Appendix B: Letter from the Home Secretary
to the Advisory Council on the Misuse of Drugs
Letter from Rt Hon Theresa May MP, Home Secretary,
to Professor Les Iversen, Chair, Advisory Council on the Misuse
of Drugs, 20 November 2013
GOVERNMENT RESPONSE TO ACMD ADVICE ON KHAT
I wrote to you on 3 July to respond to the ACMD's
advice on the potential harms of khat in relation to control under
the Misuse of Drugs Act 1971. In the letter, I set out the reasons
for the decision to control khat as a Class C drug. The Government
has now laid the draft legislation before Parliament for the control
of khat to come into force across the UK in early 2014.
I also committed to consult more widely across Government
on the ACMD's other recommendations and to provide a full response.
The Devolved Administrations have also received the ACMD's report
on khat to consider these other recommendations which relate to
their delegated responsibilities. I set out below the Government's
response to the ACMD's advice on the potential harms associated
with khat use, as well as the wider community concerns in England.
The ACMD made recommendations for locally-led policies
and community-based interventions to address the potential harms
of khat. I am pleased to have received supportive responses from
across Government and local organisations to these recommendations.
In my view, they confirm that, despite the challenges posed by
the paucity of evidence on harm, the ACMD's report has also helped
us to better understand the issues affecting local communities
where the prevalence of khat is causing concern.
Overall context
The Government has carefully considered the ACMD's
findings and all available evidence to inform our policy approach
in local communities, within the context of the pending control
of khat. We have been mindful to ensure that our response is
aligned to the Government's 2010 Drug Strategy and Equality Strategy.
The Government moved away from a focus on social identification
and background to recognising people as individuals, breaking
down the barriers to social mobility and giving them equal opportunities
to succeed. We are also giving local authorities the freedom
and responsibility to meet the needs of the diverse communities
that they serve. Government departments will therefore support
local authorities to explore and commission services that are
tailored to the needs of khat users, their families and communities.
Health risks and prevalence
Public Health England (PHE) will lead on identifying
opportunities to raise awareness of the potential harms of khat
and associated community needs at a local level. PHE has developed
the Joint Strategic Needs Assessment (JSNA) guidance and data
for local public health commissioners which include information
about khat. Additional PHE advice to local areas where khat may
be misused will cover a range of issues highlighted by the ACMD,
including the need to:
· Ensure that treatment providers are competent
to support people whose khat use is problematic;
· Alert clinicians in Mental Health services
to the scope for khat to complicate treatment of existing mental
health problems; and
· Alert midwives and health visitors to
the risk of potential harm to the child from khat use in pregnant
women or breast-feeding mothers.
PHE will further support local areas in England
where there are centres of khat use and related concerns, so that
local commissioners and providers take appropriate action. In
particular, we will ensure that local public health officials
in these areas receive updates on the timeline to the control
of khat so that they can prepare for a potential influx of users
seeking help once they find that khat is no longer available.
For example, we will use NHS News to alert them including
primary care staff to signpost khat users and their families to
the support services available to them.
Further to the ACMD's recommendation, khat use among
those seeking treatment is already included in the regular monitoring
provided by treatment agencies for national statistics, service
providers and commissioners. In its support for local areas,
PHE will draw to commissioners' attention the ACMD's advice about
regular monitoring and publication. PHE will also produce bespoke
reports for individual areas including detailed data about their
in-treatment clients to help inform the annual commissioning process.
Commissioners are expected to understand local treatment
needs and plan services accordingly. Any numbers of khat users
currently in treatment can indicate the local areas where khat
use has been the most prevalent, as well as any emerging demand
for treatment in the lead up to and following the control of khat.
Even a small increase in such demand will need to be considered
amongst new and emerging drug trends and, as necessary, influence
local commissioning plans.
The ACMD further recommended that local law enforcement
agencies monitor the prevalence of khat use, as part of regular
monitoring, to inform future research and respond to local concerns.
The Home Office will continue to monitor the situation in relation
to khat. Relevant data will be gathered through licensing and
compliance activities as well as law enforcement seizures and
treatment data - as we do with other drugs. My Chief Scientific
Adviser will also write to Research Councils to draw their attention
to the ACMD's comment on the need to better understand the harms
of khat.
As part of its considerations on local public health
approaches, the ACMD also provided advice on education and prevention
initiatives specific to khat. Accordingly, earlier this year,
the Department of Health updated the references made to the risks
and potential harms associated with khat on the FRANK website.
The Department for Education is also funding Mentor
UK's Alcohol and Drug Education and Prevention Information Service
(ADEPIS), which is run in partnership with DrugScope and Adfam.
As well as promoting the Education and Prevention Template which
the ACMD reproduced at Annex D of its report, ADEPIS will continue
to provide its toolkit for schools. Appendix B of the toolkit
contains a checklist for reviewing drug education which contains
the following prompt: "Has the local context been taken into
account, e.g. local data, local priorities for drug education?"
PHE's support for local areas will further highlight the need
to tailor (as appropriate) drug prevention initiatives where khat
is a local issue.
Protecting communities
The ACMD recommended that Police and Crime Commissioners
(PCCs) address local community concerns about social harm which
is associated with khat. Some premises where khat is advertised
for sale (and sometimes consumed) and khat users have been associated
with wider community problems. These problems include anti-social
behaviour (ASB), public nuisance, local dealing and litter. We
know that these anecdotal incidents, whilst they can appear minor,
can lead to increased disorder, low-level crime and fear of crime.
PCCs were elected to be accountable to local communities
for cutting crime and ASB in their force area, as well as working
with Health and Wellbeing Boards to support victims. PCCs therefore
need to give due regard to the plans and priorities of the local
organisations in their force areas, which may include khat if
it is a local issue.
The Government will also share and promote examples
of effective approaches and partnership working between local
organisations to respond to community concerns where there have
been centres of khat use and associated ASB. This will be done
through our communications networks with local authorities. Examples
of local partnership working include Multi-Agency Safeguarding
Hubs which co-locate police and other public protection agencies
to facilitate information-sharing and co-ordinate actions to address
a local issue between them.
Supporting people
As the ACMD considered in its report, khat use is
entwined in a complex web of issues affecting vulnerable members
and some of our communities, including users and their families.
The Government has taken the view that khat should no longer
be regarded as a minority-specific issue; it is a matter of public
health and welfare for these communities. We also recognise that
ethnic groups can be among the most disadvantaged communities.
For some, particularly recent migrants including refugees, the
problem can be further exacerbated by cultural and linguistic
barriers.
The Government's approach to integration is to give
them the opportunities to come together and play an active role
in society, emphasising the things that we have in common. This
is based around the five key themes of building common ground;
developing personal and social responsibility; improving social
mobility; increasing participation; and tackling intolerance and
extremism.
Our work on integration sits alongside the Equality
Strategy as well as the Social Mobility Strategy, which sets out
to address socio-economic disadvantage in England to benefit all
communities including ethnic minorities. We have moved away from
a top-down approach so that communities and local agencies
can make decisions at a local level. We have also moved away
from promoting programmes aimed at specific communities because
individuals face different problems and share different views.
Programmes to deliver the strategies include driving
forward improvements in health support to ethnic groups across
five major conditions (diabetes, mental health, pre-natal mortality,
coronary heart disease and stroke), which is led by the NHS, and
Department for Work and Pensions work to address the barriers
faced by particular ethnic groups in some Jobcentre Plus Districts.
We are also supporting over 30 local, practical projects which
demonstrate positive or pioneering ideas and create the conditions
for integration, like a £6 million competition to discover
new ways of delivering community-based language learning to those
most isolated through their lack of English.
The Government also has a strategy for increasing
ethnic minority employment and participation in the labour market.
We are mainstreaming access to employment opportunities through
the Government's Work Programme and Jobcentre Plus by tailoring
support to individual jobseekers' needs. Local autonomy and flexibility
in the help and services provided in this area have replaced the
one-size-fits-all approach of previous employment schemes.
Proportionate policing
In my letter of 3 July, I committed to ensuring that
we have a robust and proportionate policing response to khat-related
offences under the Misuse of Drugs Act 1971. Due to the bulky
nature of khat and its reliance on transnational freight, law
enforcement activity will primarily focus on UK borders.
However, we want to ensure that police forces are
able to address local community concerns about khat and its misuse
in an effective and sensitive manner. The Government has developed
an escalation framework for policing the possession of khat for
personal use in England and Wales. This work was informed by
the characteristics of khat which, like cannabis, can be identified
by frontline officers who will have the required knowledge and
experience of their local community. We have also taken account
of the representations made by community leaders.
The escalation policy will allow for a suitable choice
of disposals which provide opportunities to signpost vulnerable
offenders to local support and tackle repeat offending. It will
be supported by national policing guidance issued to frontline
officers. The escalation policy for khat will be similar to the
one in place for cannabis: police officers will be able to issue
'khat warnings' for a first simple possession offence and a Penalty
Notice for Disorder (albeit £60) for a second possession
offence. I am grateful for the support of its introduction from
the National Policing Lead for Drugs, Chief Constable Andy Bliss.
The Home Office has further developed a cross-government
programme of communications activity to inform the general public
about khat and target key messages to users and businesses involved
in the khat trade and local communities.
I am grateful to the Secretary of State for Communities
and Local Government, the Secretary of State for Work and Pensions,
the Minister for Integration and the Minister for Public Health
for their departments' consideration of the ACMD's report and
contributions to the Government's response.
I am copying this letter to my colleagues; the Minister
for Crime Prevention, the aforementioned Ministers, the Devolved
Administrations and Chief Constable Andy Bliss for their information.
Rt Hon Theresa May MP,
Home Secretary,
20 November 2013
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