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Mr. Henry Bellingham (North-West Norfolk) (Con): It is always a pleasure to follow the hon. Member for Bolton, South-East (Dr. Iddon), who I think followed me in the previous debate in this House on drugs. I secured an Adjournment debate on the case of Dr. Adrian Garfoot, to which the hon. Gentleman very kindly contributed. Dr. Garfoot is a constituent of mine, and I shall say more about the case a little later.
Drug addiction is probably the biggest blight on modern society. It costs many lives, and causes untold misery in thousands of families across the land. In 1954, 317 addicts were registered in this country, but the number had risen to 1,729 by 1967. Last year, 4 million people in the UK used drugs, and the Home Office estimated that 1 million of them used cocaine. Roughly 500,000 of those 4 million people are problem drug users. Replying to parliamentary questions from me, the Minister has said that there are 345,752 problem drug users in the nine English regions. In September last year, a written reply from the Department of Health stated that only 125,913 problem drug users were receiving structured treatment. That means that 219,827 get no treatment at all.
A number of hon. Members on both sides of the House have pointed out that most addicts are forced into a life of crime to feed their habits. The criminal justice costs of drug addiction are estimated at £16 billion a year. That is hardly surprising when the Metropolitan Police Commissioner estimates that 75 per cent. of all burglaries, robberies and muggings in his force's area are drugs related.
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The supply of controlled drugs, as the hon. Member for Bolton, South-East pointed out, is a vast industry worth more than £8 billion a year. There are more than 100,000 dealers in the UK, but last year fewer than 10 per cent. were convicted of drug dealing. As my right hon. Friend the Member for Haltemprice and Howden (David Davis) pointed out, with profit margins of up to 3,000 per cent., dealers can make a fortune.
I have described the context in which we should consider the Bill and judge whether it will have any impact or help those who most need it. I have maintained for some time that the criminal justice system has a key role to play in tackling drug addiction and its causes. Indeed, the drugs intervention programme is a good mechanism for identifying, assessing and diverting drug users into treatment. The Government are right to include in part 1 measures to make it an aggravated offence to be found dealing near schools or to use young people as mules to run drugs.
The Bill will give the police greater powers in relation to dealers who swallow drugs or hide them in body cavities. The police will be able to order X-rays or scans, and magistrates, as my hon. Friend the Member for Ribble Valley (Mr. Evans) pointed out, will be able to remand in custody suspects whom they believe to have swallowed drugs for a period of up to eight days. I support that change.
I have some reservations about clause 7, which contains a key proposal to amend the Police and Criminal Evidence Act 1984 to allow for drug testing after someone has been arrested for a so-called trigger offence. If that test is positive, the person will have to attend an assessment so that a case plan can be drawn up. At the moment, as several hon. Members have pointed out, a drugs test can be administered only if someone is actually charged. We will discuss the issue in greater detail in Committee, but in the meantime I share some of the reservations of organisations such as DrugScope and Turning Point.
The main emphasis in the Bill is on the punitive approach and the criminal justice system. However, an equally important priority should be ways to make treatment more effective. The Bill is mostly concerned with those drug users who come to the attention of the criminal justice system, but much more needs to be done to help people before they turn to crime. The national treatment outcomes study estimates that for every £1 spent on treatment, £18 of cost to the criminal justice system can be saved. I was therefore surprised when the Home Secretary said that the figure was £3. Perhaps he was using different statistics from another organisation.
I am also concerned about the large numbers who drop out of treatment. Indeed, in a recent report, the Audit Commission estimated that 34 per cent. of drug users who leave treatment drop out within the first 12 weeks. According to the National Audit Office, of those offenders who received a community sentence, such as a drug testing and treatment orderwhich requires that the offender undergo treatment instead of receiving a custodial sentencein 2003, only 28 per cent. completed the programme. We should not forget those people who have not committed any crime but who could be prevented from committing one by prompt access to treatment.
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I have some concerns about omissions from the Bill. Several hon. Members have pointed out that many people who are dependent on drugs and, in some cases, alcohol also have mental problems. In fact, one third of patients in mental health services have drug or alcohol problems. Many users are falling through the gaps and end up being passed from agency to agency. Furthermore, one in three problem drug users are either homeless or in need of housing support.
Mr. Pound: I am following the hon. Gentleman's argument with great interest. As ever, it is intelligent in every way. Is he saying that the addiction follows the illness, or that the mental illness follows the addiction?
Mr. Bellingham: I was saying that the two are often interrelated. There are people with mental illness who happen to have addictions and there are addicts who have mental illness. There is an obvious crossover between the two and that must be recognised.
As I said, many of those people have other serious social needs; many of them are homeless or in need of housing support. I was interested in the intervention by my right hon. Friend the Member for Chingford and Woodford Green (Mr. Duncan Smith), who referred to the scheme in Devon, the C-FAR scheme set up by a former Royal Marines major who helps people to work their way back into the community. I feel strongly that services must be able to deal with all aspects of a person's life and place greater priority on providing aftercare for addicts who are leaving treatment.
Mrs. Gillan: My hon. Friend is making an extremely interesting and cogent speech. Trevor Philpott's C-FAR operation is much to be admired. Does my hon. Friend agree that current thinking in some parts of the medical profession, especially the work being carried out by Professor Robin Murray at the Institute of Psychiatry, shows a clear link between cannabis use and the development of inner city psychosis? More such evidence is coming to light and that makes it even more imperative that we look closely at the available scientific and medical evidence, as cannabis is not the innocuous drug that everyone thinks it is.
Mr. Bellingham: I am extremely grateful to my hon. Friend for that information. I do not know whether she has visited C-FAR, but I certainly want to do so to look at the work that Major Philpott is doing. My hon. Friend is probably aware of the report issued today by the Royal College of Physicians, which comments on the serious damage that can be done by the stronger types of cannabis; younger people can end up with serious mental illness.
If treatment services do not deliver, addicts will not be able to rebuild their lives and return to society as productive and fulfilled members. Another omission in the Bill that the Government will have to address is the need for investment in staff training. There is a real recruitment and retention problem at all levels. A recent study by DrugScope estimated that there are at least 3,000 too few key staff with specialist knowledge in drug treatment centres. What does the Minister plan to do to improve the status of all staff who work with substance
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misusers? What do the Government plan to do about investment in the training, development and retention of staff? When the Minister winds up the debate, perhaps she will touch on that point.
There is a need for far greater investment and training to encourage general practitioners to work with patients with drug problems. GPs are a key resource and can help people to access other services. At present, there is a huge shortage of GPs qualified to deal with drug misuse and there is no co-ordinated infrastructure to support them. There is obviously a need for much greater liaison and partnership between GPs and specialist agencies, including many in the voluntary sector.
The hon. Member for Bolton, South-East mentioned the case of Dr. Adrian Garfoot and I, too, want to mention that extremely serious and unfortunate case as Dr. Garfoot is my constituent. Dr. Garfoot trained at the Royal Free Hospital school of medicine and was a GP in Yarmouth and Kilburn. During that time, he developed a deep interest in, and awareness of, the drugs crisis and the plight of drug addicts. In 1990, he opened the Laybourne clinic in east London, which soon became a renowned centre of excellence. During the 10 years from 1990, the clinic treated more than 1,200 patients whose typical age was 37 and a halfsubstantially older than the average age of patients in NHS clinics, which was 29. The overwhelming majority of Dr Garfoot's patients were long-term addicts who had been injecting themselves for anything from between 20 and 30 years and who maintained their habit through crimes such as theft, burglary, drug dealing, prostitution and so on.
At one point, it was calculated that the 270 patients attending the clinic had between them spent more than 600 years in prison. It is interesting that the recidivism rate for the drug addicts at the end of the treatment given by Dr. Garfoot at the Laybourne clinic was only 7 per cent., whereas the recidivism rate for those leaving the Prison Service was 50 per cent. In other words, Dr. Adrian Garfoot was able to rebuild the lives of many people, deal with serious medical conditions and restore family relationships, so I appreciate the praise given to him by the hon. Member for Bolton, South-East.
Most importantly, Dr. Garfoot enabled those people to get on with a normal life and keep out of trouble. I have calculated, with the help of several independent experts, that Dr. Garfoot probably saved the country more than £10 milliona remarkable achievement. His prescribing policy was based on harm reduction and non-coercive user friendly protocols. Above all, he used his clinical independence. He put in place voluntary and supervised withdrawal programmes. No patient ever died from an overdose during his time at the Laybourne clinic. There was one suicide when medication was seized by the police, with the result that the local hospital refused to help.
It is worth pointing out what the National Treatment Agency of Substance Misuse has said in its recent guidelines and press releases. I quote Professor John Strang:
"The message for specialist clinicians is that yes, injectable heroin and injectable methadone have a role to play in the treatment of drug misusebut it's a limited role and one that needs to be developed very carefully".
There is no evidence at all of any diversion of drugs during Dr. Garfoot's time at the clinic. He was always incredibly assiduous in preventing the diversion of prescribed drugs to the wider community. However, back in 1992, there were complaints. Later, there were further allegations, and he was summoned before a Home Office misuse of drugs tribunal on charges of alleged irresponsible prescribing. After an analysis of 1,500 prescriptions, there was no sign of any discrepancy whatsoever. Dr. Garfoot was cleared by the then Home Secretary and there was a finding of abuse of process against his accusers. The cost of that case ran into thousands of pounds.
In 2000, however, the interim audit committee of the General Medical Council imposed serious restrictions on Dr. Garfoot. He then went to the professional conduct committee of the GMC in September 2001, and there was a finding that his name should be erased from the medical register on the grounds of serious professional misconduct. He took a decision to appeal to the Privy Council, but, unfortunately, he lost.
It goes without saying that the case has been a total disaster for Dr. Garfoot, but it is also been an even bigger disaster for the patients at the clinic. The clinic carried on for a while after Dr. Garfoot left, but it was unable to continue to provide the same level of treatment. A number of patients left, 21 of whom have subsequently died. Many others have returned to a life of crime and prostitution, and they are now back on the conveyor belt that leads to crime, inadequate treatment and back to crime again. Only last week, Dr. Garfoot told me that he had two very distressing calls from former patients who were in total despair about the lack of treatment available to them.
What is also very unfortunate about the case is that, following the Shipman caseno doubt, with the best of intentionsthe then Secretary of State for Health, now Chancellor of the Duchy of Lancaster, the right hon. Member for Darlington (Mr. Milburn), insisted that the GMC should increase the period before which a doctor erased from the medical register could apply for reinstatement from 10 months to five years. An exception was made for doctors whose cases had been completed already. No doubt as the result of an oversight, no such provision was made for those whose cases were currently in progress.
At the time, I wrote to the Secretary of State to say how desperately unfair that was to Dr. Garfoot. He had been advised in writing at the outsetthe hon. Member for Bolton, South-East has seen the lettersthat restitution could be applied for after 10 months. His case was conducted from beginning to end in line with that regulation. It was not until the case had been completed that he was informed of the changed procedure. I simply submit that natural justice must cut in and lead the Secretary of State to intervene. He should investigate not only the case of Dr. Garfoot, but those of several other doctors in exactly the same position.
As the hon. Member for Bolton, South-East pointed out, in the year in which Dr. Garfoot was struck off, 20 other prescribing doctors suffered a similar fate. One such doctor was Dr. John Marks. After his clinic in Widnes closed, 42 deaths occurred in two years. The hon. Gentleman also mentioned the case of the
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Stapleford clinic, which is ongoing and thus sub judice. The situation is serious because we are losing doctors such as Dr. Garfoot.
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