Examination of Witness (Questions 1300
- 1319)
TUESDAY 12 FEBRUARY 2002
MR BOB
AINSWORTH, MP
Mr Watson
1300. I just have a point of clarification on
treatment of prisoners. You say that prisoners who were on maintenance
programmes before they went into prison can now stay on those
maintenance programmes. Is it the case that chaotic users who
enter prison and are picked up as users for the first time can
be put on maintenance programmes when they are in prison? Also
can you just clarify what you said about the post-prison treatment
and that there is a gap in the service or funding in that area?
(Mr Ainsworth) People are not put on
maintenance automatically or because they want to be when they
enter prison. The Prison Service does an evaluation and, as I
say, they have to do that within guidance set by the Department
of Health and that applies to this decision-making process, but
where they feel that they have the opportunity or where it is
beneficial to the prisoner that they go through the detoxification,
then detoxification is what is applied. It is more where they
are not going to be able to hang on to that person for the length
of time to be able to go satisfactorily through that process and
where they are already on some form of treatment before they get
in there that is clearly beneficial to them, then it is open to
the Prison Service to decide to continue that treatment within
the prison environment if they feel that it is appropriate.
1301. If they are currently being treated when
they enter prison, fine, but if they have not had any treatment
before they enter prison, is the only option available for them
detoxification or an abstinence programme or they can be treated,
for example, with methadone or, in extreme cases, heroin?
(Mr Ainsworth) Overwhelmingly, if they
are going in and the length of sentence is such that detoxification
can be completed, then whether or not they have been on treatment
before they go in, detoxification is the road that people start
to look at, but if they are short-term prisoners or if they are
prisoners on remand and there is going to be no ability of the
Prison Service to complete that situation, then they can look
at some kind of maintenance programme in order to stabilise the
individual concerned within the prison if that is what is felt
to be appropriate given the circumstances that apply to that particular
prison in terms of his state of health, his state of addiction
and length of sentence or the length of incarceration that he
potentially faces.
1302. You see, the point I am trying to make
is in my own constituency, and the very nature of the convictions
is that they generally are short term, two, three, four months,
a lot of drug workers and parents tell me that their children
go into prison, they are put on detox for three months, there
is no other support given post-detoxification and they come out
of the prison gates, meet their dealer and they are straight back
into the same cycle. What they really need is stabilisation of
their condition even in the short term and to be put through treatment
programmes when they leave the prison gate.
(Mr Ainsworth) Yes, you are absolutely
right and I acknowledge that that is a potential problem. What
we need to do is to pick people up and carry them through that
release period and to try to carry them through in a seamless
way. It is more than just drug treatment in terms of the medical
side of drug treatment; it is more to prevent them from going
back to the market, back to the crime that fed the market in the
first place, and then there are a lot of other things that need
to be joined up as well. Not a million miles from your constituency,
in Solihull, we funded a pilot whereby the local police followed
the arrestees into prison and back through and out and back into
the community again. Now, in order to do that, you are potentially
building inefficiencies into the Prison Service because you cannot
use the estate and maximise the capacity within the estate if
you are going to keep prisoners local to the area in order that
you can monitor their progress as they go into prison and come
back out of prison as well. The police in the Solihull area were
very keen on that kind of programme. At the very worst it enabled
them to pick people up for re-offending quicker than they otherwise
would do, but potentially there was the ability to help them as
well to avoid re-offending in the first place, so these things
do need to be looked at, but there are maybe substantial costs
attached to them as well.
Chairman
1303. Can I just ask you about drug abstinence
orders, Minister. We have heard that to require users to be abstinent
without guaranteeing access to treatment at the same time is irresponsible.
That is what one of the organisations who gave evidence to us
said. What do you think about that?
(Mr Ainsworth) Well, I think it would
be true and I hope that we are not doing that. For those for whom
it is felt appropriate, we should be offering drug treatment and
testing orders. For people who have a lower level of dependency,
then it may well be that drug abstinence orders are appropriate.
Then we are implementing drug abstinence orders in the three pilot
areas and we are looking to expand the three pilot areas. I think
we have designated another six areas for this kind of work, and
we have no desire or intent to roll these pilots out and to make
them available nationwide before we have the treatment capacity
in order to be able to refer people on. That is why we are absolutely
dependent upon the funding and the good work that we are hoping
is going to come from the NTA in terms of assessing the quality
of treatment and the availability of treatment across the country.
Drug abstinence orders should not be being used, and I have heard
the allegation, "setting people up to fail", but they
should be used in circumstances where people should be able to
cope with the commitment that they are being expected to make
without the testing requirement and we should not be pushing them
in there if there is no treatment available.
Chairman: Now we are coming to the bigger picture
which is the national strategy.
Mrs Dean
1304. Are you monitoring the progress of all
the national strategy targets and do you have a baseline for them
all to be able to judge the progress?
(Mr Ainsworth) Yes. When we were discussing
this potential question before I came here, the officials from
the Department said, "We are monitoring it to high heaven,
repeatedly and continually", and I think that there is some
truth in that. You have interviewed Keith Hellawell as part of
the official team that came to a meeting. When we drew up the
Drug Strategy, I do not think anybody felt or claimed that every
single piece of it was pinned down, that we had evidence to back
up targets in every case, that some of the targets, it was openly
acknowledged at that point, were aspirational and I do not criticise
that because there was a necessity to get people focused and to
force them to work together. Now, the very fact that we have that
Strategy and that we have those targets has forced people to look
at what works, what does not work, what is measurable and what
is not measurable and some of those targets are extremely difficult
to apply a baseline and a form of measurability to be able to
say in a critical way that we are or we are not on target. There
is little doubt that the one that is most measurable is treatment
and, as I have said, we are on target to deliver that and in regard
to the other targets, there is a lot of good work that is flowing
from the focus that has been given, but in some cases, and this
is part of the stocktaking review that we are going through now,
we need to develop credible baselines, we need to make certain
that what we are reaching for is in some way achievable, although
we do need people to be stretched in this area and the last thing
we want is for complacency to set in.
1305. Do you think the targets are achievable?
(Mr Ainsworth) This is part of what we
are looking at in the stocktaking review. It would be rather foolish
of me, I think, at this stage while we are still going through
that process to try to say at exactly what stage we have reached.
Let me share with the Committee one of the problematic targets
where I do not think anybody needs to be a genius or where I do
not think it requires rocket science to see that there are potential
problems with it, which is if we look at availability. Now, how
do we measure availability? This is the one that first jumped
at me in the face as soon as I saw it. One is availability. Now,
how do you measure it? What is easily measurable is seizures.
Now, we are doing very well on seizures and the very fact that
we have got people working together and we have got them working
together as a result of the Strategy being put into place has
meant a substantial increase in discussion, particularly on cocaine
where there is a very big increase and some evidence that is beginning
maybe to show through in terms of the wholesale price and the
purity of the product that is coming through. However, if we retreated
to seizures, where we have got an easily recognised and an easily
measurable target, I think we would be far too narrow in terms
of the problem that we are trying to tackle. What is the problem
that we are trying to tackle? We are trying to dismantle to the
extent that we can the illegal drug supply in the country, so
we need to focus on seizures of the supply, we need to focus on
disruption of the criminal elements that are involved within that,
a lot less measurable than seizures, we need to focus on, and
we have done this to a large degree, the Proceeds of Crime Bill,
which Tom is painfully aware of, going through the House of Commons,
we need to focus on seizing the assets and depriving those criminal
elements of the profitability to the maximum extent that we can
and then we need to use the other targets to try to whatever extent
we can to deprive them of a market in terms of the people whom
they are supplying in the first place. To what degree do we narrow
the target and to what degree do we give up the breadth of it
in order to get measurability is something we are wrestling with
in the stock-taking review.
1306. When do you expect to complete that stock-taking
exercise?
(Mr Ainsworth) By the summer, it has
to be, to feed it into the 2002 budget round.
1307. And the conclusions will be published then?
(Mr Ainsworth) Yes.
1308. And changing targets may come from that
review?
(Mr Ainsworth) The timing of your report
is fortuitous in that we can use your report to feed into our
thinking, along with things like reclassification, the Lambeth
experiment and other issues, as we check on whether or not we
have the focus right, we have the gaps right, we have measurability
where it is available. A lot of work is being done on trying to
establish some of the baselines which are necessary in order to
measure the targets in the first place.
1309. Mike Trace helped to formulate the national
strategy and he told us he thought the target on availability
was not going to be achieved. I assume that links in with the
fact you need to look again at that target. Have you anything
to comment on that?
(Mr Ainsworth) When the strategy was
pulled together and the targets were applied—and I cannot
remember to what degree they were explicit with the Committee
when they came here—they used the situation in America,
the situation in Australia, to pull some figures down to get people
going in a particular direction. I think it was widely acknowledged
at that time they were aspirational or inspirational. What is
availability? How do we measure it? I go back to that. How can
we say definitely it is achievable? These are the issues we are
trying to deal with in the stock-taking review in trying to make
sure we have credible measures which lead people to do some of
the good work which is already being done and yet get the maximum
focus and the maximum efficiency for the money we are expending.
1310. Terry Byrne, the Director of Law Enforcement
at Customs & Excise, told us that the supply of class A drugs
is now steady rather than increasing or decreasing. Do you think
that is a new development as a result of the concentration on
hard drugs by Customs & Excise?
(Mr Ainsworth) There is no doubt Customs
& Excise have upped their game quite considerably and that
also we have a very good working relationship with other agencies,
like the National Crime Squad and NCIS in terms of disrupting
supply. What we have not seen yet at the retail end of availability
in this country is an increase in price. There is some evidence
it is beginning to come through at the wholesale level. As I say,
there has been a lot of good work in terms of getting people to
work together and getting them to focus, there has been a massive
increase in seizures, and we have also been able to identify gaps
in terms of availability. One which has become pretty apparent
is what is called the middle market. We have been obliging local
police forces to look down into their own local communities, so
at the PCU level it has been focused on the streets and what is
going on in the neighbourhoods; at National Crime Squad and NCIS
level, we have been saying, "Disrupt the supply and if necessary
go back up the supply chain towards the countries of source",
and what has grown up to some extent is a potential gap in the
middle. We have a pilot going on in the West Midlands with four
local police forces being resourced from seized assets to look
at how they disrupt that middle market supply. Those kind of issues
have been highlighted by the strategy and that has been a success
of the availability target. There is a lot of good work which
is flowing from it.
Angela Watkinson
1311. I would like to turn to the effect of drugs
on young people. I understand the Government has commissioned
a long-term study into education in schools on drug, alcohol and
tobacco. I believe it has not started yet but perhaps you could
say when you expect to get the results and how long this study
is going to take?
(Mr Ainsworth) We have been using the
young people's target in order to try to widen the availability
of education within schools, and have had quite a success at doing
that. Almost 93 per cent of secondary schools now have drug education
available to them and 75 per cent of primary schools. It is not
education that is given to them in isolation, and I am not sure
it would be effective if it was. It is part of presenting people
with life skills leading them in the direction of a healthy lifestyle,
and issues like smoking, alcohol and the consequences of using
illegal substances are brought in to try and help them, to give
them the knowledge to take appropriate decisions when they are
confronted with the availability of those substances. That has
been the main thrust of the education side of the young people's
target.
1312. I wonder if you feel that imparting knowledge,
so that young people are able to make decisions, strikes the right
note, or whether education should be slanted towards prevention,
preventing the next generation of addicts? I do not know if you
have seen this, but this is a Lifeline leaflet, which is
well-funded by a wide range of organisations, and this leaflet
is called, How to survive your parents discovering you are
a drug user. It gives pieces of advice such as, "Don't
get caught in the first place. Remember, parents search bedrooms
and coat pockets. Do not expect them to agree with you. Do not
keep asking your parents for money; your drug use is your responsibility,
you should pay for it. Don't steal from them." At least that
last bit is a nod in the direction of acknowledging that drug
use can destroy moral fibre. The whole tenet of this leaflet is
that parents are pretty stupid and they will not understand, that
drug taking is okay, but do not upset them too much because you
are going to need them when your life falls to pieces and they
will have to take responsibility for the outcome of your drug
habit. This is a bit unfair because you may not have actually
seen this leaflet, but you get the general idea of the message
in it. Do you feel that is the right direction for information
to young people? Should it not be more in the direction of (a)
telling them not to do it and (b) the emotion, physical and mental
health problems which are likely to result from it and the harm
to wider society? Is drug education going in the right direction
and should we be drawing a greater distinction between education
and prevention?
(Mr Ainsworth) Let me tell you what we
are trying to do. We are trying to be effective and the judgment
that we have come to in deciding how we could be effective is
that preaching at young people is not going to work. I know there
are people who advocate that, and there was the "Just Say
No" campaign and everything else, but if we thought that
would work, we would certainly be looking to go down that road.
Our evaluation is that it is not going to and what we are effectively
going to do, if we attempt to preach to young people, is switch
them off and they will not listen at all. So what we are trying
to do is equip them with credible information, so they do not
wind up getting themselves into situations without a degree of
knowledge. We are trying to equip not only the young people themselves,
but their parents and their carers as well. One of the main reasons
why parents do not engage with young people on drugs is that they
feel they simply have no knowledge whatsoever in depth of the
issues they are getting involved in, so there is a need in our
opinion to raise the awareness and to raise the level of knowledge
among young people themselves. Peer group information is what
they are effectively getting at the moment, some of it is accurate,
some of it is totally off the wall. The whole of our recent communications
campaign which we ran over the Christmas period was to try to
advertise the availability of the National Drugs Helpline and
to say to young people in language they would perceive, with messages
coming from young people themselves, "If you really want
to know what ecstasy will do to you or what cocaine will do to
you, don't listen to your mate, ring the National Drugs Helpline,
you will not be preached at, you will be given credible information
about the effects of these substances." So that is the broad
thrust of our message. It certainly is not to encourage experimentation,
quite the reverse, it is in order to give people the information
to draw them away from it. If we thought preaching would work,
we would go there but we do not think it will.
1313. Drug taking is higher in absentees from
school and young offenders, how do we target these particular
vulnerable groups who are more likely to be taking drugs than
pupils who are in school?
(Mr Ainsworth) This is one of the issues
we have to try and take on board to a greater extent in the stocktaking
review than we have up to now. We need to try and discourage all
drug use, there is no doubt about that. It would be a very strange
message, indeed, to problematic drug users if we were doing anything
other than saying to the population at large, "These are
dangerous substances and you should not be using them". We
need that message to go out broadly to all young people. You are
absolutely right, that it is absentees from schools, it is people
with other problems, people in care, who have a far higher propensity
to become problematic drug users. The degree to which we focus
on those groups and the degree to which we are going outside the
young people's area and the degree to which we link up with Neighbourhood
Renewal and Social Exclusion Programmes—because that is
where the main impact of drug misuse is being inflicted on communities—are
issues that we are trying to pick up in the stocktaking review.
1314. When Mike Trace came and gave evidence
some time ago he felt that the rather ambitious target of a 50
per cent reduction in youth drug use was unachievable unless there
were one or two things, a significant shift in youth culture,
which would be extremely difficult we all acknowledge, or that
enforcement action would lead to a sustained drought of these
substances, in other words a much higher level of activity on
the part of the police. What do you think about that?
(Mr Ainsworth) I think that culture can
be changed over a period of time. I think that the levers are
difficult to identify and quick hits are not available. We have
seen patterns of drug use change over periods of time. For instance,
we have seen the increase in ecstasy has tailed off, sadly it
is not going down but we see it tail off, and I think that is
largely because of the message that has come through the media
over a period of time of the acute danger of taking those drugs.
LSD use has almost disappeared, not disappeared but gone down
substantially. Culture changes over a period of time and we have
to try influence it and push it in the right direction. Whether
or not we should be investing in a substantial increase of work
on enforcement—all of the money comes out of a finite pot
at the end of the day—at the expense of education, at the
expense of treatment is another thing. When we have tried to look
at what actually works we think that we have evidence that treatment
does work and that pound for pound we are getting more out of
treatment than we are out of law enforcement activity. The evidence
appears to suggest that every pound spent on treatment can effectively
save three pounds in social economic costs and the criminal justice
costs. That is why the balance of expenditure has been moving
in that direction rather than in any other.
1315. Treatment is for existing addicts. My particular
concern here is preventing the next generation of addicts. Do
you feel that drug education should be coupled with greater enforcement,
so that between the two methods of dealing with this problem we
might have a greater success if young people knew that if they
disregarded all of the advice and education that was put in front
of them that there would be a sanction in law?
(Mr Ainsworth) In my opinion we have
to keep up our efforts on enforcement and a failure to do that
will lead to increased availability and it will send a message
that the use of drugs is okay. We have to keep up our expenditure
on information. There is evidence that comes back from polling,
that I think I mentioned earlier, that suggests that a fair proportion
of people are deterred from experimentation by the mere fact that
the substances are illegal, not everyone, sadly, but a fair proportion
of people are deterred, and they give in answer to questions to
MORI polls, and the rest of it, "Why have you not experimented
with cannabis or cocaine?", the fact that they are illegal.
In my opinion we have to maintain our efforts on the enforcement
side. Education, communication and building up the capacity of
everyone concerned, whether it is carers, people who are in care,
local authority homes, parents and young people themselves is
going to have payback. It is not going to have immediate payback.
If we manage to lift the level of knowledge among young people—we
are currently measuring drug use in young people up to the age
of 25—it is going to be quite a time before it begins to
feed through into the take-up and use figures up to the age of
25. I think it is a side of the tragedy that we cannot neglect.
Angela Watkinson: Thank you, Minister.
Bob Russell
1316. Minister, would you like to comment on
how many ecstasy pills a week are taken in Britain, the official
figure or the unofficial one, or are they the same?
(Mr Ainsworth) There was a Home Office
report that suggested that 26 million a year were being taken.
There was a serious rider in that report, as I tried to say earlier,
about the methodology that had been used and people were lead
in the report itself to take this figure with great caution. It
is not often that the media do not look at the headline figure
and give the same prominence to the rider that is given in research
like this.
1317. Two weeks ago The Observer said
the figure is really two million ecstasy pills a week are taken.
Is that an exaggeration?
(Mr Ainsworth) In my opinion, as I said
before, the best and most reliable figure to use if you want to
look at prevalence is the British Crime Survey. The British Crime
Survey indicates that five per cent of young people have taken
ecstasy at some time in the last year.
1318. Finally, Minister, in the advice, education
and the rest of it that is going on are the young people warned
that the equivalent of one class every year dies from ecstasy—27
people died last year—is that information brought home not
them forcibly?
(Mr Ainsworth) If they contact the National
Drugs Help Line there is detailed, solid, comprehensive advice
on the consequences of taking any particular substance. We ran
a programme over the Christmas and New Year period trying to ward
people off excessives, that might involve drugs over the holiday
period. It was almost exclusively focused on people using the
National Drugs Help Line and we saw as a result of that advertising
campaign a 20 per cent increase in use. Most interestingly, a
10 per cent increase in use from young males, who are usually
about the hardest I am told—I cannot remember when I was
young male—to get through to. That was a specific decision
we took. What do we do with regard to our communications, and
we decided that the best way would be to lead people to credible
information, because they do get this appalling advice from their
friends, sometimes without any knowledge whatsoever. They are
confronted with taking some substance but do not know what it
is, do not know what potentially it will do to them. It does not
lead to addiction in the case of ecstasy but it can put them in
a life-threatening situation.
Mr Watson
1319. Minister, can I take you to the field of
public health. We have had a lot of evidence and submissions to
say that we really are not spending enough time and effort on
harm reduction. People have said that we are on the verge of a
hepatitis C epidemic amongst drug users. I do not want to pre-empt,
and I know you are not going to pre-empt, the review of the National
Drug Strategy, but could you see other elements of the strategy
which specifically target public health goals?
(Mr Ainsworth) I think the Home Secretary
gave you an indication this is an area we wanted to look at and
whether or not we should be upping the emphasis that is given
to harm minimisation. There was a lot of work done on harm minimisation
in this country around HIV and a degree of success was achieved
by that work but there are other issues. Drug-related deaths are
something which has given a greater emphasis to it, for instance,
in the Scottish Strategy than it has currently in the English
and Welsh Strategy. So while a lot of harm minimisation procedures
are already in place, it is something we are looking at as to
whether or not we should be lifting this up the agenda.
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