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Rehabilitation

Volume 405: debated on Thursday 22 May 2003

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3.

If they will make a statement on treatment and rehabilitation for drugs misuse. [114220]

Drug treatment was identified as a key component of tackling drug misuse in Britain in the Government's 10-year drug strategy, published in 1998. The Government set a public service agreement target to increase the participation of problem drug users in treatment programmes by 55 per cent. by 2004, and 100 per cent. by 2008. The target is supported by a substantial increase in funding for drug treatment to £236.1 million in the financial year 2003–04.

I thank the Minister. The links between drugs and crime and drugs and social exclusion are well established and indisputable. May I ask, in this ground-breaking, cross-cutting Question Time, when the Minister and her counterparts will meet the Welsh Assembly Government's ground-breaking and cross-cutting Minister for Social Justice and Regeneration to follow up on the £18 million that was announced last summer to consider further community-based drug treatment and rehabilitation services in south Wales, particularly as the dealers of south-west England are now targeting the south Wales valleys and see the area as a cash cow?

My hon. Friend makes an extremely important point. The problems relating to the links between crime and drugs challenge every Administration. We are making progress through the National Treatment Agency for Substance Misuse, introducing models of care, which is a national service framework for substance misuse, driving down waiting times, modernising services and getting more GPs and specialist prescribers involved. It is important that good practice be shared, both in England and in Wales. I shall be delighted to ensure that good practice is spread for the benefit of communities in every part of the country.

Do Ministers agree that one way of getting people into treatment and rehabilitation is via a social housing provider? Since the imprisonment of the Cambridge two, Ruth Wyner and John Brock, workers in the sector have been left feeling very insecure, which hinders good practice. Their vulnerability arises from the wide interpretation available to police officers in enforcing section 8 of the Misuse of Drugs Act 1971. The Police Federation has suggested that section 8(d) should be redrafted to read, instead of "knowingly permits", "knowingly and wilfully permits" the production or supply of controlled drugs.

In a letter to me earlier this month the Under-Secretary of State for the Home Department, my hon. Friend the Member for Coventry, North-East (Mr. Ainsworth), said:
"We do not want those professionals who carry out harm reduction and care policies when working with drug misusers to be in fear of prosecution."
Workers are pleased to hear of that intention, but what specific measures, if not the recommendation of the Police Federation, will the Government take to reduce the vulnerability felt by those workers?

The Parliamentary Under-Secretary of State for the Home Department
(Mr. Bob Ainsworth)

That uncertainty and worry has been raised with me a number of times in connection with the proposed extension of section 8 to cover other drugs and substances. We have decided for the moment not to go ahead with that, and that news has been well received by people involved in treatment and harm minimisation provision for the homeless and those in other housing situations. As an alternative, we have included a proposal in the Anti-Social Behaviour Bill to give the police powers to close down crack houses within 48 hours. We shall see whether that is effective before we go along with the proposal to extend section 8.

Have Ministers had a chance to read the excellent three-page article in The Guardian today? It is by someone for whom I have great respect, Nick Davies. He has a deep insight into the drug abuse problem, and he summarises many of my thoughts on the problem.

As successive Governments have bolted on so many policies we have been creating something of a monster and the whole situation has become rather complex. Nick Davies reckons that there are 44 funding agencies, and that 40 per cent. of the Bristol drug action team's time is spent treating patients, while 60 per cent. is spent dealing with bureaucracy—filling in forms, pulling agencies together and so on. Do Ministers agree that in the very near future we should set up an independent review of the effectiveness of Government policies on drug treatment and combating drug abuse? We could even consider a royal commission.

Yes, I have had an opportunity to read the article in The Guardian. It presents a fairly unbalanced report of current circumstances. It highlights important issues of administration, but it takes one perspective and makes the same allegations about the whole drug sector. In local communities throughout the country, people working in that sector do excellent work to fight the scourge of drugs, which causes so much distress. I acknowledge that Bristol has had problems. However, one of the authors of the information for that article was in a prime position to do something to improve services, but he chose to leave his position.

There is a desire across Departments to reduce bureaucracy and streamline funding systems, which the DAT manager in the article could have done. We do not want to spend our time on unnecessary bureaucracy. However, we are talking about a significant amount of public expenditure, so we must ensure that we monitor it to get value for money from the treatments. For years, one of the problems in drugs treatment has been that, because it has grown up from a diverse set of providers, it has not had the rigour that we have seen elsewhere. That is what we are introducing by establishing the national treatment agency.

Liberal Netherlands and illiberal Sweden are at opposite extremes in the drugs debate. Unlike this country, both treat drug addicts in primary care using medical intervention by doctors in their equivalent of the national health service. Why, for most addicts, do we not do so?

For most addicts we provide primary and secondary care, and we are increasingly engaging GPs in drug treatment services. We have just put on a course for 400 GPs and 40 prison doctors to give them greater expertise in prescribing medication and supporting problem drug misusers as patients in the community. The engagement of GPs has a significant effect on the success rate of people who enter treatment. It is vital that we provide a good primary care service.

Where people have more complex and specialised needs, it is important that specialist consultants and practitioners address their addiction issues, so that we provide the right service in the right place at the right time. That requires a range of care, including specialist rehab, detox, structured day care and counselling, and GP-prescribing services. We want to ensure that the NHS provides a range of services to support people wherever they are, to get them into treatment and to free them from the misery of drugs.

Is not the problem that the Government have said that they want to double the number of drug treatment places, but careful examination of the figures to which they refer reveals that they apply to the number of people who are in contact with drug treatment agencies? The two are not the same. That relates to the previous question.

Last February, the Audit Commission said that so far as drug treatment was concerned there were long waiting lists and limited treatment options; care management often failed to address drug misusers' wider social problems; and a lot of treatment was inconsistently delivered. Would it not be better to follow the Swedish model, for instance, and aim to provide intensive drug treatment places? That could be done; it would probably mean providing another 8,000 beds, but it is certainly an affordable proposition if the will is there. That might start to have an impact on reducing drug addiction and, above all, rehabilitating young drug addicts.

First, I say to the hon. Gentleman that treating problem drug misusers was hardly a priority for the Conservative Government. Because we recognise the scale of the problem in our communities, there is, for the first time, massive extra investment and a range of services. The hon. Gentleman's approach is fundamentally misconceived. He advocates a one-club policy, which would mean that we had in-patient detoxification only. He well knows that different drug misusers have different problems and need different kinds of care, including GP prescribing, specialist intervention, detox and rehabilitation. The world is a lot more complex than the hon. Gentleman seems to think, and it is important that the NHS provides a range of services in the right place at the right time to address people's needs.

We are now halfway through this question and answer session. With the assistance of all hon. Members, I hope still to succeed in making good progress.