Q
28Meg
Munn: I am not quarrelling with you about that general
aim, which is clearly the aim of the legislation. I am saying that I do
not see that the sanction conflicts with that. The sanction is a
mechanism for encouraging motivation and allowing people to access
support and move forward, rather than something that centres on how a
drug user may or may not be seen more
widely. Martin
Barnes: There has been a concern about the proposals
to link benefit entitlement with the requirement to undertake
treatment. Our understanding is that it was inserted into the drug
strategy document quite late on. I remember having a conversation with
an official at the Home Office and getting an off-the-record briefing
on what was likely to be in the document. When I was told that it would
include a proposal to reform the benefit system to introduce that form
of conditionality, I remember saying to the official, “You do
realise what will dominate the press coverage on this?” The
official responded by saying, “No, there is lots of other stuff
in here; it is about positive investment in drug treatment.” On
the day that the strategy was published, however, most of the coverage
given to the new strategy was on precisely this proposal, with
headlines such as, “benefit addicts to lose benefits,”
which created and reinforced the idea of being “tough” on
what is—yes—an extremely unpopular and often very
stigmatised and stereotyped group.
Similarly,
when the Green Paper was published, we were informed that there had
been a lot of effort, by some Government Departments who had a stake in
this agenda, to ensure that the press were not directed towards those
measures specific to problem drug users. While I take the point that
there are quite specific and precise issues about how the sanctions
may, or may not, motivate problem drug users, the Bill and these
proposals also need to be seen on a wider canvas. Unfortunately, there
is a concern that the driver for the proposals is partly either that it
plays well to certain sections of the media gallery, or that it could
act as a lightning-rod to focus attention on this particular unpopular
group, rather than other aspects of the Bill. That is a legitimate
concern that we have had, reinforced by the way that—as we
understand it—this issue has been played to the media by the
Government. It also is a concern among many of our members who can,
first-hand, confirm how stigma and stereotyping can be a genuine
barrier to people in drug treatment accessing basic support and
services, whether it is housing, training or the reluctant attitude of
employers.
Q
29Meg
Munn: So is it your position that there should never be
any sanctions in relation to benefits for drug
users? Martin
Barnes: Problem drug users who are claiming benefits
are already as potentially likely to be sanctioned as other claimants
for JSA. For example, from April—
Q
30Meg
Munn: No, I am not asking about what is happening. I am
asking whether the position of your organisation and your members is
that there should not, ever, be sanctions in relation to drug
users. Martin
Barnes: To be more precise, I do not think that the
evidence is there and it is not just our view, but also that of the UK
Drug Policy Commission, which has recently done a lot of research,
exploring the barriers for problem drug users trying to access training
and employment. The evidence is not there to show that the use of
sanctions and compulsion, in terms of the requirement to undergo
treatment, will actually be
effective.
Q
31Meg
Munn: So, you are saying
no? Martin
Barnes: We do oppose the proposals for sanctions that
require people to declare their problem drug use and whether they are
receiving treatment—I could explain in more detail our concerns
about that particular proposal—the requirement to undergo a
substance misuse assessment and the requirement to undergo drug
treatment as a condition of receiving benefit, as it is currently
framed in the legislation.
Q
32Meg
Munn: We are not clear about whether you have answered to
the question. My question is whether there are any circumstances in
which drug users should be sanctioned, in terms of their
benefits. Martin
Barnes: As I said, a problem drug user can currently
be sanctioned for a number of reasons within the benefit system. The
question you are posing is not one I can give a yes or no answer to,
because unless you are precise in where that sanction might
apply—
Q
33Meg
Munn: So you would admit that there are circumstances
where it might be appropriate to
sanction? Martin
Barnes: Yes, because currently if a problem drug user
is not fulfilling the actively seeking work requirement of the JSA, or
attending interviews when required to do so, they can be
sanctioned—as can any other JSA claimant. Problem drug users are
not being dealt with as some exceptional group within the benefit
system at the moment. The difficulty is that they are often invisible
within the benefit system and do not get the help and support they
require. That is why we support that commitment to provide better
support for problem drug users. We have serious concerns about the
proposals in the
Bill.
Q
34Mr.
Harper: That was helpful clarification. First, by way of
preamble, one of you mentioned progress2work. I visited the service
that is delivered by Turning Point in Cardiff. I talked to some of the
staff and clients. I got some flavour of the complexity of getting them
either into work or back into work. I support what you said on
that.
Following up
on the point made by the hon. Member for Sheffield, Heeley, if someone
is on out-of-work benefits because of their drug or alcohol problem,
why should they not have to seek some treatment for that problem if it
is the barrier to their getting into work? Certainly those looking from
outside, those who work and pay taxes, cannot see why someone whose
problem relates to their drug or alcohol abuse should continue to get
taxpayers’ money if they are not willing to take some steps to
sort that problem out. Why should they not be required to sort it out?
I will ask you in a moment about the extent to which that treatment is
available and the capacity. But in terms of the principle,
is your objection to compulsion and threatening to withhold benefits if
they do not undergo treatment philosophical or practical? Is your view
on that driven by what you think the practical outcomes will be, or do
you think it is wrong in
principle? Martin
Barnes: I think it is primarily on the practical
issues, but there is also a wider concern. I have had conversations
with the chief executive of a leading mental health charity, who has
concerns about these proposals because of the potential for them to be
extended to other groups. Why not, for example, require a person whose
main barrier to work is perceived by the DWP as being a mental health
problem to undergo appropriate treatment to reduce or sort out that
mental health problem if that is indeed the main barrier to work? That
is a genuine concern expressed to me by a chief executive of a mental
health
charity. The
main route to drug treatment tends to be voluntary. We have seen a
significant expansion through the criminal justice system and the drug
intervention programme to try to get people who have tested positive
for a class A drug into treatment. Indeed, we supported that. The Bill
is taking that much further. For the first time the state will require
someone not just to engage with an adviser and have an assessment for
drug treatment, but to undertake drug treatment as a condition of
getting benefit. At present, that type of requirement can only be
imposed under conditional bail requirements. A person can be required
as a condition of bail to attend for drug treatment or, if they have
been charged, sentenced and convicted, the sentence could include a
requirement to undergo some form of drug treatment. The context of that
is quite different from what is proposed in the Bill: to require
somebody to undergo drug treatment as a condition of getting their
benefit.
I am told by
the NTA that 80 per cent. of drug services are delivered by the NHS or
by third parties it has contracted to deliver. The NHS constitution
says that you have a right to accept or refuse treatment that is
offered to you and not to be given any physical examination or
treatment unless you have given valid consent. I suggest that such
consent can only be valid and only truly consensual where it is not
made in the context of otherwise possibly losing benefit, with all the
consequences of
that. The
NHS constitution also says that you have the right to
privacy and confidentiality and to expect the NHS to keep your
confidential information safe and secure. I suggest that that is not
compatible with the requirement in the Bill to answer questions either
about your drug use or about whether you are in drug treatment. The
constitution also says that you have the right to be involved in
discussions and decisions about your health care. I suggest that that
is not compatible with the power of the Secretary of State to impose,
as set out in the Bill, a requirement to comply with a rehabilitation
plan and to be directed to a place or institution that provides drug
treatment. As the Bill is worded, that direction can mean that somebody
is required, for example, to be a resident in a place that provides
residential rehab. That will or may specify not just that somebody has
to undergo drug treatment, but potentially the form of that treatment
as well. How can that be compatible with what the Government reasonably
have set out for every patient in the NHS
constitution?
Q
35Mr.
Harper: Dr. Roberts, do you want to add
anything? Dr.
Roberts: The point is one of effectiveness rather
than principles. There are both sorts of points. People will be
identified and pushed forward through the investigative process set out
in the Bill, which might include their initially being interviewed, and
at some point having to submit to a drugs test, and the police perhaps
being requested to provide information about them. Is someone emerging
from that process likely to form a productive and constructive
therapeutic relationship with the treatment service? Developing a
system that is more effective in incentivising voluntary disclosure has
more potential to engage more people in effective therapeutic
relationships that will address their drug problems and help them back
into work. I think that does speak to the issue about sanctioning,
because anything that offers a positive incentive inherently has a
stick attached to it. People who do not go down that route do not get
the benefits associated with it, which might for example include, under
the treatment allowance proposals, their not being required to abide by
the normal job-seeking requirements for a period of time, to give them
some space and time to focus on getting their drug problem under
control. That, for me, is a carrot that can pull people into a
voluntary form of disclosure and get them involved, which is likely to
be more effective than a stick, although neither of those mechanisms
will identify everyone who could
benefit.
Q
36Mr.
Harper: Given that you focus on the practical, what
would your response be to the man in the street who does not think it
right that he has to go to work and pay taxes to fund
benefits for someone whose primary reason for not going to work is a
drug problem and who is not willing to do something about it, when the
man in the street can see that continuing for year upon
year? How do we, as politicians, say to that person,
“That is
okay”? Martin
Barnes: I can understand the issue that you have
outlined. The difficulty is the way that the DWP is attempting to
address that in the Bill; that is where our concern lies. There are a
number of ways in which people can be required to access drug
treatment, as I have mentioned, not least through the drug intervention
programme. If you have somebody in that situation who is not willing to
engage with drug treatment, it is first important to understand why.
Some people have had quite bad experiences of the treatment system and
that might well be echoing around now, informing their perception of
the support and help that is available. It is also important to
understand the problems, barriers and difficulty that many problem drug
users face. Addaction, for example, consulted many of its service users
who are parents, and they expressed the concern that their children
would be taken away if they declared their problem drug use. Some drug
services are simply not sufficiently geared to supporting younger
people, women or some people from black and minority ethnic groups, for
example. So, it is not as straightforward as somebody just being
reluctant to undergo drug treatment. There might be reasons why that
person is in that space at that time, but has the DWP tried the
supportive, voluntary approach? We do not have evidence of that unless
it is particular schemes such as progress2work, which has been shown to
be incredibly effective as a voluntary programme for getting problem
drug users into training and support.
The other
question is whether treatment will be successful if the person
is of the mindset that they do not want to engage with drug treatment.
If the motivation and the support structure are not there, the
chances are that the person might well drop out of the
system or relapse at an early stage. Part of the
difficulty with the Bill and these proposals is perhaps a
lack of understanding and appreciation of the
sheer complexities, not only of supporting problem drug users
but of how nuanced, sophisticated and varied drug treatments sometimes
need to be to achieve the desirable outcomes.
Coming back
to asking the man in the street, when the Government consulted on the
drugs strategy I got no sense that people were banging on the door to
say that they were concerned about the number of problem drug users on
benefits. [Laughter.] You might laugh, but that
did not come through in the consultation. Can I come back to the point
of why you laugh? Probably because you pick up the attitude to problem
drug users. Take yesterday’s headline in The Daily
Telegraph.
Q
37Meg
Munn: Could we just be clear? I have estates in my
constituency which periodically suffer a great deal as a result of
people who have problem drug use. These are the people—Mark
talks about the man or woman in the street—who come up and ask
these questions. They are not the people who are going to respond to a
consultation, but I can assure you this is an issue that most Members
of Parliament will at times come across and people will raise it. To
suggest that people do not think this is a problem is wrong. We are not
raising this because we see it in the media; we are raising it because
we see it on the streets of our
constituencies. Martin
Barnes: The issue you are highlighting is an entirely
right, fair and appropriate one and that is why it is right that the
Government are putting the investment into the drugs strategy and
particularly into drug treatment. We need to support, defend and make
the case for drug treatment because it has been attacked unfairly and
unreasonably in the media and some politicians have also unfairly and
unreasonably attacked the drug treatment system, claiming that it is
not effective and that it is a waste of money. The tangible benefits
are there and we know we can do more to improve them. That is a
commitment from the Government, from the NTA and from our members. It
is symptomatic of a wider issue because perceptions about drug use are
slightly on the increase.
The
Government see this as a problem because, despite the rightful
investment in the drugs strategy and treatment, public perception of
the problem is going in the other direction. I am not saying at all
that people do not perceive problem drug use as something to be
tackled. The question—and it is your role to ask it when you
come down to the specifics of the Bill—is whether this is the
right way forward. The powers that are currently given to the Secretary
of State and the DWP to make that link between benefit claim and
attending treatment is what we have concerns about. We do not have any
concerns about trying to tackle the problem of drug use in this country
and particularly getting more people into treatment, better treatment
and aftercare.
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