Select Committee on Home Affairs Minutes of Evidence

Examination of Witness (Questions 1320 - 1339)



1320.  You have talked about the figure of £1 spent on prevention saves £3 in enforcement, can you let us know the current split in the drugs budget between enforcement and criminal justice and health issues?

  (Mr Ainsworth) Sorry, that was treatment, 3:1.

1321.  Sorry. I want to know the balance between money spent on enforcement and money spent on public health, given the comment from Keith Hellawell when he took over in 1998, "We spend 63 per cent of all our money on the criminal justice system", which he thought was a bad policy.

  (Mr Ainsworth) It is hard to measure all of the money that is spent on drug-related issues. For instance, there is a lot of expenditure by the NHS which does not fall within the ring-fenced drug budget. There is a lot of activity by the police and courts which is almost immeasurable but which has a drug connection. The only thing I can measure is the pro-active funding we are providing through the Drug Strategy, and I can give you an indication of the movements of money over a period of time, and I will provide the Committee with this, if you like, afterwards. If you take the year 2000-01 and then the last year of the current spending review, 2003-04 and the movements there have been within that, treatment will move from 33 per cent to 40 per cent over that period of time; young people, which is mostly education, will move from 9 per cent to 12 per cent; communities, which is as I have said currently targeted on re-offending, will move from 6.5 per cent to 9.5 per cent; and availability will move from 50 per cent to 38 per cent. We have not cut the money on availability, it is because the overall amount of money allocated has been growing quite considerably. For instance, in 2000-01 we were spending £353 million, and it will be £380 million in 2003-04, so the actual money has gone up although the percentage of the overall pot has declined quite a lot as we have pushed substantial growth on the treatment side.

1322.  I think we all understand the difficulty in calculating any of these costs and the opportunity costs of certain decisions. When your Department gave evidence at the end of October, we were told there was a York University Report commissioned on the overall cost of drugs to society. Can you let us know when that report is going to conclude? Presumably we will be able to see the results when it does conclude.

  (Mr Ainsworth) It has not been published in total yet but we have some headline findings of the study which are quite fascinating actually. The York Study estimates that the economic costs, mainly to the Health Service and the criminal justice system, of drug misuse in England and Wales are between £3.6 billion and £6.8 billion. Adding on the social costs, the overwhelming majority being crime and cost to victims, increases their estimate to between £10 and £18 billion. Problematic drug users, they say, are responsible for 99 per cent of that cost.

1323.  So that figure of 160 to 280,000 drug users which we call problematic are responsible, potentially, for £17 billion-worth of damage to the economy. Is that right?

  (Mr Ainsworth) Those are the headline results of the York Study.

1324.  That is very enlightening, thank you.

  (Mr Ainsworth) Yes.


1325.  Any estimate which varies between 10 and 18 billion is not that enlightening, is it? There is a lot of difference.

  (Mr Ainsworth) There are wide variations in scoping the size of the problem.

  Chairman: Finally Mr Prosser has a few questions on harm minimisation.

Mr Prosser

1326.  I would like to ask you what progress has been made on the Action Plan on drug-related deaths and whether you have any views on the use of safe injecting rooms and pill testing facilities, et cetera, to bear down on the harm?

  (Mr Ainsworth) We have underlined treatment targets and SDA set a target of reducing drug-related deaths by 20 per cent, and also the universal provision of needle exchanges and syringe exchanges in order to try to avoid sharing of equipment. I say a lot of money has already been put towards that off the back of HIV but there are other issues like hepatitis B and hepatitis C, and that concerns us as well.

1327.  Are you able to give us any indication of progress to date in reaching those targets?

  (Mr Ainsworth) Can I let the Committee have a note on where we are with that?[3]


1328.  In terms of safe injecting areas and pill testing is that something that you are considering as part of the package?

  (Mr Ainsworth) Safe injecting areas like the Swiss experiment?

  Chairman: No.

  Mr Prosser: Safe injection areas where a clean needle is provided, perhaps a safe-ish dose is provided and some level of supervision?


1329.  As in Germany.

  (Mr Ainsworth) We have provided needles to problematic drug users and syringes, and the rest of it, we are not requiring them to stay within a particular area in order to do so. I think we would be worried about them effectively walking away from that provision were we to do so.

Mr Prosser

1330.  We mentioned earlier hepatitis C, is it right that drug users are excluded at the moment from having treatment for hepatitis C?

  (Mr Ainsworth) Excluded from having treatment, in what environment?

1331.  Injecting drug users are excluded at the moment from treatment for hepatitis C, is that right?

  (Mr Ainsworth) Not that I am aware of. There is some guidance that has been issued by the Department of Health on how to deal with hepatitis C-infected drug users, so that does not match with the idea that we are excluding them from treatment. Obviously if people are not stable because of their drug habits then treatment is very difficult.

1332.  Perhaps you can come back to us with some clarification on that point as well. I am turning now to the Misuse of Drugs Act and the changes which took place, in particular amendments of Section 8 of the Misuse of Drugs Act. We have had some evidence that harm minimisation treatment by agencies and individuals could be disrupted or even stopped because of the limitations brought in by Section 8 in terms of the use of accommodation and hostels?

  (Mr Ainsworth) Yes. There is some worry and we took representations over a period of time in order to try to satisfy ourselves that Section 8 provisions were appropriate, where necessary, and would not lead to people being criminalised in an inappropriate situation. The provisions were brought in because of very real problems that exist with crack houses. We had a particular problem in North London around Camden and the Kings Cross area over a period of time. If we were to give some kind of exemption to people in any given circumstance then we could find ourselves in a situation where facilities were being abused and the prosecuting authorities would have no ability to deal with the issue. We are only aware of a couple of problems, and they arose in areas where advice was given and it was felt that despite that inappropriate practices were continuing. As long as people are sensible about how they use these provisions we would be very loathe to lose them with the consequences that could arise in terms of facilities being abused rather than used.

1333.  I turn now to Section 9A, which is to do with the pharmacists' provision of paraphernalia, as they call it. We had evidence from pharmacists to the effect that they were not allowed to prescribe citric acid and sterile swabs and this caused them great difficulty giving the sort of help they wanted to addicts with problems. Is that something that you are looking at again?

  (Mr Ainsworth) Overwhelmingly the provision of equipment has been about syringes and needles, for obvious reasons, because it is blood borne infections that people that have been worried about, hepatitis B, hepatitis C and HIV. If there is a case that can be made for the provision of other equipment we will be happy to look at it. That has to be the main focus of harm minimisation

1334.  Could we ask you to look at the evidence given by the pharmacists to this Committee, because they made a very strong point on that.

  (Mr Ainsworth) We are aware of the evidence that was given and we will be receiving your report within a very short period of time. We have no intention of ignoring any of the recommendations without properly evaluating them.

1335.  Finally, Minister, the pharmacists also mentioned the inflexibility of the Act with regards to dispensing. One of the examples they gave was when the prescription from the doctor or the consultant needed to be handwritten this caused all sorts of difficulties and there were all sorts of practical barriers in dispensing drugs in a controlled environment across the counter. In the same fashion as you will look at the evidence from them perhaps you can look at those matters as well .

  (Mr Ainsworth) I am happy to do that, but I have to say that in the relatively short period of time I have been in this job, with the opportunities I have had to get out in the field, this is not an issue that has been raised with me. The issue which has been raised with me of most concern is the preparedness of GPs to become involved in providing treatment. In any given area there are a very small percentage of GPs who are prepared to offer cooperation with drug treatment therapies, that is something we are far more concerned about. No one has raised this issue, although I saw the evidence that was given to this select committee.

1336.  We had a lot of evidence from GPs and there was a lot of contention as I recall.

  (Mr Ainsworth) They were arguing with each other.

1337.  They were indeed. Let us go back to the pharmacists, in this whole debate the pharmacists felt they were an important player and they had been ignored. I am not saying that is reflected in your evidence, but I get the feeling they do need to be engaged.

  (Mr Ainsworth) I have to admit that I have not talked directly with pharmacists, it has mostly been GPs and drug treatment centres. We will need to pick that up and find out whether or not there is an issue. Obviously we do need security and we do need to guard against leakage that is effectively going to feed inappropriate drug use. There has to be that security as well. If there are issues that pharmacists want to raise obviously we will look at them.


1338.  The witness from the Royal Pharmaceutical Society suggested there was great frustration amongst their members over their difficulty of communicating with ministers on this issue and she did raise what seemed to us to be some serious points. You might find it worth your while to have a chat with her.

  (Mr Ainsworth) I am told that she has a meeting with Hazel Blears arranged so that she can raise her concerns with the Department of Health. I do not know when that is.

  Chairman: That is fine, thank you.

Mr Cameron

1339.  I just wondered, Minister, whether you see any clash potentially between harm minimisation targets being included in the drug strategy and the very clear, although difficult to measure, target of reducing the availability of class A drugs. If you are providing syringes and possibly shooting galleries, or whatever, on the one hand but have a target of reducing the availability on the other are you not asking the strategy to do two rather contrary things?

  (Mr Ainsworth) I do not think I have said, Mr Cameron, that we are looking to provide shooting galleries. What the Home Secretary has repeatedly said in this regard, this is true about what he said about cannabis, and it is true of the whole of the debate around drugs, is that we badly need a sensible adult debate. We need to lift the level of awareness of the consequences of drug misuse in the country and as part of reducing the size of the problem, surely, I would have thought, that everyone would see that you have not only got to attack supply, the profitability of the criminal elements and disrupt the criminal gangs but you also have to try, where it is necessary to do so, depriving them of their market. Where there are people who are hopelessly addicted if you can get them into treatment, if you can stabilise the situation and pull them out of the grip of the peddlers and the traffickers that has to be a good thing in terms of the benefit to society, because they are not going to be paying for their habit through crime, and they are not going to be feeding the supply chain by providing the demand. Harm minimisation is essential from that point of view and treatment is essential from that point of view. It is, surely, also essential because of these very serious viral illnesses that there are round. As I said, the main drive in this country towards upping our gain on harm minimisation was HIV. I would hope that everyone would want us to stay focussed on the potential dangers of such diseases.

3   See Appendix, Ev226. Back

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