HC Deb 23 October 1967 vol 751 cc1368-78

Lords Amendment No. 3: after Clause 3, in page 4, line 6, at end insert new Clause A.

(1) The Secretary of State may by regulations make provision—

  1. (a) for requiring precautions to be taken for the safe custody of drugs of any description specified in regulations which are kept on premises of a description so specified;
  2. (b) for requiring the keeping of records of drugs in respect of which such precautions are required to be taken;
  3. (c) for the inspection of any precautions taken or records kept in pursuance of this section; and
  4. (d) as to the manner in which drugs are to be packed for sale by a person who, within the meaning of the regulations, is a manufacturer of drugs or a dealer in bulk in drugs.

(2) Regulations under this section may provide that such of the requirements imposed by virtue of paragraph (a) above as may be specified in the regulations shall not apply to drugs kept on premises occupied for the purposes of his business by such a person as is mentioned in paragraph (d) above; but the Secretary of State may, by a notice in writing served on such a person in such manner as may be specified by regulations under this section, specify the precautions or further precautions to be taken for the safe custody of any drugs specified in the notice which are kept on premises so specified and occupied by him as aforesaid, and the precautions specified in such a notice shall be deemed to be required by regulations made in pursuance of the said paragraph (a).

(3) Regulations under this section may also provide that where a person of a kind mentioned in section 1(2) of the Drugs (Prevention of Misuse) Act 1964 is convicted of an offence against the principal Act consisting of a contravention of regulations under this section the Secretary of State may, by a direction given in such manner and after such consultations (if any) as may be specified in the regulations, provide that the said section 1(2) shall not apply to that person while the direction remains in force.

(4) Without prejudice to the provisions of section 5(2) of this Act, section 14 of the principal Act (which relates to the entry and search of premises to obtain evidence of offences) shall have effect as if the reference to Part III of that Act in subsection (1) included a reference to this section and as if references to Part I of the Schedule to that Act included references to the Schedule to the said Act of 1964; and section 16(2) of the principal Act (which among other things limits the penalty in respect of an offence relating to the keeping of books which was committed through inadvertence) shall have effect as if the reference to the keeping of books included a reference to the keeping of records in pursuance of paragraph (b) of subsection (1) of this section.

(5) Nothing in this section shall be construed as derogating from the provisions of any other enactment relating to matters in respect of which provision may be made under this section.

4.18 p.m.

Mr. Speaker

I understand that it will be convenient if we discuss, with this Amendment, Amendment No. 6, in Clause 4, page 4, line 17, after "State"insert: to give a direction in pursuance of subsection (31 of section (Safe custody etc. of drugs) of this Act or".

The Under-Secretary of State for the Home Department (Mr. Dick Taverne)

It will, Mr. Speaker.

I beg to move, That this House doth agree with the Lords in the said Amendment.

The new Clause may, in its detailed provisions, prove difficult to digest, but its aim is to give the Secretary of State a comprehensive power to impose a single code of requirements for the safe keeping, record keeping and packaging of hard and soft drugs, and to empower the police and persons authorised by the Secretary of State to enter premises to see whether the requirements are complied with. The new Clause is not intended to affect the generality of the powers which already exist.

The Dangerous Drugs Act 1965 contains in Section 11 wide powers to prevent improper use of scheduled hard drugs under international control, but there is a doubt whether the power of inspection covers all premises where scheduled drugs are kept. There are no powers in the Drugs (Prevention of Misuse) Act 1964 to require or enforce safekeeping of scheduled soft drugs.

There is no evidence that manufacturers, wholesalers and pharmacists do not attend responsibly to the security of dangerous drugs. For some time, the police have felt concerned about the pilfering of soft drugs and in 1965 a working party, which was convened by the Central Conference of Chief Constables, suggested that such drugs should be brought under dangerous drugs control to ensure better security. With the co-operation of the associations concerned, information about security arrangements was collected during 1965 from all manufacturers and dealers registered under the 1964 Act. This survey showed that in a number of firms the safeguards against theft or pilfering of soft drugs were ineffective or non-existent.

Some of the figures of pharmacy breaking will be of interest to hon. Members. In 1966, there were at least 60 cases of breaking into pharmacies in London, 35 cases in Manchester, 25 in Lancashire and 14 in Liverpool. The risk may be increased when the restrictions on supply to heroin addicts comes into effect under this Measure.

In discussions with the Home Office, the manufacturers' and wholesalers' associations have agreed that some firms have not been making sufficient effort to prevent theft and pilfering and that standards should be brought up to the level of those adopted by the most responsible. They have asked that the Home Office should be responsible for inspection and that any new provisions should allow local requirements to be fixed, as in the case of dangerous drugs, after review of the firm's procedures, organisation and premises. They have suggested that security could be improved by control over methods of packaging; that is, the sealing of containers or packs.

The Government consider that in a situation where drug trafficking appears to be increasing, and drug abuse may be progressive from soft to hard drugs, there is need for a unified system of control and inspection of the safe custody of hard and soft drugs in pharmacies—designed mainly to prevent forcible theft —and for control of safe keeping of soft drugs in the industry, adapted, as with hard drugs, to be circumstances of the individual firm. There is no evidence at present of a drug security problem outside pharmacies and industrial premises, but it would be appropriate to take powers to cover any premises where substantial stocks of drugs may be kept.

Amendment No. 6 is, to some extent, consequential. It extends the proposals to which the provision relating to tribunals and advisory bodies may be applied by regulations under Clause 4, so that they will include any proposal made by the Secretary of State to give a direction as provided by subsection (3) of the new Clause. It will be possible, if desired, to establish, by regulations, a common procedure for dealing through these tribunals and advisory bodies with any proposal to, in effect, withdraw a practitioner's authority to prescribe, possess, supply or otherwise deal in drugs scheduled under the principal Act or the Drugs (Prevention of Misuse) Act 1964.

Mr. W. F. Deedes (Ashford)

We accept the need for the new Clause, which is one of two substantial additions proposed to the Bill. There can obviously be no quarrel with the intention to use the Bill as a vehicle for making an urgent change, although it is some way outside the original scope of the Measure. We must also accept that, like a good deal of the rest of the Bill, the proposed new Clause gives the Minister a blank cheque to make regulations which we have not seen, about which the Under-Secretary has not said very much but which, I fear, we shall be asked to approve by the negative rather than the affirmative procedure. However, I appreciate that this is to be done in consultation with the bodies concerned and, no doubt, it will be satisfactory to the industry.

Although I have a serious proposal to put in connection with the Amendment, I wish, first, to deal with some other matters which may arise and on which we require further guidance. There is no doubt that this is dealing quantitatively with by far the biggest part of the sphere of drug dependence. If we accept that amphetamines, barbiturates and their compounds represent the biggest intake, then we can accept that these proposals will deal with the safe custody and the proper keeping of records for what is the biggest part of drug dependence.

While heroin addicts are still to he numbered in hundreds and while L.S.D. and marijuana habitues are unknown in number, although they run into perhaps thousands, we are here talking of millions of not just pills but customers. I have never found it easy to "read the riot act" to the young on the evils of drug dependence when we know that adults by the million resort to such large quantities of barbiturates and amphetamines. It is the spillover, the illicit leaks, of this huge drug trade that forms the largest and, I believe, not the least dangerous part of misuse among the young.

The Under-Secretary gave the figures of raids on premises. I estimate the number to represent about 100 raids a year. During the course of these raids about half a million pills, mainly amphetamines and barbiturates, fall into the wrong hands. However, according to American records, about one-third of all production in this line in that country gets into the wrong hands.

There are two aspects of the Amendment which I wish to discuss. The first is that we know perfectly well that the vast quantity of prescribing of these drugs which leads to a good deal of the traffic which we are anxious to check arises from the fact that doctors, many of them overworked, are induced to prescribe soft drugs in vast quantities as the modem equivalent of placebos. But this is a matter for the medical profession and not for us, although in passing this legislation we should keep the subject in mind. No regulations under the Bill will stamp out the illicit traffic as long as there is licit prescribing on the present scale.

Secondly, one reason why these raids on chemists' shops are so profitable is because enormous quantities of these drugs are held in stock. Dangerously large quantities are held in stock because, under current arrangements, it pays the retail chemist to buy in bulk. Under the National Health Service a chemist receives a fixed sum on retail purchases, but from the wholesaler and manufacturer he will receive a substantial discount for purchases made in bulk. A parcel of drugs worth, say, £25 will enable the chemist to receive a discount of 5 per cent. On a parcel worth £50 to £75 he will get a discount of 10 per cent.

If a chemist is buying from a general manufacturer a mixed parcel of drugs, the content of the drugs about which we are speaking may be small, but if he is buying from the sort of manufacturer who is making these drugs, the parcel will consist of those drugs and he will be persuaded to buy large quantities indeed. This is a problem which the Ministry of Health should consider, because as long as unnecessarily large quantities of dangerous drugs are stored by pharmacists—and in this context I am not referring to wholesalers—the risk of raids being successful will continue and there will be a strong inducement to carry them out. I have no desire to lose chemists their precarious margins, but a system which induces the bulk purchase of amphetamines and barbiturates, in the light of what the Under Secretary has said on this matter, should be closely re-examined.

4.30 p.m.

I should like to make one subsidiary point about safe custody. At first sight it makes sense to persuade the chemist to segregate his hard drugs from his soft drugs and lock them away, and I understand that in future he will be punished if he does not do so. At the same time, this enormously simplifies the task of anyone breaking into the chemist's shop: he knows exactly where to look. Unless he is confronted with a very strong cabinet, or safe in which the dangerous drugs have been put, his task is, in a sense, made easier and not more difficult.

This is a point that a great number of chemists have had in mind. I know some who think that it is safe not to keep all their dangerous drugs, as it were, in one basket. I hope that debate in the industry will resolve what is the safest way of keeping drugs in premises which can never really be made entirely burglarproof. Discussions will be needed on how chemists in a small way of business are to be provided with cupboards, safes, or something similar by means of which they may comply with the law we are about to pass.

This Amendment represents a substantial change in the Bill and I should like now to mention my main point in connection with it. As I read the Amendment, it is designed not only to promote security but to provide a standardised scheme for keeping a record of the drugs—and a record that can be inspected, as laid down in paragraphs (b) and (c). I suggest to the hon. and learned Gentleman and, through him, to the Secretary of State, that we ought to go a little further and use this opportunity, as we still can, by means of regulations to be framed, to give us a system which could eventually provide us with more facts and information and with more insight into the use and misuse of mood-changing drugs. If the House looks at the provisions of the new Clause, it will see that this is now made possible.

I am quite sure that sooner or later we will have to act in this way. This vast consumption of mood-changing drugs poses much bigger problems than some that are involved in the current controversy on the drugs question, but I shall not go into that. We shall need far more research and, for that research, far more basic information. Here we have an opportunity of providing ourselves with just that basic information. We shall need to know a lot more about the social and economic geography of the dependence on drugs, and I believe that this Amendment could be used to provide the essential raw material.

One country which is doing this is Canada, though there may be other countries. There, at least, I have had a chance to make a very cursory inspection of the system. I shall not go into details of that system now, but I should like to mention to the House, how, in Canada, by the use of a very similar provision they have made a practical job. Under the Canadian system, all drug wholesalers are required monthly to return details of sales of listed drugs—that is, drugs under the Dangerous Drugs Act—to a central source. These lists are rapidly translated by a very small staff using special machines to indicate which particular doctors, chemists and hospitals have been in receipt of these supplies. Chemists make their own returns—as I understand from this Amendment they will now have to do here—on standardised forms, as, I understand, they will also have to do in this country.

In the same office where all that material is available are filed the police records of those found using drugs which are not retailed through pharmacists—L.S.D., S.T.P., marijuana and all the rest —and of those who have been on narcotics charges. Not only does this recording of licit transactions enable inspectors —who act as I understand our own inspectors will—to make meaningful spot checks of retail chemists, but in that relatively small office, with a staff of only about two dozen, there is really a full picture of the Canadian drug scene. This is something which we lack at the moment.

I would add that those engaged in research in Canada also profit from these records, but that that stage has not yet been fully developed. I am impressed with the possibilities, and I am left with the feeling that we shall not much longer be able to afford to be without the opportunities provided by this Amendment. That is what has impelled me to mention this aspect, and I am sorry that I have not been able to give the hon. and learned Gentleman longer notice.

This system will not, of course, be universally popular with the retail chemists, but a sensible system of keeping centralised records in a standardised way would not necessarily entail a lot of work —it certainly does not in Ottawa—though it would entail some additional work. If such a system were established by regulations made under this Amendment, not only for control but for research, it might be worthwhile, under the National Health Service, to allow a very small additional payment to the chemist for his trouble in respect of prescriptions of mood-changing drugs. The details and difficulties can argue for themselves, but I am certain that sooner or later we shall have to establish some such system. We are very near to it now.

We shall not solve this immensely serious problem of drug dependence by piecemeal provisions of which, if I may say so without offence, this Bill is rather characteristic. Nor shall we cure everything only by control. Every authority to whom I have talked on the subject agrees that we need far more research. We have the makings here, for all the difficulties, of a real and important advance. To make that advance, we should have to cause trouble to certain people and possibly go to a little more expense than the Secretary of State now envisages, but regulations under this new Clause could provide the necessary framework. Beyond that we could add, as I think we shall have to add in any case, some sort of central office where records could be collated. This work should not be just one part of the task of a very busy Home Department.

I beg the Minister to think further of the constructive uses we could make of this Amendment. I do not propose to use a sledgehammer to crack a nut—drug dependence, anyway, is no longer a nut, and I do not think that this organisation would turn out to be a sledgehammer —but we might seize this opportunity to extend the frontiers of our knowledge of a fearfully complex and, as the Under-Secretary himself said, a persistent epidemic that shows no signs at all of alleviation. That having been said, we give this proposal a fair wind.

Dr. M. P. Winstanley (Cheadle)

I am tempted to follow the right hon. Member for Ashford (Mr. Deedes) on one or two points. Like him, I am in broad agreement with the new Clause, which I regard as a necessary complementary measure to the Bill as a whole. It contains provisions which I am sure will prove to be necessary. The right hon. Gentleman made two points, among others, and I want to support one of them, and to warn the Under Secretary to be a little chary about the attention he gives to the other. I will deal with the latter point first.

The right hon. Gentleman referred to the biggest possible reserve of licit drugs arising from prescribing habits and from over-buying and bulk stocking by retail pharmacists. There is no doubt that this is the main source, but the remedies the right hon. Geneleman suggests are, perhaps, rather difficult to apply. One ought to be able to act without first of all placing obstructions and impediments in the way of the doctor prescribing in what he regards as the most economical way in relation to his own and his patients' time. We should also be careful about placing similar obstructions in the way of the pharmacist conducting his business on sound economic lines.

The fact remains that whatever restrictions are laid on his ordering habits and to what extent he is reduced in the amount of stock he carries, we have to remember that with the multiplicity of products of this kind we can never limit things in the way suggested by the right hon. Gentleman. The pharmacist has to keep in stock all manner of things which come into this group and, however careful he is about the numbers he has of any particular variety, the aggregate total necessarily constitutes a constant danger. I do not think that we can get at the danger in that way, but we have to go further and look at other measures such as those suggested in this Amendment.

The right hon. Gentleman also referred to the possibility of assistance to the pharmacist in providing proper facilities for the safe keeping of drugs. I underline very strongly what he said. I have had consultations with pharmacists who have suffered from raids. I know the difficulties which they have in making the necessary provisions in their premises. I have recently had correspondence with the Postmaster-General on possible methods of assisting retail pharmacists and exploring various kinds of burglar alarms. The answer is that, while it is understandable that no special steps can be taken to assist a particular type of trader and exceptions cannot be made, it is the business of Governments to make exceptions. If we do not make exceptions we do not need Ministers, but only need civil servants. We have to make exceptions in an exceptional situation.

Although we accept the proposed new Clause, I ask the Minister not to believe that that is the end of the story. I strongly recommend that in parallel with these steps the Under-Secretary and his hon. Friend the Parliamentary Secretary to the Ministry of Health, who has a responsibility here, should start considering other methods of assisting in the safe keeping of drugs by the family doctor and the retail pharmacist.

Mr. Taverne

I speak again by leave of the House to comment on some of the points which have been raised. I agree entirely with the right hon. Member for Ashford (Mr. Deedes) that here we are dealing with by far the largest part of the problem because 3½ million prescriptions are for amphetamines and l5½ million are for barbiturates.

The Scientific Committee of the British Medical Association is considering the medical value of amphetamines and hopes to report in a few months on the possi- bility of doing without them. The question of bulk purchase has been noted and will be studied in the consultations which are to take place with the trade. I also take note of the point made by the right hon. Member and by the hon. Member for Cheadle (Dr. Winstanley) about advice on facilities for the safe keeping of drugs.

Perhaps the most important point was made on records. We certainly take the point that what is needed above all is more information of every conceivable kind. The volume of drugs makes any system of keeping records a formidable undertaking, but the intelligence value of the record system has been appreciated. We are aware of the Canadian precedent and we are also aware that in Canada the problem is of rather different proportions. It is a smaller problem and Canada has no National Health Service, but we are aware of it and the subject is being explored with special reference to possible computerisation.

Like many other questions, this is something which will require further study and consultation. I am glad that on this point there is no division of opinion in this House.

Question put and agreed to.