outbreak in decades.

The service, provided by Boots in Glasgow’s Central Station, has been told that it is to be forced to close by Network Rail, which owns the station, by Friday the 29th of September, despite pleas to retain it from Scottish Drugs Forum, NHS, the police and the convenor of the Scottish Parliament’s Cross Party Group on Drugs and Alcohol Misuse.

It is understood Network Rail took the decision after a person overdosed in the station and cleaning staff discovered discarded drug paraphernalia in toilets, however the BBC has reported that Network Rail is to reconsider the decision after pressure from the aforementioned groups.

The exchange, which is open from 7am until midnight, has provided more than 40,000 sets of clean injecting equipment since it opened in July 2016 following a spike in the number of HIV cases in Glasgow – from a consistent average of 10 cases a year to 90 new cases since 2015.

According to an internal NHS report that was seen by The Herald newspaper, the service had conducted 9583 transactions to 1940 people and has provided 41,238 sets of clean injecting equipment and 20,520 sheets of foil – used to promote transition from injecting to less risky inhalation – since it opened last July.

It states: “The service has become the busiest in Glasgow and in Scotland – possibly in the UK – and provides around 1,000 transactions per month. This is a clear indication that it is meeting a significant public health need and filling a gap in existing provision that was originally identified in the public health needs assessment.”

Scottish Drugs Forum Chief Executive David Liddell said the decision to close the exchange “would be bad at any time but in the middle of an active outbreak of HIV it just seems incredible”.

He added: “I don’t know how Network Rail think this is in the public interest to do this. It also begs the question about what their accountability is as a publicly-funded agency.”

The extended opening hours offered by the Central Station service is crucial to limit the number of HIV cases among very vulnerable injecting drug users.

However, the internal NHS report revealed a small number of incidents in the station were connected to the needle exchange. It stated: “Since its introduction in July 2016, with exception of the one serious overdose incident, there have been 10 reports of minor incidents within the station, relating mainly to drug litter.”

The co-chairs of the Scottish Sexual Health and Blood Borne Virus Prevention Leads Group, Dr Andrew McAuley and Leon Wylie, issued a joint statement which said closing the facility “could not come at a worse time with many potential negative outcomes, including a possible widening of the HIV outbreak.”

Former police officer John Finnie MSP, who is convenor of the Scottish Parliament’s Cross Party Group on Drug and Alcohol Misuse, has also called for a “rethink of this ill-thought-through enforced closure.”

Finnie added: “That the service deals with around 1,000 people per month and has only had one significant incident since 2016 is testimony to the professionalism of the staff involved. Removal of this facility would be an extremely retrograde step not only for individual service users but also the wider community.”

A spokesman for NHS Greater Glasgow and Clyde said: “At a time when Glasgow is experiencing an HIV outbreak amongst injecting drug users it is especially important that they have access to clean injecting equipment. It is disappointing that after protracted discussions to set up the injecting equipment provision (IEP) service in Central Station that Network Rail is forcing the closure of the service despite it being supported by the NHS, Glasgow City Council, Police Scotland and the pharmacy.”

When questioned in Parliament, Public Health Minster Aileen Campbell MSP said the government recognised “very real concerns” about the move and told MSPs that decision-makers had “agreed to look again” at the judgement.

Ms Campbell was speaking in response to a question from Labour’s James Kelly, who said the decision had “caused a great deal of anxiety”.

A spokeswoman for Boots said: “We believe that community pharmacies are an essential part of the drug treatment system, in particular the needle exchange service, as it allows the patient opportunity to also have a conversation or counselling with a pharmacist.”

A spokesman for Network Rail said: “Glasgow Central station is used by over 100,000 visitors each day and we have a responsibility to provide as safe an environment as possible for those passengers and our staff.”

A sharp increase in the number of HIV cases among drug injectors in Glasgow have led to calls for dedicated needle exchanges and a supervised safer injecting facility to be set up in the city.

The NHS has estimated that it costs £360,000 to treat a patient with HIV over the course of their life, meaning the new cases will cost the health service more than £30m.

Whilst the operation of the service is debated, Simon Community Scotland, a homelessness organisation, is placing an outreach team outside Glasgow Central Station who will deliver a mobile needle exchange alongside providing information and advice over the next two weeks.

UPDATE

The Glasgow Central Station Boots needle exchange service closed as planned on Friday the 29th of Spetember. SDF continues to work with others on this issue.