Out of a total £2.83 billion allocated to run prisons during 2006-07 (excluding healthcare and education funding), £77.3 million was provided for custodial drug treatment. This equates to 2.73 per cent. of the total allocation.
The funding breakdown is given in the following table:
Intervention Allocation 2006-07 (£ million) Proportion of total prison spend (percentage) Clinical services 23.3 0.82 CARATS 31.7 1.12 Drug rehabilitation programmes 19.4 0.69 Juvenile substance misuse programmes 2.9 0.10 Total 77.3 2.73
Allocation 2006-07 (£ million)
Proportion of total prison spend (percentage)
Drug rehabilitation programmes
Juvenile substance misuse programmes
Prison Drug Treatment
Around 55 per cent. of those received into custody are problem drug-users (PDUs)—with some local prisons reporting up to 80 per cent. testing positive for Class A drugs on reception. This means around 70,000 PDUs enter custody each year—with 40,000 being present at any one time.
Addressing drug-misuse is a priority for the MoJ—and NOMS has in place a comprehensive drug strategy, the three key elements of which focus on: (i) supply reduction, (ii) demand reduction (through effective treatment) and (iii) building effective through-care arrangements (particularly through prisons' engagement in the HO-led drug interventions programme (DIP)) so timely continuity of treatment can be maintained as PDUs move respectively between custody and the community.
Drug ‘treatment’ in custody goes much wider than the 116 drug rehabilitation programmes running across the estate and includes: (i) clinical services (maintenance-prescribing and/or detoxification programmes) that are available in all local and remand prisons; and (ii) CARATs (Counselling, Assessment, Referral, Advice and Through-care services) that are provided in all prisons.
Spending on prisons
The total spending on prisons in 2006-07 was £2.83 billion. This figure is a provisional outturn and subject to audit. It includes HMPS, private prisons, and prison related-services managed in NOMS HQ. It does not include expenditure on education or health met by the DFES or DoH.
Spending on Prisons has increased in real terms by 36 per cent. since 1996-97 (to 2006-07). Real terms means adjusted for inflation to 2005-06 levels using the Treasury deflator.
For the purpose of this PQ, the total £2.83 billion figure cited for running prisons has been based on the funding allocated to run prisons operationally—primarily on security, safety, decency and health, maintaining their fabric and providing prison officers to deliver/oversee services for prisoners.
Prison drug treatment funding.
While it is true that the level of funding allocated to drug treatment is only a small proportion of the overall prisons budget, this needs to be seen in context. A significant proportion of the prisons budget is spent on infrastructure and staffing—essential to keep prisons safe and to protect the public. It is however, better to compare expenditure on drug treatment against actual treatment need. With funding levels up 997 per cent. since 1996-97 and overall numbers engaged in prison treatment increasing year on year, prisons are doing much to close the treatment gap. The calculations are based on additional drug treatment funding allocated as a result of successive spending reviews. The figure approximates to £7 million but it is not possible to breakdown between various treatment types. The pre-CSR baseline has therefore been excluded from the calculations.
Integrated Drug Treatment System (IDTS)
The integrated drug treatment system (IDTS) is designed to boost the quality and increase the volume of drug treatment with a particular focus on drug users during their first 28 days in custody. By March 2008 full IDTS (enhanced clinical services and psychosocial support i.e. CARATS) will be available in 17 prisons; additionally enhanced clinical services will also be available in a further 35 establishments. Collectively, NOMS/DH funding for delivery of IDTS during 2007-08 stands at £18.7 million. This is expected to see around 24,500 drug users benefiting annually from enhanced clinical services.
So far as IDTS is concerned, the Department of Health and NOMS have had to make challenging decisions in reviewing the totality of budgets in recent years. Current levels of funding are down significantly on planned expenditure.
More work is needed to identify the gaps in treatment provision. Historically, local assessment and epidemiological studies have informed treatment delivery across the prison estate. Work is already underway on a needs analysis model but, ahead of its data being available later this year, NOMS already anticipates there being a significant treatment gap. For example, to identify offenders’ drug needs effectively, the CARAT service would need to undertake substance-misuse triage assessments for up to 80 per cent. of the annual prison through-put; based on 136,000 offenders passing through custody, this would be around 108,000 offenders. As currently resourced, CARAT teams only deliver around 75,000 assessments—a potential shortfall of 33,000.