Select Committee on Home Affairs Minutes of Evidence

Examination of Witness (Questions 1300 - 1319)



Mr Watson

1300.  I just have a point of clarification on treatment of prisoners. You say that prisoners who were on maintenance programmes before they went into prison can now stay on those maintenance programmes. Is it the case that chaotic users who enter prison and are picked up as users for the first time can be put on maintenance programmes when they are in prison? Also can you just clarify what you said about the post-prison treatment and that there is a gap in the service or funding in that area?

  (Mr Ainsworth) People are not put on maintenance automatically or because they want to be when they enter prison. The Prison Service does an evaluation and, as I say, they have to do that within guidance set by the Department of Health and that applies to this decision-making process, but where they feel that they have the opportunity or where it is beneficial to the prisoner that they go through the detoxification, then detoxification is what is applied. It is more where they are not going to be able to hang on to that person for the length of time to be able to go satisfactorily through that process and where they are already on some form of treatment before they get in there that is clearly beneficial to them, then it is open to the Prison Service to decide to continue that treatment within the prison environment if they feel that it is appropriate.

1301.  If they are currently being treated when they enter prison, fine, but if they have not had any treatment before they enter prison, is the only option available for them detoxification or an abstinence programme or they can be treated, for example, with methadone or, in extreme cases, heroin?

  (Mr Ainsworth) Overwhelmingly, if they are going in and the length of sentence is such that detoxification can be completed, then whether or not they have been on treatment before they go in, detoxification is the road that people start to look at, but if they are short-term prisoners or if they are prisoners on remand and there is going to be no ability of the Prison Service to complete that situation, then they can look at some kind of maintenance programme in order to stabilise the individual concerned within the prison if that is what is felt to be appropriate given the circumstances that apply to that particular prison in terms of his state of health, his state of addiction and length of sentence or the length of incarceration that he potentially faces.

1302.  You see, the point I am trying to make is in my own constituency, and the very nature of the convictions is that they generally are short term, two, three, four months, a lot of drug workers and parents tell me that their children go into prison, they are put on detox for three months, there is no other support given post-detoxification and they come out of the prison gates, meet their dealer and they are straight back into the same cycle. What they really need is stabilisation of their condition even in the short term and to be put through treatment programmes when they leave the prison gate.

  (Mr Ainsworth) Yes, you are absolutely right and I acknowledge that that is a potential problem. What we need to do is to pick people up and carry them through that release period and to try to carry them through in a seamless way. It is more than just drug treatment in terms of the medical side of drug treatment; it is more to prevent them from going back to the market, back to the crime that fed the market in the first place, and then there are a lot of other things that need to be joined up as well. Not a million miles from your constituency, in Solihull, we funded a pilot whereby the local police followed the arrestees into prison and back through and out and back into the community again. Now, in order to do that, you are potentially building inefficiencies into the Prison Service because you cannot use the estate and maximise the capacity within the estate if you are going to keep prisoners local to the area in order that you can monitor their progress as they go into prison and come back out of prison as well. The police in the Solihull area were very keen on that kind of programme. At the very worst it enabled them to pick people up for re-offending quicker than they otherwise would do, but potentially there was the ability to help them as well to avoid re-offending in the first place, so these things do need to be looked at, but there are maybe substantial costs attached to them as well.


1303.  Can I just ask you about drug abstinence orders, Minister. We have heard that to require users to be abstinent without guaranteeing access to treatment at the same time is irresponsible. That is what one of the organisations who gave evidence to us said. What do you think about that?

  (Mr Ainsworth) Well, I think it would be true and I hope that we are not doing that. For those for whom it is felt appropriate, we should be offering drug treatment and testing orders. For people who have a lower level of dependency, then it may well be that drug abstinence orders are appropriate. Then we are implementing drug abstinence orders in the three pilot areas and we are looking to expand the three pilot areas. I think we have designated another six areas for this kind of work, and we have no desire or intent to roll these pilots out and to make them available nationwide before we have the treatment capacity in order to be able to refer people on. That is why we are absolutely dependent upon the funding and the good work that we are hoping is going to come from the NTA in terms of assessing the quality of treatment and the availability of treatment across the country. Drug abstinence orders should not be being used, and I have heard the allegation, "setting people up to fail", but they should be used in circumstances where people should be able to cope with the commitment that they are being expected to make without the testing requirement and we should not be pushing them in there if there is no treatment available.

  Chairman: Now we are coming to the bigger picture which is the national strategy.

Mrs Dean

1304.  Are you monitoring the progress of all the national strategy targets and do you have a baseline for them all to be able to judge the progress?

  (Mr Ainsworth) Yes. When we were discussing this potential question before I came here, the officials from the Department said, "We are monitoring it to high heaven, repeatedly and continually", and I think that there is some truth in that. You have interviewed Keith Hellawell as part of the official team that came to a meeting. When we drew up the Drug Strategy, I do not think anybody felt or claimed that every single piece of it was pinned down, that we had evidence to back up targets in every case, that some of the targets, it was openly acknowledged at that point, were aspirational and I do not criticise that because there was a necessity to get people focused and to force them to work together. Now, the very fact that we have that Strategy and that we have those targets has forced people to look at what works, what does not work, what is measurable and what is not measurable and some of those targets are extremely difficult to apply a baseline and a form of measurability to be able to say in a critical way that we are or we are not on target. There is little doubt that the one that is most measurable is treatment and, as I have said, we are on target to deliver that and in regard to the other targets, there is a lot of good work that is flowing from the focus that has been given, but in some cases, and this is part of the stocktaking review that we are going through now, we need to develop credible baselines, we need to make certain that what we are reaching for is in some way achievable, although we do need people to be stretched in this area and the last thing we want is for complacency to set in.

1305.  Do you think the targets are achievable?

  (Mr Ainsworth) This is part of what we are looking at in the stocktaking review. It would be rather foolish of me, I think, at this stage while we are still going through that process to try to say at exactly what stage we have reached. Let me share with the Committee one of the problematic targets where I do not think anybody needs to be a genius or where I do not think it requires rocket science to see that there are potential problems with it, which is if we look at availability. Now, how do we measure availability? This is the one that first jumped at me in the face as soon as I saw it. One is availability. Now, how do you measure it? What is easily measurable is seizures. Now, we are doing very well on seizures and the very fact that we have got people working together and we have got them working together as a result of the Strategy being put into place has meant a substantial increase in discussion, particularly on cocaine where there is a very big increase and some evidence that is beginning maybe to show through in terms of the wholesale price and the purity of the product that is coming through. However, if we retreated to seizures, where we have got an easily recognised and an easily measurable target, I think we would be far too narrow in terms of the problem that we are trying to tackle. What is the problem that we are trying to tackle? We are trying to dismantle to the extent that we can the illegal drug supply in the country, so we need to focus on seizures of the supply, we need to focus on disruption of the criminal elements that are involved within that, a lot less measurable than seizures, we need to focus on, and we have done this to a large degree, the Proceeds of Crime Bill, which Tom is painfully aware of, going through the House of Commons, we need to focus on seizing the assets and depriving those criminal elements of the profitability to the maximum extent that we can and then we need to use the other targets to try to whatever extent we can to deprive them of a market in terms of the people whom they are supplying in the first place. To what degree do we narrow the target and to what degree do we give up the breadth of it in order to get measurability is something we are wrestling with in the stock-taking review.

1306.  When do you expect to complete that stock-taking exercise?

  (Mr Ainsworth) By the summer, it has to be, to feed it into the 2002 budget round.

1307.  And the conclusions will be published then?

  (Mr Ainsworth) Yes.

1308.  And changing targets may come from that review?

  (Mr Ainsworth) The timing of your report is fortuitous in that we can use your report to feed into our thinking, along with things like reclassification, the Lambeth experiment and other issues, as we check on whether or not we have the focus right, we have the gaps right, we have measurability where it is available. A lot of work is being done on trying to establish some of the baselines which are necessary in order to measure the targets in the first place.

1309.  Mike Trace helped to formulate the national strategy and he told us he thought the target on availability was not going to be achieved. I assume that links in with the fact you need to look again at that target. Have you anything to comment on that?

  (Mr Ainsworth) When the strategy was pulled together and the targets were applied—and I cannot remember to what degree they were explicit with the Committee when they came here—they used the situation in America, the situation in Australia, to pull some figures down to get people going in a particular direction. I think it was widely acknowledged at that time they were aspirational or inspirational. What is availability? How do we measure it? I go back to that. How can we say definitely it is achievable? These are the issues we are trying to deal with in the stock-taking review in trying to make sure we have credible measures which lead people to do some of the good work which is already being done and yet get the maximum focus and the maximum efficiency for the money we are expending.

1310.  Terry Byrne, the Director of Law Enforcement at Customs & Excise, told us that the supply of class A drugs is now steady rather than increasing or decreasing. Do you think that is a new development as a result of the concentration on hard drugs by Customs & Excise?

  (Mr Ainsworth) There is no doubt Customs & Excise have upped their game quite considerably and that also we have a very good working relationship with other agencies, like the National Crime Squad and NCIS in terms of disrupting supply. What we have not seen yet at the retail end of availability in this country is an increase in price. There is some evidence it is beginning to come through at the wholesale level. As I say, there has been a lot of good work in terms of getting people to work together and getting them to focus, there has been a massive increase in seizures, and we have also been able to identify gaps in terms of availability. One which has become pretty apparent is what is called the middle market. We have been obliging local police forces to look down into their own local communities, so at the PCU level it has been focused on the streets and what is going on in the neighbourhoods; at National Crime Squad and NCIS level, we have been saying, "Disrupt the supply and if necessary go back up the supply chain towards the countries of source", and what has grown up to some extent is a potential gap in the middle. We have a pilot going on in the West Midlands with four local police forces being resourced from seized assets to look at how they disrupt that middle market supply. Those kind of issues have been highlighted by the strategy and that has been a success of the availability target. There is a lot of good work which is flowing from it.

Angela Watkinson

1311.  I would like to turn to the effect of drugs on young people. I understand the Government has commissioned a long-term study into education in schools on drug, alcohol and tobacco. I believe it has not started yet but perhaps you could say when you expect to get the results and how long this study is going to take?

  (Mr Ainsworth) We have been using the young people's target in order to try to widen the availability of education within schools, and have had quite a success at doing that. Almost 93 per cent of secondary schools now have drug education available to them and 75 per cent of primary schools. It is not education that is given to them in isolation, and I am not sure it would be effective if it was. It is part of presenting people with life skills leading them in the direction of a healthy lifestyle, and issues like smoking, alcohol and the consequences of using illegal substances are brought in to try and help them, to give them the knowledge to take appropriate decisions when they are confronted with the availability of those substances. That has been the main thrust of the education side of the young people's target.

1312.  I wonder if you feel that imparting knowledge, so that young people are able to make decisions, strikes the right note, or whether education should be slanted towards prevention, preventing the next generation of addicts? I do not know if you have seen this, but this is a Lifeline leaflet, which is well-funded by a wide range of organisations, and this leaflet is called, How to survive your parents discovering you are a drug user. It gives pieces of advice such as, "Don't get caught in the first place. Remember, parents search bedrooms and coat pockets. Do not expect them to agree with you. Do not keep asking your parents for money; your drug use is your responsibility, you should pay for it. Don't steal from them." At least that last bit is a nod in the direction of acknowledging that drug use can destroy moral fibre. The whole tenet of this leaflet is that parents are pretty stupid and they will not understand, that drug taking is okay, but do not upset them too much because you are going to need them when your life falls to pieces and they will have to take responsibility for the outcome of your drug habit. This is a bit unfair because you may not have actually seen this leaflet, but you get the general idea of the message in it. Do you feel that is the right direction for information to young people? Should it not be more in the direction of (a) telling them not to do it and (b) the emotion, physical and mental health problems which are likely to result from it and the harm to wider society? Is drug education going in the right direction and should we be drawing a greater distinction between education and prevention?

  (Mr Ainsworth) Let me tell you what we are trying to do. We are trying to be effective and the judgment that we have come to in deciding how we could be effective is that preaching at young people is not going to work. I know there are people who advocate that, and there was the "Just Say No" campaign and everything else, but if we thought that would work, we would certainly be looking to go down that road. Our evaluation is that it is not going to and what we are effectively going to do, if we attempt to preach to young people, is switch them off and they will not listen at all. So what we are trying to do is equip them with credible information, so they do not wind up getting themselves into situations without a degree of knowledge. We are trying to equip not only the young people themselves, but their parents and their carers as well. One of the main reasons why parents do not engage with young people on drugs is that they feel they simply have no knowledge whatsoever in depth of the issues they are getting involved in, so there is a need in our opinion to raise the awareness and to raise the level of knowledge among young people themselves. Peer group information is what they are effectively getting at the moment, some of it is accurate, some of it is totally off the wall. The whole of our recent communications campaign which we ran over the Christmas period was to try to advertise the availability of the National Drugs Helpline and to say to young people in language they would perceive, with messages coming from young people themselves, "If you really want to know what ecstasy will do to you or what cocaine will do to you, don't listen to your mate, ring the National Drugs Helpline, you will not be preached at, you will be given credible information about the effects of these substances." So that is the broad thrust of our message. It certainly is not to encourage experimentation, quite the reverse, it is in order to give people the information to draw them away from it. If we thought preaching would work, we would go there but we do not think it will.

1313.  Drug taking is higher in absentees from school and young offenders, how do we target these particular vulnerable groups who are more likely to be taking drugs than pupils who are in school?

  (Mr Ainsworth) This is one of the issues we have to try and take on board to a greater extent in the stocktaking review than we have up to now. We need to try and discourage all drug use, there is no doubt about that. It would be a very strange message, indeed, to problematic drug users if we were doing anything other than saying to the population at large, "These are dangerous substances and you should not be using them". We need that message to go out broadly to all young people. You are absolutely right, that it is absentees from schools, it is people with other problems, people in care, who have a far higher propensity to become problematic drug users. The degree to which we focus on those groups and the degree to which we are going outside the young people's area and the degree to which we link up with Neighbourhood Renewal and Social Exclusion Programmes—because that is where the main impact of drug misuse is being inflicted on communities—are issues that we are trying to pick up in the stocktaking review.

1314.  When Mike Trace came and gave evidence some time ago he felt that the rather ambitious target of a 50 per cent reduction in youth drug use was unachievable unless there were one or two things, a significant shift in youth culture, which would be extremely difficult we all acknowledge, or that enforcement action would lead to a sustained drought of these substances, in other words a much higher level of activity on the part of the police. What do you think about that?

  (Mr Ainsworth) I think that culture can be changed over a period of time. I think that the levers are difficult to identify and quick hits are not available. We have seen patterns of drug use change over periods of time. For instance, we have seen the increase in ecstasy has tailed off, sadly it is not going down but we see it tail off, and I think that is largely because of the message that has come through the media over a period of time of the acute danger of taking those drugs. LSD use has almost disappeared, not disappeared but gone down substantially. Culture changes over a period of time and we have to try influence it and push it in the right direction. Whether or not we should be investing in a substantial increase of work on enforcement—all of the money comes out of a finite pot at the end of the day—at the expense of education, at the expense of treatment is another thing. When we have tried to look at what actually works we think that we have evidence that treatment does work and that pound for pound we are getting more out of treatment than we are out of law enforcement activity. The evidence appears to suggest that every pound spent on treatment can effectively save three pounds in social economic costs and the criminal justice costs. That is why the balance of expenditure has been moving in that direction rather than in any other.

1315.  Treatment is for existing addicts. My particular concern here is preventing the next generation of addicts. Do you feel that drug education should be coupled with greater enforcement, so that between the two methods of dealing with this problem we might have a greater success if young people knew that if they disregarded all of the advice and education that was put in front of them that there would be a sanction in law?

  (Mr Ainsworth) In my opinion we have to keep up our efforts on enforcement and a failure to do that will lead to increased availability and it will send a message that the use of drugs is okay. We have to keep up our expenditure on information. There is evidence that comes back from polling, that I think I mentioned earlier, that suggests that a fair proportion of people are deterred from experimentation by the mere fact that the substances are illegal, not everyone, sadly, but a fair proportion of people are deterred, and they give in answer to questions to MORI polls, and the rest of it, "Why have you not experimented with cannabis or cocaine?", the fact that they are illegal. In my opinion we have to maintain our efforts on the enforcement side. Education, communication and building up the capacity of everyone concerned, whether it is carers, people who are in care, local authority homes, parents and young people themselves is going to have payback. It is not going to have immediate payback. If we manage to lift the level of knowledge among young people—we are currently measuring drug use in young people up to the age of 25—it is going to be quite a time before it begins to feed through into the take-up and use figures up to the age of 25. I think it is a side of the tragedy that we cannot neglect.

  Angela Watkinson: Thank you, Minister.

Bob Russell

1316.  Minister, would you like to comment on how many ecstasy pills a week are taken in Britain, the official figure or the unofficial one, or are they the same?

  (Mr Ainsworth) There was a Home Office report that suggested that 26 million a year were being taken. There was a serious rider in that report, as I tried to say earlier, about the methodology that had been used and people were lead in the report itself to take this figure with great caution. It is not often that the media do not look at the headline figure and give the same prominence to the rider that is given in research like this.

1317.  Two weeks ago The Observer said the figure is really two million ecstasy pills a week are taken. Is that an exaggeration?

  (Mr Ainsworth) In my opinion, as I said before, the best and most reliable figure to use if you want to look at prevalence is the British Crime Survey. The British Crime Survey indicates that five per cent of young people have taken ecstasy at some time in the last year.

1318.  Finally, Minister, in the advice, education and the rest of it that is going on are the young people warned that the equivalent of one class every year dies from ecstasy—27 people died last year—is that information brought home not them forcibly?

  (Mr Ainsworth) If they contact the National Drugs Help Line there is detailed, solid, comprehensive advice on the consequences of taking any particular substance. We ran a programme over the Christmas and New Year period trying to ward people off excessives, that might involve drugs over the holiday period. It was almost exclusively focused on people using the National Drugs Help Line and we saw as a result of that advertising campaign a 20 per cent increase in use. Most interestingly, a 10 per cent increase in use from young males, who are usually about the hardest I am told—I cannot remember when I was young male—to get through to. That was a specific decision we took. What do we do with regard to our communications, and we decided that the best way would be to lead people to credible information, because they do get this appalling advice from their friends, sometimes without any knowledge whatsoever. They are confronted with taking some substance but do not know what it is, do not know what potentially it will do to them. It does not lead to addiction in the case of ecstasy but it can put them in a life-threatening situation.

Mr Watson

1319.  Minister, can I take you to the field of public health. We have had a lot of evidence and submissions to say that we really are not spending enough time and effort on harm reduction. People have said that we are on the verge of a hepatitis C epidemic amongst drug users. I do not want to pre-empt, and I know you are not going to pre-empt, the review of the National Drug Strategy, but could you see other elements of the strategy which specifically target public health goals?

  (Mr Ainsworth) I think the Home Secretary gave you an indication this is an area we wanted to look at and whether or not we should be upping the emphasis that is given to harm minimisation. There was a lot of work done on harm minimisation in this country around HIV and a degree of success was achieved by that work but there are other issues. Drug-related deaths are something which has given a greater emphasis to it, for instance, in the Scottish Strategy than it has currently in the English and Welsh Strategy. So while a lot of harm minimisation procedures are already in place, it is something we are looking at as to whether or not we should be lifting this up the agenda.

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