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Mr. Bellingham: Is the hon. Gentleman aware that in the Garfoot case there was no evidence of any diversion of drugs from patients or of any harm that came to patients? The hon. Gentleman made a good point about GMC procedure. Is he also aware that under the old Misuse of Drugs Act tribunal procedure the punished doctor could go back to his mainstream GP practice? The new GMC procedures mean that he cannot do that and is, struck off for perhaps five years and loses his livelihood.
Dr. Iddon: I am aware of those issues.
The sweeping new measures that operate through the GMC's interim orders committee have allowed it immediately to suspend or put sanctions on a doctor who is suspected of misconduct. Dr. Garfoot was subjected to that procedure after it was discovered that he was prescribing high dose levels to his patients and was accused of irresponsible prescribing. The IOC ruling meant that he was forced to reduce the number of patients he was treating and could not accept new patients. In the aftermath of the decision, taken only a few weeks ago, two of the doctor's patients have died, and I heard today that it could be as many as four. Of the cases which I am aware, one died from an overdose after being forced back on to the streets, and another tragically committed suicide.
The GMC's case against Dr. Garfoot dates back to 1996. Since then, he has been subjected to two preliminary conduct committees, three interim order committees and one professional conduct committee. That is the harassment of a doctor who is trying to do good deeds in the community. In any case, such a legal process is incredibly costly; I believe that a similar case cost £500,000 to conduct. As the Member for North-West Norfolk (Mr. Bellingham) said, the procedures are not simple. The appeals process leads to the Privy Council, so the cost of an appeal must be prohibitive.
John Marks practised the old British system similar to the Garfoot treatment in Widnes. His practice was forced to close in 1995, and by 1997—just two years later— 40 of his patients had died. That is an incredible indictment of our drug policies, and it also shows the level of dependence that the addicts have on such doctors.
I am aware that 15 doctors have now been subject to such procedures. And what happens when they are struck off? Some 200 to 300 addicts are precipitated on to the streets of our major towns and cities, and, as the House has heard, many of them die.
When John Marks practised in Widnes, the local crime rate went down by an astonishing 50 per cent. He was driven out because health authorities refused to fund him, and he had to go to New Zealand to practice the old British system.
Dr. Garfoot has helped 1,200 addicts, and I submit to my hon. Friend the Minister that many them would have died if Dr. Garfoot had not been allowed to treat them. Indeed, may I be so bold as to request my hon. Friend to seek a meeting with his counterpart in the Department of Health so that they can review the General Medical Council's procedures as they affect doctors who are willing and able to treat long-term drugs addicts who no other general practitioner and not even the health service are willing to take on board?
When the Home Office special tribunals were set up, James Callaghan, who was Home Secretary at the time, spoke of
- "irresponsible, careless, or negligent prescribing or unduly liberal prescribing with bona fide intent, which may justify curtailing the doctor's authority in relation to controlled drugs in order to stop a supply for misuse, but not justify the drastic course of disqualifying him altogether".—[Official Report, 25 March 1970; Vol. 798, c. 145.]
I have tried to show how Government policies across the different Departments of State can have an unexpected impact on the way in which we deal with drug addiction if those policies are not thought through carefully. I hope that my contribution has been constructive and that my hon. Friend will take account of my points.
12.2 pm
Michael Fabricant (Lichfield): The Garfoot case is, indeed, a scandal. I hope that the Minister will examine it in much more detail.
This has been a particularly informed debate. Although it is invidious to pick out individual contributions, those of the hon. Members for Manchester, Central (Mr. Lloyd) and for Newport, West (Paul Flynn) were especially valuable.
I am afraid that I have to leave the Chamber at about 12.30 pm, for which I apologise. I have a constituency engagement and there is a lack of trains to Lichfield. I hope that I will be in the Chamber to hear the contribution of my right hon. Friend the Member for Hitchin and Harpenden (Mr. Lilley) but, if I am not, I promise him and the Minister that I will read their remarks in Hansard.
The Minister said that he welcomed an adult debate on the drugs issue. He was right to say that, and this has been an adult debate. Drugs are a dreadful scourge, and not just in Manchester, Central; they are a problem even in the leafy lanes of Lichfield. Market traders there have told me that syringes are often found first thing in the morning in the city square. The scourge faces us all nationally.
We are debating not whether drugs are a scourge, but how the problem can best be dealt with. It is revealing that when the hon. Member for Newport, West asked the
Minister which of the Government's strategies have worked, he was unable to answer. That is simply because there is evidence that prohibition in the broadest sense does not work.I asked earlier whether an analogy could be drawn between prohibition in the United States in the 1920s and 1930s and the prohibition that exists now in the United Kingdom. I do not advocate that we lift the prohibition on all drugs because I do not believe that we know what the consequences would be. From now on, I shall address my comments solely to soft drugs, and cannabis in particular.
I reiterate my earlier point that all the evidence shows that prohibition in America in the 1920s and 1930s bred not only gangsterism but alcoholism. If one were to draw an analogy with the United Kingdom, one could strongly observe that, under prohibition, gangsterism in drug pushing has led to greater numbers of people taking drugs and becoming addicted. The Government and academic bodies need to consider that in far more detail.
Lembit Öpik: Does the hon. Gentleman agree that one could extend the analogy and observe that, under prohibition, unregulated production meant that the alcohol itself caused death, as well as blindness? Are there not strong parallels between those circumstances and the present situation in Britain?
Michael Fabricant: The hon. Gentleman makes a powerful point. We have heard about the number of deaths caused by people taking impure ecstasy. I am not advocating the free availability of ecstasy, but clearly one could argue that if it were available under controlled conditions, at least deaths would not be caused by contaminated tablets.
Mr. Bob Ainsworth: Nobody would argue with the assertion that prohibition in America had dreadful consequences, but, in the interests of a serious debate, may I ask where the hon. Gentleman acquired the evidence that alcoholism increased during that period? Instances of liver cirrhosis fell considerably, and although the alcohol consumed was probably stronger than before because hard liquor was easier to smuggle, overall alcohol consumption fell too. I do not deny that prohibition caused massive problems, but from where did the hon. Gentleman get his evidence?
Michael Fabricant: From the United States Senate inquiry in 1941, and I refer the Minister to its report, which supports my argument. I do not believe that the hon. Gentleman and I are arguing about the general principle of the issue, but there are important analogies to be drawn.
If we had known hundreds of years ago of the consequences of consuming alcohol and tobacco, might we not have made those substances illegal too, because it is becoming clear in this debate that they are also drugs? It was said earlier that cannabis can be a gateway to harder drugs. One could argue that the gateway exists because cannabis, like harder drugs, is illegal, and alcohol and tobacco are not necessarily gateways to harder drugs simply because one can acquire them legally and does not have to come into contact with pushers. The House and the Government must consider those arguments in detail.
The Minister rightly, said that the Home Secretary's announcement during evidence to the Home Affairs Committee did not constitute an official change of policy,
although I agree with my hon. Friend the Member for Surrey Heath (Mr. Hawkins) that its timing was very suspect indeed.The Minister was also honest, as is his wont, in answering my question. He said that he would perhaps be surprised if cannabis were not reclassified—I think that I summarise his words correctly. In the light of that perfectly legitimate answer, it is worth stating the present position on taking cannabis.
I shall quote a Drugscope briefing paper, which several hon. Members have been given. Interestingly, it states:
- "Britain still has some of the toughest drug laws of any European country. Britain also has one of the biggest drug problems and the highest addiction rates."
- "Around half of young people (16-24) have tried illegal drugs, 29 per cent. in the last year. Over a third (34 per cent.) of all adults (16-59) have tried drugs, 11 per cent. in the past year."
- "Cannabis is the most widely consumed drug in all age groups and 70-85 per cent. of offences against the Misuse of Drugs Act are cannabis related—mostly possession."
My hon. Friend the Member for Surrey Heath, who speaks from the Front Bench, spoke about road accidents. I agree that it is wrong to drive a vehicle when under the influence of alcohol or any other drug, including cannabis. I hope that the Minister will say how the Home Office will assist police forces to detect those who drive under the influence of cannabis, just as they are equipped to detect those who drive under the influence alcohol. I strongly believe that there is no defence for driving under the influence of any drug, be it alcohol or cannabis.
I simply want to say in conclusion that I disagree with my hon. Friend the Member for Beckenham (Mrs. Lait) only on the medicinal prescription of cannabis and other drugs. I understand her argument that a review is being undertaken of whether drugs should be prescribed for specific purposes, but we should not hide behind that. Some health authorities hide behind the National Institute for Clinical Excellence. In south Staffordshire, anti- tumour necrosis factor drugs are not being prescribed to people with rheumatoid arthritis because it is argued that the issue is currently being investigated by NICE. That is an excuse: those drugs are not being prescribed because South Staffordshire health authority does not have the money to do so; other health authorities are prescribing them, even though NICE is reviewing their use.
Similarly, we should not use the review of whether doctors should be allowed to prescribe certain drugs for medicinal purposes as an excuse not to consider their use. Overwhelming evidence shows that those who suffer from multiple sclerosis and certain forms of cancer benefit medicinally from being prescribed those drugs. It is absolutely wrong that people who suffer from such diseases are threatened with criminal prosecution, as are their doctors for making the drugs available to them. I would be prepared to say that if we are to be cautious, perhaps two general practitioners should sign the prescription.
I urge the Minister to ensure that, as quickly as possible, the law is changed, or guidance issued to police forces, so that if two doctors believe that any drug ought to be prescribed to alleviate suffering or to cure people of drug addiction, they are allowed to prescribe it now, without fear of prosecution. I do not believe that the House—or even the Home Office—knows better than medical practitioners.
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