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16 Mar 2009 : Column 739

16 Mar 2009 : Column 740

Mark Tami (Alyn and Deeside) (Lab) then claimed the closure on the contingent Question (Standing Order No. 36(2)).

Main Question accordingly put forthwith.

The House divided: Ayes 205, Noes 16.

Division No. 73]
[9.4 pm



AYES


Alexander, Danny
Anderson, Mr. David
Atkins, Charlotte
Bailey, Mr. Adrian
Balls, rh Ed
Barlow, Ms Celia
Barrett, John
Barron, rh Mr. Kevin
Battle, rh John
Begg, Miss Anne
Beith, rh Sir Alan
Benyon, Mr. Richard
Bercow, John
Berry, Roger
Betts, Mr. Clive
Blackman, Liz
Blears, rh Hazel
Borrow, Mr. David S.
Boswell, Mr. Tim
Bottomley, Peter
Bradshaw, Mr. Ben
Brooke, Annette
Brown, rh Mr. Nicholas
Brown, Mr. Russell
Browne, rh Des
Bryant, Chris
Burnham, rh Andy
Burns, Mr. Simon

Burt, Alistair
Burt, Lorely
Butler, Ms Dawn
Caton, Mr. Martin
Chaytor, Mr. David
Clapham, Mr. Michael
Clark, Paul
Clarke, rh Mr. Tom
Clegg, rh Mr. Nick
Clelland, Mr. David
Clwyd, rh Ann
Coaker, Mr. Vernon
Connarty, Michael
Cooper, Rosie
Cousins, Jim
Crabb, Mr. Stephen
Crausby, Mr. David
Cryer, Mrs. Ann
Cummings, John
Cunningham, Mr. Jim
Cunningham, Tony
Davey, Mr. Edward
David, Mr. Wayne
Davies, Mr. Dai
Davies, Mr. Quentin
Dean, Mrs. Janet
Devine, Mr. Jim
Dismore, Mr. Andrew
Dobbin, Jim
Donohoe, Mr. Brian H.
Doran, Mr. Frank
Drew, Mr. David
Ellman, Mrs. Louise
Ellwood, Mr. Tobias
Ennis, Jeff
Fabricant, Michael
Featherstone, Lynne
Flynn, Paul
Foster, Mr. Don
Foster, Michael Jabez (Hastings and Rye)
Francis, Dr. Hywel
George, rh Mr. Bruce
Gerrard, Mr. Neil
Gibson, Dr. Ian
Gilroy, Linda
Goodwill, Mr. Robert
Gove, Michael
Grayling, Chris
Green, Damian
Griffith, Nia
Gwynne, Andrew
Hain, rh Mr. Peter
Hall, Mr. Mike
Hamilton, Mr. David
Hanson, rh Mr. David
Harman, rh Ms Harriet
Harvey, Nick
Havard, Mr. Dai
Heath, Mr. David
Hemming, John
Henderson, Mr. Doug
Hodgson, Mrs. Sharon
Horwood, Martin
Howarth, David
Howarth, rh Mr. George
Hoyle, Mr. Lindsay
Hughes, rh Beverley
Iddon, Dr. Brian
Irranca-Davies, Huw
James, Mrs. Siân C.
Jenkins, Mr. Brian
Johnson, Ms Diana R.
Jones, Mr. Kevan
Joyce, Mr. Eric
Keeley, Barbara
Kidney, Mr. David
Knight, rh Jim
Kramer, Susan
Lamb, Norman
Laws, Mr. David
Laxton, Mr. Bob
Lazarowicz, Mark
Leech, Mr. John
Levitt, Tom
Lewis, Mr. Ivan
Lidington, Mr. David
Lloyd, Tony
Loughton, Tim
Love, Mr. Andrew
Lucas, Ian
Mackay, rh Mr. Andrew
Mann, John
McCarthy, Kerry
McDonnell, John
McFadden, rh Mr. Pat
McFall, rh John
McGovern, Mr. Jim
McGuire, rh Mrs. Anne
McKechin, Ann
McLoughlin, rh Mr. Patrick
Merron, Gillian
Michael, rh Alun
Milton, Anne
Moffat, Anne
Moffatt, Laura
Mole, Chris
Moore, Mr. Michael
Morgan, Julie
Mulholland, Greg
Mullin, Mr. Chris
Murphy, rh Mr. Jim
Naysmith, Dr. Doug
Norris, Dan
Öpik, Lembit
Owen, Albert
Pearson, Ian
Pelling, Mr. Andrew
Penrose, John
Plaskitt, Mr. James
Prescott, rh Mr. John
Pritchard, Mark
Prosser, Gwyn
Pugh, Dr. John
Randall, Mr. John
Raynsford, rh Mr. Nick
Reed, Mr. Andy
Rennie, Willie
Robathan, Mr. Andrew
Rogerson, Dan
Roy, Mr. Frank
Roy, Lindsay
Ruane, Chris
Salter, Martin
Sanders, Mr. Adrian
Seabeck, Alison
Sharma, Mr. Virendra
Shaw, Jonathan
Sheerman, Mr. Barry
Sheridan, Jim
Skinner, Mr. Dennis
Smith, Ms Angela C. (Sheffield, Hillsborough)
Snelgrove, Anne

Soulsby, Sir Peter
Spellar, rh Mr. John
Spink, Bob
Spring, Mr. Richard
Starkey, Dr. Phyllis
Steen, Mr. Anthony
Streeter, Mr. Gary
Stunell, Andrew
Tami, Mark
Taylor, Ms Dari
Taylor, David
Taylor, Matthew
Taylor, Dr. Richard
Timms, rh Mr. Stephen
Timpson, Mr. Edward
Tipping, Paddy
Twigg, Derek
Vara, Mr. Shailesh
Walley, Joan
Walter, Mr. Robert
Waltho, Lynda
Watts, Mr. Dave
Webb, Steve
Whitehead, Dr. Alan
Williams, Mrs. Betty
Williams, Mr. Roger
Williams, Stephen
Wilson, Phil
Winnick, Mr. David
Wishart, Pete
Wright, Mr. Anthony
Wright, Mr. Iain
Wright, Dr. Tony
Yeo, Mr. Tim
Young, rh Sir George
Tellers for the Ayes:

Helen Jones and
Helen Goodman
NOES


Bacon, Mr. Richard
Binley, Mr. Brian
Brady, Mr. Graham
Browne, Mr. Jeremy
Burgon, Colin
Campbell, Mr. Gregory
Davies, David T.C. (Monmouth)
Davies, Philip
Davis, rh David
Heathcoat-Amory, rh Mr. David
Hollobone, Mr. Philip
McAvoy, rh Mr. Thomas
Russell, Bob
Swire, Mr. Hugo
Viggers, Sir Peter
Whittingdale, Mr. John
Tellers for the Noes:

Mr. Peter Bone and
Mr. Christopher Chope
Question accordingly agreed to.
16 Mar 2009 : Column 741

16 Mar 2009 : Column 742

Resolved,

Lembit Öpik (Montgomeryshire) (LD): On a point of order, Madam Deputy Speaker. I am one of the two MPs who originally campaigned for the issue just decided; the other was the late Andrew Rowe. Obviously, I am delighted with the outcome of the vote. May I ask that the Speaker’s Office and the Leader of the House be given the opportunity to speak with the organisers of the UK Youth Parliament to ensure that the processes and procedures that it uses respect the traditions of the House and enable the very best to come out of this outstanding and inspirational decision tonight?

Madam Deputy Speaker: Hon. Members’ remarks will be on the record, but I will ensure that Mr. Speaker’s attention is drawn to the hon. Gentleman’s remarks.

Mr. Chope: Further to that point of order, Madam Deputy Speaker. May I put on the record the fact that the hon. Member for Montgomeryshire (Lembit Öpik) did not participate in either of the two days of debate on this matter? It is a pity that he did not make his points during the debate.

Madam Deputy Speaker: That is not a point of order, but a matter of debate. It is on the record.


16 Mar 2009 : Column 743

Mr. Brady: Further to that point of order, Madam Deputy Speaker. Some of us who attended the debates on the use of the Chamber were not able to speak because of the closure motion, but much of the argument has turned on the point of precedent. May I seek a ruling from Mr. Speaker in due course to the effect that a precedent has at least now been established? If the Chamber is to be used by bodies other than the elected House of Commons, we have established that that must follow a debate and vote of the House.

Madam Deputy Speaker: The hon. Gentleman’s remarks are on the record, but I undertake to draw Mr. Speaker’s attention to them.


16 Mar 2009 : Column 744

Dr. Adrian Garfoot

Motion made, and Question proposed, That this House do now adjourn. —(Mark Tami.)

9.17 pm

Mr. Henry Bellingham (North-West Norfolk) (Con): I wish to raise the case of my constituent, Dr. Adrian Garfoot, and to discuss in a little detail his dealings with the General Medical Council.

Dr. Garfoot is a very distinguished constituent of mine; incidentally, the Reverend John Garfoot, his father, is a popular and well-known Methodist minister. Adrian trained at the Royal Free Hospital school of medicine and served as a GP in a number of locations—in Yarmouth, Sevenoaks and Kilburn. During that time, he became increasingly aware of and involved with the plight of drug users. He saw that many users and addicts were very sad figures and had often been rejected and failed by NHS treatment centres; I am talking about the 1970s and 1980s. There were long waiting lists. Many of the drug addicts became ever more ill and many ended up in prison.

Tragically, quite a few of the young addicts with whom Adrian came into contact at that stage, when he was a GP, died from their addiction. He wanted to do something about it, so he decided to move from general practice to specialist drug treatment. Inevitably, that meant moving into the private sector, which he was reluctant to do. It was, however, the only way in which he could get involved with drug addicts from his position as a GP. As a result of his decision, the Laybourne clinic was born. It was launched in 1990 and after a while it moved into London docklands. I had the pleasure of visiting the clinic on a number of occasions. It soon became a centre of excellence and during its first 10 years it treated more than 1,200 patients, whose typical age was 37 and a half—substantially older than 29, which was the average age of patients in NHS drug clinics.

The overwhelming majority of Dr. Garfoot’s patients were long-term addicts who had been injecting themselves for between 20 and 30 years and maintaining their habit through crimes such as theft, burglary, dealing in drugs, prostitution and so on. Most had already spent lengthy periods in prison. At one point, it was calculated that 270 patients at the clinic had between them spent more than 600 years in prison—a fairly staggering figure. Many had been committing up to four crimes a day—in other words, well over 1,000 crimes a year. However, it is interesting that the recidivism rate for drug addicts at the end of a treatment at the Laybourne clinic was only 7 per cent., whereas for those coming out of the prison system it was 54 per cent.

Dr. Garfoot was rebuilding the lives of many people, dealing with serious medical conditions and restoring family relationships. He enabled those people to get on with a normal life and keep out of trouble. In fact, I worked out that during those 10 years he probably saved the country well over £10 million. Many testified that he actually saved their lives in the process.

I want to mention some of the achievements of addicts who underwent treatment at the Laybourne clinic. One reformed addict ended up playing the violin in an orchestra; another founded a national charity; another completed an MA degree in computer studies at the age of 30; and two gained places at medical school. That is a fairly remarkable list of achievements.


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I should like to read out a tribute paid by Gary Sutton, who was one of the addicts treated at the Laybourne clinic. I met him on one of my visits to the clinic. His account refers to a particular occasion in 1996. A patient who was in the clinic with him at the time was being treated at St. Mary’s hospital and discharged himself with a butterfly needle still in his arm. A few hours later, laboratory results were returned showing that he had a potentially life-threatening infection. The police were alerted and called to the patient’s address, but were unable to find him. The hospital rang up Dr. Garfoot. As it was a Sunday morning, Dr. Garfoot was at his home, but he drove up to London and spent seven hours trying to track the patient down. He eventually found him and took him to Homerton hospital. The following day the consultant rang up Dr. Garfoot and personally commended and thanked him for saving this person’s life.

Dr. Garfoot had a prescribing policy that was based on harm reduction and non-coercive user-friendly protocols. Above all, he used his clinical judgment and independence. He put in place voluntary and supervised withdrawal programmes. It is interesting to examine the guidelines from the National Treatment Agency for Substance Misuse. When it refers to injectable prescribing, it makes it clear that the recommended daily dosage is between 60 and 120 mg, which is within the effective therapeutic range. Certainly, what Dr. Garfoot was prescribing was within that limit. None of his patients died of any overdose, and there was no evidence whatsoever of diversion of drugs into the wider community. His philosophy was one of maintenance prescriptions with gradual reductions. Let us not forget that many of his patients had been on 12 or more failed oral treatment courses over periods of addiction of 20 to 25 years.

It is worth looking at what the National Treatment Agency for Substance Misuse has said. According to Professor John Strang:

Its guidelines say that

and that

That sums up what Dr. Garfoot was doing.

It is also telling to have a look at the 2008 drugs strategy. Page 6 mentions the need to

In Dr. Garfoot’s day, the officially preferred and enforced treatment was low-threshold, short reduction therapy. He was struck off for higher-dose long-term maintenance treatment and injectable prescribing, which is now sanctioned. I will come on to his being struck off in a moment, but it is worth pointing out that what he
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was doing during his years running the clinic was very much in line with current drugs policy, as outlined in the 2008 strategy.

As I have mentioned, there was no evidence whatever of any diversion of drugs during Dr. Garfoot’s time running the clinic. He was always incredibly assiduous in preventing the diversion of prescribed drugs to the wider community. That was recognised on a number of occasions when he clashed with the authorities. There were complaints back in 1992, and later there were further allegations. He was summoned before a Home Office misuse of drugs tribunal under the Misuse of Drugs Act 1971, on charges of alleged irresponsible prescribing. There was even a raid on the Laybourne clinic, but after analysis of 1,500 prescriptions there was no sign of any discrepancy whatever. Dr. Garfoot was cleared by the then Home Secretary, the right hon. Member for Blackburn (Mr. Straw), and there was also a finding of abuse of process against his accusers.

At that stage Dr. Garfoot took the view that he would be left alone, but unfortunately it was not to be. In 2000, the interim orders committee of the General Medical Council imposed serious restrictions on Dr. Garfoot after a number of a complaints against him. He was then taken to the professional conduct committee of the GMC on 11 September 2001—a date that none of us will ever forget, for other, tragic reasons. The finding was that he should be erased from the medical register on the grounds of serious professional misconduct. He decided to appeal to the Privy Council, and lost. I do not want to go into great detail about the GMC’s findings. Suffice it to say that it agreed that he had believed that he was acting in the best interests of his patients. It also agreed that there had been no diversion of drugs and accepted that no one had died of an overdose while under his care.

In due course, the clinic closed. What happened was obviously a disaster for Dr. Garfoot, and I shall turn to that in a moment, but it was an even bigger disaster for the many patients of the clinic. It 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, and six of them have subsequently died. Many others have gone back into a life of crime and prostitution and back on to the conveyor belt that leads to crime, inadequate treatment and back to crime again. What has happened is a tragedy, because many of the adults and youngsters concerned had nowhere to go once the clinic had closed down.

It is worth briefly examining the wider drug situation in the UK, as it puts into perspective the work that Dr. Garfoot was doing. The cost to the UK of drug abuse is absolutely massive. I have had a look at a York university study that puts the total annual cost at £19 billion, which is £850 for each household in the UK. I know that that might not sound a vast amount of money given the billions being thrown at the bank bail-out scheme, but it is a very large amount. It includes the cost of drug-related crime, which comes to £12 billion, and the extra burden on the police, prisons and the NHS. Interestingly, the study also found that 99 per cent. of that cost was caused by a hardcore group of roughly 280,000 users. That puts the nature of the problem into perspective.

I wish to say a word or two about Dr. Garfoot himself and what has happened to him since. He has been unemployed since he was erased from the register. He
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has been lost to the profession. I also feel that he has been extraordinarily unfortunate because his case was heard on 11 September 2001 and, since then, the rules have changed.

An amendment to the Medical Act 1983 was made in 2000 in statutory instrument No. 1803, which came into force on 3 August 2001. It provided that a 10-month suspension would be replaced by a five-year suspension. Of course, that was the Government’s response to the Shipman disaster. The minimum period of suspension—erasure—was previously 10 months, but was increased by the then Secretary of State for Health to five years.

It is interesting to note that, on 2 November 1998 and again on 10 January 2000, Dr. Garfoot was supplied with a copy of procedure rules, which were dated July 1997, on which proceedings against him would be conducted. Paragraph 28 stated that

Paragraph 30 states:

Dr. Garfoot was not informed of that until after his appeal to the Privy Council was heard. In other words, the proceedings against him in 1998 and 2000 were conducted under the unamended 1983 legislation—the statutory instrument did not come into force until 3 August 2001.

Through me, Dr. Garfoot contacted the then Home Office Minister concerned, the right hon. Member for Barrow and Furness (Mr. Hutton). In his reply, the Minister said that although there was a provision for exempting doctors who had submitted applications for exemption before 3 August, there was no such provision for doctors whose cases were in progress at the given date. I believe that that is incredibly unfair—the goalposts were moved while the process was continuing. It is not only unfair but arguably a breach of article 7 of the European convention on human rights, which states:


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