Home Affairs Committee
Oral evidence: Drugs, HC 198
Wednesday 22 February 2023
Ordered by the House of Commons to be published on 22 February 2023.
Members present: Dame Diana Johnson (Chair); Ms Diane Abbott; James Daly; Carolyn Harris; Tim Loughton; Stuart C. McDonald.
Questions 345-423
Witnesses
I: Angela Constance MSP, Minister for Drugs Policy, Scottish Government.
II: Rt Hon Chris Philp MP, Combatting Drugs Minister and Minister for Crime, Policing and Fire, Home Office; Caroline Hart, Deputy Director for Drugs Supply and County Lines, Home Office; and Marcus Starling, Deputy Director, Drug Misuse Unit, Crime Reduction Directorate, Home Office.
Written evidence from witnesses:
Witness: Angela Constance MSP.
Q345 Chair: Good morning and welcome to the final session in the evidence gathering phase of our drugs inquiry. We are taking evidence this morning from both the Holyrood Minister and the Westminster Minister with oversight of drugs policy. Angela Constance, you are very welcome to this Committee. We will have a number of questions for you.
I thought it might be helpful if I set out that, on 15 November last year, the Committee visited Glasgow and met representatives from the Glasgow Alcohol and Drug Partnership and the Scottish Drugs Forum, and the chair of the Scottish Drug Deaths Taskforce, David Strang. We also visited a recovery café in Springburn, Glasgow, and Turning Point Scotland’s alcohol and drug crisis centre. They were very useful meetings and visits that helped us to understand what was going on.
To start us off this morning, would you like to say a few words about the current situation in Scotland in relation to drugs? What is your overview of what is happening in Scotland?
Angela Constance: Thank you very much, convener, and good morning to all Committee members. I very much welcome this Committee’s inquiry; I appreciate your interest in Scottish drugs policy and I am particularly pleased to be here to give evidence in person.
I am sure that every member of the Committee is aware that in Scotland we continue to face a serious and significant public health challenge, which in my view requires a fully fledged public health approach. The scale of the challenge in Scotland is far greater than anywhere else on these isles, and there are many underpinning factors. The scale of the challenge that we face to save and improve lives is greater in Scotland than anywhere else in Europe, and we really need all the tools in our box to tackle this public health emergency. I hope to be able to outline to the Committee what we are doing in Scotland to maximise the impact of our own powers and resources.
As you would expect, I have views around the Misuse of Drugs Act and so on, but I can say that we have seen some encouraging signs as a result of our investment and reform of services. Our annual report, which is the confirmed number of drug deaths, shows that last year, for the first time in seven years, we did not have an increase. I take small comfort from that, because drug deaths are as tragic as they are unacceptable, and we must remember that drug deaths are preventable.
Our challenge is great and we are determined to do everything we can to implement that public health approach. We are doing much to reform services, but also to tackle culture; we need change in legislation, and in how we design and deliver services, but we also need to tackle stigma and discrimination.
Q346 Chair: Could you outline the relationship you have with the UK Government when it comes to making the case for a public health approach, which you obviously feel is very important? What kind of meetings do you have? What kind of engagement have you been able to have with UK drugs Ministers? I know they have changed recently.
Angela Constance: I have been in this post—the first ever dedicated Minister for Drugs Policy in Scotland—for over two years now, and I have reached out to every UK counterpart. There have been four in my time. I have had face-to-face engagement with Kit Malthouse and Chris Philp. There are a number of UK forums in which people seek to work collaboratively and share the challenges that we have in common, but also to debate and discuss our different views. I am a regular correspondent to the UK Government—the Home Office has no shortage of letters from me—because I am really keen to debate, within Scotland and elsewhere, what the evidence tells us; and the evidence, overwhelmingly across the world, points to the necessity for a public health approach.
Q347 Chair: Are you disappointed that you have not been able to persuade the UK Government to follow through on your view that there should be a public health approach?
Angela Constance: I am deeply disappointed in that, convener, of course, but my philosophy in life is that you must seek to engage more with those who you disagree with, so we will continue to be as constructive and engaging as possible. I do, of course, wish to see movement within the UK Government. I appreciate that different politicians or Governments are elected with different mandates. Regarding the specific example of the Misuse of Drugs Act, if the UK Government were not going to review or reform that Act, I would continue to encourage them to devolve it so that we could proceed with that fully fledged public health approach.
We are doing everything we can within our own powers, and we are obviously always open to challenge and accountability about what we are doing with our current powers and resources, but there is a level of accountability and responsibility through every tier of government. I must reiterate that the scale of the challenge in Scotland is so great that we need every tool in the box.
Chair: Thank you.
Q348 Carolyn Harris: We recently visited Glasgow, and I was overwhelmed by the extent of the drug problem, which was far worse than I ever imagined it would be. What is the Scottish Government doing to address the increasing use of benzodiazepines and synthetic drugs?
Angela Constance: That is a really good question, because one of the underlying reasons that the challenge in Scotland is greater is the implication of benzodiazepines and in particular street benzodiazepines. We also have a higher implication, and a greater opioid problem, in comparison with other parts of Europe and other parts of the country.
There are a number of strands to my response to Ms Harris’s question in and around benzodiazepines. First and foremost, it is about improving treatment options for benzodiazepine dependency. That is complex, and care needs to be taken with it for many good clinical reasons. We do need a better treatment offer. The Scottish Government is funding and supporting a benzodiazepine treatment clinic in Fife, and that is to build on the most up-to-date guidance produced by our Drug Deaths Taskforce. That has been endorsed as the most up-to-date guidance, but further research obviously needs to be undertaken. Of course, we need to treat every individual as an individual, so person-centred and tailored treatment is crucial. Treatment is first and foremost.
We have been engaging with the UK Government in and around some sort of regulation for pill presses, because synthetic benzodiazepines are very much made and produced in Scotland. It is comparatively easy to purchase a pill press and for vast quantities of street benzodiazepines to be produced and circulated in our communities, and they are sold very cheaply. I am glad to say that there has been some movement on that, and that the UK Government are bringing forward measures as part of their approach to tackling serious organised crime. We will of course engage constructively in that.
The other aspect to tackling our benzodiazepine problem—but not just our benzodiazepine problem—is drug checking facilities. Unlike other countries in Europe, we do not have an extensive network of drug checking facilities anywhere in the UK. In Glasgow, Dundee and Aberdeen, our local partners are working on applications for the Home Office for drug checking facilities, as well as a national hub. I can speak a little more about that later if you wish. Drug checking facilities are imperative. I continue to engage with the UK Government on that because, once the applications are submitted, I really will be seeking a favourable outcome. People are consuming large quantities of benzodiazepines with no understanding or knowledge about what is in these substances, and drug checking enables better and quicker public health alerts.
Q349 Carolyn Harris: The reality is that when someone is in that space, they are looking for the drug that will annihilate everything else except the drug taking. The drug dealers and the manufacturers know that and they create a product that will constantly change. But in the early data for 2021 and the first months of 2022, there has been a record fall in drug misuse deaths. What are you doing in Scotland that is contributing to that?
Angela Constance: An important point of clarity: for transparency, accountability and quicker responses, we now publish suspected drug deaths data, and that is Police Scotland management information. The confirmed deaths, as always, are in the annual report. Forgive me, convener; I appreciate that for many people listening, we are talking about data and statistics, when behind every statistic there is a grieving family and a life lost.
The suspected drug deaths data is an early indicator, but I have to caution that it is not confirmed. Saying that, in the first nine months of the last calendar year, we saw a 21% decrease in suspected drug deaths. However, we did see a peak in October/November, when we had an alert around nitazenes, which was very concerning. I think we are due the suspected drug deaths data for the final quarter of the last calendar year next month, which will give more of a picture of the direction of travel. The suspected drug deaths can be a barometer; we just have to interpret them with care.
Carolyn Harris: Thank you.
Q350 Stuart C. McDonald: Thank you very much for coming to speak with us this morning. It is fair to say that the Scottish Government’s submission to this inquiry was fairly critical of the current UK legislative framework, and you have touched on that a little bit already this morning. What would you ask the UK Government to change, or what would you do differently if you had control over the legislative framework? You have touched on one or two examples, but can you say a little bit more about how, precisely, you would want to see the Misuse of Drugs Act changed?
Angela Constance: Let me just, by way of a very brief premise, say that my focus in this portfolio, as someone who is pragmatic to the core, has to be getting on and doing what we can with the powers and resources available to us, and my priority has been investing in and reforming services. Notwithstanding that, I cannot ignore the impact of the Misuse of Drugs Act and equality legislation.
If the Misuse of Drugs Act was in my gift, first and foremost I would review it with a view to reforming it. The legislation is, like me, the wrong side of 50. It is outdated. I mean, it still talks about opium dens. It is just not fit for purpose and it curtails harm reduction. I look at facilities and approaches that are commonplace in other European countries and places like British Columbia, and we do not have that same network of harm reduction services, whether that is safe drug consumption facilities, drug checking facilities or heroin-assisted treatment. I am absolutely an advocate for residential rehabilitation and abstinence-based programmes. Recovery needs to be visible, because that is what gives people hope. We have to be serious about abstinence-based recovery, but we also need to be fearless about implementing harm reduction, because it works: it saves lives.
I would also want to have a legislative framework to implement safer drug consumption facilities. While I was on holiday in New York, I visited OnPoint, the safer drug consumption facility. That had a profound impact on me. I would want to clarify the law, especially the clauses in and around paraphernalia, to make it clear that all services could distribute all forms of harm reduction interventions. Although there is a licensing framework currently in and around drug checking facilities and heroin-assisted treatment, I think it tells a story that we now have only one heroin-assisted treatment project in the UK, after the very sad loss of funding to the Middlesbrough project, which I visited, and that we do not have an extensive network of drug checking across the UK.
There are other very pragmatic things we could do around naloxone—for example, taking naloxone from a prescription-only drug and putting it on the general sales list for pharmacies. There are lots of things we could do in fairly short order if there was a review and reform of the Misuse of Drugs Act.
Q351 Stuart C. McDonald: You made reference to equalities. What are you getting at there?
Angela Constance: The Equality Act 2010 disability regulations actively exclude people with addictions, unless the addiction is the result of prescribed medication; it does not include addiction as a health condition or in the definition of disability. Yet the World Health Organisation recommends that we should be looking at drug and alcohol problems first and foremost as a health conditions. That should be paramount in how we reform our legislation, redesign services and prioritise investment. This is a health condition, and part of our work in the Scottish Government is to get that paradigm shift away from seeing problematic drug use as solely a criminal justice problem, and turning the dial up on the public health approach, because that is where the evidence tells us we should go.
Q352 Stuart C. McDonald: The priorities you have set out for the Scottish Government include safe consumption rooms and drug checking. What if the UK Government were not willing to undertake wholesale reform of the Misuse of Drugs Act? Is there a way to enable the Scottish Government to trial measures such as safe consumption rooms, or to change the drug-checking regime, without fundamental reform?
Angela Constance: As well as a number of European countries, I look closely at British Columbia, because in many ways the nature of the opioid problem there—although it is much more of a synthetic opioid problem, rather than a heroin problem—is closest to the experience in Scotland. They have done three things very well. There is same-day prescribing and quick access to treatment, which we are pursuing in and around our implementation of our new medication-assisted treatment standards. They have an extensive naloxone programme, as do we, but they also have safer drug consumption facilities. That would be an important difference.
I know great care has to be taken when comparing jurisdictions. There is no shift and lift here. We really have to look at and learn from international experience; this is not a cut-and-paste job. The other thing about British Columbia is that the Federal Government in Canada have given British Columbia an exemption from their controlled substances legislation. They are undertaking a pilot which is, I think, around the non-criminalisation of possession of certain drugs. My priority for a pilot right now, given the challenge we face in Scotland—you mentioned Glasgow—would be safer drug consumption facilities. I just cite British Columbia in Canada as an example of where Governments with different jurisdictions recognise that there are different challenges within a shared territory, and sometimes we need to be doing different things. We do not all need to be doing the same thing all the time.
Q353 Stuart C. McDonald: We have had some evidence that psychoactive substances are becoming increasingly important. Has that been picked up in Scotland?
Angela Constance: Psychoactive substance abuse is still an issue in parts of the homeless community and in our prison estate. I was a prison social worker a long time ago—20 years ago—and the issues then were around cannabis and heroin in prisons, whereas more recently we have seen a shift away from heroin to psychoactive substances. What has changed since the introduction of the 2016 legislation is that purchasing these substances online or in face-to-face outlets seems to have dissipated; none the less, since that legislation was passed, we have seen, particularly in Scotland, the growth of illicitly produced synthetic benzodiazepines. Scottish drug deaths in which benzodiazepines are implicated have increased by 450% since 2015-16. While direct comparison with England is difficult for various reasons, there appears to have been an increase there of about 50%.
Q354 Stuart C. McDonald: Do you think that increase has something to do with the 2016 Act? Is there a case for reviewing that Act as well, or do you think something else is going on?
Angela Constance: Actually, I think if we’re going to review drug laws to ensure that we have the optimum approach and optimum provision, we should do a review in the round—a review of the Misuse of Drugs Act and other legislation, including the 2016 Act. I have also made a pitch for the Equality Act because it makes it lawful for organisations to exclude people. Stigma is a barrier to treatment, and any barriers to treatment increase the risk of people dying, so tackling stigma seriously is really important to get cultural change in our society and services—not just drug services, but all public services.
Q355 Stuart C. McDonald: Finally from me, there has been a lot of attention around the Lord Advocate’s decision to allow Police Scotland not to record first-time drug offences in their records. Some argue that it is de facto decriminalisation. Could you say a little about the Lord Advocate’s decision and what the Scottish Government’s position on it is?
Angela Constance: The issues around recorded police warnings are entirely for the Lord Advocate, who has all responsibility and discretion in and around prosecution policy in Scotland. The Lord Advocate, Scotland’s most senior Law Officer, Dorothy Bain KC, said in her extensive statement to Parliament that this does not amount to decriminalisation, so you will forgive me if I take her word on that.
Recorded police warnings have existed in Scotland since about 2015-16. A warning is at the discretion of the police officer, tailored to the circumstances of the alleged offence. That has existed for a number of years in relation to category B and category C possession-only offences, and the Lord Advocate extended it to class A.
Stuart C. McDonald: Thank you.
Q356 Ms Abbott: I noticed that in 2021, the chair of the taskforce, Professor Catriona Matheson, and the vice-chair resigned. Professor Matheson said he felt that the work of the taskforce no longer had the Minister’s full support. What would you say about that?
Angela Constance: Professor Matheson is a woman. Obviously, I refute that. I was very grateful for Professor Matheson’s work on the Scottish Drug Deaths Taskforce. The taskforce did some sterling work on medication-assisted treatment standards, on identifying risk factors, on the nature of the unique challenge in Scotland and on the national naloxone programme. Where I think Professor Matheson and I had different views is that I wished the taskforce to provide vital final recommendations to the Scottish Government quicker than was initially planned. The taskforce predates my appointment. When I came to this post, I was clear, in challenging services at local and national level, that we all needed to pick up the pace. That challenge has to apply to Government as well. I wanted the vital final recommendations from the taskforce earlier than was originally anticipated.
I was very sorry to see Professor Matheson and the vice-chair resign. Professor Matheson is an eminent academic, who has devoted much of her life to this subject. I was pleased that David Strang, a former chief inspector of prisons and a former chief police officer, was able to take over leadership of the taskforce. It delivered its final recommendations last summer. At the start of this year, I introduced to the Scottish Parliament our cross-Government plan in response to those recommendations, to take us on to the next stage of our national mission to save and improve lives.
Q357 Ms Abbott: It is early days yet, but is there any sign that drug deaths are coming down as a result of the work of the taskforce?
Angela Constance: It is fair to say that it is early days. As I indicated, our annual report on drug-related deaths showed that for the first time in seven years, we did not have an increase. We still had the second highest death rate on record, but for the first time in seven years we did not have an increase, so I hope—I can’t predict, but I hope—we have halted that increase. It is perhaps a small sign that we are beginning to turn things around. I said to your colleague Ms Harris that some care is needed in interpreting the suspected drug deaths, but for the first nine months of last year, they were at least moving in the right direction.
What is more encouraging is that, with the roll-out and introduction of things like medication-assisted treatment standards, more people know and are claiming their rights to treatment, to quick access and to choice. We have invested heavily in some exciting new services. As in England, the number of women we are losing is increasing; last year in Scotland, we had a decrease in the number of men dying—it is predominantly men who die from drug-related death—but we have seen a disproportionate increase in women. The gap between the death rate for men and for women has been narrowing over a number of years, so we have introduced some great new services to keep children with their mothers with addiction problems.
In Dundee, we have just opened a new mother-and-child recovery house. We have our first national family residential rehabilitation service, Harper House, in Ayrshire, which is for mums and dads. That is part of our promise to Scotland’s children that, where possible, we will do everything to keep families together, because we know that one of the factors for the women we lose is the grief and trauma of losing their children.
Q358 Ms Abbott: Finally, when do you anticipate that drug deaths might actually start to come down as a result of the work of your taskforce?
Angela Constance: The work of the taskforce is now complete. The Government have taken on board its recommendations, and we now have a cross-Government plan. It is about galvanising that all-Government, “Team Scotland” approach. I have wrestled with this a lot, Ms Abbott, because I am asked a lot, “When will we see substantive reductions?”. That is difficult to predict. I don’t want to start plucking figures out of the air, because that would add to the grief and trauma of those who have lost people, or of families who have lived with the risk or fear of losing a loved one.
As time progresses, we may come to a different view, but we know that if we focus on getting more people into treatment, that will have an impact. If I had to distil our national mission to save and improve lives, it is of course about having the courage to meet those longer-term commitments to focusing on reducing the number of people with problematic drug use. At the very core of our response is getting more people into the treatment that is right for them. Whether that is residential rehabilitation, recovery or harm reduction, we need to have a balanced approach.
Q359 Tim Loughton: Minister, welcome. Thank you for coming to the Committee. I am interested in your take on why there is such a difference between serious substance misuse in Scotland and in England, for example.
Angela Constance: It is complex, deep-seated and many years—decades—in the making. Some of the factors will of course be familiar across the UK and in other jurisdictions. We know about the relationship with deprivation, poverty and inequality, mental ill health and adverse childhood experiences. We also know that a drug or alcohol problem can happen to any family in any part of the country; it cuts across the socioeconomic divide. Scotland has double the prevalence rate, but clearly it is fair to say that prevalence estimates across the UK are probably out of date. I am aware that all countries are working to update how to understand prevalence in their own country.
As for the information that we have currently, it appears that prevalence of problematic drug use in Scotland is double what it is south of the border. That will speak to socioeconomic and some cultural aspects as well. We have already spoken about the increased prevalence of opioids and benzodiazepines, so I won’t repeat that. Other aspects include poly-drug use being higher in Scotland, so we have more lethal combinations of substances. Also, the drug taking is higher risk. If you compare opioid use in Scotland and in the Netherlands, say, far fewer opioid users in the Netherlands would inject. There is a real combination of factors.
Q360 Tim Loughton: Sorry to interrupt you, but the question was why. I was not asking for a description. You have challenged the figures, so are you saying that the figures the Committee has—
Angela Constance: Not at all.
Tim Loughton: You just said that you thought some of the prevalence figures were out of date. Do you agree with the figures—that the death rate from drugs is five times higher in Scotland than in England, and by far the highest across the whole of Europe? Are the figures correct or not?
Angela Constance: The annual report, absolutely; we have the worst drug death rate in the UK and across Europe. I have never, not for one minute, ever disputed that. I was just trying to say that the data around comparing prevalence, and the implications of substances, are a bit more complex. Laying that aside, I do not dispute the drug-related death figures at all.
Q361 Tim Loughton: So why is it so bad?
Angela Constance: Because we have double the prevalence. That is a reason.
Q362 Tim Loughton: Why?
Angela Constance: We have an increased implication in deaths from benzodiazepine, and a greater opioid problem.
Q363 Tim Loughton: Why?
Angela Constance: We know that deprivation is a factor. We know that there is a need to reform services, so that they are more joined up. As a former mental health officer, I could talk for a long time about the connectivity between mental health problems and substance use. I have also touched on the fact that we need all the tools in our box, and that the current legislative framework impedes harm reduction.
Q364 Tim Loughton: Ms Constance, you are still not telling me why. You have attacked out-of-date legislation; that point applies to the whole of the United Kingdom. I think we are agreed on that, and this Committee will make recommendations about whether the Misuse of Drugs Act 1971 is fit for purpose or beyond its sell-by date. The fact is that that legislation applies to England and to Scotland. Under the same legislation, the record of serious substance misuse in Scotland is much worse, and we are trying to get to the basis of why you think that is.
It is not just in drugs, is it? The record for alcohol is equally as appalling—1,330 drug-related deaths in Scotland and 1,245 alcohol-specific deaths in Scotland, so again way worse than the rest of the United Kingdom. You have the same laws, you have devolved health, and everything you have mentioned so far seems to be that the solutions are down to health, so why is it so much worse in Scotland than in England? What are you doing wrong, or what is different about the Scottish population that you have not been able to address, as against England or the rest of the United Kingdom?
Angela Constance: With respect, sir, I think you have misrepresented my position. I have been very up front and direct about things such as the Misuse of Drugs Act, but if I refer you to my earlier comments, I have never for a minute demurred from our responsibility as a devolved Administration in and around health services or our justice system. However, again with respect, I have pointed to the nature of the challenge and the significant differences. I know that people will want to point-score and make political points, but I have not sought to do that; I have sought to be very pragmatic and to focus on the evidence. I would contend that we all have a responsibility. Scotland’s situation does not reflect well on any tier of Government. For example, we have taken some innovative strides to address child poverty: the Scottish child payment will lift 50,000 children out of poverty—
Q365 Tim Loughton: Just a second, you have just said that you were not interested in point-scoring, but—
Angela Constance: I am giving you an example of how we are using our powers.
Tim Loughton: You are now going on to a completely different area of policy, away from drugs. I have asked you a simple question, asking for your view, so that this Committee can get an understanding of why the situation in Scotland is so appallingly worse than in the rest of the United Kingdom and Europe. You pointed a lot to the law, but that is irrelevant, because the same law applies. The reason, it strikes me, is that the health approach has not been effective. You are now trying to say that it is deprivation, but there are many parts of England where deprivation is as bad or worse than across Scotland, and yet we do not have the same prevalence of drug-related deaths, let alone alcohol-related deaths, as you do in Scotland. What is going wrong in Scotland that your record—whether you want to put it down to your Government or not—is so bad?
Angela Constance: I have never once in my position as the Minister for Drugs Policy walked away from our responsibilities. I am accountable to the Scottish Parliament and to the people of Scotland on our record and on the actions that we have taken, past, present and future. We have reinvigorated investment in and reform of services, because they were not meeting needs. That is a very frank admission of things that have not been done as well as they should have been.
The Conservative Drug Policy Reform Group often points to how we all end up posturing, as opposed to looking to the evidence. One of the very important changes that we are trying to implement with our national mission to save and improve lives is to ensure accountability—but accountability, yes, of the Scottish Government, with implementation of local services, but also of the UK Government. We are all part of the problem, and we are all part of the solution. Laying aside politics—as much as we can as politicians—when it comes to saving lives, I think absolutely no solution should be off the table, because our problem is so great in Scotland.
I have outlined—I think fairly extensively, verbally and in my written submission—the factors underlying this. I would also point out that it is not just with the Misuse of Drugs Act and the Equality Act that we do not as yet have a full range of economic and social welfare powers, but that of course is a matter of debate for another day. If I can end on a point of consensus, perhaps we can all accept that we all have a role to play, we are all accountable and we are all part of the solution.
Tim Loughton: That is apple pie and motherhood.
Angela Constance: It’s what works, Mr Loughton.
Tim Loughton: What I want to understand is why it is not working in Scotland and it is working better—still not well—in the rest of the United Kingdom, but let’s move on because you seem to want to blame everything on devolution.
Angela Constance: Absolutely not; I think the record will show that.
Q366 Tim Loughton: Why was your post—the title is Minister for Drugs Policy—created in December 2020 given that there is an equal, if not greater, problem of alcohol-related deaths and alcohol prevalence? Is there an equivalent Minister for alcohol policy? As the Minister for Drugs Policy, how do you fit in with health? How does it actually work within the structures of Government, and how joined up is your role across various different Departments and disciplines?
Angela Constance: Part of our thinking for this dedicated post, if I can be candid, was informed by the need for a newer approach. Bearing in mind that we have seen record levels of drug deaths across the UK, we—the UK as a whole—are not leaders in the field. We are not the pioneers of interventions that work, and across the UK we have much to learn from others. Notwithstanding that, the challenge in Scotland is undoubtedly greater.
On the purpose of my post, drugs policy used to sit in the justice portfolio. It then moved to the health portfolio, and there was a recognition that we needed to have a dedicated, much more cross-cutting approach. Part of our national mission is to ensure that drugs policy is not seen in isolation, because people are far more than their substance problem.
We need to ensure that drugs policy is joined at the hip with mental health and our work on homelessness. We have some new legislation coming through on increasing the prevention of homelessness duties. We need to ensure that we are focused on education and prevention as well. I spoke quite a lot about addressing poverty and inequality. Of course, it is important that, as well as taking a public health approach to drug policy, we are taking that public health approach to justice services, too.
Q367 Tim Loughton: You have mentioned mental health, homelessness prevention, education and a public health approach. Which of those are not devolved matters?
Angela Constance: I can only, as a Minister—
Tim Loughton: It is a factual question, Minister.
Angela Constance: I am a Minister in a devolved Administration, so inevitably my job is focused on devolved services.
Q368 Tim Loughton: Which of those subjects you mentioned that are part of your job are not the exclusive preserve of your Government to tackle without having to apportion blame to the UK Government?
Angela Constance: I think I have been very clear that we all have a responsibility here, particularly when it comes to addressing poverty and inequality. I have never disputed our responsibilities and, actually, I have often spoken very frankly, given my own frontline experience, notwithstanding that it was 20 years ago. This just looks like what the Conservative policy reform group was talking about on political posturing. With respect, Mr Loughton, I am focused on solutions.
Tim Loughton: I am not sure who this group is. What has it got to do with this? Who is this group?
Chair: Can I just say that we are running short on time, so if you could—
Tim Loughton: We are not getting any answers, so let’s move on.
Chair: Do you want to ask any further questions?
Tim Loughton: No.
Q369 James Daly: We don’t have very much time. I am probably going to ask you questions that you would need more time to answer, but I am going to ask them anyway, so forgive me for that. One of the things that we talk about is people who are taking drugs—drug users—and how we respond to their addiction. What I am interested in is how we stop people taking drugs in the first place. That is a wider question that involves all sorts of social factors. I am assuming that you, as the Minister, recognise and accept the point that that is part of your policy tools. What are the Scottish Government doing specifically to ensure that young people are getting the picture that you should not take drugs?
Angela Constance: I think it is really important that as part of our public health approach, we are focused on prevention and intervention work that is actually effective with young people. If I think back to my own youth, there was a lot about fear tactics and just saying no. One of the benefits of Curriculum for Excellence is that it gives flexibility within schools, but as well as informing young people of the harms associated with various substances, whether that is alcohol, drugs or tobacco—
Q370 James Daly: I think that is a very fair answer. The reason why I say that is that the impression I get in respect of Glasgow and the major urban cities, where the problem is worse—this is perhaps not the correct phrase, but we have a conveyor belt of addiction from generation to generation in certain parts of Scotland. In respect of those areas where the problem is worse—to the level that Mr Loughton has described—it is going to take more than what you are describing. It is no criticism of you whatsoever, but what intense work is going in to assist young people in those urban areas to stay away from drugs?
Angela Constance: We have very intense work going on in and around how we improve services for young people, because we need services that are designed for the specific needs of young people, as opposed to those of older people. There is a real focus on diversion and early intervention. We need to keep young people out of the criminal justice system where possible. I remember that the Scottish Affairs Committee inquiry, which was undertaken in this place in 2019, associated the criminal justice system—
Q371 James Daly: Can I put it as bluntly as this? Do you think that the public health message to young people—forget about the criminal justice system—should be as blunt as, “Taking drugs is bad,” and that that message should be reaffirmed from their earliest point of understanding in schools? It can be done in various ways, whether it is through media outlets or other things. I don’t see that happening in England, I don’t see it happening in Scotland, and I don’t see any fightback. What I see is that we are responding to a problem that is getting worse and worse and worse and worse because there is no—I will not say “moral”—standpoint taken by the Government that says, “Taking drugs is a bad thing that is going to have a bad impact on your life.”
Angela Constance: We need to inform young people of the risks. Again, the research is a strong indicator of what works with young people. Part of the public health approach is indeed to increase resilience, increase confidence and ensure that young people are best equipped to make healthier choices. That is, of course, about pointing out risks, but it is also about harm reduction information as well.
Q372 James Daly: Thank you very much. Obviously, you now have the adoption of a public health approach within the criminal justice system. There are contradictions, and we have to be honest about this. This is where we have to have some honesty in terms of outcomes. I worked in the criminal courts in England for a long time. In my experience, rehabilitative sentences do not work. That does not mean we should not keep trying, because we need to support people in desperate circumstances, but I think we need to get away from the situation where a drug addict appears in front of a court with some very severe social problems and severe addiction problems, and we think that imposing a drug rehabilitation requirement, as it would be in England, is the answer to the problem.
I wonder if you could comment on the public health approach. Does there have to be a realisation that the rehabilitative sentences imposed by criminal courts in Scotland and England are not getting the results that we want them to get, which gives more leeway to taking a different approach, or do you feel that the rehabilitative measures that are part of the criminal justice system are working in Scotland?
Angela Constance: There is a different youth offending system in England, which I am not going to speak to. What I can say is that a public health approach has worked in Scotland in terms of reducing knife crime, for example, and it has also worked in terms of reducing youth offending.
Q373 James Daly: Okay, so the idea would be that if it has worked in those areas, it is going to work in respect of drugs. Is that the idea?
Angela Constance: Yes. I am conscious that we seek to adopt a public health approach where possible. Obviously, public protection is always paramount, but there is evidence, in a Scottish context, that a public health approach with young people in terms of knife crime and of youth offending works. There are trends in drug taking among young people that are different from those among older people, and these trends need to be recognised.
Q374 James Daly: This will be the very last question from me because of time. Police Scotland expects 12,500 officers to carry naloxone. What has the response been? Could you, in just a minute, tell us what the impact of that has been?
Angela Constance: More than 100 lives. Police Scotland, since they committed to the national roll-out of police carriage of naloxone, have intervened more than 100 times. They have intervened to help save more than 100 lives in Scotland, and they should be commended for that.
James Daly: That is very good news to finish on. Thank you, Minister.
Q375 Chair: Has the roll-out been completed?
Angela Constance: It should be complete by this spring.
Q376 Chair: By the spring—okay, thank you.
A number of us have asked the question about why things are so much worse in Scotland than in the rest of the UK. We have never really got to the bottom of this, and we and you have had this exchange today. If you have any information that you want to send to the Committee to try to explain, that would be very helpful. If there is anything else that you want to send to us, please do so. I note that the brief that we were given as a Committee says: “In 2021, after adjusting for age, people in the most deprived areas were 15.3 times as likely to die from drug misuse as those in the least deprived areas…Greater Glasgow and Clyde had the highest drug misuse death rate of all health board areas for the 5-year period 2017-2021.” Obviously, deprivation is a big issue. We would be very interested to know how the Scottish Government are going to focus particularly on that issue—the most deprived areas, which are just so out of kilter in terms of the number of drug deaths. I would be particularly interested in anything that you have on that. And could you send us some information about the services that you were describing that are working with women and focusing on women, children and families? It would be very helpful for the Committee to know about that work.
Angela Constance: Yes, we can indeed send you lots of information in terms of the work we are doing via Social Security Scotland and the comparatively new powers that we have in and around that—the Scottish child payment, etc. We can certainly send you information on the work that we are doing in cities. We will look to see what else we can add for you to understand the Scottish challenge. I have submitted—earlier—written evidence and touched on a lot of it today. We would be absolutely delighted to send you more information about the new services that exist for women and children in Scotland.
Chair: Great. Thank you very much. And thank you for attending today in person. We very much appreciate that. It has been very helpful to our deliberations, so thank you.
Witnesses: Rt Hon Chris Philp MP, Caroline Hart and Marcus Starling.
Q377 Chair: I apologise for keeping our second panel waiting. We had a very interesting first panel and that session overran a little bit, so apologies for that. It would be very helpful if the members of our second panel introduced themselves. Minister, would you like to start?
Chris Philp: I would, Dame Diana. First, thank you very much for the invitation to appear today and for the opportunity of speaking to the Committee. Most of you probably know me. I am Chris Philp. Since, I think, early November, I have been Minister for Crime, Policing and Fire, but included within that is cross-Government responsibility for drugs.
Marcus Starling: I am Marcus Starling, deputy director for drug misuse in the Home Office.
Caroline Hart: I am Caroline Hart, deputy director for drug supply and county lines in the Home Office.
Q378 Chair: Thank you very much. We will have a series of questions from members of the Committee. I would like to start by asking you, Minister, about the Misuse of Drugs Act 1971. It is over 50 years old. It was obviously a landmark piece of legislation. There are lots of questions about whether it is fit for purpose. When we had Dame Carol Black in front of the Committee, we noticed that the review that she carried out did not include a review of the legislation and whether there was a need for new legislation or a review of that Act. Could you explain why the Government took the view that it was not appropriate to look at the Misuse of Drugs Act?
Chris Philp: I am very glad you had evidence from Dame Carol, and I would like to start by commending Dame Carol for the extraordinary work that she did in producing that review, which, as she will have probably told you, we are implementing. Of course, she is also serving on an ongoing basis as an adviser to the Government on drugs issues. I have met Dame Carol several times just in the last few months—most recently a couple of weeks ago, when she attended a cross-Whitehall meeting on drugs strategy. She contributed very significantly to that meeting. Her role is an ongoing one.
Perhaps I can start by answering your question on the 1971 Act, and then maybe say a word or two, briefly, about the approach that we are taking more widely. The view that the Government have is that the Misuse of Drugs Act 1971 provides a framework that is sufficiently flexible that we do not need to revisit it, at least just at the moment. Clearly, you can have different classifications of drugs, and you can move drugs between those classifications. Of course, you also have schedule 1 and schedule 2, which provide some flexibility—the potential to undertake research activities with licence in schedule 1, and for schedule 2 drugs the possibility of medically prescribing them.
Because the Act contains within its architecture those classes—A, B and C—and schedules 1 and 2, we think that gives flexibility to allow an evolution as time goes on. Of course, if there are specific new threats that emerge, psychoactive drugs for example, Parliament can legislate specifically, as we did in 2016 with the Psychoactive Substances Act, which appears to have been very effective in reducing psychoactive drug consumption. That is the reason for taking the view that we do. If I may, I will say a word or two briefly—I know we are probably quite short for time—on the approach that we are taking more generally. Under the 10-year drugs strategy—
Q379 Chair: We will come on to that. We want to hear from you about the 10-year drugs strategy; we certainly have lots of questions. Can I just go back to some evidence that we heard very early on in our inquiry? That was from scientists, who made the point that the current scheduling of drugs imposes significant barriers to researching controlled drugs. What we want to ask the Government is whether there would be a commitment to reducing those barriers. You have talked about the flexibilities in the Misuse of Drugs Act. Is there the flexibility to make this easier? We know that there are certain drugs now that could treat mental health issues, but the way that the law is currently being used prevents that from happening. These are scientists who want to do the research.
Chris Philp: I am very sympathetic to this, and I say that as someone with a science background at university. I am very sympathetic to the calls by the UK scientific community, both in universities and commercial scientific researchers in pharmaceutical companies, to be able to conduct research in such a way that the bureaucratic and other barriers are as low as possible. I am sure that all of us in Parliament across the House would want our UK research community, both academic and commercial, to be as vibrant as possible, and reducing barriers to research such as this one—there are obviously lots of others—is one way we can make the UK more attractive as a destination. I am very sympathetic to this.
You are probably aware that we asked the ACMD—the Advisory Council on the Misuse of Drugs—to look specifically at the rules around synthetic cannabinoids and whether we should reschedule those, because moving things from schedule 1 to schedule 2 makes it easier to undertake research activities. It has delivered its report on phase 1. We have not responded publicly to that yet—we are considering it. But we have commissioned phase two already.
I wrote to them a couple of months ago to commission phase 2 of that work to look at all drugs. We might need to better facilitate research. In principle, I am very, very sympathetic to making it a lot easier and less bureaucratic and burdensome for academic and commercial researchers to be able to research, and then for doctors to prescribe where there is a genuine medical need.
Chair: That is very helpful. We are pleased to hear that. Thank you. Carolyn Harris is next.
Q380 Carolyn Harris: You mentioned the Psychoactive Substances Act 2016. I have vivid memories of that going through the House of Commons. I also have vivid memories of the consequences of psychoactive substances in our communities and the devastation that they caused to individuals and families. There are some, however, who argue that the Act forced the substances underground and that that in turn has led new products to be more potent. What is your opinion on that?
Chris Philp: Thank you, Carolyn. It is nice to talk to you again in this context rather than in the gambling context, which we used to talk about. Both are obviously equally important. When there are substances that are harmful, it is reasonable for Parliament to take steps to stop them being consumed. Clearly, there is always the risk that when something is either banned or regulated it might go underground, but I do not think that is a reason for not trying to regulate and not trying to prevent harm. It’s a bit like the debates we used to have on gambling. People on the Betting and Gaming Council used to say, “If you regulate gambling more, you will drive it underground,” and you and I did not agree with that. We thought we should regulate it more toughly in order to protect vulnerable people. I think the same argument applies here. We need to be mindful, though, of that and take an appropriate enforcement approach and also stay vigilant to other emerging areas. I could say a word about nitrous oxide, but you might want me to save that for later—I don’t know.
Chair: We might come back to that.
Marcus Starling: The Home Office did a review of the Psychoactive Substances Act in 2018 as part of post-legislative scrutiny. We found that the open sale of NPS had largely been eliminated. Overall use of NPS in the general population had reduced. The potency had reduced, and the cost had increased. We believe, therefore, that the health harms to the population had reduced. That is not to say there were not additional challenges, as you pointed out, but I think the Act did achieve its primary objective in that sense, from that review.
Carolyn Harris: I would agree entirely. Thank you.
Q381 Stuart C. McDonald: Following up on the Psychoactive Substances Act, we have had some evidence to this inquiry that potency has now started to increase. Has the Home Office been monitoring that? I speak as somebody who supported that Act. I welcome all post-legislative scrutiny, but it does not stop two years later. It has to keep going.
Chris Philp: I think it is quite right that we continue to look at this. We know that the availability of these drugs has dramatically reduced, as Marcus said a moment ago. The 2018 review that Marcus mentioned found that 332 retailers across the whole United Kingdom, including Scotland, were identified as having either closed down or stopped selling new psychoactive substances. There is clear evidence of a reduction in availability. You are right that we should keep monitoring it. This should be an ongoing topic that Parliament, this Committee and the Home Office consider.
In relation to the specific point about potency, perhaps I can turn to Marcus.
Marcus Starling: This will very much depend on which substances you are talking about. Since the Act came in we have had various changes. We have synthetic cannabinoids now under the Misuse of Drugs Act, so it might depend on which types of substances we are talking about. We have some ongoing monitoring. In the National Crime Agency, for example, and also in treatment and accident and emergency there is monitoring of drug overdoses and potency. I am not aware of any specific evidence around new psychoactive substances within the PSA in terms of their potency, but we can certainly take that one away.
Q382 Stuart C. McDonald: Thank you. Let me turn to the 10-year strategy and particularly issues around funding. It is fair to say that a lot of the evidence to this Committee has welcomed large parts of the strategy and the increased funding, but when we held a roundtable a few months back with lots of folk involved in treatment and various other aspects of this, one concern was about the timing of the allocation of funding coming very late in the day and being pretty short term, and that made it incredibly difficult for service providers and others to plan. Is that something that the Home Office will listen to concerns about?
Chris Philp: Yes, and I share those concerns. The 10-year drugs strategy contained within it a lot of extra money for treatment, which I think is really important. It contains an extra £100 million for this current financial year, 2022-23; an extra £161 million next year; and an extra £272 million the year after that—2024-25—making an extra £532 million over three years that will fund the creation of an extra 54,500 treatment places. I think all of us can welcome that. Treatment is clearly critical, and it is good that so much extra money is going into it. To put that in context, the baseline is £670 million, so by the third year—2024-25—that extra £272 million is getting on for a 50% increase on where we were last year.
You raise a really good point about timing, and Dame Carol has actually made the same point to me. The funding is in the spending review for the three years, but only the first year’s funding—the current year—was confirmed, about a year ago. Dame Carol said to me a month or two ago, “Can you please get on with confirming the funding to local authority public health providers quickly, so they can start making plans for next year and the year after, and to avoid laying people off?” I responded to that, engaged with DHSC and the Treasury, and was successful. About a week ago—in fact, I think specifically last Thursday—the funding was confirmed. That was not just the £161 million extra next year, 2023-24, but also the year after that. That was a problem; I was concerned about it; and as of Thursday of last week, we have confirmed the funding, not just for the next year but for the next two years.
Clearly, the point that you have raised and that Dame Carol and others have made is a really good one. In fact, that is a point we might take on board more generally in Government, because particularly when you are funding charities or third-party bodies, giving them funding just for a year makes it quite hard to plan. Giving people funding for two or three years in one go makes it much easier to plan and organise services, particularly in the voluntary sector and the charity sector.
Q383 Stuart C. McDonald: I am sure that will be welcome, and we will see what impact that has.
One aspect of the 10-year drugs strategy that has been a little bit more controversial has been in relation to the “Swift, Certain, Tough” White Paper. There has been a lot of evidence to this Committee that that was perhaps going to increase stigmatisation and involve unnecessary criminalisation, and perhaps an element of mixed messaging, as against a public health approach. I think the Scottish Government have made a similar submission to you. Where are you in relation to that White Paper, and will you listen to some of those concerns and take them on board?
Chris Philp: Yes. The consultation on the White Paper concluded, I think, in October—three or four months ago—and we are still carefully considering the responses to it. The principles in that White Paper were not unreasonable, in the sense that it sought to have a clearly pre-defined set of escalatory measures. It started off with those tier 1 interventions, where somebody got essentially a penalty notice, a fine and a drug awareness course as the first step. That is not dissimilar—in fact, it is almost identical—to what you would get if you did 40 in a 30 zone, right? Then it escalates beyond that if the drug use is repeated over time, so I think the principle of a proportionate but escalating response is not an unreasonable one.
It is important to bear in mind that Parliament has legislated that possession and consumption of class A, class B and class C drugs is illegal, and it is right that there are some consequences—proportionate and calibrated consequences, but consequences none the less—that follow. I think the public are sometimes concerned that there are parts of the country where cannabis use on the street is very prevalent, and that is not what Parliament intended when it legislated as it did. Now, the approach to that point sits alongside a very robust approach to enforcement in terms of supply, which I could talk about now or later. I look to the Chair for guidance.
Stuart C. McDonald: Maybe later. We’ve got loads of questions on—
Chris Philp: Okay. That in no way diminishes the approach on treatment as well. You could, and should, have an approach that seeks to treat people with addiction—that is why we are putting all this extra money into it—seeks to stop supply, and seeks to reduce use and demand as well. I think those three things can happen together; they are not mutually exclusive.
Q384 Stuart C. McDonald: We will look forward to the Government’s response in due course, and we can debate that further.
Can I turn to harm reduction? We also visited Middlesbrough and the diamorphine assisted treatment facility there. Everyone on that visit was impressed with the work it was doing. It was closed, essentially, because it couldn’t find funding. I think everyone on this Committee pretty much regrets that. It pretty much leaves England without any of these facilities at all. We have made the case in a letter to you for central pot funding for that type of facility, targeted in areas where it is most needed. What is the Home Office response to that?
Chris Philp: In terms of providing financial resources, as I set out a moment ago in response to your first question, very substantial additional amounts of money are being provided through DHSC to local authority public health services, to fund treatment, because it is really important for the obvious—
Q385 Stuart C. McDonald: Sorry to cut in—it is just because of time—but does the Home Office not itself have a view that there is a role for diamorphine assisted treatment facilities, and therefore it should perhaps ringfence or directly fund in certain areas, such as Middlesbrough, a facility like that?
Chris Philp: Look, the facilities are completely legal, providing that they are licensed by the Home Office, and it is open—I think—to any local public health authority to fund a service of that nature, if they choose to. Generally speaking, we believe in localism and devolution—I am sure you do as well—and giving local authorities the freedom to decide the shape of treatment services that are appropriate for their area seems reasonable. If you think about the places where these kinds of facilities might be most useful, it is probably going to be big cities, and very often, big cities, like London, Manchester, Glasgow and so on, have sufficiently large public health budgets that they could, if they chose to, set these facilities up themselves.
Q386 Stuart C. McDonald: Finally, picking up on the devolution point and on the excellent work that Dame Carol Black did, Dame Carol gave evidence to this Committee that she would support a trialling of a drug consumption facility, and she thought Glasgow would be a good place for that. I appreciate it is controversial. The Home Office back in 2014 did some international comparisons, and found some positives, found some negatives. Surely, it would be in everybody’s interests just to see how it would work within the UK legal framework—just to trial this. We have met the health and social care partnership in Glasgow. I think they are pretty much ready to go. Again, is that something that the Home Office would be open to considering?
Chris Philp: Facilitating drug consumption outside of a treatment programme is not something we think the law currently allows. I have discussed this with Minister Angela Constance, who you had before the Committee immediately before me. I know that she is currently working on some proposals in relation to Glasgow, as you say. I am going to get this wrong, but I believe that the procurator fiscal or the Lord Advocate, or both—or maybe they are the same—
Stuart C. McDonald: It could be both, yes.
Chris Philp: It could be both. I believe that they are currently considering the position from a prosecutorial perspective. If Minister Constance approaches us with a suggestion or with legal analysis, clearly we will consider that, but our off-the-cuff assessment is that facilitating drug consumption outside of a treatment programme is legally problematic, and we would prefer to concentrate our efforts on treating drug addiction. But, when Minister Constance comes forward with her legal analysis, we will very happily consider it in a constructive and collegiate way.
Q387 Stuart C. McDonald: Sure, and that is good, and that is all I could really hope for. I suppose that the point that would be made in response to that is that drug consumption rooms are actually a way to get people into treatment, because they are having face-to-face contact with people who can provide information and persuade them to get into treatment.
Chris Philp: I will be interested to see, when I receive any proposals, actually how that pathway would work. My understanding, when Minister Constance and I discussed this a month or two ago, was that the Scottish Government’s concept would sit separately to a treatment facility and there would be no obligation or even attempt necessarily to get people from the DCR into a treatment programme.
Now, your question implied perhaps something a little bit different, so I would obviously be interested to hear about that. But our initial view is that we should be treating people for drug addiction rather than facilitating it, and that there are very significant legal obstacles. But, as I say, I want to be very constructive and collegiate in discussing these issues with devolved Administration Ministers in Wales and Northern Ireland as well. So when Minister Constance is ready, we remain very willing to at least talk.
Stuart C. McDonald: Okay. Thank you.
Q388 Chair: And of course, Minister, the Health and Social Care Committee in 2019 made a recommendation about safe consumption facilities, as did the Scottish Affairs Committee in its report “Problem drug use in Scotland”. This has been kicking around for quite a while.
Chris Philp: Yes it has, and—
Chair: So it is not a new thing that the Minister is suddenly coming up with, is it?
Chris Philp: No, but I think currently the matter is with the Procurator Fiscal or the Lord Advocate to consider from a legal point of view. That is currently with them. I haven’t been shown any legal analysis. As I say, our view in the Home Office remains that treatment is where we should be focusing our attention, and drug consumption rooms, which purely seek to facilitate the consumption of illegal drugs without any attendant treatment, are problematic from a legal and policy point of view. But I am always happy to engage in constructive dialogue with fellow Ministers around the United Kingdom.
Q389 Chair: Okay. You talked in your opening comments about the flexibility that you felt was in the Misuse of Drugs Act for innovative approaches.
Chris Philp: Yes, that is flexibility regarding things like research and prescription. As I understand it, the drug consumption room proposal in Scotland doesn’t entail prescriptions.
Chair: Okay.
Q390 James Daly: What does drug treatment mean?
Chris Philp: That is a very good question. Drug treatment ultimately means trying to get people who are addicted to drugs off drugs, so they can live a life free of addiction. If that is not possible, at the very least it enables them to control and live with their addiction.
Q391 James Daly: So if we were to say that the point of Government policy has been, for a number of years, to attempt to treat people to the point of abstinence where they are no longer taking drugs, that policy has been spectacularly unsuccessful. Would you agree?
Chris Philp: Not entirely, no. The analysis conducted by Public Health England in 2018 showed a short-term return on investment of four to one: for every £1 spent on treating drug addiction, there was a £4 return, as assessed using the normal rules. In fact, looking at that over a 10-year period, it suggested a 21-times return on investment.
Q392 James Daly: But what does that mean? We are talking about human lives here. Are you telling us that the majority of the people who are going on these treatment programmes are getting to a point in their lives where they are no longer taking drugs?
Chris Philp: Well, I wouldn’t say the majority. I would say that sufficient people are either conquering or at least dealing with their addiction, to the point that it produces benefits to them and wider social benefits that exceed the cost of the entire treatment programme for everybody, including the people for whom treatment is not successful. That is why we are ramping up the spending. Last year, it was £670 million a year. By the time we are at the end of the three-year period, that will have gone up to £942 million a year—almost a 50% increase. We think it does work, and that is why we are putting more resources into it.
Q393 James Daly: You have been the Minister for a very short period of time, so this is an unfair question. As with every Government policy, outcomes are the key. Some outcomes in terms of how you measure them are very different. Every single person who is in treatment is a different individual with different challenges and different needs. But what I would like to know, Minister, is how does somebody in your role—let us hope you are sat there for many years to come—measure those outcomes? Who tells you whether these programmes and the money you are spending are successful and actually impacting people’s lives? Not taking drugs any more is one thing, but we want rehabilitation to be a wider thing than that, certainly within the criminal justice system.
Chris Philp: Those are all very fair questions. We discussed this at the cross-Whitehall meeting a week or two ago. First of all, Dame Carol will have said to you that she believes, based on her expert opinion, drug treatment is an effective thing to do. Dr Ed Day, who is our adviser as well, has similar views. But I want to make sure it is effective, so I have asked Dr Day and the national public health lead, who was in the meeting as well, to look at best practice and advise us which interventions work best, with a view to spreading that best practice around the country.
You are right to say it is easy in Government to measure input, and Governments of all colours very often measure input. We measure how much money we are spending, how many people are being hired and how many places we are creating—54,500 extra places. That is all important. We are doing that not to say we have spent money, but to deliver results. Tracking the outputs and making sure they are effective is incredibly important, which is why I have asked them to go and look at that and report back. Marcus, I can see you are twitching in such a way that suggests you want to contribute.
Marcus Starling: One of the challenges with what has happened in the past—or at least the criticism—is that there has been a medically driven model, which focused on treatment as the way in which you get someone from being addicted through to recovery. In Dame Carol’s report and now in the drugs strategy there is a much greater emphasis on different aspects of recovery, such as housing support and DWP’s individual placement scheme, where you get employment support for people who have had a drug dependency. It is seeing recovery as something that has to last over many years and it is not just about a medically driven model.
Chris Philp: Do you want to talk about the metrics—the numbers that we will be tracking and perhaps reporting as well?
James Daly: Because of time—I think you have made the point in respect of what I am saying.
Chris Philp: James, could I make one other point, just very briefly? One of the other metrics, of course, is criminal justice reoffending. I would estimate that between 30% and 50% of criminal offences are in some way related to drug addiction and the reoffending rates can be extremely high. Another measure of success would be getting those reoffending rates down as well. That is a very tangible measure.
Q394 James Daly: But the point—I keep making it—is this. As you know, I stood in many courts mitigating for people with drug problems over many years. The problem is that with the person who is severely addicted to class A drugs, the courts, for the best of reasons, impose drug rehabilitation requirements on them. They may well be homeless; they may well not be in a position to be able to abide by those requirements. When we are talking about success, we see repeated examples in the criminal justice system of orders—very costly orders—that are imposed upon people, for the best of intentions, which have no chance of being successful—zero chance. Rather than asking you to comment on that, I will just ask you to take that away as part of the debate.
Chris Philp: I will say on that point, James, that you are right about that. It is not just about treating the addiction; it is about the other things that go around it. At the first meeting that I chaired on this topic, two weeks ago, we had a Minister from DWP, we had the Housing Minister there and we had the Prisons and Probation Minister, to talk about how—particularly for prison leavers, who are leaving prison with drug addictions—we can make sure the housing wraparound is there. They are being helped by DWP into support—ideally into work, but at least into support. The point you are making is well made and accepted—and there is some money behind that as well.
Q395 James Daly: You have commented already, Minister, about criminalisation and decriminalisation, and what the Government position is in respect of that. But I think it is fair to point out—I wasn’t in the House in 2016, but Ms Harris has talked about this—that it is not an offence to personally possess psychoactive substances under the Psychoactive Substances Act 2016, but obviously there are some contradictions to that within the 1971 Act. We appear to have a two-tier system in the UK, in that decriminalising possession for certain things seems to be okay but for others it isn’t. There is a rather big question mark behind that statement. I just wonder what you feel about that contradiction, Minister.
Chris Philp: There are some substances that it is not considered appropriate to place within the context of the 1971 Act, notwithstanding its flexibility, which I talked about earlier, but where a slightly different approach is required. Clearly, when the then Government and Parliament came to consider psychoactive substances, they decided that the 1971 Act did not provide quite the right framework. As I said at the very beginning in answer to the first question, it is open to Parliament to legislate differently, as it did in 2016 to treat psychoactive substances a little bit differently from class A, B and C, because they are a little bit different in nature.
In answering the very first question about whether we are going to look at the 1971 Act again, I think the fact that we had these different substances, which were new and weren’t around in 1971, meant that we didn’t think that the 1971 framework was quite right, so we created a new Act to deal with them. That demonstrates why my answer to the very first question was that, no, we don’t need to reopen the ’71 Act, because when things arise by exception that we cannot foresee today, if the ’71 Act doesn’t provide the flexibility, we can legislate in a bespoke manner, as we did in 2016.
Q396 Chair: Just so we are clear, you are saying that possession of a psychoactive substance under the 2016 Act—possession for personal use—is okay.
Chris Philp: In order to make sure that we are legally and technically correct, I will ask Marcus to answer, to just make sure we are being precise.
Chair: I think that is the legal position. We are just trying to ask why you have accepted that but don’t accept it for possession of other substances under the Misuse of Drugs Act. Obviously, they are different, but they are still drugs, aren’t they?
James Daly: It is how you define the difference—that’s the thing, isn’t it? The same argument could be made in respect of class A—heroin. You can make the same argument in respect of lots of different things. What is it specifically about those things that are covered in the 2016 Act that allows you, or Parliament, to make that decision?
Marcus Starling: It is correct that there is no possession offence under the PSA. I think that you have to understand the purpose of the PSA. Before the PSA, those new psychoactive substances that were appearing in the UK were not controlled at all. The purpose of the PSA was to catch those substances, in order that the supply offence would bite and the National Crime Agency could take action against criminals.
The Misuse of Drugs Act controls drugs based on their chemical structure, so criminals would adapt the chemical structure of a drug just so that it bypassed the Misuse of Drugs Act. They were equally harmful in many cases, but the problem was that we could not control things under the Misuse of Drugs Act quickly enough. The Psychoactive Substances Act was intended as a way of catching all those substances, by dint of them being psychoactive, before we could get to the Misuse of Drugs Act. In many cases, once those substances have appeared in the UK, we then get the advisory council to look at them, and if they are deemed sufficiently harmful, they move into the Misuse of Drugs Act, which takes precedence and the possession offence applies. If they are not deemed sufficiently harmful, they are still controlled through the supply offence under the Psychoactive Substances Act, but there is no possession offence. It is a way of dealing with the flexibility and adaptability of criminal gangs.
Chris Philp: I think that was debated quite extensively in Parliament at the time—this point about the chemical compound being altered a little bit and the machinery of the ’71 Act, with the Advisory Council on the Misuse of Drugs, not being quick enough to catch all the changes to chemical compounds. The Psychoactive Substances Act has a more general approach. However, by virtue of being more general, obviously you want to be careful before you criminalise individual possession.
Q397 Tim Loughton: Welcome, Minister. Going back to the Middlesbrough treatment centre, we were all very impressed with it, and we were very disappointed when we heard that the funding is coming to an end, so it is likely to have to close.
You mentioned that it is up to local health authorities to be able to continue to fund those sorts of things. The whole point about Middlesbrough and why we were particularly impressed is that it was funded under Project ADDER, which is a joint initiative between the Home Office and the Department of Health and Social Care. Its purpose is to co-ordinate law enforcement activity alongside diversionary programmes and effective treatment programmes. It is perhaps a rare example of good, joined-up government on a subject which, as this Committee knows and as you know, goes well beyond just law enforcement.
It was starting to prove itself. It was certainly proving itself in terms of all those people who have been through it, and we met many of them, who had ceased their criminal activity in terms of theft or whatever to fund their drug habit. It is very relevant for the Home Office. Why, therefore, do you not think that the Home Office should continue to fund that and be able to upscale those sorts of projects as an effective way of dealing with hard drug use, which has a serious impact on local crime?
Chris Philp: Thank you, Tim. First of all, as I said previously, although Project ADDER funding, and indeed public health funding more widely, is provided centrally, how that is spent is decided by the local authority. They decide which projects to fund and which not to fund. That includes public health projects funded under Project ADDER and that includes the DAT—diamorphine assisted treatment—pilot that was running in Middlesbrough. The decision to remove the funding from that facility was a Middlesbrough decision, not a central Government decision.
Q398 Tim Loughton: Only because the Home Office element of the funding comes to an end.
Chris Philp: As I have said, in relation to the ADDER component, that was provided, I think, for a limited period of time, but the wider public health funding—in answer to Stuart’s question—is continuing and, indeed, increasing. It will increase in Middlesbrough as it is increasing across the country. They could choose to spend it on that if they wanted to.
Q399 Tim Loughton: I understand that. Often these projects work so that some central seed funding, acting as pilots, will test whether they work or not, and then there will be other forms of local funding which could be tapped into if they see the merit of it. I entirely see that model. The issue here is that this was still in its relative infancy. There are virtually no other similar projects in the whole of the United Kingdom. There is a similar but differently run project in Glasgow, and there is perhaps another one in England. If this is to work, it needs to be funded for longer and then some serious analysis done on whether it can be upscaled. Does the Home Office think that this project worked? If so, is it prepared to continue to put its money where its mouth is until it becomes mainstream across the United Kingdom?
Chris Philp: There are three points to make in answer to your question, and I will come to your last question last.
While it is true that the ADDER funding was time limited, the wider public health funding has now been secured for next year and the year after and in Middlesbrough, as elsewhere, it will go up. If Middlesbrough wanted to use the extra funding they will be getting through the regular public health grant to continue this project, they could have made that choice.
Secondly, it is worth mentioning that eight patients were involved in this. It is worth keeping in mind the scale of it. You asked whether I or the Home Office have a view on the effectiveness of this particular treatment mechanism. I do not have a personal view, because I am not a clinician, and I have not received any specialist advice on the effectiveness of this particular diamorphine assisted treatment intervention, but you will recall that I said a few minutes ago that, at the meeting I chaired two weeks ago, I asked a number of experts, including Dr Ed Day and the national public health lead for England, to do some work on best practice. They may well be looking at this as part of that, but, following your question, after this meeting I will ask that they specifically consider the effectiveness of this kind of treatment. If those experts review it and say they think it has loads of merit, we can look at ways of trying to continue. If, on the other hand, they say as experts that it has questionable or limited value, I will respond accordingly.
You asked a reasonable question. I do not have the answer, because I am not an expert, but I will make sure that the experts look at it and come up with an answer.
Q400 Tim Loughton: That is really helpful. We were so impressed by this place and it appeared to be working, but it is coming to an abrupt end. The fact that the Home Office does not appear to have done a proper analysis of whether it worked or not would be a complete waste of that experience. We wrote specifically to Minister Malthouse when we heard about the funding issue, so if you were to have greater oversight of whether it has worked and what could be done to encourage it to carry on, that would help. I am aware that the public health funding is there, but because there have been such constraints on public health funding in other areas, it is more than likely that it will go to other areas that have lacked funding before new innovative areas like this. If you are going to look at it, that is really helpful.
May I come to another subject now, which is Scotland? Before you, we had the Scottish Drugs Policy Minister, who seemed singularly incapable of explaining to us in simple terms why drug-related deaths in Scotland are the worst in Europe and five times worse than in England. She was at pains to go on about legislation, which is irrelevant because it applies to the whole United Kingdom, and to point out how it is to do with matters of mental health, education and prevention, as well as other matters, which are all devolved. She said she had had some very nice face-to-face meetings with you, but she cannot explain why the situation is so much worse in Scotland. What is your view about why Scotland has such a big drugs problem in terms of prevalence and drug-related deaths? It is not limited to drugs, because the alcohol-related deaths are equally bad. What is going wrong in Scotland, in your view?
Chris Philp: Let me start by strongly agreeing with the point you touched on. It is not the UK national drugs legislation framework—the Misuse of Drugs Act 1971 and related legislation. As you say, that applies across the whole United Kingdom equally, yet in Scotland drugs deaths per capita are approximately four and a half to five times higher than they are in England and Wales. Speaking from memory, I think that in Scotland it is something like 25 deaths per 100,000 per year, whereas in England and Wales it is approximately five per 100,000 per year. The difference is about a factor of four and a half to five, yet the national legislative framework on what drugs are illegal or legal and so on is the same across the whole of GB. It is definitely not the drugs legislation.
The areas one might look at would clearly include both enforcement and treatment as well as social policy more widely. There are clearly differences in how the Scottish Government have approached the enforcement question and the public health questions. They obviously have different education and social policies to us, as well. The NHS is also devolved, obviously. I do not want to get into throwing stones at other bits of the United Kingdom, but those are areas that the Scottish Parliament would no doubt want to scrutinise carefully to understand why it is so much worse in Scotland.
Both in England and Scotland I think the deaths tend to be among somewhat older people, sometimes in their 40s or 50s, who have long-term drug addictions. I do not offer that as an explanation, merely as an observation. Clearly, the policy levers that relate to drug deaths, such as enforcement, the health system, social services, education and social policy more generally, are all devolved.
Q401 Tim Loughton: Broadening it out more, the record of the United Kingdom on drugs is not good. It is particularly bad in Scotland, but it is not good in the international context, which is why we are looking at what various other countries have done. We have looked very closely at Uruguay on the legalisation of cannabis, as well as at the American experience, at the British Columbia experience and at Portugal and other countries. What is the Home Office doing in terms of trying to learn from other parts of the world as to how we might use their examples to improve the situation?
Chris Philp: We do keep it under review, and we are very much looking forward to reading the Committee’s report on your work in Uruguay—I believe you went to Uruguay a few months ago and also looked at Canada as an example. Obviously, different countries have very different societies and economies, so comparisons are not always as straightforward as might be initially suggested. We are conscious that in some places a more permissive approach does not seem to have had a positive effect, so I am interested in the comments made recently by the mayor of San Francisco, California about the permissive approach that has been taken in recent years in that city specifically. The mayor seems to have suggested in recent speeches that the proliferation of drug abuse and drug deaths in San Francisco means that the approach needs to be changed. The mayor has talked about adding a significant enforcement element to their approach.
One can look at different examples. I would encourage the Committee, if you have time, to look at the San Francisco example. If you do not have time to go to San Francisco, it would be worth at least doing a review of the papers on it, but there are lots of different examples around the world.
Q402 Tim Loughton: I am sure the Committee would love to go to San Francisco—
Chris Philp: I thought that would be a well-received suggestion.
Tim Loughton: That is very kind of you, Minister, but we do have pressures on our time at the moment. We heard last week that the Netherlands is backtracking on the use of cannabis in red light districts, for example. There are quite a few examples of where there has been a more “liberal” approach which has appeared to cause some problems. We certainly saw some of those in Uruguay, which was very interesting, and we will report on our travels the week before last.
On a personal basis in the privacy of these four walls, what is your hunch for where they are getting it right? Could you point to a country where we should do some more work, where they seem to have a policy that is different to ours and where the prime impact is not so great and the public heath impact is being dealt with better? Do you think ultimately drugs are a public health issue, or are they a law enforcement issue?
Chris Philp: I do not think I know enough about other systems to pick one out and say, “That is the model we want to emulate.” Because of the differences I mentioned previously in societies and economies, I am not sure direct comparisons are always completely instructive or straightforward.
One project that I have come across that struck me—and it may be something that the Committee will want to look at—is a project in Hawaii called Hawaii Hope, which involved taking people who passed into the criminal justice system with drug addiction and using treatment orders combined with recall to prison provisions as a way of incentivising people to get off drugs. It included frequent random testing. A combination of the treatment order, the random testing and the rapid consequence of incarceration if the test was positive led to extremely high rates of people coming off drugs and extremely low—comparatively—reoffending rates. I would add that when that was repeated in some other American states, it was less successful, for different reasons. The Hawaii model is one that I think is definitely worth considering.
On your final question about whether it is law enforcement or public health, the truth is that it is both. Clearly, for people who are addicted, we need to treat that as an addiction. We need to get them into treatment and try to do everything we can to get them off drugs, hence the enormous additional investment. Of the extra £900 million or so that we are putting into this beating drugs strategy in the next three years, the lion’s share—well over half of it—is going on treatment, for that reason.
It is also a law enforcement issue. Possessing drugs is illegal, and we cannot ignore that—it would be wrong to ignore that. Dealing drugs, or supplying drugs, often fuels massive criminality, including very violent organised criminal gangs. We need to hit that even harder as a law enforcement project. We have not really talked about law enforcement, so Caroline has had an easy outing this morning, but we are investing in enforcement as well. The short answer is that it is both.
Marcus Starling: There is something I could add to that, if it is helpful. While not comparing a country in its entirety with the UK in looking for comparisons, we have done a number of pieces of work around, for example, pill presses and comparing different approaches to them in order to inform our own approaches. We are now consulting on a new offence that would affect the illicit use of pill presses. On fentanyl, we have been looking closely at what has been happening in the US and Canada, and at how they are dealing with what is an enormous problem there, in order to learn from some of their adversity and how we might apply that in the UK. Also, when the Advisory Council on the Misuse of Drugs does its reviews, it often looks at international comparisons, or recommends that we do so, and that comes through in some of our work.
Chair: I think we are going to come on to the advisory council. Stuart McDonald wanted to come back quickly.
Q403 Stuart C. McDonald: I am forced to come back with some follow-up questions. I do not want to start a blame game or anything like that, but in fairness to the Minister, when she was asked what was the cause of Scotland’s incredibly horrific rate of drug deaths, she pointed immediately to opioid use and in particular the method of use, poly-drug use and a specific problem we have currently with street benzos. Does that analysis chime with your own? Do you have a different analysis of the immediate cause?
Chris Philp: I think it is fair to say that those things contribute significantly to drug deaths. Those are fair observations.
Marcus Starling: Absolutely. We are seeing the same in England, to a lesser extent.
Q404 Stuart C. McDonald: The evidence we had when we went to Middlesbrough, for example—from the person in charge of the diamorphine assisted treatment facility, I think—was that the drug death rate there was pretty close to what it is in Scotland as a whole. You mentioned pill presses, which was interesting, and Minister Constance was welcoming the progress on that. The other thing I was going to ask on drug deaths is: how imminent is regulation of pill presses? That would have a really direct impact on street benzos in particular.
Marcus Starling: The NCA did an internal review for us on the threats and the different options. As a result, we are looking at a new offence, which would allow law enforcement to act where people have pill presses and may intend to use them for illicit purposes—so, giving new powers to law enforcement. Regulation is not currently an active proposal, but the National Crime Agency is continuing to look at how it can act more firmly against pill presses. There are some interesting examples of where factories have been discovered—one in Kent, for example, which was quite large scale—and where it has been able to act against those. We need to look at the options.
Q405 Stuart C. McDonald: That is very welcome. For my final question, I do not want to reopen the drug consumption room debate, so I am happy to leave it at, “Let’s see the proposal and we will consider it.” The point that could be made on drug deaths is that—putting aside what we were discussing, and whether that is then a pathway to treatment—ultimately, to put it in a rather gruesome way, we cannot treat someone if they are dead because they were consuming drugs in an unsafe way. Again, Scottish Ministers and the Glasgow City Health and Social Care Partnership would say, “If we can have safe consumption facilities, we can then look to get someone on to treatment.” It is about reducing the risk of death.
Chris Philp: You have made the point very eloquently.
Q406 Ms Abbott: I listened with interest to what the Minister had to say. Among a lot of other things, this Committee is looking at decriminalisation of some types of drugs. As you heard, we have been to Uruguay, we are hoping to go to Portugal and, I gather, the Minister has suggested that we go to Hawaii—
Chris Philp: And San Francisco.
Ms Abbott: And San Francisco.
Chair: Steady now. I think the Liaison Committee budget is going to be shot.
Q407 Ms Abbott: Anyway, a bit more seriously, this question is for Marcus Starling. Did the 2016 ACMD unpublished report on drugs recommend that the Government consider reviewing the criminalisation of the possession of drugs for personal use under the Misuse of Drugs Act 1971?
Marcus Starling: I am not going to talk about the contents of that report. I know that you discussed it with Professor Owen Bowden-Jones.
Q408 Ms Abbott: Why won’t you talk about the contents of it?
Marcus Starling: It was not a report with published recommendations—
Q409 Ms Abbott: That is what I was coming to. Why was it not published? This is the only report from that organisation that has not been published.
Marcus Starling: It was a piece of advice that was provided by an outgoing chair of the ACMD to Ministers. It was marked as confidential, so the Home Office has not disclosed that report, partly to protect the safe space between Ministers and our expert advisers in which they can have those conversations. We have chosen not to publish the report, so I will not discuss the contents.
Q410 Ms Abbott: Is it your expert advisers who have said that they do not want it to be published?
Marcus Starling: The report itself was marked as confidential.
Q411 Ms Abbott: Is it the expert advisers, who helped draw up the report, who are saying that it should not be published?
Marcus Starling: Unfortunately, the chair of the ACMD of that time is no longer with us, but the committee currently agrees that the report is a confidential piece of advice for Ministers. So we are respecting that and we want to protect that safe space.
Q412 Ms Abbott: But will you confirm that that is the only ACMD report that has not been published?
Marcus Starling: It is the only one that I am aware of, yes.
Q413 Ms Abbott: Isn’t that a bit singular?
Marcus Starling: It happens to be a piece of advice that was put on paper and shared with Ministers, but Ministers at any time can have conversations with expert advisers, and those conversations are not made public. So this is about protecting that safe space for Ministers to have conversations.
Chris Philp: Wasn’t this recently the subject of litigation, and the court found that the handling of the matter was lawful. Somebody FOI-ed it and the FOI application was ultimately rejected for these kinds of reasons.
Marcus Starling: Yes, with one exception, which was that the court asked us to release recommendation 5, which was a recommendation that we review the protocol between the ACMD and the Home Office. It was not to do with the policy substance of the advice.
Ms Abbott: Thank you for that.
Q414 Chair: Would you be willing to release that to the Committee on a private basis?
Chris Philp: No. The advice was provided privately. It is important—
Chair: We wouldn’t do anything with it. We are not going to publish it.
Chris Philp: I will undertake to consider it as a courtesy to you, Chair, but it is highly unlikely that we would want to disclose it. Parliament has a proper role to scrutinise, but it is important that Ministers in any Department are able to have confidential conversations with advisers. That is why there are exceptions in the Freedom of Information Act passed by a Labour Government. They are designed to facilitate private, confidential conversations. If every bit of advice that a Minister received or every conversation that they had was subject to disclosure, it would have a chilling effect.
Q415 Chair: I don’t think we are asking for that, but we are saying that this is the only document that has not been published. Obviously, you want to have transparency around what the ACMD is saying to Government. It is the only document that has not been published. Perhaps you could go away and have a think about whether you will let us have a look it.
Chris Philp: I will consider it, but it was marked as confidential. The matter has been litigated and gone all the way to a court. Someone put in a freedom of information request and—
Q416 Chair: I am just asking as the Chair of the Select Committee whether you will consider allowing the Committee to have access to it.
May I ask you a couple of other things before we finish? I think you made reference to the eight people who were on the diamorphine assisted treatment programme in Middlesbrough. We were very clear when we met a number of those eight that they were a significant problem in Middlesbrough in terms of crime. That programme was helping to reduce the rates of offending and crime in Middlesbrough. I just wanted to point that out, so you are aware of it. The numbers are low, but the effect in terms of crime was significant.
I know that you are new in post, but the Health and Social Care Committee and the Scottish Affairs Committee have both recommended that drug policy should be moved out of the Home Office into the Department for Health and Social Care. Are you willing to consider that? I am not prejudging what we are going to say as a Committee, but two other Select Committees have made that recommendation. It was rejected by your predecessors. Are you willing to look at that again?
Your post is very wide-ranging. You have a lot of responsibilities. Do you have any view about whether there should be a stand-alone drugs Minister?
Chris Philp: I will try to answer those questions quickly. On the Middlesbrough question, Caroline may want to come in on the criminality in a moment, but a letter was sent to the Committee on 31 October by the joint director of public health for Public Health South Tees, Mark Adams, which confirmed, “We are satisfied that the variety of alternatives to DAT can benefit the eight patients, as well as other people” within our local community, et cetera. So, Public Health South Tees has confirmed to the Committee, in writing, that it is satisfied that there are alternative options for those eight people.
Caroline, do you want to come in on the criminality point?
Caroline Hart: Just to clarify, we have committed, in the drugs strategy, to continue Project ADDER for a further two years, so we are not closing down Project ADDER. We are following what those projects are doing very closely, because they bring together—
Q417 Chair: I don’t think I was asking that. I was making a specific point about the reference to the eight people who are on that diamorphine assisted treatment programme. That was my only point.
Caroline Hart: Sure. So, I guess that funding is there, and, as the Minister has said, it is for that local area to decide how they might use that.
Chair: Yes, we have heard that.
Chris Philp: And the public health director, Mark Adams, has written to the Committee saying that he is satisfied that there are appropriate alternatives for those eight patients.
Q418 Chair: Well, I think that we take a different view, and I just wanted to highlight that point about the eight people that you referred to. But what do you say about moving drug policy into the Department of Health and Social Care?
Chris Philp: Well, so the Prime Minister decided, shortly after he was—
Chair: Which Prime Minister?
Chris Philp: The current Prime Minister—the current and future Prime Minister, who will be serving for a long time—decided to continue the previous arrangements, where the cross-Whitehall combating drugs Minister was also the police and crime Minister. I was very happy to accept that appointment.
I think that it does make sense to anchor it in the Home Office. We have the joint combating drugs unit based in the Home Office, with lots of very capable civil servants working on that. Clearly, there are obvious links into law enforcement and policing, and links with police and crime commissioners, who chair local criminal justice boards and will be playing a key role in community safety partnerships.
We also do work in a very cross-Whitehall way. I mentioned that meeting that I chaired two weeks ago, which had Ministers from three or four different Departments—
Q419 Chair: Could you send us details of who sits on that committee? It would be very helpful to understand that cross-departmental working.
Chris Philp: Certainly. There was the prison operations Minister, a DWP Minister and a housing Minister. Dame Carol Black was there. Public health leads were there. The chief constable who leads on drugs was there. A couple of police and crime commissioners were there. Dr Day was there—we will give you a full list.
Q420 Chair: Okay, please do send us that information. I am very conscious of time, so I just want to ask if you would also send us some information around what you are looking at in terms of drug-checking services and whether there is any further flexibility around that. There are concerns that the drug-checking services are, again, rather bureaucratic and difficult, so could we have something on any flexibilities you are looking at?
Also, could you write to us about naloxone and what has happened in Scotland, and the roll-out across police forces to all police officers, and whether in your view that is something that should happen in the UK—
Chris Philp: And Wales. They are doing it in south Wales, as well, very effectively.
Q421 Chair: Yes, okay. Also, could you write to us about your view on a national diversion scheme? At the moment, we know that there are different schemes operating around the country. It would be helpful to get your view on whether there should be a national one, so that we don’t have a postcode lottery.
Chris Philp: Do you mean diversion within the criminal justice system, or more widely?
Chair: Within the criminal justice system.
Chris Philp: Yes. I would like to just put on the record one point that we haven’t discussed, and perhaps the Committee can consider it. I think far too few people passing through the criminal justice system get diverted into treatment by way of a drug treatment requirement, an alcohol treatment requirement or a mental health treatment requirement. I think only 2% to 3% of community sentences are for drug, alcohol or mental health treatment, even though well over 50% of people being convicted have those problems. That is an area that I raised at the meeting that I mentioned. I think there is a lot more that we can do as a system to get people referred from the criminal justice system into treatment.
Q422 Chair: Right. We welcome anything you would like to tell the Committee about that. Finally, you have not been in post very long, but what is your personal target as the drugs Minister? What are you aiming to have achieved by the time you leave office?
Chris Philp: The 10-year drugs strategy set out some fairly clear objectives.
Chair: But what is your key aim?
Chris Philp: First of all, to deliver the 10-year drugs strategy and make sure that everything we have committed to—the funding and the 54,500 extra treatment places—is delivered. That is all critical. I mentioned a second ago the point about referrals from the criminal justice system. I would like to see a lot more community sentences direct people towards treatment, given that so many have an addiction problem. In fact, the same applies to mental health and alcohol addiction as well as drug addiction, and I will be working with colleagues in the Ministry of Justice, and indeed the Crown Prosecution Service, to do that. To achieve it, we need to build judicial confidence that treatment capacity is available, we need to make sure the right pre-sentence reports are compiled so that a judge, on sentencing, knows that the person in front of them has a drug addiction, mental health or alcohol problem that needs to be treated, and then we need to make sure that that gets followed through and the treatment is delivered.
Q423 Chair: So by the time you finish in post, that is what you want to have achieved. We can judge you on that.
Chris Philp: Among others. More people in treatment—
Chair: I have just asked for one, because time is pressing. If that is your No. 1, it is an interesting one for us to judge you on.
Chris Philp: There are many others as well, but that is one of them.
Chair: Okay. Thank you very much indeed for appearing before us today; it has been very helpful. That concludes our evidence sessions on drugs. We will be writing a report, which we will obviously be sending to the Government, and we look forward to the Government’s response to our recommendations. Thank you very much for your time today.