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Lord Mancroft: I am most grateful for that answer, too. I probably should have said earlier that the amendments are tabled as they are because, in the short time available, I could not think of a better way to ask the questions. That is solely the purpose of them. I hope that the noble Baroness will forgive me for that.

I am delighted that there will be guidance and consultation. I urge the Government to make that consultation as wide as possible, as the real expertise in these difficult areas lies not in the statutory sector, but in the voluntary sector. That is terribly important. Not enough people in the voluntary sector are consulted. I
 
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have sat through many Bills such as this over the past 18 or so years, and so often one hears, after they have been enacted, leading people in the field saying, "We never knew anything about it". So I would urge the Government to consult as widely as possible in the field, through the tentacles of the NTA, but also wisely. I beg leave to withdraw the amendment.

Amendment, by leave, withdrawn.

Lord Mancroft moved Amendment No. 12:

The noble Lord said: The purpose of the amendment is to raise concerns about the phrase that appears in line 11, regarding a "propensity to misuse" drugs. There has been a difficulty for a long time in this country about the difference between misusing drugs and addiction to drugs. These are important.

In the initial and follow-up assessments regarding the sending for treatment of people who commit crimes due to their drug addiction, "treatment" is another word for healthcare. Healthcare is for people who are unwell. In the area that we are discussing, that means addicts. Treatment for drug addicts is getting much better in this country and is working well in many fields. That is great. But you cannot treat misusers, because misuse is not an illness.

The alcohol analogy is the simplest—many, or one or two, of your Lordships occasionally use alcohol. One or two of your Lordships may know people who are alcoholics. One or two of your Lordships may have occasionally misused alcohol once or twice in their lives. Those three matters are completely different. Whereas you can treat alcoholism, you cannot treat misuse. The fact is that users misuse and alcoholics misuse. But misusers are not necessarily alcoholics. That may sound complicated and I hope that it will look better in Hansard tomorrow morning. The reality is that the phrase "propensity to misuse" is most extraordinary and I have no idea how anyone will be able to understand its meaning or identify it.

We know that genetics plays a part, as does environment, but those cannot be grounds for a referral to treatment, unless you wish to clog every treatment facility with unmotivated and disruptive time-servers who are sent there by the courts. As chairman of the Drug and Alcohol Foundation, which is one of the leading day care providers here in the City of Westminster in Dartmouth Street, exactly one street away from the Home Office, I can say that we are, as a tiny agency, clogged with people who are sent to us by the courts. Those people are not motivated, they should not really come to us and they are extremely disruptive both to the staff and the other clients. That is a real problem and my understanding is that it is a growing problem in many agencies throughout the country. It relates to our discussions during an earlier amendment regarding misdiagnosis, which has always been a particularly British problem.

In tabling this amendment, I draw attention to the fact that a "propensity to misuse" is a deeply unfortunate phrase. It would be better if it were not in the Bill. I hope that guidance can ensure that people
 
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who misuse, but are not addicts and probably not treatable, are not referred to, and therefore clog up, treatment facilities where there are few enough places at the moment for too many clients. I beg to move.

Baroness Scotland of Asthal: First, perhaps I may comfort the noble Lord in saying that the term "has a propensity to misuse" has already been used in other legislation. For example, it is used in Section 19 of the Criminal Justice Act 2003, which amends Section 3 of the Bail Act 1976. It is a term with which those who have to deal with legislation are familiar, and know how to interpret it. Therefore, it is understood to a great extent.

Amendments Nos. 12, 13, 14 and 17 would reduce the scope of assessments in Part 3 of the Bill to establishing only whether a person had a dependency upon any specified class A drug. It would preclude establishing whether those individuals who have not reached the stage of dependency may have a propensity to misuse specified class A drugs. The aim of Part 3 of the Bill is to help those who are using specified class A drugs—heroin, crack and cocaine—into treatment and to lead drug-free and crime-free lives.

These drugs not only do terrible harm and damage to the individuals taking them, but to the communities they live in. The initial and follow-up assessments will give help and advice and steer those who need it into treatment. We do not want to help just those who are already dependent on those drugs, but those who may be just starting on a way of life involving drug misuse and the crime associated with it.

The noble Lord, from his long experience of dealing with those who have, tragically, become addicted to drugs, knows that sometimes the journey to that dark place of total addiction can be rapid—but can sometimes take a long time. If we can interrupt that pathway quickly and at the first stage, it may be that the drug addiction will not ripen into a full-blown, debilitating addiction, which destroys the life of the abuser and, usually, everyone around them—particularly their family, who love them, often very dearly.

8.15 p.m.

Lord Mancroft: I am grateful for that explanation. As I said—and we have said twice tonight, I think—early diagnosis and early intervention are extremely important. This is an extremely difficult issue. I raise it because it is causing considerable difficulty in the field. There are too many inappropriate referrals, and they are fantastically disruptive when they do happen, as I have said, to staff and other clients.

We have not yet got this right. Definition is very important and very difficult: the difference between abusers and misusers, and addiction and dependence. It is very confusing. Quite a number of pieces of legislation, whether they are inspired by the Department of Health or the Home Office, cross over, and occasionally
 
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definitions change, which causes immense problems. Most of them started wrong and got wronger, though over the years they have been getting slightly righter.

If the noble Baroness reads tomorrow what she said today, I think she will find that the swapping of those words and the meanings that are attached to them by different people in different spheres, whether in the criminal justice system, the healthcare system or the social services system, is one of the problems. I would urge the Government to look at that very carefully. However, this propensity to "misuse" strikes me as an extremely dangerous route to go down. I think that we should view it with very great care. Meanwhile, I beg leave to withdraw the amendment.

Amendment, by leave, withdrawn.

[Amendments Nos. 13 and 14 not moved.]

Clause 9 agreed to.

Clause 10 [Follow-up assessment]:

[Amendments Nos. 15 to 18 not moved.]

Clause 10 agreed to.

Clause 11 [Requirements under sections 9 and 10 supplemental]:

[Amendments Nos. 19 and 20 not moved.]

Clause 11 agreed to.

Clause 12 [Attendance at initial assessment]:

Lord Mancroft moved Amendment No. 21:

The noble Lord said: This is another probing amendment, simply to ask a question. Page 13, line 35 of the Bill states:

and so on.

Presumably—I do not know—the initial assessor does not work for the criminal justice system or the police. There is no sanction if he does not inform. Indeed, what happens if he does not? Are we going to charge him as well? At what point does someone's healthcare become their own business? What happens if the assessor is concerned about patient confidentiality, which is very important? This is a very difficult healthcare issue and these are very difficult and vulnerable people—even if to some they are simply awkward offenders, as undoubtedly they are. However, they have their right to privacy and their need for healthcare as well, which is really why we are going through this process.

So, at what point does someone's healthcare become their own business? As I understand it, at this stage the person has still not been found guilty of an offence. We are already obliged to appoint suitably qualified persons as assessors, as we have just discussed. However, if in the process those suitably qualified persons, who presumably have a duty of confidentiality as part of their qualification as assessors or as healthcare professionals, betray the confidences of their client, then they, like most of the qualified people I know, would lose their licences to practise. So perhaps the counsellor will wish to keep the treatment process confidential.
 
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My experience of treatment, which is quite considerable now, is that breached confidences in the treatment process invariably wreck that process. I am certain that that is not the Government's intention. It seems to me that the drafting of this clause is somewhat draconian, although it provides no sanction. Unless I have misunderstood it, which I may have done, it may have the exact opposite effect of that intended. I beg to move.


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