Dan Carden (Liverpool, Walton) (Lab) I beg to move, That this House
has considered Dame Carol Black’s independent review of drugs
report. It is a pleasure to serve under your chairmanship, Ms
Fovargue. I refer Members to my entry in the Register of Members’
Financial Interests. The damning conclusion of part two of Dame
Carol Black’s review, setting out a way forward on drug treatment
and recovery, was that “the public provision we currently have
for...Request free trial
(Liverpool, Walton) (Lab)
I beg to move,
That this House has considered Dame Carol Black’s independent
review of drugs report.
It is a pleasure to serve under your chairmanship, Ms Fovargue. I
refer Members to my entry in the Register of Members’ Financial
Interests. The damning conclusion of part two of Dame Carol
Black’s review, setting out a way forward on drug treatment and
recovery, was that
“the public provision we currently have for prevention, treatment
and recovery is not fit for purpose, and urgently needs
repair.”
I have called today’s debate because the report’s recommendations
are too important to be left gathering dust on ministerial
bookshelves. I want Dame Carol’s words ringing in ministerial
ears. She says:
“Government faces an unavoidable choice: invest in tackling the
problem or keep paying for the consequences. A whole-system
approach is needed…This part of my review offers concrete
proposals, deliverable within this Parliament, to achieve
this.”
Of the review, Dame Carol says:
“It calls for significant investment, but the payoff is handsome:
currently each £1 spent on treatment will save £4 from reduced
demands on health, prison, law enforcement and emergency
services. I am hopeful that the recommendations will be welcomed
by this government as they strongly support its crime reduction
and ‘levelling up’ agendas.”
The 32 recommendations are a gift to the Government, and should
be a moment for change. It is fitting that the debate falls on
Budget day. The economic cost of drug misuse is upwards of £20
billion each year; yet the spending on prevention and treatment
stands at just £650 million. The recommendations give hope that
real change is possible. Addiction is a national crisis. Drug and
alcohol-related deaths are the highest on record, at the very
moment that treatment services are most ill-equipped to deal with
the soaring need.
Forward Trust estimates that more than 2 million people are in
need of help with alcohol, drugs or gambling, and its recent
YouGov poll showed that 64% of people said that they knew someone
personally struggling with addiction. Since I talked openly about
my personal experience of addiction and recovery, I have been
over- whelmed by the thousands of people who have reached out to
tell me their personal stories—of the horror of addiction, and
the blessings of recovery. The tragedy is that addiction is
everywhere, yet remains so hidden.
In 2019 Dame Carol was commissioned by the then Home Secretary,
the right hon. Member for Bromsgrove (), to independently review
illicit drugs in England. I thank her for her commitment and
dedication over the last few years, and all those who contributed
to this groundbreaking report. Most of all, I hope that my
contribution today does justice to the absolute clarity that Dame
Carol brings to these incredibly complex matters. Part one of her
review was published on 27 February, and made for uncomfortable
reading. The unflinching analysis detailed the extent of
drug-related harm and the challenges posed by drug supply and
demand, including the ways in which drugs fuel serious
violence.
The Department of Health and Social Care swiftly commissioned
Dame Carol to produce part two of her independent review, which
focused on how to improve the funding, commissioning, quality and
accountability of drug prevention, treatment and recovery
services in England. Part two of her report, published in July,
pulls no punches either. It says:
“Funding cuts have left treatment and recovery services on their
knees. Commissioning has been fragmented, with little
accountability for outcomes. And partnerships between local
authorities, health, housing, employment support and criminal
justice agencies have deteriorated.”
The report goes on:
“The workforce is depleted, especially of professionally
qualified people, and demoralised. Vital services have been cut
back, particularly inpatient detoxification, residential
rehabilitation, specialist services for young people, and
treatment for cannabis and stimulant users.”
(Strangford) (DUP)
I commend the hon. Member for bringing this issue to Westminster
Hall for debate and discussion. Does he agree that more should be
done to ensure that alcoholism in particular is treated urgently,
along with drugs, and that help needs to be given to families for
rehabilitation, which he has referred to, not in a punitive
fashion, which is how some would like to do it, but instead to
help to draw people away from their addiction? That has to be
done in such a way that people wish to get away from their
addiction and try to move forward.
Absolutely. That is a valuable intervention, and it is good that
we have a Health Minister responding to this debate, because it
is a health response, joined up across Government, that this
issue calls for.
Part two of the report goes on:
“Areas of the country with the highest rates of drug deaths or
the poorest treatment services are the very same areas where the
need to level up is greatest. These communities want to see
urgent and effective action to tackle the violent drugs market,
alongside purposeful efforts to rebuild treatment services and
recovery support so that people can get the help they need.”
(Edinburgh East) (SNP)
The hon. Gentleman is making an excellent speech, and I very much
endorse and support the recommendations of Dame Carol Black’s
review. However, I have heard her present these reports, and she
has been very clear that the framework that she was given—the
parameters that she was allowed to look at—deliberately excluded
any review of the legislation that frames this whole matter.
Given that this is a unique health pandemic—because the victims
of it are liable to criminal prosecution if they seek help, and
many who would seek to help them would be liable to criminal
prosecution if they tried to do so—is it not time for the
Government to begin a review of the Misuse of Drugs Act 1971, to
ensure a more up-to-date legal framework to deal with these
problems? Would that not assist in the implementation of Dame
Carol Black’s recommendations?
The hon. Member makes an important point, although it is one that
I will not get drawn into today.
A month after part two was published, the Office for National
Statistics confirmed that drug-related deaths had hit an all-time
high in England and Wales—the highest number of deaths since
records began. Drug deaths have risen 60% in the last decade. In
2020, 4,561 people lost their lives to drugs. Each life lost
represents years of pain and suffering; each life lost leaves a
family devasted and shattered irreversibly; each life lost is
evidence of a missed treatment opportunity; and, most importantly
for us today, it is important to accept that each life lost is a
failure of policy, too.
I want to make special mention of the stigma that surrounds
addiction. Someone who finds themselves dependent on a substance
deserves the evidence-based health treatment and support that
works, yet stereotyping and prejudice remain all too common in
our approach to addiction. It was disappointing to see the
Government’s response to the review referring to addiction as a
“scourge on society”. The dehumanisation of people who become
drug-dependent feeds into the stigma that we must eradicate, so
we must steer the discussion, the policies and the treatment
towards a compassionate and person-centred health response.
Last week I joined the Forward Trust at the launch of its “Taking
action on addiction” campaign, which aims to improve public
understanding of addiction as a erious, chronic mental health
condition. The Duchess of Cambridge, patron of the Forward Trust,
spoke there. I want to quote her at length:
“Addiction is not a choice. No one chooses to become an addict.
But it can happen to any one of us. None of us are immune. Yet
it’s all too rarely discussed as a serious mental health
condition. And seldom do we take the time to uncover and fully
understand its fundamental root causes.
“The journey towards addiction is often multi-layered and
complex. But, by recognising what lies beneath addiction, we can
help remove the taboo and shame that sadly surrounds it. As a
society, we need to start from a position of compassion and
empathy.”
As many as 80% of the public support more treatment and care for
people struggling with addiction; less than 10% believe more
punishment and condemnation would help. Intolerance, shaming,
tougher punishments and denial will not rid society of addiction,
because addiction is an illness. It is a matter of public health,
and Dame Carol puts it best when she says,
“It must be recognised that addiction is a chronic mental health
condition, and like diabetes, hypertension or rheumatoid
arthritis, it will require long-term follow-up.”
Sadly, as things stand, I cannot think of another illness that
causes so much harm to society, that is given so little, and the
sufferers of which are treated with such contempt. It is the only
illness in which blame is placed on the person suffering. Instead
of blaming the individual for making bad choices, we need to ask
why so many people are turning to substances in the first
place.
Now to the prevention, treatment and recovery system as it
stands: not fit for purpose, in urgent need of repair, years of
austerity, continued disinvestment, fragmentation and a dire lack
of accountability throughout. The Health and Social Care Act 2012
shifted addiction treatment out of the NHS mental health services
on to local authorities, at the same time as their budgets were
being slashed. On that matter, Dame Carol is clear:
“We recommend that funding for drug treatment be allocated to
local authorities based on a needs assessment and then
protected.”
We also urgently need to improve the situation for people
suffering co-occurring mental ill health and drug or alcohol
dependency. Too many people are being bounced between fragmented
services and end up falling between the cracks. It is simply
wrong that mental health services can require patients to reduce
their alcohol or drug use, without providing the proper support
to do so, before they can receive the treatment they need. Or
that drug and alcohol services do not possess the competencies to
support someone with significant mental health issues, thereby
often leaving sufferers with no support whatsoever.
There must be a “no wrong door” policy. One young woman, whom I
will call Jane, told me:
“It was as if I had to get more ill, drink and use more, until I
got the right help and support. For 18 months, my mental health
deteriorated. Mental health services couldn’t help me and
addiction services struggled to support me because of my poor
mental health. I was so frightened, I had to reach crisis point
and rock bottom before I was able to be considered for
residential treatment.”
Jane is now in recovery and leading a happy, healthy life, but
she did not receive public funding. In fact, she was denied that.
If it had not been for a chance meeting with Action On Addiction,
which provided her with a bursary-funded bed, she would not be
alive today. It should simply not fall to charities to catch the
increasing numbers of people falling through the threadbare
safety net. Access to treatment should not be about luck, only
available to those who can afford it or those who live in a local
authority that prioritises it.
Currently, the drugs treatment market operates in a similar way
to that of adult social care. Providers are being squeezed and
staff poorly paid. There is high turnover in the workforce and a
depletion of skills. The number of medics, psychologists, nurses
and social workers in the field is falling significantly.
It is time to repair that broken system and overhaul addiction
treatment, and we have the road map for the future—the 32
recommendations of Dame Carol Black’s independent review of
drugs. The scope of the recommendations is far-reaching and the
solutions span many Government Departments, local government and
other organisations.
Dame Carol’s review has pursued three main objectives: first, to
increase the proportion of people misusing drugs who can access
treatment and recovery support, including more young people, with
earlier interventions to divert offenders away from the criminal
justice system; secondly, to ensure that the treatment and
recovery package offered is of high quality and includes
evidence-based drug treatment, mental health and physical
interventions, and employment and housing support; and thirdly,
to reduce the demand for drugs and prevent problematic drug use,
including use by vulnerable and minority groups and recreational
drug users.
To achieve those objectives, significant changes need to be made
in four areas: radical reform of leadership funding and
commissioning; rebuilding of services; increased focus on
prevention and early intervention; and improvements to research
and how science informs policy, commissioning and practice. And
the 32 recommendations cover a wide range of
responsibilities.
The Government have already begun to set in motion some of the
structural changes, which I welcome, and the policy commitments
that will help to drive through the review’s recommendations. It
is reassuring that Dame Carol herself will continue to act as an
independent adviser to Government. However, the remaining
recommendations are contingent on Government investment.
In January 2021, the Government announced £148 million of new
money to cut crime and protect people from the harms caused by
illegal drugs, which I also welcome, with £80 million of that
money to be invested in treatment and recovery. That £148 million
must be the first instalment of the £1.78 billion that Dame Carol
has called for over the next five years and I hope that the
Minister has come with hot-off-the-press Budget commitments. Dame
Carol’s spending recommendation would restore addiction treatment
to what it was before 2012. Although local authorities are well
positioned to oversee services, drastic cuts to public health
grants have led to cuts to addiction treatment services over many
years. The Local Government Association has long argued that
reductions to the councils’ public health grant, which is used to
fund drug and alcohol prevention and treatment services, is a
false economy, which will only compound acute pressures for
criminal justice and NHS services further down the line.
I must stress to the Minister that if the Treasury is unable to
find all the funding that the review calls for, the money it does
find must not be thinly spread across the country. Instead, it
should be targeted at those areas most in need, and efforts must
be made at least to pilot the whole-systems approach that Dame
Carol has called for. Small amounts of money given to each local
authority will not bring about the long-term transformational
change that the review demands.
There has simply never been the political will to act on
prevention, treatment and recovery from drug and alcohol harm,
but we have reached a crisis point, with record deaths, rising
economic and social harms, and depleted treatment services. Dame
Carol’s groundbreaking review, which was commissioned by this
Government, is the moment for change, and the Government cannot
meet their pledges to level up the deprived communities that they
seek to represent, which are often found in the north, unless
they recognise that. In the words of Dame Carol herself:
“The Government must either invest in tackling the problem or
keep paying for the consequences.”
(in the Chair)
A number of Members are waiting to speak. I am not imposing a
formal time limit, but please keep contributions to four minutes
or others will lose out. I call .
16:49:00
(York Central)
(Lab/Co-op)
It is a pleasure to serve with you in the Chair, Ms Fovargue. I
congratulate my hon. Friend the Member for Liverpool, Walton
() on securing today’s debate,
and I thank Dame Carol Black for putting
forward such strong recommendations: 32 in all that must be
adopted in full.
Some 3 million people have used drugs in the last year—an
indicator of why the issue is so urgent. As we have heard, in the
last year 4,561 people have lost their lives, including a young
boy in my constituency. That brings it home how important it is
to tackle the issue and move it into a public health framework.
We know that it preys on people whose lives have been afflicted
with trauma and many complex needs, but it can also be
indiscriminate. That path is not inevitable. Things can change,
and the report describes a pathway for bringing about change.
I was struck by the call for a change in governance and ensuring
that there is a central drugs unit. That should be a priority for
No. 10 and a sub-committee of the Cabinet in order to bring
together Government Departments to bring the laser-like focus
that is needed. When money, time and people are focused, it can
shift agendas. We need leadership. We need to build an evidence
base and to invest in research on the best treatments and early
intervention. If we take a half-hearted approach, we will not
shift the dial. That is why the Minister should step up and make
it possible to bring about change.
We need to see diversion as well so that people are not sucked
into the criminal justice system, but brought out of it through
diversion and ensuring that, for instance, young people are not
arrested but pushed down the line of education, giving them a
pathway out into apprenticeships and work, and giving them the
chances in life that they have never had. We need to invest in
and mentor young people so that their future goes a different
way. Many of the people dealing drugs are being exploited by
criminal gangs, and they too deserve a future that is very
different from the paths that they are on.
We need investment in treatment, as has been articulated, not
only for mental health but for physical health as well. We need
to build stability, too, with a housing first approach so that
people have a house. When people leave the criminal justice
system, they need a house, a treatment plan, a bank account, and
also a job to move into if that is appropriate. We should look at
the person and not just the issue.
We need to go further, so I urge the Minister to look at how we
can create drug consumption rooms where people can engage with
services, while recognising that it will take people six or seven
attempts on average to move out of a life on drugs. Also, I want
the Minister to look into heroin-assisted treatment so that we
can take a different approach to break the cycle of substance
misuse. There is a real opportunity ahead of us, and I trust the
Minister will step up and deliver.
16:53:00
(Glasgow North) (SNP)
It is a real pleasure to serve under your chairmanship, Ms
Fovargue. I congratulate the hon. Member for Liverpool, Walton
() on securing this debate, on
his courageous and dedicated approach, and on setting out so
clearly the context of Dame Carol Black’s independent review. As
he said, the whole point of commissioning reviews from
independent experts is to provide a way forward, and not for them
to simply sit on the shelf as the completion of a process when
they should be the start of it. Precisely because they have been
independent, they provide grounds for cross-party consensus that
all of us, from all parties, can get behind. I hope that that
comes out strongly from the debate today and in what we hear in
response from the Minister.
It is not a secret that drug deaths in Scotland are unacceptably
high and among the worst in Europe. I would imagine that most
Scottish Members of Parliament will have come into contact with
someone affected by, or connected to a death, whether that is a
constituent or their family, a minister—some ministers in Glasgow
have to conduct services far too frequently—or indeed through
their own friends or family. Certainly, I have had all three of
those experiences. Every death is a tragedy.
The First Minister has admitted that more should have been done,
and that more needs to be done going forward. For me, that must
include the adoption of the recommendations made by
Dame Carol Black It must
include the kind of responses that my hon. Friend the Member for
Edinburgh East () spoke about as regards
reform of the Misuse of Drugs Act—clearly, after 50 years, a
piece of legislation that is well past its sell-by date. It is
clearly not doing what it was originally intended to achieve.
I welcome the steps that the Scottish Government have taken so
far, in the additional funding they have announced—£250 million
over the next five years to be spent in a range of different
responses. They continue to look at some of the things that the
hon. Member for York Central () spoke about, such as
prevention facilities or drug consumption rooms—depending on what
we want to call them—and heroin-assisted treatment facilities.
They are not quite within the devolved powers, but the Scottish
Government will do what they can. Ideally, the UK Government will
give them the powers if they are not willing to legislate in
those areas.
Finally, I want to reflect on the recovery strand. The amazing
charity Faces and Voices of Recovery UK, run by Anne Marie Ward,
is based in my constituency. In 2018, it launched a charter, a
declaration of recovery rights for people seeking to recover from
drug and alcohol addiction. That declaration, and the early-day
motion that I tabled at the time to support it, was signed by
many Members of this House, on a cross-party basis. It was
compiled after a year of consultations across the UK into what
the charity identified, even then, as a drug death crisis.
The declaration states that all people in recovery have a right
to recover from addiction, if they find themselves in that
situation. It seeks to build communities of recovery and pledges
that people who are current or former substance users should be
able to live their lives free from stigma, with access to quality
care, meaningful political representation—which is a duty on us
all—and well-informed choice, and touches on a range of other
important aspects.
It has support from a wide range of organisations, including the
Scottish Drugs Forum, Alcohol Change UK, the Scottish Recovery
Consortium, the National Association for Children of Alcoholics,
and so on. It is based on the underlying principle that people in
recovery have a right to respect and dignity, and to live free
from stigma and discrimination. If the Minister is not familiar
with that document, I am very happy to send her a copy, and I
very much hope that she will familiarise herself with it and
adopt its principles as part of the Government’s response to Dame
Carol’s report.
16:58:00
(Luton South) (Lab)
It is a pleasure to serve under your chairship, Ms Fovargue. I
congratulate my hon. Friend the Member for Liverpool, Walton
() on securing today’s debate.
His campaigning on the issue has been excellent, and I am pleased
to support the points he has raised. I refer to my entry in the
register of interests, as I speak as a vice president of the
Local Government Association.
We know that drug misuse has had a devastating impact on UK
society, costing over £19 billion per year. Drug-related deaths
have risen by 80% since 2012, and we are still seeing worrying
rises in young people reporting early onset addiction. The latest
LGA estimates suggest that around 200,000 people are receiving
help for substance misuse, and another 100,000 are not receiving
support. Addiction must be seen as a chronic health condition.
Like other conditions, it requires long-term follow up. Trauma
and mental ill health are identified as key drivers and an
accompaniment to much addiction. They are comorbidities, rather
than separate problems.
Tackling the problem requires a holistic multi-agency approach,
with Government Departments working together to invest in and
improve treatment, employment, housing support, and the way
people with addictions are treated in the criminal justice
system. However, access to addiction treatment and recovery is
now a postcode lottery. More than half of state-funded
residential addiction rehabilitation centres in the UK have
closed in the last eight years, and the capacity of prison
recovery programmes has reduced by over 60% in the same period.
In some local authorities, funding for addiction services has
been cut by more than 40%.
Since 2014-15, the Government have presided over a real-terms cut
of £700 million to local councils’ public health funding, and
single-year settlements and the late allocation of budgets have
created unnecessary uncertainty. The LGA has long argued that
reductions to councils’ public health grant, which is used to
fund drug and alcohol prevention and treatment services, are a
false economy that will only compound acute pressures for
criminal justice and NHS services further down the line.
The Government are also failing to facilitate early intervention
to divert young people away from drugs and crime, which is an
issue raised by many of my constituents. Under the Tories,
spending on young people’s services has been cut by 73%. Some 900
youth centres have been closed, and 4,500 youth worker jobs have
been cut. Although today’s Budget announcements are welcome, it
is obvious that the Government have reflected that much of this
was a mistake.
For every £1 spent on addiction treatment, the Exchequer saves at
least £3 in crime, health and benefit expenditure, and for every
£1 spend on family intervention services, the Exchequer can
generate £2.76 in savings. The public provision for prevention,
treatment and recovery needs urgent repair, with the impact of
the pandemic meaning that the problem will almost certainly get
worse and act as a major barrier to levelling up.
To build on what my hon. Friend the Member for Liverpool, Walton
has already said, I hope the Government will commit to take steps
to adopt Dame Carol Black’s recommendations to properly fund and
resource addiction recovery services and, importantly,
cross-Departmental liaison. I hope the Minister understands why
last week I asked when she had spoken to the Local Government
Association and the Association of Directors of Public Health to
discuss covid, addiction and other important issues, because they
are so cross-cutting. I look forward to her response.
(in the Chair)
I will be calling the SNP spokesperson at 5.10 pm.
17:01:00
(Middlesbrough) (Lab)
It is great to see you in the Chair, Ms Fovargue. I congratulate
my hon. Friend the Member for Liverpool, Walton () on his bravery and on securing
the debate.
I very much welcome the review by Dame Carol
Black but I note with great sadness her stark observation
that Governments have de-prioritised these problems—from drugs
entering the country, right through to helping drug users access
appropriate treatment and achieve recovery. It is that second aim
on which I will concentrate my brief remarks because, sadly,
Office for National Statistics data show that the north-east is
the worst area in the country for drug-related deaths. That makes
it all the more important that programmes to address addiction as
a health and public protection issue are successful. Accordingly,
I was delighted in 2019 that the then Labour police and crime
commissioner for Cleveland, , provided the essential
funding, derived from the proceeds of crime, for the
heroin-assisted treatment programme based in my Middlesbrough
constituency—the first and only one of its kind in the UK.
This is undoubtedly a hard road, but there is no doubt that the
programme has been immensely successful. The first cohort
accepted on to the scheme were 14 of the most at-risk individuals
in Middlesbrough, who caused the most concern to the criminal
justice agencies and the health and social care services. Some
had been using street heroin for over 20 years, and all other
treatment had failed. Whereas six of them had committed 541
detected crimes before the scheme, with an estimated cost to
victims and the public purse of £2.1 million, their combined
crimes fell to three lower-level offences after starting their
treatment.
In all cases, the individuals concerned either completed their
probation or showed improved compliance with a probation order,
and there was a 98% attendance rate at the twice-daily sessions,
which continued through covid and lockdowns. None of the
participants went back to sleeping on the streets, their use of
illicit substances declined markedly, and their mental wellbeing
improved. I am delighted that the clinical lead on the programme,
Danny Ahmed, has been in Parliament today, and I pay great
tribute to the superb work that he and his colleagues have done
in showing the country the way to address this most complex of
issues.
In closing, I would also like to pay tribute to the courageous
stance taken by the chief constable of Cleveland, Richard Lewis,
in his recent article in The Guardian where he said amongst other
things that,
“The heroin-assisted treatment programme offers hope, if scaled
up on a national level, that demand for heroin can be cut. When
the state offers a meaningful alternative to the street drugs
that can be bought from organised crime groups, the demand for
them decreases.”
Finally, he said that the programme in Middlesbrough
“could possibly represent the beginning of the end for the ‘war
on drugs’ that has already taken too many lives.”
I wholeheartedly agree, and I trust that the Government will take
on board each and every one of the 32 recommendations that
Dame Carol Black makes.
17:05:00
(North Tyneside) (Lab)
It is an honour to serve under your chairmanship, Ms Fovargue. I
congratulate my hon. Friend the Member for Liverpool, Walton
() on securing the debate, and on
the way that he spoke with great knowledge and passion. I declare
my interest as co-chair of the drugs, alcohol and justice
cross-party parliamentary group. In that capacity it was my
privilege to introduce Professor Dame Carol
Black to address our group the week after she published her
report. My co-chair, , has repeatedly asked in
the other place when the Government will establish the
long-awaited royal commission on the criminal justice system. I
hope the Minister may have some news on that for us.
Dame Carol’s report recommended earlier interventions for
offenders to divert them away from the criminal justice system,
particularly prison. Providing people with pathways into
treatment, rather than into the criminal justice system, seems an
eminently sensible approach because, as Dame Carol observed:
“Rarely are prison sentences a restorative experience.”
Over a third of prison places in England and Wales are taken up
because of drug-related offences.
I pay tribute to the pioneering work of the late , who, as Durham’s police and crime commissioner,
introduced a successful checkpoint scheme. We have since heard of
other excellent diversion schemes, such as those developed in the
West Midlands and in Thames Valley—we desperately need more like
them. I am glad that Ron’s successor, , along with Dorset PCC Dave
Sidwick, is leading the PCCs’ work on addiction. I am sure the
Minister will join me in welcoming their dedication to helping
people towards a safer and healthier future.
Dame Carol understands that addiction is a chronic health
condition, arising as people try to cope with trauma and other
issues. Her report rightly condemned the current situation as
intolerable. Drug-related deaths are at record levels, the impact
of drug-related harms in many places is getting worse and the
worst affected areas are those with greatest deprivation. I am
sad to say that the highest rate of drug misuse deaths in 2020
was once again in the north-east, which according to the ONS has
had the highest rate of drug misuse for the past eight years,
with a significantly higher rate than other regions of England
and over three times the rate of London.
We know drug treatment has seen years of disinvestment. Some
services have seen budgets nearly halved as funding has been
redirected to other local government priorities. There has been
an absence of political leadership and financial commitment to
address the concerns of the sector, with very clear and obvious
consequences. A range of treatment providers welcome Dame Carol’s
review, fully endorse her recommendations for a whole system
approach and told our group they were keen to seize this unique
opportunity to rebuild and renew our treatment and recovery
system. Jon Murray, an executive director at With You told
us:
“This review represents a potentially defining moment in the
course of drug treatment in the UK.”
Yasmin Batliwala, chair of the Westminster Drug Project said:
“This report has the potential to be a game changer!”
Karen Tyrell, executive director at Humankind added:
“Dame Carol Black has
provided the map needed to get the sector back on course and we
urge the government to employ their moral compass, invest
accordingly and help us turn this ship around.”
For far too long, piecemeal investment through path- finders and
pilot schemes failed to provide the stability for providers to
develop the long-term plans, and recruit and retain the
high-quality staff, that are needed to meet the ambitions laid
out in the review. As recommended, ringfenced funding is
essential for the sector to build and maintain a resilient
support system for the hundreds of thousands of people who so
desperately need and deserve those services. I sincerely hope
that the Government will act on all of Dame Carol’s
recommendations.
17:10:00
(Inverclyde) (SNP)
Thank you for allowing me time to speak, Ms Fovargue. I
congratulate the hon. Member for Liverpool, Walton () on securing the debate.
Having read Dame Carol Black’s “Review of drugs part two” several
times now and having listened to her present and answer questions
on the report, I find myself increasingly frustrated, not with
Dame Carol Black but within
myself. The inadequacies of the existing system are laid bare for
all to see in the report. Crucial areas that must be addressed
are explained and, as we have heard, 32 recommendations are
detailed. Drug treatment, recovery support, funding,
commissioning, diversion, employment, housing, mental and
physical health, prevention, intervention and research—the report
has recommendations on them all. It is right and proper that we
tackle drug policy in that way. Patching will not do; we need
reform on a grand scale, put into the hands of the people best
placed to make it effective.
For too long, drugs have been designated as a matter for the
judicial system, and our health services have been left to pick
up the pieces. The report puts health at the heart of the
solution and should be commended for doing so. However, apart
from making recommendations, there is nothing that the report or
I can do. That is the cause of my frustration. Dame Carol Black is
absolutely clear that if the UK Government start to pick and
choose which of her 32 recommendations to implement, it will not
work. I applaud her for saying that. Too often we make do and
mend with policies that have been ripped up and rewritten.
The Misuse of Drugs Act 1971 is a case in point. For 50 years, it
has made the situation worse, but to expect the UK Government to
have a sudden blinding flash of understanding and compassion
would be naive. They will not implement many of the
recommendations; they will pick a few, dress up a few others, pay
lip service to some and ignore the rest. I say that with
confidence and a heavy heart: confidence, because the UK
Government just do not get the issue of drug addiction and
harm—while the administration of the area continues to be held in
the Home Office, the situation will not improve—and a heavy
heart, because as people in the drug rehabilitation community
keep telling me, “You keep on talking and we keep on dying.”
That is not Dame Carol Black’s fault. As my hon. Friend the
Member for Edinburgh East () mentioned, Dame Carol’s
remit was deliberately precise. She was not allowed to recommend
any new legislation, which in effect neuters her report. How can
she be expected to identify improvements for a system that is
tied up and gagged by the law if she cannot suggest some changes
to the law? Dame Carol Black however,
had a good go at that by recommending a new structure for the
mechanics of government which, if it were allowed to function,
could within itself produce the required legislation. I am sure
that Dame Carol Black would be
happy with the outcome: she feeds in all the good ideas and the
UK Government put them through a mincer, come up with a solution
that she proposed, and implement it, taking the credit.
To be honest, I would be more than happy if that happened, but I
just cannot see it, because one recommendation is the creation of
a new central drugs unit. According to the report, that unit
should be placed
“in whatever department or joint arrangement seems
appropriate”.
Unless that Department is the Department of Health and Social
Care, it is a non-starter.
The intransigence of the Home Office has been a feature of this
UK Government, and I cannot see that changing any day now. I
expect warm words for Dame Carol Black’s report, which could be
seen as progress, but I do not expect that the UK Government will
do anything other than launch inquiries, form committees, divert
responsibility and talk about budgets and constraint. However, I
am pleased that we have a Minister from the Department of Health
and Social Care present, because historically the UK Home Office
is where good ideas go to die.
At the start of Dame Carol Black’s report, as has been said
already in the debate, but it is worth repeating— I love this
quote—she states:
“Government faces an unavoidable choice: invest in tackling the
problem or keep paying for the consequences. A whole-system
approach is needed”.
She is absolutely correct. I say to the Minister, go on: agree to
all 32 recommendations, fund them and put the power of
implementation into the appropriate Departments, proving me 100%
wrong—please.
17:14:00
(Leicester South)
(Lab/Co-op)
It is a pleasure to see you in the Chair, Ms Fovargue. I commend
all hon. Members who have spoken, with great insight and
authority. They made many serious points, which I hope the
Minister will respond to.
I pay particular tribute to my hon. Friend the Member for
Liverpool, Walton (), for not only his superb
presentation of the issues in the Black report but for the way in
which he spoke with great eloquence and bravery about his
personal story of addiction. I am not ashamed to say that it
moved me to tears. I, too, have spoken about how addiction has
affected my family and what it meant for me as a child growing up
with a father who had a serious drink problem. I know that
thousands of people who are, struggling with addiction, or see a
loved one doing so, will have heard my hon. Friend’s speech.
Although they may never get in touch with or meet him, his speech
will have been a tremendous comfort to them, and we should all
thank him for his bravery.
I will focus on the addiction crisis that we face as a country. I
commend Dame Carol on her excellent report. Her 32
recommendations should be taken forward by the Government, and we
need to hear from the Minister exactly what their attitude is to
them. I offer to work with her on a cross-party basis on this
public health crisis. In the last year, more than 7,000 people in
England and Wales have died from alcohol-related causes.
Alcohol-related liver disease is increasing. More and more people
are dying from drug poisoning across England and Wales. There
are, of course, particular issues in Scotland, which Members who
represent Scottish constituencies rightly raised.
We are at risk of our society falling into a situation where
deaths among those in their 40s and 50s are increasingly either
the result of suicide or are drug or alcohol-related. They are
called deaths of despair. For quite some time, this been a well
known and tragic phenomenon in the United States, and we are at
risk of seeing it become a feature here in the United Kingdom. My
hon. Friend the Member for Liverpool, Walton is right that
addiction is a national crisis, and spot on when he says that it
is everywhere but well hidden.
We are having this debate on the day the Chancellor has presented
his Budget, but even though this is a public health crisis, and
we are still experiencing another public health crisis, public
health did not feature in the Budget. As a number of Members have
quoted, Dame Carol says:
“Government faces an unavoidable choice: invest in tackling the
problem or keep paying for the consequences.”
The Chancellor ducked that choice today, and public health did
not get the substantial increase in funding that it needs. As my
hon. Friend the Member for Luton South () said, the Budget comes
after real-terms cuts in recent years of £800 million to £1
billion, depending on how we calculate the figures. Those
real-term cuts mean that drug and alcohol addiction services have
lost £122 million in recent years—a 15% cut.
The Health Secretary likes to use Blackpool as an example of why
we need to level up, pointing out the stalling life expectancy
there. Blackpool, which has the highest mortality rate in the
country for alcohol-related deaths and has the thirteenth highest
number of deaths from drug poisoning, has had a £43 per person
cut to public health funding in recent years. Manchester, which
had the fifth highest number of deaths from drug poisoning in
2020, has had a £33 cut per person in public health funding in
recent years. In 2020, Liverpool had the joint highest number of
deaths from drug poisoning, with 89 people losing their lives,
yet the city has had a £34 per person real-terms cut in public
health funding. We look forward to the Minister telling us how
local authority drug and alcohol addiction services are expected
to cope if the cuts are not reversed—
(in the Chair)
Order. I am afraid I have to call the Minister.
Will the Minister respond on the public health cuts? When will we
see the investment in drug and alcohol addiction services that
Dame Carol Black’s report calls for?
17:20:00
The Parliamentary Under-Secretary of State for Health and Social
Care ()
It is a pleasure to serve under your chairmanship, Ms Fovargue. I
congratulate the hon. Member for Liverpool, Walton () on securing this extremely
important debate. I pay tribute to all his work on addiction and
his openness regarding his personal experience in previous
debates. As the right hon. Member for Leicester South () said, he brought many of
us to tears. No doubt his example will serve as inspiration for
others to take that crucial first step of coming forward to ask
for help.
I thank all those working in the drug and alcohol addiction
sector, particularly during the pandemic. I commend the work they
do to help people through periods of their lives that are
exceptionally difficult, often through no fault of their own. As
the hon. Gentleman highlighted, the drug and alcohol addiction
sector faces challenges. There is no hiding from it. Drug misuse
deaths in England have been on the rise for many years and are
currently the highest on record. That is true across most of the
United Kingdom. Our neighbours are all grappling with this
devastating issue, particularly Scotland, where deaths rates are
the highest in Europe, as hon. Members have highlighted.
Drugs destroy lives, ruin families and tear apart communities.
That is why in February 2019 the Home Secretary appointed
Dame Carol Black to
undertake an independent review of drugs. Part one was published
on 27 February 2020, during the Government’s UK-wide drugs summit
in Glasgow. It provided a detailed analysis of the challenges
posed by drug supply and demand, including the first detailed
analysis of the drugs market and the ways drugs fuel serious
violence. After being commissioned by the Health Secretary, part
two of Dame Carol Black’s independent review of drugs was
published earlier this year, on 8 July. As hon. Members have
highlighted, Dame Carol made it clear that tackling drug
addiction needs to be more health focused. I am committed to
making it so. I agree with the hon. Gentleman that now is the
moment for change.
I would like to talk about the substantial action the Government
have already taken and our commitment to go much further. Dame
Carol has been a fantastic champion for better treatment and
recovery services. I am very pleased she will be working closely
with the Government as an independent advisor, holding us to
account each step of the way and providing advice on how we can
make real change. We are already making improvements to treatment
and recovery through the £148 million crime package announced in
January this year. Of that, £80 million has been allocated to
local authorities for drug treatment and recovery services. This
is the largest increase in drug treatment funding for 15 years,
and it is already making a difference.
That funding allocation is being focused on increasing the number
of treatment places for drug users in contact with the criminal
justice system, diverting people away from custody and into
treatment services and, crucially, making sure that we get more
people into treatment after they are released from prison. It is
also being used to fund additional in-patient detox beds, further
residential rehabilitation places and the life-saving overdose
medication naloxone. The additional treatment places are most
needed, and they will benefit people with alcohol dependency as
well as drug dependency.
The Government published our initial response to the findings of
part one and part two of Dame Carol’s independent review on drugs
on 27 July 2021. The response did not hold back in setting out
our clear cross-Government commitment to this agenda and to
taking effective action, given the urgency of addressing these
issues. We committed to responding to Dame Carol’s review in full
by the end of this year, and to set out a long-term drug
strategy. That is exactly what we will do. I would like to
reassure hon. Members that Dame Carol’s review will definitely
not sit on the shelf.
As Dame Carol points out, we must work across the whole of
Government to combat drug misuse and drive down drug supply and
demand. That approach is absolutely key. That is why, in July
this year, we established a new joint combating drugs unit, whose
mission is to co-ordinate and drive a genuinely
whole-of-Government approach to drug policy. The joint unit is
already bringing together multiple Government Departments to
tackle the problem across society. I am pleased that a number of
staff from my Department have joined the unit, again ensuring
that there is a health focus and that health lies at the heart of
analysis and decision making.
(Reigate) (Con)
I want the Minister to take up the offer to work together made by
the Opposition spokesman, the right hon. Member for Leicester
South (), and to work with
colleagues such as me who take a specialist interest in this
area. This should not be used as a political football in any
circumstances. The crisis is too great and all of us stand ready
to try to help her and her colleagues to deliver improvement in
this area.
I thank my hon. Friend for that intervention. He is right that
this is too important an issue to become partisan over, and I
completely accept the offer from the Opposition spokesman of
joint working on this. We are all passionate about this important
issue and we need to make sure that we get this right for
individuals who can really benefit.
I thank the hon. Member for Liverpool, Walton for securing a
debate on such an important issue. This Government are absolutely
committed to ensuring that everyone with a drug problem can
access the help and support that they need. He stated that
support must always be compassionate and person-centred, and the
hon. Member for York Central () highlighted that the way
forward is to have an individual-centred approach. We cannot have
a one-size-fits-all approach. Our long-term plan will be set out
in detail in our cross-Government drugs strategy, which will be
published later this year.
We understand that there is still a lot of work to do. There are
also huge challenges across the drug and alcohol sector. This
cannot be fixed overnight and we cannot do it without the help of
every single local authority in the country, as well as through
truly collaborative cross-Government and cross-party work
involving the NHS. As a number of hon. Members have mentioned,
the voluntary sector plays an important part, too. I put on
record my thanks to everybody who is making a huge difference,
whether that is at a statutory or a voluntary level, to so many
people’s lives and to their futures. I genuinely believe that by
working together, we can make a huge difference, and I look
forward to that in the future.
17:28:00
I thank the Minister and right hon. and hon. Members for their
kind comments, particularly, the Opposition spokesperson, my
right hon. Friend the Member for Leicester South (). I will hold the
Government to account on this issue. I want to see regular
reports back. I want to see how the Government intend to
implement Dame Carol’s 32 recommendations. I share the
cross-party spirit that has been expressed on this matter,
because in the end, this is about families and people up and down
this country who, when things go wrong with addiction and with
drug and alcohol problems, lose loved ones, always in the most
dramatic and unfortunate circumstances. I welcome the
Minister’s comments and look forward to holding the Government to
account on this in future.
Question put and agreed to.
Resolved,
That this House has considered Dame Carol Black’s independent
review of drugs report.
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