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John Mann (Bassetlaw) (Lab): The Bill, although limited in scope, contains one provision that, slightly amended, would provide a tremendous opportunity to enhance drugs work throughout the country. I shall deal with that in some detail later.
The underlying problem in our debates about drugs is that we talk about drugs in general rather than the different types. If we were discussing cancer care, hon. Members would talk about the range of such care.
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For example, the diagnosis and treatment of skin cancer cannot be equated with that of liver cancer. Nobody would contemplate not differentiating in a debate on funding and organising the health service to tackle the problems of cancer. We do not do that when we discuss drugs, yet there is a great range of different drugs. We discuss the treatment for heroin as if it is the same as that for cannabis, anabolic steroids or cocaine. The treatments are different—sometimes there is a crossover, but sometimes they are entirely different. That is one of the big weaknesses in our approach to drugs.
Let me consider the specifics of the Bill. Clause 1 mentions the "vicinity of a school". When I conducted an inquiry in my constituency, 3,000 constituents wrote in and gave evidence at my instigation. More than 200 expressly made allegations about drug dealing outside the school gate. They were highly precise and they named individuals. That was a major cause of concern, especially for parents. It is obviously something that a Member of Parliament would pick up. I therefore methodically spoke to those people and found that they were wrong. Their thoughts were not wrong but they were wrong to suggest that there was evidence. They all had an anecdote but none had evidence.
I went into schools on many occasions to discuss the issue with pupils, especially but not only sixth formers. I asked them about drugs in school, at the school gate and outside the school. It would be accurate to summarise their response as deriding my suggestions. A comment was often repeated: "Why do you think we'd be stupid enough to buy or sell drugs in or just outside school? If we want drugs, we know where to get them and we'll get them. These are the kind of places where we'll get them." Parties were especially mentioned, but also premises where drugs would be supplied from time to time and individuals who were known to possess specific types of drug.
There was fairly widespread knowledge, especially in some schools, about who could supply drugs, and indeed who should be avoided. However, the idea that people would bring drugs into school or that dealers would wait at the school gate was laughed out of court. That was a great surprise to me, because although I did not believe that the problem could be tackled easily, I presumed that it could be highlighted and that something could be done about it. Only one incident could be found in police records, and it occurred significantly nearer my office than any school. Indeed, it was nowhere near a school gate. We need to consider what we mean by
particularly in the light of the proposal from the hon. Member for Ribble Valley (Mr. Evans) about aggravation in relation to sale to a minor. Whether we refer to any changes as strengthening or altering the law is really a political point, but we should be more precise.
We should not give a false impression to the population at large that drugs are a major problem in and around schools. My contention is that that is not the case. Drugs in the community are the problem, not drugs in schools. These measures give our schools a bad name, and if we do not analyse the real problems, the solutions that we as legislators introduce will be the
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wrong ones. I therefore strongly recommend that the Government reconsider not the principle of what they are trying to achieve but whether their proposals will in fact achieve it. I do not think that they will.
My second point relates to drug testing, of which I am totally in favour. Indeed, I might go even further than the Government in this regard. Drug addicts, particularly heroin addicts, repeatedly say to me, "Test us, stop us, force us, coerce us into treatment." There is obviously no opposition from the general population to compulsory drug testing, but the drug-using population in my area also supports it. It could also be extended to drug users returning to work. The testing might need to be voluntary in those circumstances, but not necessarily. Large employers in my constituency who refuse to take people on who have a criminal record for theft—which nearly always relates to their having previously been a drug addict—would do so if drug testing were available to them.
I am suggesting that there should be compulsory drug testing, and that people with a criminal record for theft or for drug addiction who apply for jobs should accept that as perfectly reasonable. What form should such a system take? There is an important opportunity for union negotiation in this regard. I am involved in discussing with certain unions the possibility of establishing a fair and appropriate system that would give people the chance of re-entry into the workplace.
The testing proposed in the Bill is a separate issue. The provisions talk about class A drugs, but I want to ask the Minister why we should not include class B drugs—especially amphetamines—as well. The problems caused by amphetamines are as great as those caused by cocaine, crack cocaine and heroin. They do not cause the biggest problems here—indeed, they are quite a small problem in my area—but amphetamines are the major problematic drug in countries such as Australia.
Mr. John MacDougall (Central Fife) (Lab): Glasgow council and Central Fife council have introduced a system of drug treatment and testing orders, which offer an alternative to imprisonment for people indulging in drugs. They are given the opportunity to rehabilitate rather than go through the judicial system. Does my hon. Friend agree that that would be of benefit?
John Mann: I commend that approach as more effective and more cost-effective to the taxpayer.
To return to the classification of drugs, I believe that the whole range of amphetamines should be reclassified as class A. I would like, however, to suggest an even better system. There should be three classes of drugs. The first should contain those drugs that are legal but damage people's health, such as nicotine, alcohol and certain over-the-counter drugs. Such drugs are likely to cause damage to people's health but not to the rest of the community, although perhaps we could argue about alcohol in that regard.
The second class of drug should include those illegal drugs that happen, conveniently, to be in class C at the moment. It should be made explicit, however, that they can damage people's health but taking them is unlikely to lead to anyone taking action that would damage other people. In my view, it was right to reclassify
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cannabis as a class C drug, although I come to this argument from a slightly different angle from the Government. Cannabis can cause significant damage to health but it does not lead to people behaving in a way that would cause damage to others.
The third class of drug should contain those that we now call class A drugs—there would need to be some changes in the classification, involving the total removal of class B—which damage people's health and are likely to lead them take action that would damage the community. We know that people who take cocaine and crack cocaine regularly are likely to be more violent. We also know that people who are addicted to heroin are likely to steal to feed their addiction. Amphetamines fall into both the second and third categories, which is why I feel they should have a higher classification.
Those should be the three categories of drugs: two containing illegal drugs, the third covering legal ones. Some of the non-debates that we have about cannabis—we seem to have an obsession with cannabis—could be conducted in a more constructive context if that were the basis of drugs classification, because that is the basis on which we police those drugs, and rightly so. It also ought to be the basis on which we resource action against them. The highest priority ought to be given to those drugs that will cause damage both to people's health and to the rest of the community.
Mr. Clapham: I hear my hon. Friend's proposal for the three classifications. Will he accept, however, that a cannabis user who also drinks can present a real problem so far as antisocial behaviour is concerned? Part 4 of the Bill introduces the means of tackling such problems. In my community, cannabis dealers have been dealing to young people who have then gone out drinking. The drinking has fuelled antisocial behaviour and caused huge problems. We need to bear it in mind that there is a crossover point.
John Mann: I am no supporter of being weak on cannabis. It is a very dangerous drug in terms of the health ramifications involved in its use. I am not sure that it is the cannabis that is causing the antisocial behaviour in my hon. Friend's constituency, however—I have seen no evidence that it can do so—whereas excessive use of alcohol is clearly directly related to antisocial behaviour and other criminal activities. This is the only lack of logic in my argument. We could say that there should be two categories of legal drugs. The important point, however, relates to illegal drugs. We should place drugs that damage people's health in one category, and those that also make it likely that their user will cause damage to the community in another. That would allow us to have a much more effective debate and to take more effective action on drugs.
My third point on the contents of the Bill is by far the most important. A slight amendment would give us the opportunity to revolutionise drugs treatment, particularly for users of heroin but also for users of other drugs such as amphetamines. My proposal relates to the definition of assessors and follow-up assessors. The biggest weakness in drug treatment in Britain is without question the vagueness of the assessment procedure. Unless the Government are proposing any changes in this regard—I do not see any in the Bill—an assessor or a follow-up assessor may come from any of
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a whole range of professions. A psychiatry student straight out of university could be asked to make an assessment of a person's drugs treatment, for example. That is my experience, and that, in my experience, is why so much drug treatment in this country does not work.
The situation in my constituency is fascinating. Two areas are particularly unsuccessful when it comes to drug treatment. The figures are astronomically different. One small area, Worksop, is covered by Mansfield primary care trust, which does not regard drug treatment as its responsibility—it believes that primary care should not be taking the lead. The same applies, incidentally, to all other Members' local PCTs. As far as I know, the only PCT in Britain that takes a lead is Bassetlaw. My constituents in Worksop with drug problems go and see, perhaps, a young psychiatry student just out of university, who tells them "You have a drug problem," and refers them on—and on, and on. Those who live in Bassetlaw go and see a GP. They do not see just any GP. They do not see the GPs people living in Worksop and Mansfield might eventually see—GPs who do not get jobs in practices when they apply for them. The GPs in Bassetlaw are highly professional, and people living there go and see them, unless they are subject to drug treatment and testing orders.
If someone has a DTTO, a probation officer makes the decision. The only constituents in Bassetlaw who do not manage to see a GP for drug treatment are those with DTTOs. Some do, but not all do. A probation officer can look me in the eye and tell me what drug treatment should be given—what substitute drug should be prescribed, and what the dosage should be. That is the system that we have in Britain. That was the mess we had in Nottinghamshire, and still do in some parts of it. That, indeed, is the mess that we have in most of Britain.
Were we to include in the Bill the modest proposal that the assessor could be the local GP—or, far better, should be, but I think the response would be that the health service is not quite ready for that—it would provide an opening to a drug treatment service that would work in most parts. Sweden has now moved away from residential rehabilitation, which is not particularly successful, and towards a GP-led service that is highly coercive. Someone caught with drugs in Sweden can be put straight into a secure unit—it is called a hospital—with locked doors. They will stay for five days, and when they come out their GPs will treat them. I would love to see that system operating in Britain. Sweden resources it very well.
Although the Swedish system is not residential rehabilitation—one of the Opposition parties seemed confused about that—it is coercive, and it is compulsory. The parents of young people must accompany them to counselling sessions, and I think we could adopt that model as well. In my area, coercion is not the problem with DTTOs—quite the reverse: the problem is the treatment modality.
Two years ago, only two people in my area were being treated by a GP. Today the figure is about 320. I do not have the precise figure, because it is rising daily. Virtually no one has dropped out: the drop-out rate is no more than 2 or 3 per cent. The figure has been rising for 18 months, so this is not a flash in the pan. Strangely,
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crime has fallen during the same period. The average number of burglaries in west Bassetlaw is down from 80 to 20 a day. I believe that that is the biggest fall in acquisitive crime in Britain. I stand to be corrected, but that is what the police tell me. The reason is simple: all the drug addicts who were doing all the thieving, burgling and shoplifting, or at least a significant proportion of them, are now having treatment.
There are other benefits to the economy. Some of those people are returning to work, and instead of being benefit recipients they are becoming taxpayers. They are contributing to society. I think that that is a rather good definition of rehabilitation. People can go to their own GPs in their own communities. What is the first thing most of us do when we move house? We register with a GP. In a sense, that defines living in a community. It is wrong that a person's own GP should not be prepared to treat that person for an illness that is having an impact on the rest of the community. More than just medical treatment is needed from GPs: psychological treatment is important as well.
All the evidence from Sweden, France and Australia suggests that when people go back to work, the vast majority no longer commit crimes and do not use the drugs that were causing them problems earlier. There are other benefits. Two years ago, 173 people were admitted to Bassetlaw hospital's accident and emergency department following drug overdoses; in the past 12 months, 39 have been admitted. The situation is much better for my constituents, who no longer see so many drug addicts clogging up the accident and emergency queue, and it means a phenomenal saving for the hospital.
There is even better news about in-patient admissions for drug-related illnesses. Deep vein thrombosis is the main reason for a heroin addict to be admitted. Two years ago, at any one time two beds in Bassetlaw hospital would be occupied by drug addicts. Other patients stood a fairly good chance of having a drug addict in the bed next to them. That has been reduced by 400 per cent.
There is a further saving to the health service. The hospital's main worry was that drug suppliers—friends of patients, rather than dealers—would go on to its premises to provide heroin or amphetamines for their friends. That is now a very small problem, because hardly any addicts are occupying hospital beds. The most startling development, although it is not one that most of the community is bothered about—it mainly concerns the mothers and families of addicts—is that whereas two years ago there were 11 overdose deaths, there has been none in the past 12 months. Those statistics are not mine—they are official, although that does not necessarily mean that they are undeniable. Because they mirror what has happened in France, Australia and Sweden, they should dictate what we do here, especially when it comes to treatment for heroin addiction.
I recently met the prisons Minister, my hon. Friend the Member for Wythenshawe and Sale, East (Paul Goggins), who told me that the Prison Service was adopting essentially that approach. I am pleased about that, because it is the right approach, but it should be built into the Bill, because giving assessment duties to probation officers or drugs workers—whatever that means—constitutes a fundamental weakness. We
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should be methodically beginning to ensure that whatever treatment is provided is under the control of a person's GP. If a GP wants to refer someone for residential treatment for a week, a month or six months, that is excellent if it is appropriate for that person. If GPs want to involve specialist mental health care, as those in my area regularly do, they should be able to. The GP should be the pivotal point in the treatment. That is the big difference between us and countries that have been far more successful with drug treatment.
Modest though the Bill is, with those slight amendments it could put real pressure on the health service to deliver. The levels of crime reduction and health improvement that we are seeing in my area could then spread to the rest of the country.
2.59 pm
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