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House of Commons Hansard
16 March 2015
Volume 594

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I beg to move,

That the draft Drug Driving (Specified Limits) (England and Wales) (Amendment) Regulations 2015, which were laid before this House on 5 February, be approved.

The instrument will include amphetamine, with a limit of 250 micrograms per litre of blood, in the new drug-driving offence of driving with a specified drug in the body above a specified limit. The new offence was provided for in the Crime and Courts Act 2013, which inserted new section 5A into the Road Traffic Act 1988. The Drug Driving (Specified Limits) (England and Wales) Regulations 2014, made on 24 October 2014, specified 16 other drugs and their limits, and the new offence came into force in England and Wales on 2 March. Indeed, the first arrest was made on that very day. I recognise the positive engagement and support of the Opposition in introducing the new regulations.

As hon. Members are aware, the review of drink and drug-driving law by Sir Peter North concluded that there was

“a significant drug driving problem”

and recommended the new offence. It also recommended the inclusion of amphetamine. The expert panel on drug-driving, in its report of March 2013, also recommended the inclusion of amphetamine in the new drug-driving offence. It quoted the European driving under the influence of drugs, alcohol and medicines project—the so-called DRUID project—which suggested that amphetamine caused a medium to high risk of a traffic accident. The DRUID researchers did not find an impairment effect at therapeutic doses, but a negative driving performance could be detected at high doses.

As hon. Members are probably aware, the Government have considered carefully what the appropriate level should be for amphetamine. The expert panel recommended a limit of 600 micrograms per litre of blood if our approach was to look at when the risk of a road traffic collision was most likely to occur. However, although there is significant medicinal use of amphetamine, the Government were concerned about the amount of illegal use. The expert panel described it as “an illicit substance” and

“a long standing member of the drug scene”.

The approach to setting a limit for the drug was therefore not as clear-cut as for the other drugs, because a zero tolerance approach was taken to illegal drugs such as cannabis and cocaine, whereas a road safety risk approach was taken to drugs that were more associated with medicinal use.

The Government used the consultation in summer 2013 to seek further views and evidence on what a suitable limit might be. Many of the responses proposed a limit that was much closer to the zero tolerance approach, so we re-consulted on a limit of 50 micrograms per litre from December 2013 to the end of January 2014. However, we received several objections from the medical profession to the proposed limit.

Specialists in attention deficit hyperactivity disorder, or ADHD, for which amphetamine is a recognised treatment, argued that the condition affects the ability to concentrate and that, although patients represent an increased road safety risk when unmedicated, they are just as safe as the general population when taking their medication. Those respondents backed up their arguments with research. Their concern was that prescribers and ADHD patients must not be discouraged from prescribing medication or taking it. We recognise that adult ADHD often goes undiagnosed and that treatment is often stopped after people have had it as a child. That presents road safety risks that need to be addressed through treatment. We concluded that the limit of 50 micrograms that we initially proposed might discourage those with ADHD from seeking or continuing with treatment.

To be clear, the amphetamine treatment for ADHD that we are talking about is not Ritalin, which is often associated with ADHD. Although similar to amphetamine, Ritalin is a methylphenidate. Amphetamine drugs, including lisdexamfetamine, which is produced by Shire pharmaceuticals, tend to be used as a second-line treatment when methylphenidate is not successful.

It is therefore appropriate to set a limit that is above the therapeutic range that ADHD sufferers are most likely to be prescribed and below the level that is most likely to be the result of people abusing the medication. After holding extensive informal discussions with specialists in ADHD and the Secretary of State’s honorary medical advisory panel on alcohol, drugs and substance misuse and driving, we have agreed that 250 micrograms per litre of blood is the most appropriate limit. The advisory panel quoted the analysis of 2,995 blood samples that were taken between 2008 and 2012 across the UK in suspected drug-driving cases, which showed an average concentration of amphetamine of 456 micrograms per litre of blood. The Government concluded from their consultation with the ADHD specialists and the advisory panel that the level of 250 micrograms would successfully balance the legitimate use of amphetamine for medicinal purposes against its abuse by those who represent a risk on the road as a result of taking it.

The House may recall that in September last year, during the debate on the regulations that specified the 16 other drugs and their limits, the Government indicated that they intended to re-consult on a limit for amphetamine. Given the extensive discussions that we have held with medical stakeholders, we take the view that we have had sufficient opportunity to consider the views of all the relevant parties and that conducting a third formal consultation on a limit for amphetamine is no longer appropriate or necessary.

The new drug-driving offence commenced on 2 March, and the Government believe it important that amphetamine is added to the list of drugs as soon as possible, so that those who abuse amphetamine and continue to drive and put lives at risk can expect to be caught and prosecuted for the new offence. I acknowledge that there is no roadside screening device for amphetamine—currently only cannabis and cocaine have an approved device that tests saliva—but should there be any suspicion of the consumption of that drug or any other specified drug, a blood test can be carried out, and a blood concentration level above the specified limit will result in prosecution.

Specifying amphetamine will create certainty in the market and enable manufacturers to consider the research and development of roadside screeners for that drug, which is one of the most significant in drug-driving cases. I urge right hon. and hon. Members to support extending the regulations to include amphetamine at the limit proposed, to send a strong message that the House, Parliament and wider society will not tolerate those who persist in drug-driving and the threat they pose to other road users. I recommend that the House approve these regulations.

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It is a pleasure to follow the Minister on this subject. He and I may have a sense that, if not groundhog day, it is perhaps groundhog piglet day because—he alluded to this—we discussed the closely related draft Crime and Courts Act 2013 (Consequential Amendments) Order 2015 only last Monday. I will therefore do my best to focus specifically on the amphetamine aspects of today’s debate, although as the Minister demonstrated, some points may overlay with the broader discussion from last Monday.

The Minister has rightly said that the order confirms the limit for amphetamines in the new drug-driving legislation—indeed, amphetamine was the only drug that the Government did not confirm the limits for in October 2014—and he spelt out in some detail and with considerable clarity the iterative process that led to the Government proposing that limit. I understand that, and the Minister dealt manfully with the various chemical substances that were referred to, and in the process he gave the House a useful insight into the risk-benefit analysis that must take place in such areas—I hesitate to call it a master class, but it was informative and useful.

I want to raise one or two points with the Minister, although as he will know the Opposition strongly support the broad thrust of these regulations and the previous ones. I do not propose to quote in detail from last week’s discussion, but he will recall that when I asked why the consultations on amphetamine limits had been cancelled, he replied that he thought the balance achieved was absolutely right. Today, he has given chapter and verse on that process and why he thought the third consultation was no longer necessary. However, that does not explain why the Department for Transport originally proposed to re-consult on the amphetamine limit, if it was already holding extensive discussions with medical stakeholders that it now says makes such consultation unnecessary.

Will the Minister clarify why the Department said in September that the consultation would take place, only to announce in March that it will not? If we had had an earlier statement, would there not have been ample time for a formal consultation to be held and still make the order today? I make that point not in a spirit of churlishness or to be slightly anorak, but because it is essential to have a broad breadth of consultation and agreement on this issue.

Will the Minister update the House on why, as amphetamine has to be treated differently from other illegal drugs, the advice of his own expert panel, which originally recommended 600 micrograms of amphetamine per litre of blood, was set aside?

I want to touch on the 50 microgram limit arrived at in the proposal. Will the Minister explain again, for the benefit of the House and Members who may not have been present at the more general discussion of the previous order, how this argument relates to the level set for the eight drugs used for medicinal purposes? Does that not perhaps occasionally undermine the Government’s continued statement that the medical defence provided to drivers on prescription drugs will be enough to ensure they will not be discouraged from seeking treatment?

On a previous occasion, I alluded to the fact that the essential element is not simply the passing of an order, but the ability to enforce it and the resources to go with that enforcement process. I do not propose to repeat the concerns we raised last week. However, the Minister made much of the fact that, although the main screening in police stations was going to cost about £3,000, 35 of the 42 police authorities—if I have the figures right—already had them, so I was not to be too concerned about the postcode lottery issue, which I had raised. He also said that the roadside tests for these substances, the so-called use-once Drugwipe device or the electronic Dräger device, would be available, quoting the figure of £20.

On enforcement, the Minister’s hon. Friend in the other place said that in most cases it was not necessary for this to be done in the station, but on roadside screening devices. However, she also said that it was up to manufacturers to market them and the police to purchase them. It is therefore still by no means certain that roadside screening for drugs will become routine across the country. How has this significant uncertainty been factored into the Government’s estimates of how many more convictions for the offence there will be, how many crashes may be prevented and how many lives may be saved?

We join the Government—and, I think, all Members—in wanting the new regulations to be imposed as speedily and effectively as possible. It is therefore incumbent on the Government to ensure, insofar as is humanly possible, that the resources and quality of enforcement across the country are adequate and sufficient.

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I served on the Committee that considered the related order. I should like to put on record my appreciation to successive Governments for legislation that has resulted in the number of deaths on our roads being today approximately one third what it was 50 years ago. The regulations are a step along the road of reducing that number still further.

We all need to emphasise that we are talking here about drugs in the round: drugs prescribed for medicinal purposes and existing illegal drugs. We need to ensure that people who are prescribed drugs realise that they could, just possibly, be in breach of the law. We need to stress that point.

I do have a regret. As we approached the 2010 general election, we were looking forward to a reduction in the level of alcohol with which people were allowed to drive legally. Unfortunately, that was never implemented, so the drink-drive limit in England is still too high. I hope that the Minister will indicate whether the next Government might want to reduce it.

I welcome the measure, but I stress again the importance of getting the message across that we are talking about drugs prescribed for medicinal purposes and that people need to ensure that they do not break the law unwittingly. The message should be, “If in doubt, don’t risk it.”

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I thank the hon. Member for Blackpool South (Mr Marsden) for raising several questions, some of which we covered in Committee last week. He asked why we did not re-consult on the level. Although we decided that 50 micrograms was not the correct limit at the end of March 2014, we had to consult informally with a range of medical experts to ensure we got the number right, and that took time. Most importantly, we are confident that 250 micrograms is correct, as it successfully balances the legitimate use of amphetamine for medical purposes against its abuse by those who represent a risk on the road as a result of its use. Given our extensive discussions with medical stakeholders, we think that we have had sufficient opportunity to consider the views of all relevant parties and that conducting a third formal consultation on the limit for amphetamine use is no longer appropriate or necessary. No additional significant risk is associated with going from 50 micrograms to 250 micrograms, as advised by the Secretary of State’s advisory panel.

Importantly, the level we have set for the eight illegal drugs effectively represents a zero-tolerance approach. We have set the level sufficiently high so that there can be no opportunity for loophole lawyers to get people off or for people to use the defence that they were accidentally exposed to drugs by, for example, sitting next to somebody who was smoking cannabis or handling an item that had been used for cocaine.

It is important to remind the House that existing legislation on impairment remains on the statute book, and many prescribed drugs will carry a warning indicating that people should not take them if they feel drowsy or their vision is blurred. That has not changed, so people taking prescription drugs below the levels set in the regulations will still be committing an offence if they are impaired. If they take levels above those set in the regulations, but are not impaired, they will have the medical defence. The advice has gone out to pharmacists, doctors and patients that if necessary they should carry evidence of their prescription as a medical defence.

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I want to make a point about notices on prescription drugs. Many years ago, the message that cigarettes were harmful to health would have been smaller and much less obvious than it became. That seems to apply now to prescription drugs. Does the Minister have a view on whether the message about the danger of taking prescription drugs, even below the levels he has mentioned, should be much more obvious to users?

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We have issued specific advice to pharmacists on the nine drugs we are specifying, but there is a general warning to patients as well that taking prescription drugs can affect them. In the case of the drugs specified in the regulations, we have issued stickers to pharmacists and doctors to provide an additional reminder.

On the cost of screening, it is true that although a breathalyser now costs about 17p to administer at the roadside—we now have breathalysers that are evidential—the cost of these new roadside tests will be about £20. Of course, we want more competition in the market in terms of the number of devices available and the number of drugs that can be detected. As we get more competition and more players in the market, the cost will come down. I am sure that police forces and police and crime commissioners will take decisions based on where this equipment is deployed. Even if it is not in every police car, it will be important, particularly for fatal or near-fatal accidents, that the equipment is available, to ensure that a screening test can be quickly taken. Of course, if the two drugs that we can currently test for are not detected, there will be the option of going to the police station to take the test there. The blood test, not the roadside test, will form the basis of the prosecution.

My hon. Friend the Member for Colchester (Sir Bob Russell) said that this is a further step made by the Government towards improving road safety. Personally, I am pleased that we have now reached, I hope, the end of the road on this; I personally insisted that the issue should be put in the Conservative manifesto at the last general election. With a couple of weeks to go, we have finally got the matter completed and on to the statute book.

Drink-drive limits were mentioned. I shall not be tempted to speak at great length on that issue because it is not within the terms of today’s debate, but it will be interesting to take account of the experience in Scotland. It is important to note that when the drink-driving legislation came in, many people thought that drink-driving was acceptable, but we subsequently saw a great cultural change take place on this issue. If we read about the horrendous accidents that occur because of drink-driving, we often find that the driver was three or even four times above the existing limit. As I say, it will be interesting to see how things develop in Scotland. We will, of course, keep everything under review. I conclude my comments there.

Question put and agreed to.