Examination of Witnesses (Questions 1220-1239)
JOAN RYAN
MP, AND MR
VERNON COAKER
MP
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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