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John Mann : My right hon. Friend has mentioned treatment, but is there any chronic, relapsing disease other than drug addiction that those who provide the treatment paid for by the state need have no medical qualification to do so? Is there any other condition that I could set myself up to treat and potentially receive money from his Department for doing so?

Mr. Clarke: That is an important and difficult question. When the National Treatment Agency was established—I was a junior Minister in the Department at the time and involved in the discussions—there was much controversy about whether the appropriate form of treatment for particular conditions at particular times was medical or not. A range of provision existed around the country. One of the aims of the NTA was gradually to reach an agreement about the best form of treatment—medical and non-medical—for certain conditions. Since being appointed, I have asked the question that my hon. Friend asks, and I believe that we are closer to being clear about the best form of treatment for particular conditions.

Mr. Iain Duncan Smith (Chingford and Woodford Green) (Con): I have spent much time in the past few months visiting many centres in the inner cities that deal with drug rehabilitation, and I have identified some serious problems with the way in which the Government are currently thinking about the issue. For a start, they need to stop talking about treatment and start talking about rehabilitation. Treatment includes detoxing, and that is a temporary affair at best. Rehabilitation is the only way ahead. The Secretary of State should look further than what is happening in Britain, because some other countries are way ahead of us. Sweden is a classic example, which has a high success rate in rehabilitation. It has a tough policy: a person has to take the rehabilitation course immediately they have been tested
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and found to have been taking drugs or they face criminal penalties. The rehabilitation course starts the following day. It is a residential course that can take months and includes mentoring back into the community. It is expensive, but Sweden's addiction rates are far lower and, as a result, its crime rate is far lower, too.

Mr. Clarke: That is a helpful intervention. I agree with the description that the right hon. Gentleman gives of the Swedish approach, which does give people the hard choice that he describes. I agree that that is where we want to be. Why are we not there yet? It is because we cannot immediately make available a course of treatment or rehabilitation—whatever we call it—but, as I said to my hon. Friend the Member for Stoke-on-Trent, North (Ms Walley) a moment ago, we are committed to reaching that point. We have made significant progress.

The question about the most appropriate form of rehabilitation, treatment or therapy—I use those words in different ways—is important. Even before I started my present job, I was aware that many people had opinions about the success or failure of particular approaches to the problem. The only way to decide that is to call in top medical opinion and monitor what happens in various programmes. That is what we are doing to try to improve the quality of what is available. The core solution is the one that the right hon. Gentleman implied in his question—to ensure that the best solution, whatever it is, is available from day one, so that the choice he describes can be offered. In some parts of the country, we are close to that point, but we are not yet there across the country. Clause 8 is intended to enable us to provide what one might call the Swedish choice.

Brian Cotter (Weston-super-Mare) (LD): My constituency contains more than 10 per cent. of the drug rehab beds in the whole country. Will the Home Secretary personally consider a report that has just been produced by the police and other agencies in the area, because I think that he would find it helpful in addressing the issues before us? We have many concerns in Weston, with many people coming to the area from other parts of the country and, if I may, I shall send him a letter with details of that and the report. We are especially concerned about cracking down on unrecognised and unauthorised rehab centres that promise rehabilitation but do not necessarily provide the best programmes to achieve it. Will that also be investigated?

Mr. Clarke: I look forward to receiving the letter and reading the report to which the hon. Gentleman refers. He illustrates the approach that I have described. It is important to examine the record of particular approaches in particular circumstances. That is what the National Treatment Agency and the professionals in the field are doing. I have just been told by the Under-Secretary of State, my hon. Friend the Member for Don Valley (Caroline Flint), that Sweden, when it reviewed the situation, decided not to proceed with some forms of treatment or therapy after such monitoring. Across the world, people are considering each stage of rehabilitation carefully. Our problem is
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that the treatment programme has not been strong enough, until recently, for us to say that any proper programme was on offer. Our first ambition was to reach the point at which options for treatment were available. We have reached that point, but our second ambition is to ensure that those options are universally available. As part of that, we need to monitor and review the treatment properly.

Paul Flynn : While my right hon. Friend considers the Swedish experience, which has seen a recent relatively large increase in drug use, will he also consider the Portuguese experience? In 2001, Portugal decriminalised all drugs, which meant an immediate drop in the number of prosecutions from 2,005 to fewer than 13 in the last year. Drug deaths have also halved and the number of AIDS cases—[Interruption.] This is more serious than the intervention by the right hon. Member for Chingford and Woodford Green (Mr. Duncan Smith) because the number of deaths in Portugal has halved from 369 to 132. More people use the prescribing system, but the number using drugs has fallen.

Mr. Clarke: My hon. Friend is well known for making that argument over many years and he is entitled to make it. It is self-evident that if something is decriminalised, there will be fewer prosecutions for it, so that does not tell us anything. The interesting question arises from the other points that he made. The short answer is that I will consider the Portuguese experience, as I will look at every option, but I do not believe that decriminalising drug abuse is the right approach. Indeed, it is the exact opposite of the right approach. As the right hon. Member for Chingford and Woodford Green (Mr. Duncan Smith) said, the core issue is the relationship between the criminal justice system and proper treatment or rehabilitation. That is the approach that we need to take to resolve the situation, not least because nobody should minimise the massive impact of drug abusers and their behaviour on the civil liberties of regular citizens. It is our obligation to address that.

Mr. Michael Clapham (Barnsley, West and Penistone) (Lab): The National Treatment Agency has suggested that the drop-out rate is due more to the procedures in clinics than anything that is wrong with the clients. It is clear that we need to spread best practice through the system, and it is important that my right hon. Friend meets the Secretary of State for Health to decide how that can best be done.

Mr. Clarke: My hon. Friend is right. We need to keep learning. For example, the user groups associated with some drug action teams can give genuine feedback on what approach made a difference. I do not pretend that there is a universal solution—a magic wand that can be waved to solve the problem for every individual. People develop drug abuse habits in various ways, and various means will be needed to tackle their problems. I am encouraged to see that we are beginning to make substantive progress, as the figures that I gave earlier suggest. That provides the basis for further progress in the future.
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Dr. Iddon : What would my right hon. Friend say to civil liberties groups such as Liberty that say that testing for class A drugs at arrest rather than at charge is setting a dangerous precedent? Does not that criminalise people de facto, ask Liberty and similar organisations?

Mr. Clarke: With all respect to Liberty, I fundamentally disagree with that view—strongly so. We have to get drug abusers who come into contact with the criminal justice system into treatment—whether rehabilitation or whatever word we use—as rapidly as possible. That is the core. No one has a right to abuse drugs, especially when we see the consequences of that abuse in so many aspects of crime. I understand my hon. Friend's concerns; he is well intentioned and has been a clear campaigner on civil rights issues of that kind, but if the choice is between the civil rights of a drug abuser or of those who are abused by the drug abuser, I choose the civil rights of those who are abused by the drug abuser. That is what lies behind the orientation of the Bill, but my hon. Friend is right to raise that point.

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