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The Earl of Dudley: My Lords, I hope the noble Baroness will forgive me for intervening. I believe she misunderstood the purport and tenor of my question. I was anxious to ensure that no restriction was placed on the use and prescription of methadone in the health service as a heroin substitute. It can be a useful aid both in the prevention of heroin addiction and of crimes arising from heroin addiction.

Baroness Jay of Paddington: My Lords, I apologise to the noble Earl. Indeed I did misunderstand him. In an effective way he was perhaps using a double negative, which I misunderstood. I repeat that I entirely agree with the ACMD report that the benefits have now been clearly demonstrated. I am glad that he too supports that view. I apologise to him for that misunderstanding.

The Green Paper does not reaffirm in quite the same strong way, as do the documents to which I have just referred and the previous document on the health of the nation, the basic tenets of the AIDS and drugs programme which have been so successful. I hope that by presenting the Green Paper the noble Baroness, Lady Cumberlege--who was very much in the forefront of these programmes--is not lending the Department of Health's authority to an approach which seems to be based far more on control and punishment than on public health.

AIDS prevention and treatment in this country has always been based on open access and non-discrimination. That has been particularly valued by drugs misusers who often felt stigmatised and ostracised by care services. On World AIDS Day it is important that we remember the significance of human rights in the AIDS battle. I shall conclude by quoting Dr. Jonathan Mann, who is the founding director of the WHO global programme on AIDS. In a recent speech he said:

I very much hope that that philosophy will be in the White Paper which, in the spring, takes forward Tackling Drugs Together.

4.2 p.m.

Lord Addington: My Lords, the Green Paper contains one theme which must be recognised immediately. It takes on the idea of horizontal integration of responsibility for a wide social problem in a practical way. It is signed by five senior members of government, including three Secretaries of State. The document deals at all levels with horizontal integration of authority for the problem. It is probably the one theme that runs through the document upon which we can congratulate the Government. It does not try to pigeon-hole treatment of the problem to one specific area. As the noble Baroness, Lady Jay, said, it places

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most emphasis on criminal activity, at least in the first part. At page 10 of the document, paragraph 1.6, under the heading "Crime", the Government's main objectives are,

    "to see that the law is effectively enforced, especially against those involved in the supply and trafficking of illegal drugs; to reduce the incidence of drug-related crime; to reduce the public's fear of drug-related crime; and to reduce the level of drug misuse in prisons".

Laudable as those aims are, I am afraid that we can do little more than put a brake on the flow of drugs and the activity of those who are using them in our society. We are not a police state and I hope that we shall not become one. We have open borders and these substances will make their way into our country. Indeed, many of the synthetic drugs are produced here and we export them. There is a real problem in this country. We cannot stop the drugs becoming available. It is therefore commendable that the Government talk of education. However, when they do so they are faced with the problem that they will not be believed. They put forward a clever and simple message about drugs misuse; but even so people will rebel, especially the young. The young will always rebel against advice, no matter how sensible it is.

The dabbling in, and experimentation with, drugs and substances has always gone on. Indeed, one need only look at the use of alcohol in our society and the amount of under-age drinking that takes place to realise that there is always a mystique about these things. The fact that what we are discussing are new substances will not stop them becoming available. The Government therefore find themselves in the position of having to control the input of drugs and dealing in the strongest possible way with those who supply them while in fact not being in a position to control the situation.

We talk of control and the effective use of drugs in prisons. In our society it is only in a prison environment that there is containment and the legal authority to control the amount of drugs being used. But even inside prisons we have failed. It may be possible to tighten up the situation but I doubt whether, in any circumstances, we shall ever be able to stop the misuse of drugs in prison.

Bearing that in mind, will we ever be able to stop the misuse of drugs in our society? The answer is no. When discussing the problem we must bear in mind also that if we can make drug misuse less socially acceptable to the general public, the problem will grow more slowly. Drugs tend to appear in fashion waves, as does everything else. Thus we may drive back certain types of drugs and banned substances. Indeed, we have seen one such success in our society; that is, the cutting back of tobacco. That was not achieved by making it a prescribed drug but through social pressure, and we have actually cut down its use.

It may be possible to create the same effect with illegal drugs and substances. But they may be replaced in other ways. Education can only be a long-term process. A reinforced message will still be ignored at times by certain people. But through education we can integrate further the fight against crime relating to drugs

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misuse. We may once again put a series of brakes on the process but we shall never be able to stop the integration of drugs into our society.

The Government should perhaps have placed more emphasis on rehabilitation--as we do with criminals--of those who have started experimenting with banned substances. If we can convert people from continuing a habit, we shall cut down the market for the drugs which will ultimately reduce the supply.

The noble Earl, Lord Dudley, who, unfortunately, is not in his place, said that if we can provide a legal and controlled substitute for certain categories of drug, we shall stop part of the upward spiral of misuse and availability of drugs. In the Green Paper the Government mention on numerous occasions those types of activity. But if they want to make an effective inroad into the problem they will have to put far more emphasis on that area.

The linkage between the spread of the HIV virus and drugs, as the noble Baroness, Lady Jay, said, is primarily the sharing of needles. Basically we are talking about the transference of infected body fluids. Thus when we talk about the spread of this killer virus, we must also talk about our attitudes towards sex education and relate the two. Over the past couple of years we have had a series of stormy debates in this Chamber on the subject. If I stand back from any party political stance, I believe that we saw a series of over-reactions to political correctness in certain handbooks and to specific interest groups, and we heard many justifiable moral stances. In the end we backed down from a sensible position which was being abused by a few. I hope that the Government will be encouraged to re-establish their position of providing as much knowledge as is necessary and as much knowledge as a child can take on board and that they will do so without providing the moral judgments that go with it. Indeed, I was forced to admit that certain articles which I read out in the Chamber were not for the consumption of people below the age of 12.

A storm was also raised about articles designed for teachers giving them answers to questions that were to be asked. In a recent case questions about certain sexual practices were put by a child to a nurse giving information on this subject and the teachers supported the nurse who answered the questions correctly. She said that certain sexual practices can lead to the transfer of the virus. If we can re-establish that publicly as the Government's position we will be helping everyone because we will know what we are allowed to do and what we are not allowed to do in the classroom. If that is taken on board we will be able to transfer information. In addition, as anyone who has ever tried to get across any message knows, one can reinforce types of information by linking them to other types of information--the horizontal integration of knowledge. We shall be able to reinforce both types of message.

When dealing with a subject of this complexity the Government are very much to be congratulated on having done something here which we have criticised them very often for not doing in the past. They have given a series of initiatives which will be assessed over a period of time. The new local health authority-led action

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groups will be able to provide incentives. They will also be able to respond to vocal problems. I have not mentioned the fact that certain urban environments have led to pockets of very high drug misuse. Badly designed council estates provide lots of dark corners with lots of easy access and a good environment for crime generally and drug-related crime in particular. Once crime is flourishing, prostitution will also flourish, which can lead to the transfer of the HIV virus.

There are many good things in this document. There are no big ideas, probably because they have all been tried and many of them have failed, but the Government are at least initially taking on board the fact that there is a multiplicity of problems connected with this one area. I hope that the document will lead to a growth in more consultative and positive work in this area.

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