Select Committee on Science and Technology Minutes of Evidence

Examination of Witnesses (Questions 1220-1239)


14 JUNE 2006

  Q1220  Dr Harris: I do not think they do say that. Let us be very clear, because you have said three times now that you take advice from the ACMD; that the ACMD appear to take evidence; and that you are happy and they are happy that there is evidence. I quote Professor Nutt who chaired the ACMD Technical Committee, who argued to us that a more scientifically based scale of harm would be of value in the situation. He said, ". . . in education the message has to be evidence based. If it is not evidence based, the people you are talking to say it is rubbish". He co-authored a report that said that, with respect to the correlation between the class of a drug in the current ABC system and its harm score, calculated using their—I would say scientific—approach, was so low that it was "not statistically significant". So your main source of advice says that there is not enough evidence out there and the ABC classification in relation to harm has a non-statistically significant correlation. You should be furious about this: that your whole policy is based on an evidence vacuum.

  Mr Coaker: We do not believe that it is based on an evidence vacuum. There is always a need to improve; there is always a need to look at the evidence that you take. However, as I say, the Nutt matrix forms part of the harm index matrix that the ACMD uses itself in order to determine the recommendations they make to us. They have a number of headings that they use. There are priorities within that. They score that according to the various priorities. There are nine priorities, I believe, and they score that. Then that determines the recommendations they make to us. So there is a matrix; there is a harm index which they use. That itself is influenced by Professor Nutt's criteria.

  Q1221  Chairman: Why is he so critical, though?

  Mr Coaker: That is something he has every right to say. We will always look at people who have criticisms to make; suggestions about improvements, and so on. The point I am making, however, is that the ACMD—which is a statutory consultee for the Government—does work according to a harm index which it uses to score drugs which it believes to be harmful. We will come back to a drug where it has actually used that in order to determine harm. It is fair comment and we will need to look at the comments Professor Nutt has made. That may be his individual view but, as I say, on the ACMD we have that harm index which is used by them.

  Q1222  Dr Harris: Professor Nutt's quote that I gave was from a paper where he was calling for the scale to be a rational scale of harm. You say there is evidence. Are you aware that the amount we spend per head of population on addiction research is a hundredth what the Americans spend, and that the budget is somewhere between a hundredth and a thousandth? That is not a judgment call as to whether we are not spending enough versus other priorities. It is just 1% per head of the population of what the Americans spend.

  Q1223  Mr Coaker: On . . .?

  Q1224  Dr Harris: On research into addiction—which would include the evidence base around this. It is a real problem.

  Mr Coaker: As I said to what Brooks was saying, the money that has been made available to drug treatment programmes and this whole area of work has increased significantly. There is always the question of where you spend that money. It may be addiction that should have more spent on it, alongside some of the other priorities that you have. So there is always a scale of priorities. One of the things we can do as a result of the report that the Committee will no doubt make about it is to have a look at that, to see whether it is appropriate for us to look at the amount of money that has been spent on it.

  Q1225  Dr Harris: To what extent do headlines in the newspapers influence, as a politician, your policy in this area? Do you use the newspapers as a proxy for public opinion?

  Mr Coaker: No, certainly not. We try very hard to have a drugs policy, which we drive according to what we think is in the best interests of the population and the best interests of the communities that we all represent. Going back to what I thought was Adam's very important point at the beginning, about what is the purpose of the drugs strategy that we have, as I say, it is about enforcement; it is about education; and it is about drug treatment. Obviously, within that there will be disagreements and debate about the best way of delivering all of those objectives. We are not driven by headlines; we are driven by what is best for the people that we seek to do our best for.

  Q1226  Adam Afriyie: If there were a town, a city, or a country elsewhere—outside Britain, obviously—that had been almost totally successful in reducing the use of drugs and in getting rid of the harmful effects of acquisitive crime around drugs, would you be willing to look at that example, even if it meant that you had to re-look at the classification system?

  Mr Coaker: I think that it would be very arrogant of anybody to say they would never look at what anybody else is doing, or try to learn. Indeed, part of what the Select Committee itself is about is to make recommendations to government about how to improve policy. Obviously, you have to look at that and consider it. Whether you then say, "This is applicable to our situation; this is applicable to our communities; this is something that we will do", is a different matter; but certainly you should always look at what is going on, try to learn from other people, and see whether it is applicable.

  Q1227  Chairman: Our concern, Vernon, is the way in which the Home Office goes about researching, getting proper evidence on which to make its policies. That is a genuine concern for us, which is why we are bringing this to you.

  Mr Coaker: That is fine.

  Q1228  Dr Harris: Do you think decisions on classification should—I think that you are saying this, whatever we think of the evidence base—be based on evidence of harm and therefore we classify on that basis, or should it be to send out signals to the public?

  Mr Coaker: I think that what the classification does is categorise drugs according to harm. I also think that it does send out messages; it does send out signals to people, in a way which people understand. I think that most people, if you talk to them, would understand that Class A drugs are the most dangerous drugs. That is the advice we have received from ACMD, from the police, and so on. So I think that it is a balance of those things.

  Q1229  Dr Harris: Andy Hayman, who chaired the ACPO Drugs Committee, told us in oral evidence, "I cannot envisage any user—a dependent user, that is—having any kind of thought as to whether it was a Class A, B or C drug they were consuming". I think the advice he would give, therefore, is that you cannot really send out messages to addicts with your classification system. I am saying that it has to be based on harm.

  Mr Coaker: But is not part of any system with respect to drugs—as I think the Government would argue, and I would argue—not only trying to send messages out to people who misuse drugs but also about trying to send messages out to people out there in the community? So that when teachers are in schools, the parents are there, or the police are working, or whatever, there is a message there about which drugs are regarded by society as the most harmful. I would argue that it is about that as well.

  Q1230  Dr Harris: If it is about that, then surely there should be evidence as to whether that is having any effect? Are you aware of any Home Office-commissioned evidence about the impact of the messages that you are trying to send out? Because if there is not any, then it is just rhetoric, is it not?

  Mr Coaker: It is not just rhetoric, in terms of where we were before. The evidence base for us with respect to the last few years has been in the reduction of drug misuse. It has also been in the evidence that we receive from the ACMD, who advise us on these matters. We come back to this. If this is so unimportant in that sense—or not "unimportant"—if it is so unnecessary, why is it that people make such a big thing about the importance of reclassifying particular drugs? They do that because of the message that it sends out to people, and the belief they have that, by doing that, it sends an important message to people—which helps in controlling the prevalence of that drug.

  Q1231  Margaret Moran: Coming on to the ACMD, we have had evidence from a variety of sources who raised concerns that this independent advisory committee is perhaps not functioning as well as it should. There was concern about the appropriateness of membership, about its expertise and transparency. Mary Brett, who is the UK representative on the board of Europe Against Drugs, asked the question, "Where are the biologists, the neurologists, toxicologists . . . ? . . . there is not a single member of an anti-drugs charity". In other words, in her words, "[the] committee lacks any sort of balance". Where is the independent evaluation of the quality of the ACMD's advice, given those levels of concerns? Would you support the introduction of a regular independent review?

  Mr Coaker: As you know, the Home Secretary appoints the people to the ACMD. Looking at the list, I would say that there is a fair cross-section of people from across society. Does it always mean that every single section and part of society is actually represented? There is always a case for continuing to look at that; for continuing to make sure that the balance is there. We value very highly the advice we get from the ACMD. We believe that it is independent advice. We believe that it challenges us—which is very important. I think that we need to continue always to look at how we improve—

  Q1232  Margaret Moran: I was asking specifically about independent evaluation by the Government of the quality of advice that is being offered, and regular reviews of the quality of that advice.

  Mr Coaker: We always reflect on the advice that we get from the ACMD. Whether there is a case for us to reflect on how we might improve that, what more we might do, is comment we need to listen to and to think about. However, the advice comes in to us from there and we often take further advice on the advice we have received from the ACMD. We often consult with other bodies about it as well.

  Q1233  Chairman: Who do you consult?

  Mr Coaker: We may go out and we may say, "This is the advice". We talk to other ministers. We listen to what other people have to say. These things can often be a case for us listening to what others have to say about the information that we get.

  Q1234  Chairman: With respect, other ministers will not give you the sort of evidence that Margaret is asking for, in terms of that independent review. Who else would do it?

  Mr Coaker: An independent review? Obviously, as ministers, we often go out to consult with people about—

  Q1235  Chairman: Like who?

  Mr Coaker: Not formally, but we informally talk to charities or others about the sorts of policy directions that we have, and listen to what they have to say. For example, only last night drugs charities were in the Home Office, being asked about their views and opinions about the drug policy. So there is a whole variety of ways in which things feed into the decisions that are actually made. There was a formal event at the Home Office yesterday. Lots of drugs charities were there, lots of stakeholders there, talking about—

  Q1236  Chairman: So it is a purely ad hoc process. That is what you are saying?

  Mr Coaker: But there is a process.

  Q1237  Margaret Moran: We talked about the balance of expertise of membership. I referred to that and so did you. The question then is who is appointing this independent panel. Do you not think that the chairman of the committee plays an overly influential role in appointing the panel? Surely the Chief Scientific Adviser should have some role or oversight in this?

  Mr Coaker: The Home Secretary, in the end, is the person who determines the membership of the committee. Looking at the membership we have, I think that there is a fair reflection of the various sections of society across the board who are members of the committee.

  Q1238  Chairman: But it is dependent on the chairman. That is the point that Margaret is making.

  Mr Coaker: Dependent on the chairman to advise him as to who should be on that, but the Home Secretary in the end makes the final decision.

  Q1239  Margaret Moran: Where is the Chief Scientific Adviser in all of this?

  Mr Coaker: Again, who the Home Secretary consults, who the Home Secretary listens to—he will get the recommendations and he will take advice accordingly.

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