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We need an urgent review of systems and structures for delivery and better coordination. I am not advocating decriminalisation alone. I remind the House that 40 years ago we partly decriminalised personal use of heroin for a short time. That does not encourage us to drop the decriminalisation policy. I, like others, am advocating that we should move away from a wholesale criminalisation policy to a much greater multi-faceted approach.

The dangers of misuse are quite widely known, but they need to be reinforced by a major public health campaign. How much really effective youth education

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could be delivered for the more than £1 billion or so that we currently spend on this ineffective policy? Young people respond well to accurate and balanced information, but are rightly sceptical of scare stories. It is useless, for example, to prohibit ecstasy when their experience tells them that it is usually harmless, is available at every party they go to and they see it in use.

I do not want to play down the dangers of drugs nor the profound harm. As a psychiatrist, I know that my colleagues in general psychiatry services all have to be experts in drug misuse and dual diagnosis in a way that my generation did not. Just as tobacco and alcohol controls are far better achieved by fiscal policy and easy access to opportunities to get help with misuse, so cultural change through public education and through much greater investment in masses of help for those who misuse drugs are likely to prove better strategies for reducing harm. I ask the Government what approach is being taken to examine the balance of government drug expenditure and what steps can they take to try to persuade others in Europe that we need a different United Nations concordat this time round.

12.27 pm

The Earl of Listowel: My Lords, I too thank my noble friend for calling the important and timely debate. It is also an honour to follow my noble friend Lady Murphy, given her detailed understanding and her long professional experience in this area.

I wish to concentrate on one of those facets to which she referred: the supply of children and young people who want to take drugs and want to continue to take drugs when they know, from their experience, that they make them feel worse and worse. Why do so many young people want to take drugs which they know to be harmful and then persevere with that over long periods when they see their health deteriorating and when they see their looks going?

What can all parties do long term to improve the quality of childhood in this country? It requires a clear, cross-party, long-term commitment to improve the experiences of young people’s childhood. I suggest that one reason young people take up drugs and alcohol and stick with them is often because they are very unhappy with their lives, have low self-esteem and perhaps take drugs to forget how bad they feel, or to attack themselves. They feel they do not deserve to be treated well.

I say that because of my experience listening to young people coming off drugs and alcohol and hearing their life stories. You hear that their fathers and mothers were alcoholics, their grandfathers were alcoholics and their brothers and sisters were alcoholics or drug users. One young man, who cared for his alcoholic mother, said that one morning she would be all light and brightness towards him and the next morning he would go upstairs with a tray of bacon and eggs, or whatever he had made for her, and she would almost throw it in his face. These young people have such histories that they have very low self-esteem and are very vulnerable to people who are often hooked on drugs.

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I remind your Lordships of last year’s UNICEF survey on the welfare of children in the 21 most developed countries, in which the UK came lowest. One of the areas looked at was the relationships children enjoyed in their families. It highlighted that in Italy it is still the norm for children to sit regularly with their families over a meal and enjoy the relationship with their parents. A Minister in this House, who was advocating the use of more early years childcare, said that children are entering primary school unable to speak because, rather than sitting with their family and talking, they are sitting in front of the television. There is no opportunity for them to sit together, enjoy relationships with their parents and speak.

If we wish to cut the supply of children and young people keen to try drugs and to stick with them, no matter how they harm them, we must address the need to support parents better, have adequate housing for families and support the professionals who work around them. I am encouraged by the Government’s work on the childcare workforce and what they are trying to do with the social work workforce with their taskforce on social work. It is encouraging that they are looking at how we can improve social work courses so that social workers are better equipped when they start working with children and families. They are seeking to recruit higher calibre people—social work requires the best people—and are looking at how to support new social workers in their practice.

The Conservative Party’s initiative and its attention to social work also encourage me. The report produced by that party No More Blame Game looks at social work and calls for a champion for social work, a chief social work officer to make clear to government social workers’ development needs.

We cannot write these families off. They need help if we are not to have generations of young people involved in these activities. Last week, I met four consultant social workers from Hackney Council. It was encouraging to hear those fairly young—to my eyes—people talking about their work with families over the past year under a new initiative, a new form of approach, in Hackney. Only one of them was English because one has to look abroad for good quality social work training at the moment. We have some fantastic social workers, but they are a mix because we have not given a commitment to social work in the past. Hearing what they are doing in Hackney, with its poor history in this area, gave me hope.

It also gave me hope to read in Hansard what the right honourable Mr Iain Duncan Smith said recently in a debate on early intervention supporting families:

“The key is getting a 20-year programme of change that we agree on. We need not agree on all the mechanisms to be used, but we should at least agree on the objectives. If we do that, we will have achieved something that is about good government. We go on about the nanny state, but we are already the nanny state in these areas, and an ineffective one. The costs of that are enormous and we still fail to change people’s lives. This is not about having no government or smaller government, but about having effective government”.

Earlier in his speech, he said:

“More than 30 per cent. of those in prison come from care homes, although only about 0.6 per cent. of all our children have ever been in care”.—[Official Report, Commons, 13/1/09; cols. 15-16WH.]

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The most neglected children are getting involved in drugs and the criminal justice system. That is an important facet of reducing supply.

We do not need constant new initiatives, constant changes or constant new structures, as well intended as they may be. We need a consistent policy supporting parents, families and the professionals who work around them. We also need to resource that consistently. We need to consider how to resource the social work and other professionals working around families in the long term, and not suddenly cut their resources so that they have too large a caseload without proper supervision, so that the best leave the profession and we find ourselves back where we are again. I look forward to the Minister’s reply.

12.35 pm

The Earl of Onslow: My Lords, I thank the noble Baroness, Lady Meacher, for her eloquent opening speech. It was not quite up to Obama’s standard, so she will have to work on it a bit. This has not been a debate. A debate is somebody here saying one thing, somebody there saying another and somebody over there saying a third thing. This has been a chorus of abuse for the present drug policy.

On the evening of the election for hereditary Peers all those many years ago for our temporary stay in this House, I was on “Have I Got News for You” and what’s-his-name—the man who got sacked for cocaine use and for playing with tarts—turned to me and said: “Lord Onslow, you’re pro the legalisation of drugs, aren’t you?”. I said, “I will answer that question seriously because I think it’s the most disastrous social policy that we have in this country. I do not approve of drugs. I think anybody who takes them is silly, but to follow the present policy is absolutely mad. They should be available under controlled legality, and we should cut out the crooks and the ungodly”. The audience cheered me to the rooftops. Perfectly reasonably, it was not put in the programme, not because it was wrong, but because it was taking something seriously.

I have always held this view. I am old enough, or perhaps privileged enough, to remember Lady Wootton, who sat on the Liberal Front Bench. She made a programme saying that pot was not too bad for you. Incidentally, we have had the farce of the reclassification of cannabis. The Government have blatantly ignored their professional advisers because they think they are in league with the Daily Mail and had better try and do something popular, as messing up the economy is not popular. We have got to look at this programme again. A noble Lord on the Cross Benches who is a judge told me that 75 per cent of the people who came in front of him at his Crown Court were involved in drug crime of one sort or another. It is not the better off and the privileged who suffer. It is those on the poor estates, where there are drug needles lying in lifts, people get bashed up and the underprivileged get burgled by the even less privileged. It is a terrible, ghastly social problem. The total failure of the present policy is making it worse.

I take a drug: it is called drink. Possibly, I take too much of it. Several of my forebears have died of it. One of them was sent back from Hong Kong because

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of drink. In 1914, he was in hospital in Paris, complained that all the milk was being given to the wounded soldiers, and died, so I am not particularly proud of him. Drink is a drug, and it causes more deaths than heroin and the illicit drug trade combined. Smoking is also a drug. I do not smoke any more. I used to, but I felt that it was a silly thing to do and gave it up. I am not being smug about it. Thirty years ago, practically everybody in this House smoked. Now we do not. Smoking has come down enormously.

The noble Lord, Lord Mancroft, produced the argument about Afghanistan. Let us imagine that, instead of the Afghan opium crop being criminalised, it was bought legally, under very strict control, and was then used either for diamorphine for the National Health Service or under a controlled programme for people who have become drug addicts.

The point about supplying drugs in that way is that there is no incentive to go on producing more. Members of the ungodly who make money out of drugs have an incentive to increase their market. The essential thing is to ensure that those who supply the drugs—there will always be demand for them, let us not kid ourselves about that—do not have an incentive to increase the market to increase their profits. Criminality, as the noble Baroness, Lady Stern, said, involves corruption in prisons, police forces and other law enforcement agencies. The more that you corrupt law enforcement agencies, the more society collapses. That is not unknown in this country. It is considerably better known in several other countries. That has a disastrous effect on civilisation.

That is why we should change our views. I am absolutely certain that there will be an unholy alliance between the two Front Benches and the Daily Mail and the Sun to say that we must continue with criminalisation—anyone can take me out to a very expensive dinner in Whites or some five-star restaurant if that is not the case, but I am sure that it will be. We must change, because the current situation is doing so much damage to our society. The noble Earl, Lord Listowel, made the point about the damage that it does to children. There are failures in society of which we should be ashamed, and we should not continue with a policy that makes things worse.

12.42 pm

Lord Birt: My Lords, the noble Baroness, Lady Meacher, is to be congratulated on initiating this debate. I shall echo many of her sentiments. I also applaud the powerful global sweep that we have just been offered by the noble Baroness, Lady Stern.

The UN resolution on drug demand reduction adopted by the General Assembly in 1998 was well intentioned. Its focus on the problem drug user was welcome. But the resolution lacked clarity on what success would look like and how it might be achieved. I declare an interest as the strategy adviser to the previous Prime Minister. I led the 18-month-long study on drugs, mentioned more than once already in the debate, conducted by the Cabinet Office Strategy Unit, alongside the Home Office in its old, mighty form and other government departments and agencies.

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I was involved in a number of such long-term studies when I was in government, but none took as long as that one. The reason was—again, there are echoes from earlier in the debate—that despite a welter of activity in the UK and around the world, hard evidence was difficult to come by and it took a large, capable team a very long time to quarry, to assess and to analyse the data available.

We finally identified a cohort in the UK of about 300,000 heavy users of heroin and crack. I have no doubt that that cohort will have grown since. Those problem drug users had a massive and adverse impact on themselves, their families and on the rest of us. Most problem drug use arises from—and intensifies—deprivation. It costs the wider society tens of billions of pounds a year in harms caused.

The health and welfare cost was significant, but the biggest economic impact was through crime. Five years ago, offending by problem drug users to fund their habits cost the economy £16 billion. Problem drug users commit 80 per cent of all burglary and about half of robbery and fraud. Crack addicts can be very violent indeed.

At any one moment, 80 per cent of the 300,000 heroin and crack users in the UK were not in receipt of treatment of any kind. On the other hand, most encounter the criminal justice system and the treatment agencies over and over again, as if in some continuously revolving door. Some spend short terms in prison. Others experience multiple treatments from multiple providers, constantly slipping out of the system, constantly relapsing.

Our best estimate of long-term abstinence in the UK and around the world as a result of treatment was 20 per cent. For nearly all problem drug users, their addiction will be a lifelong condition. Even those who have abstained for long periods can relapse.

Every concerned person who looks at drugs leaps at the notion that supply should be staunched. But the illicit drugs industry has built over decades into a vast worldwide business comprised of tens of thousands of interlocking organised crime networks and hundreds of thousands of individual, front-line user-suppliers funding their own habits. In so far as drug production can be depressed in originating countries, historically it has just displaced production elsewhere. There is as yet no example of sustained success in substantially disrupting supply. The big, depressing picture over decades is that supply volumes have soared and prices have dropped. Seizures worldwide run at about 20 per cent of production. For the drug industry, that is no more than the cost of doing business.

There are many good reasons for countering criminal networks but, as the noble Lord, Lord Mancroft, reminded us at the beginning of our debate, we invest far too much money in a chimera: that we can solve the drug problem by attacking supply.

There is a chorus and consensus in this debate, by which I am slightly surprised. The overwhelming drive of drug policy in our country and other countries should be to focus on reducing the harms that arise from drug use. To do that, we need to set aside

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prejudice, unevidenced assertion and the vested interests —not to be underestimated—of the multiple agencies that identify with the status quo.

There are no easy ways forward to reduce the harms caused by heroin and crack addiction. In this country, we need a brand new legal framework to enable us to identify, grip and hold on to the problem drug user to stop them constantly slipping away from us and causing widespread social harm. We then need a treatment regime tailored to individual need that offers a range of medical and social interventions directed at reducing harm of every kind. For some, this would mean heroin prescription, and we as a society should not fight shy of that. Finally, we need a new, clear, simple organisational regime to bring accountability, authority and funding into line.

None of that is politically easy in any country, least of all ours, but let us hope that this year's UN review will demonstrate rigour as well as noble and good intention.

12.50 pm

Lord Williamson of Horton: My Lords, I, too, thank the noble Baroness, Lady Meacher, for initiating this debate and for raising the specific issue of the forthcoming 10-year review of the United Nations declaration on countering the world drug problem, which will take place in Vienna in March. I will stick, so far as possible, to the issues relating to the review because that is the immediate issue; we may in the end revolutionise our system in this country, but we must first consider the review. It gives us an opportunity to comment on the problems that drug addiction causes for individuals and society and invites us to look at the need continually to examine—and, I would say, re-examine—ways of tackling these distressing problems. To that extent, I go along with the chorus referred to by the noble Earl, Lord Onslow. We must be realistic; even if we changed the system substantially, there would still be a lot of problems—violence, danger to health and so on; they would not be swept away immediately.

I say to the Minister that I am not critical of the Government; indeed, I have supported them on a number of occasions. More generally, I believe that those who are working in the difficult areas of drug addiction, preventing illegal importation, reducing drug-fuelled crime, educating our young citizens on the risks involved and seeking to help those suffering from drug addiction are doing their best in difficult circumstances. That list amply demonstrates the spread of the problem.

I am not critical but, like many of our fellow citizens, I am concerned because it is obviously in the interests of our country to cut back crime that is directly related to hard drugs and prevent, where possible, mental health problems that are related to drug usage. We are doing our best but the results are not as good as we would have hoped. The level of drug-fuelled problems is much higher than we would have wanted. The World Drug Report 2008, which the Minister made available to us—thank you very much—shows that although the world drug problem is being

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contained, the world is under threat: I read that to mean that the UN’s view in that document is that it will probably get worse.

The Minister may know that I have taken an active part in legislation on mental health. I am the patron of a mental health charity, Rethink, and I am aware that drug usage is not always—perhaps never—the sole cause of mental health conditions such as schizophrenia and depressive illness. None the less, drug usage probably contributes to the development of some of these conditions; there are social problems and the loss of quality of life for individuals and carers.

For a number of reasons, I support the plea of the noble Baroness, Lady Meacher. We should give some priority to the UN review on countering the drug problem. The review is imminent and, if we are to play some role, this debate is timely. It is not clear how much knowledge and experience we have to contribute or how much we can learn from other countries, but it is certain that the drug trade and practices are an international matter. As many noble Lords have said, illegal drugs are one of the world’s largest trading products and are a serious concern to many countries. We need to make the most of the opportunity of the review to see what we can learn, how we can improve our record and how international co-operation can cut back supplies and improve the health of our citizens.

I understand that the European Union was seeking to reach a common position to respond to the United Nations review. I see no difficulty in that. If we care enough, we can influence that position satisfactorily. Even if the search for consensus makes it necessary to have a common position that does not correspond totally to the wishes of some noble Lords, we should be able to provide in the text of the common position sufficient pegs to make possible at least a thorough examination or re-examination in the UN context in future years of ways of achieving better results in the struggle against the harm caused by drugs. Although the review in March is a fixed point, it may also involve an ongoing programme and I would expect further regular reviews over time.

I turn to the UN declaration on countering the world drug problem and the context of the review. I attach importance to the explicit commitment to the concept of harm reduction and the eradication—accompanied, if possible, by alternative developments—of dangerous crops. We must keep those two basic ideas at the forefront. We should not step back from a forceful approach to those points, and the convention remains a framework for national law in this regard.

I share the view of the noble Baroness, Lady Meacher, that there is another opportunity to examine ideas discussed, advocated or adopted in other countries. We should have an envelope, if that is the correct term—it is a good term—in the review that does not inhibit sensible examination of such ideas.

The Minister’s opportunity to give full answers to this debate may be limited by the fact that we are currently working in the European Union to construct, as far as is feasible, a common position. Most importantly, there is a very good chance of including in the common position an accent on evidence-based practice as a

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feature of any forward programme resulting from the review. That would be consistent with a point in the original declaration of 1998, which deals with this possibility. That implies that we, in common with our international partners, should do our best to collect that evidence. It would involve some experimentation on methods without prejudicing the basic principles of harm reduction and the elimination of dangerous drug crops. I hope that the Minister will comment on that point about evidence-based practice.

12.57 pm

The Earl of Erroll: My Lords, I thank the noble Baroness, Lady Meacher, for this opportunity to discuss this problem. I have no axe to grind except as a citizen who is threatened by the spin-offs from the problem. I have never been addicted and I do not have a desire to indulge in illegal drugs. I am worried about the misdirected use of taxpayers’ money in dealing with this.

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