Lords Sitting of 30 January 1991

Preamble
The House met at half-past two of the clock: The LORD CHANCELLOR on the Woolsack.
Prayers—Read by the Lord Bishop of Newcastle.

Wales: Army Command Structure
Lord Parry Lord Parry asked Her Majesty's Government:
Whether they have anything further to add to the assurances given about the role of the General Officer Commanding Wales and the future provision for the army in Wales given by the Earl of Arran on 18th June 1990 (HL Deb., cols. 725–6.).
The Parliamentary Under-Secretary of State, Ministry of Defence (The Earl of Arran): My Lords, I have little to add to the Answer I gave to the noble Lord on 18th June last year. Although no decision has yet been taken, consideration of the review of the United Kingdom land forces is now at an advanced stage and further announcements will be made at the appropriate time.
Lord Parry: My Lords, the House and the Minister will recognise that while I thank him for that Answer, it is not helpful at this stage. In view of the changes in international affairs that have taken place since last June, and in view of the concerns of the Welsh people, will he add to his Answer and tell me how he ascertained the views of those in Wales as he promised in June that he would?
The Earl of Arran: My Lords, we have had extensive consultations at ministerial and official level with the Welsh Office. Furthermore, many prominent people from the principality have had discussions with the Ministry of Defence.
Lord Hooson: My Lords, is the Minister aware that there is extreme sensitivity in Wales over this matter? Wales is a nation within the United Kingdom. When, about four or five years ago, it was suspected that there would be a downgrading in Wales, the then Secretary of State for Defence, Mr. Heseltine, met an all-party delegation which consisted of the noble Lords, Lord Cledwyn, Lord Gibson-Watt and myself. Is the present Secretary of State willing to entertain a similar delegation to enable it to put the views of Wales to him?
The Earl of Arran: My Lords, we are aware of the sensitivity of Wales on this subject, but what is obviously of prime importance is the operational effectiveness of the United Kingdom land forces. As regards a delegation to my right honourable friend the Secretary of State, I believe that enough consultation on the subject has already taken place.
Lord Cledwyn of Penrhos: My Lords, is the Minister aware that what is of prime importance is that the feelings and views of the people of Wales should be taken fully into account? Will he confirm that the contribution of Wales to the armed forces is higher in ratio than that of England, Scotland and
700
Ireland? Will he give the House the figures? Will he take account of what my noble friend Lord Hooson said? Feelings in Wales on this subject are running high? If Wales is downgraded in the terms mentioned by my noble friend, and Scotland is left as it is, the repercussions will be extremely serious for the Ministry of Defence, the Secretary of State for Defence, and the noble Earl, if he is not careful.
The Earl of Arran: My Lords, I think your Lordships will agree that I should ignore the last past of the noble Lord's question. I repeat that we are aware of the sensitivity of Wales over the streamlining of United Kingdom land forces. The strength of the military in Wales is currently about 600 people.
Lord Harmar-Nicholls: My Lords, leaving aside the particular aspects of this Question, is it not unusual, when a delegation of Members of Parliament asks for a meeting on such an issue, for that request not to be granted?
The Earl of Arran: My Lords, as I said, representations on this subject have been made by many prominent people, including councillors and Members of Parliament.
Lord Parry: My Lords, with the permission of the House perhaps I can come back to the Minister and ask whether he believes that merely to quote the numbers involved addresses the Question that I asked or the question asked by my noble friend Lord Cledwyn, which was not answered, about the ratio and recruitment of the soldiery in Wales to the British Army? Does the Minister accept that it is no coincidence that one of the most recent General Officers Commanding Wales, Lieutenant-General Sir Peter de la Billière, is now commanding the British forces in the Gulf?
The Earl of Arran: And a very good job the general is doing in the Gulf, if I may say so, my Lords. I must repeat that it is not a question of numbers; it is not a question of there being about 600 people; it is a question of streamlining and of making as efficient as possible the operational effectiveness of United Kingdom land forces. In no way shall we be demeaning or downgrading Wales in our esteem.
Lord Nugent of Guildford: My Lords, is my noble friend aware that when, on a recent visit to less dangerous ground than Wales, a photograph of him in service uniform in the Gulf appeared in the newspapers, he cut a very good figure?
The Earl of Arran: My Lords, that is a particular piece of flattery which I am certain I do not deserve.
Lord Williams of Elvel: My Lords, what is wrong with Brecon as the headquarters of Western Command? Why is it to be moved to Shrewsbury?
The Earl of Arran: My Lords, I believe that the noble Lord is speculating.

Charities: Reform of the Law
2.43 p.m.
Lord Allen of Abbeydale Lord Allen of Abbeydale asked Her Majesty's Government:
What plans they have for reforming the law relating to charities.
Lord Reay: My Lords, the Government's proposals are set out in the White Paper Charities: A Framework for the Future. The Government hope to be able to introduce legislation to give effect to the proposals during the lifetime of this Parliament.
Lord Allen of Abbeydale: My Lords, I thank the noble Lord for that Reply although I am not sure that it adds greatly to previous knowledge. Is he aware that there is widespread disappointment cutting across political boundaries that the Government have not introduced a Bill this Session implementing their admirable White Paper? There are grounds for thinking that potential donors are discouraged when they know that under the present powers the Charity Commission is handicapped in dealing with fraud and other forms of abuse and when the controls over fund raising are, to put it mildly, somewhat inadequate.
Lord Reay: My Lords, first, we remain committed to the proposals in the White Paper, but the legislative programme is full and there is pressure on space. With regard to the second supplementary question, we have no evidence that fraud or mismanagement are widespread or that they have had an effect on donors.
Lord Houghton of Sowerby: My Lords, while we are awaiting legislation, will the noble Lord consider giving the public more advice and information about the powers and weaknesses of the Charity Commissioners? Their writ rests mostly upon the ignorance and fears of the public and not on any statutory basis. Will he therefore enlighten the public on the risks they take if they give way to tendentious appeals for charitable help without some selection or inquiry? Before they give money to charities they should inquire what the charity is, what it does and more about it. Does the Minister realise how vulnerable people are at present? While we are waiting for legislation many will undoubtedly give money, as gullible members of the public do.
Lord Reay: My Lords, the noble Lord gave good reasons why there should be legislation. Those are the reasons why we intend to introduce legislation when we are able. I am sure that the other warnings that he issued are well made and will be taken widely into account.
Baroness Robson of Kiddington: My Lords, is the Minister aware that old-established and genuine charities are concerned about the delay in introducing legislation to deal with charities? They are anxious about the responsibilities of trustees of charities as against directors of charitable companies. As yet there seems to be no clear cut-advice to give people.
Lord Reay: My Lords, being a trustee involves responsibilities. The proposals of the White Paper are intended to make those responsibilities clearer.
702
Meanwhile the Charity Commission continues to give general advice and to advise charities on matters relating to their duties.
Viscount Whitelaw: My Lords, is my noble friend aware that I totally agree with the noble Lord, Lord Allen of Abbeydale? He is, therefore, perfectly correct in assuming that there is a cross-party view of the problem though maybe not a cross-Home Office view. Nevertheless, be that as it may, I hope that my noble friend realises that delay in carrying through the legislation and giving the Charity Commission the job, the duties and support which it needs to deal with charities is dangerous for the future of charities and charitable giving. I hope that my noble friend will represent strongly to his honourable friends in the Government that I and many in this House believe that there ought to be legislation this year, and I hope that they will take note of that.
Lord Reay: My Lords, I am happy to give my noble friend that assurance. We consider that legislation is necessary and wish to introduce it as soon as possible.
Lord Molloy: My Lords, is the Minister aware that the important matter raised by the noble Lord, Lord Allen, and the supplementary questions are of vital importance? Does he agree that the existing regulations are ignored by some charities, including some of the larger ones? It is about time that before we consider making new regulations we find some procedure to ensure that existing regulations are enforced.
Lord Reay: My Lords, the Charity Commission devotes considerable effort to monitoring charities and combating abuse. The proposed new powers will enable it to be more effective.
Lord Richard: My Lords, the Minister tells us that the Government's policy is set out in the White Paper. Can he say whether the Government accepted the comments of the charity world—for want of a better phrase? The Charity Commission cannot justify charging in order to expand its role if the Treasury then deducts any income from the Charity Commission grant.
Lord Reay: My Lords, there has been extensive consultation following the White Paper. We have received a great many constructive contributions which have been taken into account.
Lord Williams of Elvel: My Lords, the noble Lord said three times in his answers that the Government wish to introduce legislation as soon as time permits. Given that this is the lightest Session for legislation that we have seen for a long time, is he prepared to consult through the usual channels to ascertain whether we can accommodate a Bill immediately?
Lord Reay: My Lords, it is not up to the usual channels to take that decision.

Bank Commission Rates
2.50 p.m.
Lord Ezra Lord Ezra asked Her Majesty's Government:
Whether they consider that the commissions being charged by British banks on transactions in foreign currencies are too high.
The Parliamentary Under-Secretary of State, Department of Social Security (Lord Henley): My Lords, the commissions charged by British banks are determined by competition within the industry. The most effective way to reduce commissions is through increased competition, technological change, and co-operation between banks in developing systems for making payments.
Lord Ezra: My Lords, is the Minister aware that recently I received a dividend to the equivalent value of £42.28 on shares held in a French company and that my clearing bank charged me £20 commission for that transaction? After the payment of UK tax I was left with £5.37. Is the Minister surprised to learn that in my complaint to the clearing bank in question I asked whether it should not have taken the lot and saved the paperwork? Does the Minister not agree that transaction charges of this order are likely to limit the benefits which we could otherwise expect to receive from the creation of a single market? Does he further agree that this is perhaps the strongest case for creating a single European currency?
Lord Henley: My Lords, I offer my commiserations to the noble Lord on the fact that he lost so much money. All I can advise him to do is to shop around and try to find a lower commission rate. The noble Lord asks whether his experience is not a good argument for adopting a single currency throughout Europe. I do not believe that a single currency would solve all the problems incurred in making cross-border payments. Some problems still exist in a single currency area such as the United States of America.
Lord Boardman: My Lords, does my noble friend agree that there are many hundreds of British and foreign banks operating in Britain and that that situation should ensure that the competition to which he referred does occur?
Lord Henley: My Lords, I thank my noble friend for that supplementary question. He is right to say that there is competition between banks and between banks and bureaux de change.
Lord Taylor of Gryfe: My Lords, does the Minister accept that it might help the Government's prospects if they offered a special discount on transactions involving the hard ecu?
Lord Henley: My Lords, we do not have the hard ecu at the moment.
Lord Peston: My Lords, I am puzzled by the remarks made about competition. Is the Minister not aware that all banks seem to offer exactly the same bid and offer prices for retail transactions of this kind? At least that appears to be the case from prices printed in the newspapers. Is the Minister really happy that a small currency transaction will involve a charge of
704
some 6 to 7 per cent. just on the bid and offer price, plus at least another 10 per cent. handling charge? A 17 per cent. charge seems very large for, as it were, ordinary transactions. I could not follow the Minister's argument. Will he explain how, if we had a single currency, there could be any charges for currency conversion?
Lord Henley: My Lords, I said that there would still be problems with cross-border payments. Moving money around is not as simple as all that.
Lord Peston: My Lords, I am totally at a loss to understand the Minister's argument. If we are all dealing in the same currency, we simply write cheques in the same currency. Other problems may arise but they cannot possibly be of the magnitude of those that the noble Lord, Lord Ezra, faced. Surely the Minister agrees with that.
Lord Henley: My Lords, I agree with that. I was merely saying that there would still be problems when moving money around.

Skills Training
2.53 p.m.
Baroness Turner of Camden Baroness Turner of Camden asked Her Majesty's Government:
What action they are taking to ensure that the recession does not cause a cutback in expenditure on training.
The Parliamentary Under-Secretary of State, Department of Employment (Viscount Ullswater): My Lords, the Government's plans for strengthening the skills base of the country are unaffected by the economic down-turn. We are establishing training and enterprise councils with resources and influence to transform training locally. We are proceeding with major reforms of education to provide a proper foundation of working skills. These, and other reforms, will provide a strong framework for training, within which it is primarily for employers to decide how and when to invest in skills.
Baroness Turner of Camden: My Lords, I thank the Minister for that response. Will he comment on the recent press report that government funds for training for the unemployed will be cut by 12.5 per cent. in cash terms, and that youth training budgets are planned to fall from £907 million to £828 million? That is a reduction of 9 per cent. Is it not unwise in the present circumstances to cut arrangements for training and retraining for unemployed people?
Viscount Ullswater: My Lords, training is not always the most appropriate solution to the problems that the long-term unemployed face in getting back to work. We are offering a better mix of provisions by expanding by some 100,000 places job clubs and job interview guarantee schemes which already have a track record in helping long-term unemployed people get back to work. Turning to the youth training budget, the resources for youth training will be increased by about £38 million compared with previously planned resources. This includes extra funds for piloting training credits for young people.
Lord Mellish: My Lords, what is the position now as regards one of the best of the training boards, the Construction Industry Training Board? The Minister will know that last week I made a fine speech in which I thoroughly covered the work of the training board. However, the Minister who replied to that debate simply said that he would drop me a line on the matter. That is not very satisfactory. Will the Minister give me some more information now?
Viscount Ullswater: My Lords, I read with great interest the fine speech that the noble Lord made on that occasion. Appointments to the CITB are made for a three-year period. I believe the noble Lord indicated that to your Lordships. As is normal for all non-departmental public bodies, including industrial training boards, a review of the continuing need for such bodies—and in this case for a statutory levy—will be carried out before a decision on reconstitution is made in 1993. However, I understand that my noble friend Lord Strathmore and Kinghorne will write to the noble Lord on the issue shortly.
Baroness Seear: My Lords, will the Minister confirm that money paid through the training and enterprise councils—I believe it is also paid to the TECs—will, at any rate to some extent, be dependent on results? Results are interpreted as the number of jobs which trainees obtain. If that is the case, is it not true that with rising unemployment and in areas where unemployment is highest, funds will be reduced in just the areas and at just the time when it is extremely important to increase training?
Viscount Ullswater: My Lords, the noble Baroness is correct to a certain extent. Targets will be set for the TECs, not only on the number of jobs that are secured but also on the level of training issue and the qualifications gained, especially by youngsters undergoing youth training. I do not agree that the reassessment and the amount of money being passed from one block to another will have the effect that the noble Baroness has referred to.
The Viscount of Oxfuird: My Lords, will my noble friend confirm that the recent CBI report, which I understand was published yesterday, highlights the considerable increase in funding for training? That has become an evident and important point in this Government's favour over the past few years.
Viscount Ullswater: My Lords, I thank my noble friend for his comments. They demonstrate the success of our voluntary approach. The CBI survey, to which I believe my noble friend was referring, continues to show that more employers are planning to increase training than to cut it. Here is an indication of a steady employer commitment to training despite the downturn in the economy.
Lord Dormand of Easington: My Lords, is the Minister aware that he gave a puzzling reply to my noble friend? The Minister has spoken of TECs. Will he confirm, as I am sure he must, that training in this country is now based on the private sector? In those circumstances, and in view of the many redundancies which are being declared every week, and the reduction in expenditure in industry because of the
706
recession, is it not inevitable that companies and industries will cut costs? The Government have no control over that.
Viscount Ullswater: My Lords, the Government's role is to help young people to acquire the skills that are needed in the labour market; to help unemployed people to acquire new skills to enable them to find jobs; and to improve the training infrastructure and create a climate in which enterprise can flourish. That is why I detailed what the TECs will be doing. It is their commitment, and the commitment of local industries to TECs, that will result in that programme being delivered.
Baroness Turner of Camden: My Lords, will the Minister please confirm or deny the truth of the report, to which I referred, that government funds for training the unemployed will be cut by 12.5 per cent. in cash terms in the coming financial year? Is that report in the Financial Times correct?
Viscount Ullswater: My Lords, I do not believe that the figures have been released, so that is speculation.
The Countess of Mar: My Lords, is the noble Viscount aware that many directors of training and enterprise councils are very despondent because, far from the funds that were promised when TECs were originally envisaged, funds have been reduced constantly? Is he aware that the directors now say that "enterprise" might as well be wiped from the name and very soon "training" might as well also be removed?
Viscount Ullswater: My Lords, I find that a most extraordinary statement. Many of the TECs—and I have visited a few myself—are extremely pleased with the funding that they have received. In cash terms they have the same money this year to do what they and the Government have to do. While the amounts of money in their budgets have been changed, there is a great deal that they can do themselves in directing that money, and that is a demonstration of the flexibility that we needed to build in.

Business
Lord Denham: My Lords, with the leave of the House I should like to say a few words about the length of speeches in today's debate standing in the name of my noble friend Lord Rodney, to which your Lordships have agreed to apply a five hour time limit. While the number of speakers is such that it is not necessary to apply a formal time limit I feel that the House would appreciate it if speeches were kept within limits compatible with the spirit of these limited debates.

Drug Misuse
3.1 p.m.
Lord Rodney Lord Rodney rose to call attention to the importance of efforts to reduce the demand for drugs, and the case for intensified efforts to tackle drug misuse; and to move for Papers.
The noble Lord said: My Lords, I am very pleased to have been asked to introduce this debate on the misuse of drugs. It is, I believe, one of the most severe threats to civilisation today. It is true that for the moment, with the war in the Gulf, the problem may not uppermost in our minds. But when the war is long over and forgotten this scourge will, I fear, still be with us.
I do not think that anyone honestly believes that a total solution to the problem will ever be found. That is no excuse for throwing up our hands in despair and advocating the legalisation of drugs. As we all know, alcohol is legal and alcoholism is possibly even more of a problem than drug misuse. Regrettably we cannot turn the clock back. However, we can ensure that drugs do not become as readily available as alcohol.
As chairman of SCODA, the Standing Conference on Drug Abuse, which is the national umbrella association for drug services, and as secretary in the House of Lords for the Parliamentary All Party Drug Misuse Group, I am and have been particularly concerned with the problem for some years now. It is a menace which, as I said, I do not believe can ever be completely eradicated. However, much is being done and can be done to contain it.
Most people agree that in the long run reduction in demand provides the best chance of achieving some success. To state the obvious: if there were no demand there would be no drug problem. Having said that, it does not obviate the necessity to attack the supply and suppliers of drugs by all means possible.
We have seen recently the extent to which modern technology can pinpoint targets in time of war. I have little doubt that if the same resources were devoted to identifying the presence of drugs, their supply could be very seriously curtailed. As I said, the most effective means of containing the drug problem is to reduce demand. Her Majesty's Government deserve some credit for the initiatives they have taken in recent years to achieve that objective. I do not want to pre-empt the contribution of my noble friend the Minister to the debate, but I should like to mention some of the steps that have been taken to make the young in particular aware of the risks and traumas associated with indiscriminate indulgence in drug taking. Today, there is the added risk of contracting AIDS.
The Government's main campaigns, which were started in 1985, centred around the media, using television, cinema and radio commercials together with advertisements in the press and posters in schools and other public places. Additionally, and equally important, the Government initiated a number of educational campaigns in schools to inform students about drugs, warn them of the pitfalls and try to steer them away from drugs before they became involved. Under the new National Curriculum for England and Wales there is for the first time a statutory obligation that all pupils in both primary and secondary schools receive education about the harmful effects of drug abuse. It is, however, unfortunate that this should come under the science umbrella rather than being included in the section that covers social and personal involvement. When my noble friend replies perhaps he
708
would care to comment on that point. The objective of the educational initiatives is to catch them young and warn them off before they succumb to the temptation of illicit drugs.
A scheme, which originated in Australia, deserves particular mention and support. It consists of life education centres which tour the country visiting schools and instilling into the children a pride in their bodies and physical health. It shows them, in some cases using original methods, what harm they can do to their health by indulging in smoking, drinking and drug taking.
I should not want to give the impression that reduction in demand can only be achieved through education. Important as that is, there are other initiatives which are also effective. For instance, young people can be offered attractive alternatives by making available sporting facilities, opportunities for public service and intellectual and cultural outlets; in fact, anything that will give them an interest away from the possible temptation of taking drugs.
Another important aspect is the reduction of what is known as peer pressure—nothing to do with Members of this House. That can be achieved by directing drug misusers to rehabilitation centres and isolating them from those people who might otherwise influence them and tempt them to follow their example.
Indulgence in illicit drug taking spans all elements of society—the rich and the not so well off, the privileged and the underprivileged, the intelligent and the not so intelligent. As I said, we have to combat peer pressures and the very considerable efforts made by the drug pushers to spread the disease for their own gain. We have to convince our young people that taking drugs is the road to despair and possibly death and that it is an indulgence that should be avoided at all costs.
It is therefore the reduction of demand which in the long run has the best chance of influencing the extent of drug misuse. On the other side of the coin are the efforts made nationally and internationally to reduce the supply of drugs and to inhibit their distribution. I fear that where there is demand suppliers will always find a way to meet it. Nevertheless I fully endorse all the efforts being made to make the supplying of drugs as difficult and hazardous as possible.
One recalls the continual recriminations between the so-called supplier nations and the user nations, each blaming the other. Happily, the situation seems to have improved somewhat in recent years. There is much better international co-operation and a closing of ranks against the common enemy, the trafficker. That has resulted to some extent, I believe, from the fact that the nationals of a number of supplier countries have themselves become users, as evidenced particularly in Pakistan. The war against the drug barons and their supply routes is of necessity an international operation. One country on its own is very limited in what it can do to control the supply of drugs across its borders.
Her Majesty's Government can take credit for the initiatives they have taken. They are an active member of the United Nations' Commission on Narcotic Drugs; they are party to both United Nations conventions to regulate illicit trade in drugs; they played an active role in preparations for the special session of the United Nations General Assembly on drugs; and they sponsored the world ministerial summit in London in April of last year, announcing at that time the formation of a demand-reduction task force with the objective of making available to other countries the United Kingdom's expertise and experience.
Finally, the United Kingdom was until very recently chairman of the Pompidou Group which co-ordinates Europe's efforts against drug abuse. Incidentally, that group has recently been enlarged to include its first two East European member countries: Hungary and Yugoslavia.
Apart from those initiatives, British drug liaison officers are stationed in Western Europe, Asia, South America, the Caribbean and the Mediterranean. On a number of occasions, in spite of considerable danger to themselves, particularly in places like Colombia, they have been very effective in alerting the authorities in this country to the arrival of consignments of drugs. I think that most of the big consignments that are caught are nearly always as a result of these officers alerting people here.
As your Lordships will recall, in this country steps have been taken to dissuade people from becoming involved in the drug trade. First, there was a Bill to increase the maximum sentence for trafficking from 14 years to life imprisonment. That has had the effect of increasing sentences across the whole range and has meant that now top offenders can be taken out of circulation for quite considerable periods of time.
The other main piece of legislation was the Drug Trafficking Offences Act, involving on conviction the sequestration of all assets of a criminal unless he could prove that they did not derive from the drug trade. It also enabled the authorities to trace, freeze and seize all assets derived from drugs, including those transferred to third parties. In addition, there are provisions covering money-laundering and requirements on banks to divulge the movement of large sums of money. These laws have been introduced to dissuade the run-of-the-mill criminal—that is to say, the ordinary criminal—from entering the drug trade and to ensure as far as possible that a convicted drug trafficker cannot, after a short gaol sentence, enjoy the proceeds of the crime of which he was convicted.
So far I have dealt with the steps taken to reduce the demand for illicit drugs and to combat distribution. There has been criticism of some of the efforts made by Her Majesty's Government—I am sure there always will be—but there is no doubt that the United Kingdom has played a major role in the fight against drug trafficking. Without that lead I am sure that the situation today would be much worse.
Perhaps I may turn for a moment to policies and attitudes towards drug-misusers. Not so long ago there was little sympathy in this country for these people: they were breaking the law, their affliction was of their own making and in most cases if convicted they were imprisoned. Happily, society today takes a more charitable view, and in some areas drug-taking is considered more a sickness than a crime. In some police areas first offenders are given a caution, and in the case of cannabis a fine rather than imprisonment is imposed for a second offence.
Nevertheless, attitudes vary considerably from one area of the country to another and there seems to be little consistency in sentencing. I am fully aware that the treatment of drug misusers from a legal point of view is a very sensitive subject. There is no argument that people who indulge in drug abuse are breaking the law. But is putting them in prison the best solution? If other crimes besides drug-taking are involved it probably is. But if convictions are simply for taking drugs, possibly combined with the minimum of pushing to finance the habit, will putting people in gaol stop them taking drugs or dissuade others from following their example? It is much more likely that they will come out of gaol after a month or two with new criminal tendencies which they have learnt from other inmates. Surely, the object of a custodial sentence should be to get them off drugs and to rehabilitate them and send them back into society with a good chance of renewing a stable and constructive life.
It is interesting that 50 per cent. of those sent to prison for drug misuse receive sentences of less than one year, indicating that their offences are fairly minor. I would like to suggest that these people would be much better served by a compulsory stay in a rehabilitation centre where they would receive specialised treatment and be helped to shake off their habit once and for all.
In conclusion, I am encouraged by the proposals in the Criminal Justice Bill to use community sentences wherever possible, although the details may need further thought. Perhaps my noble friend the Minister can devote a a few words to the thinking of Her Majesty's Government' on custodial policy.
My Lords, I beg to move for Papers.
3.18 p.m.
Baroness Ewart-Biggs: My Lords, the theme of our debate this afternoon is a sombre one. We know only too well how drug addiction has brought tragedy to the lives of very many young people, while at the same time creating tension, anxiety and pain for their families. As the noble Lord, Lord Rodney, said, drug addiction does not distinguish between different families, and parents from any background share the common fear that their son or daughter may have succumbed to this destructive evil. It is a fear which is combined with a sense of uselessness and helplessness when they start to watch for the first tell-tale signs of their child experimenting with drugs.
It is because of the devastating effects of drug misuse, together with the high degree of crime it

711
generates and the manner in which previously innocent people such as women couriers are drawn into crime while the true culprits evade the law, that the noble Lord, Lord Rodney, has this afternoon asked your Lordships to examine how best to reduce the demand for drugs and to tackle drug misuse. We are grateful to him both for having done that and also for the very clear manner in which he has introduced the debate.
It is a fact that drug use has been part of everyday social activities ever since human beings discovered that the properties of plants altered their mood or behaviour. Since that time they have been refined and produced for illicit and licit pleasure seeking. There are now many different types of drugs available to those wishing to seek altered states of mind either for pleasure or as a problem-coping mechanism. As the noble Lord said, today drug misuse has become a major social problem within our society.
The 1980s saw a heroin epidemic of a character never previously experienced in this country. That was followed by increasing amounts of cocaine being imported so that cocaine seizures by customs officers now exceed those for heroin. Amphetamine abuse remains a cause for concern and the number of drug addicts known to the Home Office increased from 5,107 in 1980 to 19,179 in 1988. Undoubtedly the number of people with drug related problems is very great and much higher than that figure. Indeed official estimates suggest that there are between 150,000 and 300,000 people with such problems. Now the transmission of HIV infection and AIDS through sharing injecting equipment has added a new dimension to the drug problem and has had a significant impact on the direction of recent drug policies.
Nevertheless I believe that it is important to keep drug misuse in perspective. The widescale use and abuse of substances such as alcohol and tobacco in fact inflict far more harm on individuals in society than do illicit drugs. I am glad that the noble Lord, Lord Rodney, also pointed to that. HIV infection may prove to be the important exception to the previous rule.
I believe that we need a calm, non-sensational approach to policy development in this area and one which places these serious problems in context. For example, there should not be an over-concentration on supply issues. The "war against drugs" approach most notably adopted by the USA, which spent billions of dollars in attempting to stop drug supplies, cannot by itself control the drugs problem. It should be remembered that throughout the 1980s the drugs that were consumed by and large in this country came out of the pharmaceutical industry illegally.
Unfortunately there is still a thriving cottage industry in the manufacture of illegal drugs within the United Kingdom. More attention and a much greater proportion of resources must be given to the domestic market and strategies to prevent the use of drugs and minimise the harm that they cause. Both demand reduction and harm minimisation are important concepts. Policy development should have the joint
712
aims of discouraging people from misusing drugs in the first instance and helping those who become dependent toward the ultimate goal of abstinence. In that regard perhaps I may ask the Minister whether the Central Drug Protection Unit set up in the mid-1980s at the very time of the crack scares is not expanding its role to take in the problems of heroin and multi-drug use and whether it will now have a role in harm minimisation programmes such as needle exchange. Perhaps he could tell the House the original budget of the unit, and whether in fact that budget has been increased.
As I said, although drug abuse is no respecter of social groups, nevertheless research on the 1980s heroin epidemic has shown the link between drug misuse and deprivation. The most severe problems of low level dealing and drug misuse are concentrated in areas of high socio-economic deprivation and unemployment. No government can hope to contain drug addiction unless they are prepared to tackle urban decay. I believe that drug policy is inextricably linked to our general policy of rejuvenating the inner cities, restoring social and health provision, tackling homelessness and reversing the trend towards a deeply polarised society such as we have seen in recent years.
As the noble Lord, Lord Rodney, said, drugs education has a vital part to play. The Government have relied in the past on mass advertising to counter drug misuse. It would be interesting to know what research has been done on the effectiveness of the anti-drug advertising campaigns. I do not know whether such information is available. While it is clear that the campaigns have made an important contribution to the drugs debate, it is not clear whether they have encouraged a shift to less dangerous practices among drug users. It would be very interesting to know that.
Drugs education should take place within a broad health education programme, in the first place in our schools, as the noble Lord, Lord Rodney said. Such education should be supported by work relating to drugs taking place within the national curriculum. I too wonder, as he did, when the National Curriculum Council will publish its document on cross-curriculum themes and whether that will give guidance on education about drug uses.
Youth clubs and detached youth workers also have a vital role to play. I should like to mention an organisation called the London Connection which has workers who go out on the streets and identify very young people who are starting to become addicted. A normal case that was described to me when I visited the organisation the other day was that of a 14 year-old girl who was found by its street workers. She had been abused at home and had taken to the streets where very soon she was into prostitution and heroin. However, as she was found at an early stage by those youth workers, she was brought into the London Connection where there was counselling, advice and other young people with whom to associate. Therefore a referral to a long-stay hostel was possible. She has now lost her drug addiction and is no longer a prostitute. That is very important work because it is the only way to get through to certain very young

713
people who are on the streets and therefore not known to many institutions but only to those youth workers who work on the streets.
From the point of view of treatment, it is essential to provide a wide range of flexible treatment options and some kind of organisational structure in which they can be delivered. The services should include residential rehabilitation, crisis intervention, detoxification, day care, counselling, advice, outreach work and home visiting, all of which I have mentioned.
We should aim to provide treatment on demand. It is vital to the individual, the family and society as a whole that drug problems are tackled. The Standing Conference on Drug Abuse, of which the noble Lord, Lord Rodney, is chairman and whose work is so very much admired, estimates that only 10 per cent. of drug users are currently in touch with drug services. For that reason it is important to try to get in touch with the other 90 per cent. That is why the kind of treatment that I outlined is of so much importance.
At the moment treatment is characterised by wide geographical variations. For example, there are few residential services in the North and wide variations in the availability of prescribing options. Current treatment facilities appear to be failing to meet the needs of black people in particular and women.
I should like to end with a few words about women and drugs. It is a fact that in June 1989 of the men in prison 10 per cent. were there for drug offences. At the same time of the women who were in prison 26 per cent. were there for drug offences. That dramatic rise in the number of women is due to the very sharp increase in sentencing of female drug couriers mainly from West Africa, South America and Asia.
I have visited prisons and seen, for instance, women at Cookham Wood prison. In 1989 28 per cent. of the women there were foreign deportees, most of them sentenced for being couriers. A pattern exists among those women; they are rural women found by drug barons and for a small amount of money they agree to carry drugs. They face prison sentences of between three and 12 years. What efforts have Her Majesty's Customs and Excise been making to discourage couriers from bringing drugs into this country? I have asked the question before and am led to believe that there are plans to institute wider advertising campaigns abroad to try to warn such women that they face long prison sentences. That is a fact about which their employers never warn them. Furthermore, do the Government plan to act on the recommendations of Jill Joyce, who reported to the Home Office following her trip to Lagos to investigate and publicise the dangers of trafficking?
Many women are in prison for drug misuse. As was said by the noble Lord, Lord Rodney, the Criminal Justice Bill is designed to steer them away from prison. However, many are now in prison and there is not a single drug rehabilitation unit in any women's prison in England. Many women would like to kick the habit and would like an opportunity to do so while they are in prison.
Once a drug user is arrested for an offence the criminal justice system must operate in a way which
714
maximises the opportunities for the drug user to obtain treatment and minimises the use of custodial sentences. I agree with the point made by the noble Lord, Lord Rodney. Such an approach benefits the individual and the community. At present about 80 per cent. of drug offences are for the possession or use of cannabis. We believe that that is not the most sensible use of scarce resources and staffing. Enforcement agencies should be directed to prioritise dangerous Class A drugs such as heroin, amphetamines and cocaine. Can the Minister tell the House about the criteria used by the police when cautioning for drug offences? We believe that the caution could be further extended in order to divert people from the criminal justice system.
The drug situation is dangerous and everything possible should be done to improve it. There is considerable merit in combining education and treatment services for all substance abuse, whether it be drugs, drink or tobacco. Again, I follow the noble Lord, Lord Rodney, along that route. There is an overlap between the work of different ministerial groups and advisory councils. At local level resources could be used more effectively; for example, by the provision of a crisis-intervention hostel for both drink and drug abusers. That would benefit all those unhappy people who are addicted to such substances.
3.34 p.m.
The Viscount of Falkland: My Lords, I speak with diffidence because many noble Lords who are yet to speak in the debate have great experience of the dreadful problem of drugs. I am sure that we shall learn a great deal from them. I am grateful to the noble Lord, Lord Rodney, for giving the House the opportunity of talking about drugs, particularly with the emphasis on demand rather than supply. I agree that the supply of drugs is an important issue and the Government are to be congratulated on combating the supply of drugs and on the recent successes in stopping large consignments of cocaine from reaching markets in this country.
The problems are difficult to grasp but perhaps they are connected with age. As a young man I was not aware of drugs, nor, I suppose, were those who were older than me. I am now in my middle 50s. I was married and had children in my 20s. During their up-bringing the problem of drugs became a reality. The noble Baroness has mentioned the fears and anxieties of parents that their children may be exposed to the dangers of drugs. Increasingly parents are faced with the problem of their children becoming involved with and drawn into drug taking. I do not believe that people of my generation and older people understand enough about the attraction of drugs to the younger generation. The issue still causes me anxiety because I have teenage children. Luckily, there are no signs of their being drawn into the area, but friends have got into trouble, some of them into bad trouble. It is destroying not only their lives but the lives of members of their families.
We are living in an age when problems of compulsive behaviour which may lead to addiction are becoming more evident. Perhaps that has always been

715
under the surface but now we read every day about compulsory activities that are allied to drug taking. They may appear to us to be strange. Many young people, particularly females, suffer from problems connected with food; for example, anorexia or the related problem of bulimia. The first is the addiction to starvation and the second to food. We also see in some people the extraordinary compulsion to take excessive exercise. It results in activities which to those of us who are old and lazy are quite extraordinary. Some people spend hours each day building their bodies into fantastic shapes—
The Earl of Longford: My Lords, does the noble Viscount not welcome the fact that we cannot now walk along the streets without seeing many people jogging? Does he not regard that as a healthy development?
The Viscount of Falkland: My Lords, the noble Earl has put me on the spot because I was about to say that jogging is an addictive activity. I shall not be tempted to develop the argument but I should like to discuss the matter with him outside the Chamber. It may well be mentioned by other speakers in the debate. Merely jogging down the street occasionally to exercise the limbs is one thing but jogging for several hours every day can become a compulsive activity.
Work can become compulsive; we have heard of workaholics. Certain people have increasingly pressing sexual problems. All those problems make up a package of activities which are related to increased anxiety in our society. They cover up the need of people, in particular young people, to divert their energies into activities that we do not fully understand. The problem is made worse by the fact that the generation gap makes it increasingly difficult to communicate with the young. I do not intend to condemn what has become known as the permissive 60s, but since then it has become more difficult to communicate with the younger generation.
I do not wish to be flippant, but when we debated the Broadcasting Bill I put forward the view that rock and pop were different forms of music. That prompted the noble Earl, Lord Ferrers, to make the remark, which was probably jocular, that all young music seemed to him to be thump-thump music. My daughters took that as being indicative of the lack of understanding that the older generation has of the younger.
There is a strong connection between modern music available to the young and drug problems, problems of addiction and the anxieties which the young feel. Indeed, that is expressed in words of songs and has become part of the culture. Of course, changes have taken place within the family unit, to which I dare say the right reverend Prelate will refer. The constraints which families and individuals felt through their religious responsibilities have become less. Those factors have contributed towards making it very difficult to deal with the anxieties of the young and their tendency to choose mood producing substances to allay those anxieties. I do not believe that we have tackled those problems with sufficient imagination.
716
I wish to concentrate upon education because we are most anxious about young people. It is probably true to say that there has always been a minority of people in our society or in any society with a predisposition towards becoming addicted to one substance or another. When talking to members of Alcoholics Anonymous, or any of the other associations which come together to deal with those problems as a group, one is often told that an individual felt that he had within him the capacity to become addicted to one drug or another. One must accept that about 5 per cent. of the population will be drawn in to that extent. However, we should worry about the other 95 per cent. because people become drawn in to addiction unnecessarily through lack of understanding, education and treatment for those on the threshold of becoming affected by the dangers of drugs, alcohol or other substances.
As regards education, it is extremely difficult for teachers to deal with problems of drugs and addiction. They do not have the time, and have even less time now. I remember that during the passage of the Education Reform Bill we pressed for an amendment—I see the noble Baroness on the Cross-Benches nodding at me—on health education which would have provided a much more concentrated form of education in this area. That was rejected. There is so much competition for jobs and qualifications that it does not allow sufficient time to deal with those problems, which are so important.
My children are in private sector education and I have not been impressed by the standard of teaching on drugs and alcohol available to them. By and large, it has been unimaginative and inaccurate. I do not know much about other schools, either in the maintained or private sector, but if they are of a similar standard they are sadly wanting —indeed some laughably so. My daughters found the hour set aside for the subject to be an hour for mirth rather than instruction.
Therefore, I believe that in education there is need for much more careful and imaginative thought about the people who are brought in from outside—and usually they must be brought in from outside. They need to talk to young people without talking down to them. Young people need to be told about their bodies and the dangers of these substances in a way which they accept and which may prevent some young people from becoming addicted through ignorance.
As regards treatment, residential treatment for those who are addicts is extremely expensive and arduous for the patient. There are various treatments available which have had a degree of success. In fact the percentage of successful treatment is increasing. However, as has already been mentioned, there is a grave problem for people who cannot afford treatment.
I endorse what has been said about prisons, prison sentences, prison populations and the drug problems connected with people who are sent to prison, even those not sent to prison for drug-related offences. I do not believe that in this country we have even scratched the surface in dealing with drug-related problems within our prison service; for example, their

717
availability, the effects of drugs on prisoners and the effects of putting prisoners in close proximity to those who have had drug problems and so on.
A colleague has very kindly given me details of a course of treatment available in a prison outside Stockholm. It started as an experiment in the 1970s. It consists of a course of treatment for prisoners who are serving longer than eight months' imprisonment. They are not compelled to take the treatment but they can enter for it, and it includes detoxification if necessary and counselling. That is not a soft option and about 50 per cent. of inmates do not complete the course. However, it has proved successful for a small and increasing number of prisoners who have found a way of dealing with their drug problem. Therefore, when they are released they can go out into the world free of that dreadful affliction. Of course, drug problems affect them throughout their lives and can lead to further criminality.
I agree with the terms of the Motion for intensified efforts although I would include the description "imaginative" efforts. We need new, imaginative and intensive efforts to reduce this terrible problem.
3.48 p.m.
The Lord Bishop of Newcastle: My Lords, in common with other speakers in this debate, I express my gratitude to the noble Lord, Lord Rodney, for introducing this Motion. Like many members of the public, I am generally but dimly aware of the personal tragedies and social evils associated with the misuse of drugs. We read of a notable haul by Customs and Excise or the immigration authorities or we hear of a poignant case affecting our family or friends and we become all too vividly aware of the problem.
This afternoon's debate can serve to raise the general level of awareness about this subject in the country at large and can provide an opportunity for specific proposals to be made in this sphere. No doubt the debate will concentrate on prevention and cure. Perhaps the most effective way, although not the only way, to prevent the misuse of drugs is to ensure that they are not available. However, there are obvious limits to that policy. The size and scale of profits in the trade of illicit drugs makes the task of preventing their sale very daunting. Also, if illicit drugs are not available, the sale of everyday commodities such as nail varnish, lighter fuel, mothballs and butane gas cannot be prevented, nor can their misuse.
The debate will no doubt focus on illegal drugs and on the ills associated with them, but the availability of other substances may remind us of the destructive power of other drugs. It is said that every year around 25,000 people die from alcohol-related causes, and approximately 100,000 die of tobacco-related illnesses. Therefore on the subject of prevention there is a limit to the extent to which the interception of illicit drugs by the Customs and Excise or the police can be effective.
Inquiry into the causes of drug taking may be another way to tackle the subject of prevention. There are commonly said to be several overlapping factors;
718
for instance, there are the physiological, sociological, psychological and environmental aspects. No one of those holds all the answers. In some areas history has a part to play. There is evidence of alcohol dependence and heavy drinking occurring in Tyneside ever since mediaeval times.
If one asks why people turn to the misuse of drugs, both licit and illicit, often one hears that they are looking for relief, comfort, assurance; they want to feel good, they may be after ecstasy or they may be seeking a sense of belonging. I note that all those reasons are to be found among the reasons why people turn to religion; not surprisingly, for they are dealing with features of life which shed light on one another.
Those who favour the theory of disease and concentrate on the physical and biological roots of drug addiction, tend to say that the only cure lies in total abstention and in a radical redirection of life akin to religious conversion. Those who work on the more psychological, social and individual influences as providing the best explanation for drug taking and drug addiction, tend to use a therapy not unlike that of spiritual direction whereby the person is enabled gradually to take control of his or her actions and grow by stages into freedom. No single theory fits all the cases. Both approaches certainly work in certain cases in effecting that redirection of life in which religion is concerned or that redirection of life which various agencies for relief and cure are concerned to promote with regard to drug addiction.
I turn to a different part of the subject. I am enormously impressed with the vast amount of work being undertaken in the field of drug addiction. There is an astonishing variety of agencies both statutory and voluntary which provide evidence of good and expert practice. I hold a booklet produced by the Newcastle Drug Liaison Committee. It is a guide to services for young people written specifically for young people with regard to substance misuse. It provides details of the principal competent agencies in the area, and there are many.
I should like to draw on specific experience gained from my connection with a charity of which I have the honour to be president. It works in close conjunction with the Northumbria and Durham probation services. Its aims are to provide activities and accommodation both for prisoners on discharge and for those people the probation services consider to be on the way towards a custodial sentence. Our aims therefore concern both prevention and cure. Some of my experience in connection with the charity provided points which will contribute to the debate, points gained in practical work with specific people in a particular area. I have placed the points under four heads.
The first concerns the importance of health education in this field: this has been underlined by all the other speakers in the debate so far. In their general health education the accommodation projects of this charity cover a range of subjects including drugs, alcohol, HIV and AIDS. We all know that the best education on these subjects is provided, perhaps unconsciously, by the lifestyle, values and outlook of parents in the family. If parents can cope with the

719
stresses of life without recourse to pills or drugs, whether stimulants or tranquillisers, that is the most telling lesson of all. But group pressures on the young are very strong, both in their classes at school and at parties. Where the parental example is either not heeded or is not available then the need for educational work in this field is all the greater.
There is a need for educators who have the time and resources for that work—a point close to that made by the noble Viscount, Lord Falkland. Social workers are far too occupied nowadays with child abuse and GPs with screening activities; and, despite its place in the National Curriculum, this subject tends to be marginal in many schools. There is some danger also that the responsibility for this work will slip between a number of statutory authorities and agencies. One wonders whether the statutory responsibilities of the health authorities and the local authorities are defined with sufficient clarity; in any case we have heard that resourcing is a problem.
Experience has shown that voluntary bodies are able to contribute, draw upon and use a great deal of expertise. There is much expertise in both the local authorities and the health authorities. However I suspect it to be the case that many generic social workers on the staff of social services departments of local authorities are neither trained nor resourced to deal with the specific problems raised in the specialist field of drug addiction. Moreover, experience shows that voluntary bodies are well placed to draw on charitable funding and to act as co-ordinators in this work. A specific example comes to mind.
Under the auspices of the charity in question there will be opened this year just outside Durham a project which will concern itself principally with alcohol-related problems. In its establishment the local health authority, the county council and a mediaeval foundation have all been partners under the umbrella of our charity; it is our charity which has raised from national trusts and foundations the greater part of the initial funding. That is one example of the achievements possible as a result of partnership between voluntary and statutory bodies.
That brings me to my fourth and final point; not surprisingly, it concerns funding. Much work is done in this field by voluntary charitable bodies. If our experience is at all typical, there is a problem with regard to core funding; that is to say, with regard to the funding of general administration. To work with ex-offenders or potential offenders is unglamorous; equally, work in connection with drug misuse is unglamorous. Administration is another particularly unglamorous field. It is very difficult to raise money for administration. A real difficulty exists, for we are concerned with needy client groups. Inevitable costs are involved in putting together projects to meet their needs. The cost of monitoring and managing such projects has to be taken account of, and I should be surprised if charities which work in this field do not all experience difficulties with regard to core funding. We probably all need injection of funds for this purpose. It is not mere office work and therefore to be despised, but rather it provides a reliable central core to
720
voluntary organisations. Core funding gives projects an element of continuity and stability, so it is important for the client. It provides the staff with a sense of confidence. It is a commitment towards the provision of such core funding which will be most welcomed by many voluntary bodies as an outcome of today's debate.
4 p.m.
Lord Mancroft: My Lords, I too thank my noble friend Lord Rodney for instigating today's debate. It has been some years since we had a debate on this subject in your Lordships' House. On the last occasion the name "Mancroft" was again on the list of speakers. Then my father held the banner which I wave with slightly more enthusiasm today.
Before I start, I must declare my interest. I sit at the moment as chairman of the Addiction Recovery Foundation. I am also a trustee of the Drug and Alcohol Foundation and of ADAPT, a charity which runs a treatment centre in the west country. Until recently I had commercial interests in this field and I hope to have commercial interests again in the future. I congratulate the Government on their new policy of drug demand reduction which I suspect results from the failure in their attempt to control supply. Though the seizures of illegal drugs entering this country rise year after year, the fact is that the price and availability of street drugs in our cities remain the same. The price is the same; and in the case of cocaine it is lower than it was in 1978. That is an unusual economic occurrence.
Drug demand reduction is a rather fancy phrase for three separate entities—that is to say, education, treatment and, ultimately, prevention. In his fine speech the right reverend Prelate outlined the need for increasing awareness. That is at the core of education. The policy of drug demand reduction is outlined in the Government's document UK Action on Drug Misuse: The Government's Strategy. It is extraordinary that only two out of the 24 pages deal with treatment and rehabilitation, and half of the pages are photographs. There is only one mention of the voluntary sector. However, the right reverend Prelate is entirely correct. The Government recognise that the voluntary sector carries the bulk of the burden of treatment in this area.
Although the Government announced their intention to concentrate on drug demand reduction, the money allocated to treatment and rehabilitation in the United Kingdom is currently £17.5 million per annum as compared with £13.5 million currently spent in Asia, Africa, the Caribbean and South America on programmes of crop replacement. They are programmes which have no practical benefit at all in the United Kingdom. I suspect that the reason for that approach is the complete failure to understand the enormousness and complexity of the problem that faces us.
There is a vast amount of conflicting evidence on the nature and size of the problem. I have taken some trouble to try to collate that evidence for today's debate. It is reckoned at the moment that there are over 700,000 alcoholics in the United Kingdom. Up to 150,000 people are dependent on heroin or cocaine

721
though that figure is very difficult to collate. We are sure—and the Association of Community Care Councils for England and Wales made it well known in its excellent 1989 report—that between 1 million and 1.5 million people are dependent on prescription drugs. Over half of those are over 60 years of age.
That is just breaking down some of the figures. Action on Addiction put in rather more bluntly. It estimates that 10 per cent. of the population is dependent on one drug or another and that does not include nicotine. That means 10 per cent. of parents, teachers, social workers; 10 per cent of doctors, policeman and magistrates; 10 per cent. of Members of another place and, yes, 10 per cent. of Members of your Lordships' House. If that does not clear the Bishops' Bar nothing will!
These figures are in fact pretty bland. I should like to look for a moment at the effect they may have on our national life. In the magistrates' courts 80 per cent. of the cases are drink-drug related. Fifty per cent. of those facing sentences of up to three years imprisonment are for drink or drug-related crimes. Thirty per cent. of all hospital admissions are alcohol-related. There are 25,000 admissions to National Health Service psychiatric wards each year for alcohol-related problems. Alcoholism is not a psychiatric disease. Alcohol misuse is the most common traceable cause of early death in this country. Forty per cent. of traffic incidents are drink related, and there is no means of knowing how many are drug related. The Home Office has put the cost of drug-related street crime in London at £1.85 billion for 1989. The CBI has estimated a cost to industry of £3 billion per annum.
Action on Addiction reckons that absenteeism due to drug or drink problems amounts to 6 million working days lost each year which is the equivalent of a small general strike, if there is such a thing. What are we doing about it? Turning Point figures suggest that there are 2,000 beds available in the voluntary sector. My own researches suggest that that could be a very generous figure. The Government have recognised that the greater burden of in-patient treatment lies with the voluntary sector because that sector, as the right reverend Prelate said, has the greatest level of expertise and experience.
In the United States of America there is one bed for every 2,000 of the population for in-patient treatment for what they call "chemical dependency". In the United Kingdom that figure is one bed for every 122,000 of the population. That is a really horrific figure. In the National Health Service and Community Care Act the Government recognised the funding problems of the voluntary sector by ring-fencing the money to ensure that local and health authorities met their responsibilities. They further allowed an amendment to permit emergency assessment to be made by the voluntary sector although there is increasing evidence that local authorities, particularly in Scotland, are proving themselves most unwilling to implement that.
722
The existing voluntary treatment centres are having problems. Two closed last year because of the shortage of funds even though they both had patient waiting lists. There was no money to pay for the patients. It seems that local and health authorities are unwilling to contract out. I am a trustee of a treatment centre in Kent which has been open for about five years. It has never been full and it has never received a penny from either health or local authority. In the correspondence concerning the publication of their community care policies for the future, they have announced that they do not intend to implement any use of that facility because they have adequate facilities. In that area there are no beds.
The reason why I am concentrating my remarks on treatment is simple: treatment works. For at least 30 per cent. of patients, and even for the most difficult ones, treatment works. At the other end of the scale it can work for between 60 per cent. and 70 per cent. of the patients. However, we do not know that education or prevention programmes work. There is still no conclusive evidence to prove the success of these programmes though that does not mean that we should not persevere with them. We also know that attempting to control the supply of drugs simply does not work. Apart from that, most addicts in the United Kingdom are addicted to easily and legally obtainable drugs; namely, alcohol and prescription drugs.
It is important to realise that this is the age of the poly-addict. Most illicit drug users have problems with alcohol and prescription drugs. In our clinic in the Midlands we found that most of those who came to us as alcoholic had an underlying and often worse dependence on prescription drugs originally prescribed as a treatment for alcoholism. So there is no point in concentrating our efforts on eradicating the supply of illicit drugs entering the country only to ignore the fact that the greater proportion of British addicts get their drugs from the largest supplier of addictive drugs in the world: our own National Health Service.
That is not to say that we should relax our efforts to beat the drug trade. To risk an increase in drug trafficking would be, in my view, playing with fire. We must concentrate on the one thing we know can produce rapid and effective results—that is to say, treatment and rehabilitation. As I have said, the Government have recognised that by introducing their policy of drug demand reduction. They have further recognised that by the amendments incorporated into the National Health Service and Community Care Act. But that is only a start and we have got to build on it.
First and foremost it is essential to combine the fields of alcohol and drug treatment, as the noble Baroness, Lady Ewart-Biggs, said. At one end of the scale here at Westminster there is one all-party group on the misuse of drugs and another on alcohol policy. At the other end of the scale there are regional and district health authority drug advisory committees, and parallel but quite separate, regional alcohol

723
co-ordinators, often giving diametrically opposed advice. The excellent Dr. Les Rudd, the chief executive of Turning Point, said:
"The Government continue to separate drugs and alcohol, which is often a nonsense at the service delivery end".
It goes without saying that the misusers make no such distinction.
This is partly due to an extraordinary conflict of treatment philosophies in the statutory and voluntary sectors. One of the standard treatments for alcoholism is to try to teach the alcoholic to drink in a controlled way, whereas the goal of drug treatment is abstinence. The two approaches are often incompatible and totally unco-ordinated, which only results in confusion.
This is not the correct forum to discuss treatment philosophies and methods; but if the Government are intent upon a policy aimed at reducing the demand for drugs then it is a subject that cannot be avoided. Having already stated that we know that treatment works, I must qualify that by saying that only appropriate treatment, carried out by trained professionals works: treatment that exists largely in the private and voluntary sector, but largely does not exist in the statutory sector. I should like to say more about training but time does not allow. Suffice it to say that still in 1991 medical schools training doctors spend only one, two or possibly three hours on addictions. In the probation offices of social services departments there is no treatment. In the UK there is still no real qualification or standards for drug and alcohol therapists. That is not a situation which can be allowed to continue.
The fact is that most addicts and alcoholics even if they can find treatment in the National Health Service rarely get any better and often get worse, reappearing for treatment at a later date in what we call the revolving door syndrome. In a debate in your Lordships' House some six years ago my father asked why the Government did not send a team to Minnesota, the world headquarters of drug treatment, to learn how doctors there had been successfully treating patients for more than 30 years. The answer was that the Government did not believe that they had anything to learn in that area from the United States. I was delighted to learn that my right honourable friend the former Secretary of State for Health, Mr. Kenneth Clarke, finally agreed to send a team last year, but that idea seems to have lapsed. I wonder whether my noble friend can assure the House that this will happen and that we will be allowed to know the results of that trip.
What I have attempted to do in the few minutes allotted to me is to make the case for rationalising and expanding our resources in the one area where we can obtain definite, positive results. To do that we need only to redirect money that is currently being wasted on schemes and ideas of unproven worth. When I started my speech I made quite clear to the House my various interests in this field. What I did not make clear was my motivation. For several years my own life was governed by an overpowering addiction to heroin, cocaine, alcohol and pills. In their distress my
724
family searched everywhere to find the help that I needed. But though I was sent to all the leading experts of the day and spent time in a variety of hospitals and clinics, my condition continued to deteriorate. At one point I was sent to see a senior Home Office psychiatrist. His diagnosis and treatment of me were such as to be wholly inaccurate and almost dangerous. He is still a senior Home Office psychiatrist.
Finally, in 1982, I was referred to the Hazelden Foundation in Minnesota. As a result of its expertise, professionalism and experience I was able to make a full recovery. My experiences do not make me an expert but they gave me the motivation to become somewhat of an authority on addiction and alcoholism in Britain. The knowledge I have gained brings me to two inescapable conclusions. The first is that the chances of an addict getting any help in Britain in 1991 are scarcely better than they were in 1981, when they were virtually non-existent. The second is that the price of addiction and alcoholism in social, health and economic terms is no longer acceptable, and we must not therefore accept it.
I support, and will continue to support, this Government because I believe they are capable occasionally of making brave, radical and difficult decisions when they consider them necessary. I trust they will now do so to implement fully their policy of drug demand reduction.
4.14 p.m.
The Earl of Longford: My Lords, it is not often that a speech in this House awes one into a respectful silence. The noble Lord has moved us all, speaking as he did from personal experience of suffering and with so much commitment now to helping those who suffer also. At any rate I am sure the Minister will pay the utmost attention to everything said by the noble Lord.
We are all grateful to the noble Lord, Lord Rodney, for introducing this debate. His effective speech was well followed up by my noble friend Lady Ewart-Biggs and others. The noble Lord is the chairman of SCODA, the organisation which co-ordinates the work of so many agencies concerned with drugs. I have a special respect for SCODA, whose director, David Turner, I appointed director of the New Horizon Youth Centre many years ago. One of his colleagues, Mary Tracey, is still on the council of that same organisation. I have always taken great interest in the work of SCODA.
I come before the House not as an expert in the sense that the noble Lord who has just spoken is an expert. I come before the House with no great expertise. I was concerned with drug addicts when I was chairman of the organisation to which I referred, the New Horizon Youth Centre in Soho. In the early days the clients were nearly all drug addicts from the Piccadilly area. In the first year or two 30 of them died. Heroin addiction is a killing disease. I have shared a lavatory with people who freely discarded their syringes on the floor. I have vivid recollections of the life of the heroin addicts in those years.

725
Many years later I visited in prison a young woman who had obtained drugs for a friend who, in the event, died tragically soon afterwards from a combination of drugs and alcohol. She was a young woman of great talent as she proved later in a book that she wrote. I shall not speak to any extent about the legalities of this issue. I am not in favour of legalising drugs. One can argue that drugs are no worse than alcohol, but without going into all the arguments, I am not in favour of legalising drugs. I am sure that if they were legalised much more use would be made of them. In my eyes, that is a sufficient reason for not legalising them. Many people talk of decriminalising drugs, but that is only a euphemism.
What I am against is sending people to prison for the possession of drugs or, as was done by the young woman I mentioned, for obtaining them for a friend. If, as I think they do, the Government favour a policy of sending fewer people to prison there is an easy way of reducing the prison population. They could do so by not sending people to prison for the possession of drugs. That is enough about my views on the legal aspects of the matter.
In speaking today, I have had special assistance from, among others, an organisation called Cityroads (Crisis Intervention). Cityroads has for 13 years provided a crucial service. It is the only residential crisis intervention centre in the greater London area and occupies a pivotal position. A significant number of its residents are homeless, vulnerable people. They do not stay at the centre for very long. Some are perhaps persuaded to move on to centres such as Phoenix House. They often come back. I learnt today that someone has come back as often as 22 times, but only for a few weeks. The value of this work cannot be questioned. Therefore, it is worth spending a few moments offering the point of view of an organisation like this, and of other organisations whose views are being put forward in the House today.
I have given the Minister detailed information and there is one question which I put to him. He will be glad to know that I shall not speak at length and I know that he has only 25 minutes in which to reply; but I hope that he will be able to reply by letter. Can he give us any assurance, either today or in writing, about the future of the Pan Thames funding mechanism in respect of health services? There is a great fear in the minds of these organisations that this mechanism will end in April 1992. I hope the Minister can give us some assurance that that is not to be the case because it would be fatal to the whole work of the drug agencies in London.
By and large, as so often when we are talking about the future of the social services, it is inevitable that we come back to money. With the best will in the world, the government of the day may express all sorts of good wishes and high intentions about providing the kind of services demanded by the noble Lord, Lord Rodney, and others; but in the end it is a question of money.
We are told now that we are entering a new phase of caring conservatism. I last heard about caring
726
conservatism when I was working for the Conservative research department from 1930 to 1932. That was roughly 60 years ago and I have not encountered any caring conservatism since then. Furthermore, the classless society is upon us and the common man is in the ascendant. I suppose that one part of the Government's conscience is well aware of all these crucial needs, but the other part, which is bound to assert itself, is represented by the Treasury. We are also told that we are entering a depression of almost unprecedented implications. We also know that the Gulf war—which, with the usual regret, I entirely support—will be very expensive. Therefore, the Government have a battle to fight between the good side and the harsher side of their conscience, and none of us can tell whether there will be more help given to those who suffer in the future than was given in the past.
When we talk about the millions and billions of pounds and the administrative issues arising in Whitehall, we must remember what this means to some individual on the ground. When I visited the Cityroads centre I talked to various young people, one of them aged 23. He had become a heroin addict at the age of 15, so he had been on drugs for eight years. At that age he was introduced to heroin by an agreeable young fellow in a pub. That man was then aged 20 and for eight years had been a heroin addict. He had been in prison several times for stealing money in order to obtain drugs. The question of how far that chap will be helped, on the lines demanded by all speakers, depends on how much money the Government will produce. Therefore, we must always think back to the individual. That young man to whom I spoke is going to that fine place, Phoenix House, which has developed its ideas in recent years. Some years ago a young woman there, who was a little stout, had a notice placed across her chest saying, "I am a fat pig". That was called confrontational psychology but I gather that such treatment has now been abandoned and more enlightened methods are pursued.
Phoenix House is at present doing a wonderful job. Ultimately, all such initiatives and welfare arrangements depend upon money. Although the voluntary sector is playing a valuable part, we come down to the question; which is relevant for anyone who comes out of prison: how much will this Government, or any government, be ready to provide for this crucial need?
Before I sit down, there is one point which I venture to lay before the House with some trepidation, and it certainly does not commit my dear friends and my leader on the Front Bench, though it might strike a jarring note. The noble Lord, Lord Rodney, spoke with some satisfaction about increased penalties for people who import drugs. It is part of the Government's programme. What does that policy mean in practice? Some time ago I spoke on behalf of a prisoner who had just been convicted, rightly or wrongly, of a drug offence. There is an appeal, so I must be careful in what I say. I asked the counsel, "How much do you think he will get?" and he replied, "Well, it might be 10 years or 15 years at the outside." In fact, that man got 25 years with an extra penalty, which was far beyond his means to pay, of £300,000.

727
I only hope that the noble Lord, Lord Rodney, did not derive any satisfaction from the fact that the penalty was very much heavier than the well informed QC imagined at the time.
I listened to the judge—again, I must be careful because the case is subject to appeal—who said coolly enough, referring to the importation of cocaine and heroin in which that man had had a share, "Do you realise that you might as well have been firing bullets into a crowd?"—in other words, committing murder. I call that hysterical comment. When we think of a number of people we know, who have gone through life on cocaine and cannabis, to say that importing it is equivalent to murder is a great exaggeration.
If that is to be the new policy, I disapprove of it. All experience of prison shows that increased penalties do no good. The noble Lord, Lord Donaldson, who is a great expert in this field—I am sorry that he is not speaking today—will know, as others know, that all research points to the conclusion that increased deterrents do not diminish crime, so it is dangerous nonsense to increase the penalties for this and other offences. That does not mean that I do not think that the offence is a grave one and that a person should not go to prison for a long time. But there is a certain point where all reason is lost. Those remarks may not be acceptable to all, but one must make them in all honesty.
I had plenty to do years ago, and more recently, with people who suffer at the consumer end, and I agree with everything that has been said about the need to help. I hope that there will be a more generous response, either today or later, from the Government than there has been from any government in the past.
4.29 p.m.
Baroness Seear: My Lords, I should like first to make it absolutely clear that I am speaking this afternoon in no way as a representative of my party but purely on a personal basis. I should also like to say that I claim no special knowledge whatsoever in this field. I have not given the Minister notice, as I should have done, of the question that I want to ask him and I do not expect him to give me a straight answer this afternoon. The question that I want to ask him is whether he thinks that the time has come for another high level, highly specialist and preferably international inquiry into the case for the decriminalisation of drugs.
Nobody so far has supported the idea of decriminalisation, or legalisation, as the noble Earl, Lord Longford, chose to call it. I am not saying that I think that should happen, but to my knowledge there has not been an inquiry into the matter since Lady Wootton of Abinger conducted one in the 1960s. In the more than 20 years since then, we have had a good deal of experience of the drugs problem and of attempts to deal with it, but the fact remains that we have not succeeded. This is the first reason why I am putting this question to the Minister.
Nobody can say that the present policies have been a success. Just as prohibition did not stop alcoholism in the United States, so criminalisation has not stopped drug addiction in this country. That by itself
728
is not a sufficient reason for decriminalisation but what I am trying to put forward this afternoon are reasons why we should examine again the case for decriminalisation. The first, as I have said, is that it has never succeeded and a comparison with prohibition in the United States, which was a disastrous failure as nobody would deny, leads us to suppose that we might be equally wrong in the drugs field in this country.
There are some remarkable inconsistencies in the way we handle different types of addiction. To put it mildly, it seems extraordinary that a man can go home drunk every night and provided he does not commit an offence on the way home he is not behaving illegally, whereas if he has a small amount of cannabis in his possession he is. I find it difficult to justify such a difference of treatment between those two situations. On the basis of common sense, one would have thought that going home drunk every night was a more serious offence than having in your possession a small amount of cannabis.
But there is more to it than that, is there not? The fact that the possession and use of drugs is illegal surely has an effect on the extent to which people who are involved with drugs go for support and help. The noble Baroness, Lady Ewart-Biggs, made the point that only one in 10 drug addiction cases were using the services. It is reported that doctors are saying that people do not go to them for help. There may be many reasons but surely one of them may at least be—this is the kind of aspect that needs exploring—that to go for help if you are a drug addict means that you are admitting a criminal offence. If you go for help with alcoholism you are not admitting an illegal offence, whereas to go for help over drugs means that you are a criminal.
Further, there is no doubt that for some people there is a challenge in the very fact that the taking of drugs is criminal. It is just because it is prohibited that it can be alluring, to some young people particularly, to challenge it, to take it on, to fight the powers-that-be just because they have made it illegal.
Along with this there is surely the fact that it is very damaging to youngsters—although of course it is not only youngsters who are affected—because they are driven into the criminal classes. When they start, even on soft drugs, they have committed a criminal offence. The way in which they go about trying to get their drugs drives them into the society of criminals, and far more serious criminals than they themselves are. They become part of a criminal underworld from which it is very much more difficult to rescue them than it would have been if their offence, taken early, had not been seen as criminal.
These are just some of the reasons why, from the point of view of the individual drug addict, or indeed someone who has not yet become an addict but who has committed a criminal offence by indulging in the use of drugs on occasion, the mere fact of its illegality may make it more difficult, not easier, to deal with the problem.
However, it is not only a question of the effect of criminality on the individual user. The fact that

729
supplying and using drugs are illegal has developed in the countries which produce the drugs a mafia of colossal proportions. I listened last summer to a most impressive talk by a man who had studied the problem in Colombia. It was quite clear—I do not think anybody would deny this—that the drug barons in Colombia have taken over to a considerable extent the running of a great deal of their country. The legal system has been largely, if not completely, undermined by the power of the drug barons. They intimidate people into going along with providing the drugs they wish to sell, and when the legal authorities, including judges let alone policemen, attempt to enforce the law against the people who are supplying the drugs, the drug barons concerned not only bribe people to get them to continue to supply but, if a judge is trying to take action, they deal with him summarily by putting a bullet through his head.
Once you get a mafia of this kind developing, the implications of it and the extent to which the evil spreads, because you have a society in which the law has been undermined, are very serious indeed. You may say that that is Colombia's problem, not ours; but to the extent that in this country we have a large number of people who are involved in using drugs and a smaller but still substantial number who are involved in supplying them we are helping the development of just such a mafia and the creation of just such a criminal society.
For these reasons I ask the Government to think again and see whether they can get together some of the ablest and most experienced people of the kind mentioned in the very moving address by the noble Lord, Lord Mancroft, when he told us about what was happening in Minnesota and the way in which people there have been dealing with the drug problem. We need people who are expert to examine whether there is a case if not for total then for partial decriminalisation, so that it is just as easy for people to go for help if they have started to take drugs as it is if they are beginning to feel that alcohol is getting on top of them. I speak as a total non-expert in this field and I am sure that a great number of people will disagree violently with me, but I am only asking a question which I think should be asked.
4.38 p.m.
Lord Hunter of Newington: My Lords, I should like to add my thanks to the noble Lord, Lord Rodney, for his introduction to the debate. The clarity and balance of his presentation I found absolutely excellent.
Where does one start? So far as I am concerned it is some 50 years ago since I saw my first case of addiction to morphine—a delightful lady suffering from inoperable cancer—though I had previously heard of an aged relative who was found to have dozens of bottles of chloral hydrate in her bedroom cupboard and who had consumed great quantities in secret. The medical profession has always justified the use of massive doses of opiates in tragic circumstances, but sometimes the patient recovered and there was the continuing addiction problem. At that time drug addiction was most often doctor-induced, and one of
730
the issues that must be discussed today is the responsibility of doctors in these matters, then and now.
The battle to legalise marijuana goes on, the argument being that it does not do much harm to most people and that there are places in the world where it is part of the social structure, as the smoking of opium became in China. Then of course there is alcohol, a potent cause of drug addiction. There are 25 private units for the treatment of addiction in this country. Most are dealing with alcohol addiction and base their treatment on the Minnesota model, an American system. The British Journal of Addiction recently stated that claims for the value of the treatment did not survive the most cursory scientific scrutiny. My experience is that the recovery rate was about 40 per cent. I was interested to hear what the noble Lord, Lord Mancroft, said about the topic.
In a few weeks' time the royal colleges of physicians of London and of Edinburgh will be having a joint meeting on these matters. The final major debate is entitled, "Are legal restraints on alcohol consumption necessary or effective?" The uncertainty continues.
There are two points to be made in the debate. The case for intensive efforts to be made to tackle rising misuse is clear. But how does one reduce the demand for drugs? An important point is that the age of new addicts is mainly between 17 and 25, in contrast with the position years ago. So there is a need, as has been said, to educate young people. Large quantities of drugs are obviously now being made available. That supply must be stopped if at all possible. In contrast with the depressant drugs such as morphine, which have an important therapeutic use, the problem has been intensified by the introduction of amphetamine and its derivatives, cocaine and legally produced heroine.
Is it the Government's view that the misuse of therapeutically available sedatives and tranquillisers, which have a legitimate use, tends to lead to drug addiction or do the drug addicts only use them as second best when cocaine and amphetamine derivatives are not available? The noble Lord, Lord Mancroft, made an important contribution with regard to that question.
There has been the discovery among drugs with a widespread legitimate medical use of the long-term effects of barbiturates. We now realise that Valium (diazepham) and its cousins may cause dependence. Doctors have inadvertently contributed to the Valium problem by continuing prescriptions and sometimes not seeing patients when they do so.
We have learnt a great deal in the past 10 years. As I said, there is the question of the responsible prescription of Valium. The charity MIND estimates that one million people may have become addicted or are to some degree dependent. We want to know what guidance the Government have given pharmaceutical retailers to help avoid the sale of misusable products to the wrong people.
Pharmacists have an increasing and important role to play in advising people about drugs in general and encouraging them, as doctors should, to clear out old medicines from bathroom cupboards. We have learnt

731
that addiction to morphine, heroin and cocaine cannot be treated adequately in general practice. Serious addiction requires the discipline and support which institutional care can give. Few addicts are now treated with heroin on prescription. Methadone is used instead. It is an important aid in stopping the use of heroin.
Are the facilities for treatment of addicts adequate? With the rapid increase in the number of addiction cases that is an important and urgent factor. In April this year, the noble Lord, Lord Waddington, in his report on United Kingdom Action on Drug Misuse said:
"Effective international co-operation, in which the United Kingdom plays an active part, is vital if we are to stem illicit supply and trafficking. Reducing the demand for drugs through measures taken at the national and local community level is equally vital….The misuse of heroin, cocaine or other drugs not only affects the health of individuals, it brings distress to families and damage to whole communities. Added to all this we now have the risk of AIDS being spread through drug misuse by injection".
In an ideal world, the attack should be against all drug misuse. But the dimensions of the problem vary, and so perhaps should the strategies. As present most of the offences involved are for unlawful possession. The majority of those are for the unlawful possession of cannabis. Possession with intent to supply unlawfully is increasing.
One wonders whether on the practical side drugs should be broken down into groups. One group comprises drugs which are used properly in medical treatment. Here, the pharmaceutical industry, doctors, pharmacists, nurses and social workers have an important educational role to play. At the other end of the scale there has been the introduction of crack—cocaine in a smokeable free-base form. It can be manufactured easily in the kitchen using simple ingredients such as ammonia and baking soda. It is the most important and toxic form of cocaine available and is some 10 times more addictive than cocaine taken in other forms. No therapeutic remedy is possible. It is almost instantly addictive. It can take a person's life in under a week. There is no such person as a fully recovered crack addict. There is no known antidote, and the absence of a cure is one of its most frightening aspects.
A most significant difference between crack and other hard drugs relates to the number of women addicts. Fewer than 20 per cent. of heroin addicts are women; over 50 per cent. of crack addicts are women. The impact on family life and children is devastating. Even marijuana and morphine addiction pale into the shadows when confronted by that dreadful tale. I wonder whether the Government feel that they should take special steps to find the people who make and sell crack. Is it possible, for example, to offer rewards for information about those who manufacture heroin and cocaine derivatives illegally?
We should constrain the use of marijuana, which is still the most widespread drug in use, and make doctors, nurses, social workers, pharmacists and others more actively concerned about the misuse of
732
drugs in medical use. Action on heroin and cocaine needs the further strengthening of intergovernmental co-operation.
4.48 p.m
Lord Campbell of Croy: My Lords, I congratulate my noble friend Lord Rodney on his comprehensive introduction to our debate and on the clear expression of his views on how the matter should be handled. I shall confine myself to three subjects, one of which is most unlikely to be raised by other speakers.
My first subject is the substance which has been given the name crack. Noble Lords will remember my Questions on that subject which I asked several months ago at Question Time. Crack had become a serious problem in the United States. We were told that children were peddling it on city streets. Unfortunately, it is easy to produce and very addictive. It has dangerous effects on the behaviour and personalities of addicts. I believe that we may have some brighter news than usual in the field of drugs, because it seems that crack has not crossed the Atlantic as ferociously as some of us had feared. I should be grateful if my noble friend would give me the latest information on that point when he replies. Our hopes at those Question Times that measures might be taken to repel the invasion of crack may to some extent have been rewarded.
The second matter is money laundering. I believe that governments, including ours, are right in the attitude that they have adopted. An important method of detecting drug pushers and international gangs in this business is looking out for attempted concealment of the ill gotten money. Recent Bank of England guidance to banks and building societies in this country, extending to about 20 pages, urges the adoption of ways in which suspicious transactions should be noticed and reported. The guidance also urges that identification should be stricter and nothing less than passports should he demanded on appropriate occasions. This all follows the 1989 Basle statement.
There have also been reports that within the EC members are committed to new legislation on the subject. I ask the Government for an outline of these proposals. It appears that it might be a criminal offence to fail to report suspicious circumstances.
In general, I support action such as is in the guidance to tighten up the system in order to make money laundering exceedingly difficult. However, if the reports are correct, it is not easy to visualise an acceptable new statute whereby an employee of a bank or building society would commit a criminal offence by not being alert enough. Is it the intention to legislate for this in the Criminal Justice Bill which we expect in this House in due course? I hope that my noble friend will be able to say something about it, although I realise that the provisions may have to be considered in detail later on if we have legislation before us. I declare an interest because I am a director of a building society which also owns a bank, the Girobank.
My third and unusual subject is smuggling. Three weeks ago it was reported in the Scottish press that a

733
huge quantity of cocaine had been discovered on the west coast of the Highlands, near Ullapool. It was thought to be the largest single discovery of drugs ever made in this country. Ullapool is only about an hour's drive to the west from my home. I am not declaring an interest in the smuggling. I say this because those of us who are familiar with the area suspect that the culprits use the cover of international fish marketing operations which have taken place over the years and still take place in Loch Broom.
For long periods of the year 20 to 30 large freezer and factory ships lie at anchor off the coast at Ullapool. They come from many nations; for example, some are Polish, Soviet and even Korean. They do not fish. Most of them are not from EC countries. Therefore they cannot fish within the EC fishery limits. However, they buy the fish caught by British boats, process it and take it away. These vessels are known as "Klondikers". They provide additional markets for our fishermen and so perform a helpful service. They assist the local economy of the Highlands and on the whole they have good relations with the local people, even though there are language difficulties.
There has been concern in recent years that it is easy for the crews or others to come ashore from these vessels without going through the normal immigration or port formalities. In the past the concern has been related to the IRA and other terrorists. That has been uppermost in most people's minds, in thinking of them as unwanted intruders or purveyors of arms. After these reports, however, we must regard this part of the west coast of the Highlands as a possible entry for drugs. The camouflage of foreign ships can easily be adopted and the shores of the lochs to which they have easy access are unfrequented.
While I understand and respect the need to keep counter operations confidential, I should be grateful if my noble friend could give us an authoritative comment tonight from the Government to reassure us that this possibility is being effectively monitored.
4.55 p.m.
Lord Rea: My Lords, I join others in congratulating the noble Lord, Lord Rodney, on choosing this topic and particularly on the wording of the Motion. To centre the debate on demand rather than supply is logical. As one coca-growing Colombian peasant said when interviewed in a recent TV documentary, "Why blame us? We're only responding to the market in the north. When the price falls, we shall be more ready to grow other crops". International and national conferences and reports recognise this, but in my view they fail to bring forward constructive suggestions on how to reduce demand, despite thousands of words of advice.
To lower a demand we must look closely at the consumers—the drug dependent community. I have some experience of dealing with patients with drug problems in my practice, in collaboration with the Angel Project, which is a non-prescribing, non-statutory counselling agency for drug abusers, largely
734
funded by the London Borough of Islington. I collaborate also with the University College and Middlesex Hospital Drug Dependency Unit, which prescribes. However, in the past it has frequently had a long waiting list and I have often coped with patients while they are waiting to join the drug dependency unit.
This experience, plus many conversations with drugs workers and addicts, both former and present, inform the words that follow. I am particularly indebted to Dr. John Marks, who runs the service in Merseyside, and Mr. George Linton, who is a psychiatric nurse working with the UCH-Middlesex Drug Dependency Unit. However, I do not hold them in any way to blame for my opinions which follow.
To reduce demand, there are logically two approaches, which one can describe as the stick and the carrot approaches. The stick approach has now largely been abandoned and involves increasing penalties for possession and dealing. This has been discussed by many noble Lords already. It would have an effect if we had a big crackdown of swelling our already overcrowded prisons and making them into even greater dens of iniquity than they are already. It would not greatly lower demand, even if the whole of the 100,000 or 150,000 heroin and cocaine users were imprisoned. Prisoners are astonishingly adept at getting drugs into prison. Those who are naive enough to think that a spell in prison is a spell off drugs have a lesson to learn, I am afraid.
The more liberal, or carrot, approach could characterise our present approach. It is to offer more assistance for users to give up drugs—not as much assistance as the noble Lord, Lord Mancroft, would like to give—and greater health education to prevent abuse starting, to be given in the media, in schools or at workplaces.
Drug dependency units and collaborating GPs offer reducing courses of drugs on an out-patient basis to ween people off drugs. Residential rehabilitation units assist longer term users with detoxification programmes. Some of these activities seem to be successful, at least initially, but a high proportion of users fail to finish the programmes or relapse soon afterwards. Many reports have stated that success rates are in the region of 5 to 10 per cent. on long-term follow up of programmes. Although certain methods claim success, I personally would like to see a scientifically evaluated assessment of the claims of the Minnesota Method. I still believe that we do not have enough information about the effects of the various different methods of residential treatment that are on offer.
It is my opinion that both the stick and the carrot approaches misunderstand the true nature of drug addiction. I have most experience with heroin abusers, but other drugs have varied but in many ways similar effects. Without heroin or a safer substitute such as methadone—that has been mentioned by the noble Lord, Lord Hunter—life for abusers, even if they have recovered from the physical effects of withdrawal, is grey, meaningless and often miserable. They lack self-respect and they seldom have the energy or confidence to hold down a regular job. There are

735
exceptions, of course, but they are in the minority. When an additional stress occurs such as eviction from squatted accommodation, loss of a partner or a death in the family, they cannot cope. They succumb to the first offer of heroin or a similar drug. They immediately feel vastly better!
If only such people could follow the advice of the right reverend Prelate and look to religion, things would be vastly better. However, to turn a Marxist slogan on its head, opium is the religion of the people. To achieve the feeling of well-being which drug abusers obtain through their opiate or cocaine, it is worth shoplifting, house breaking and stealing my hi-fi or your car radio. It is also worth while for a drug abuser to say to a drugs worker who has the power to prescribe that his failure to stay off drugs is temporary and that he really intends to come off drugs, if by saying such things he achieves a prescription. A contract to accept a reducing course is agreed to because initially the dose is high enough to give relief and allay the urgent need for drugs. Later, as the dose becomes lower, it is more difficult to adhere to that contract—sometimes entered into honestly, but sometimes not—and illicit drugs start to be used again. That situation will be familiar to many of your Lordships who have tried to give up smoking. The addictive power of nicotine has been compared with that of heroin.
Those with long experience of working with drug dependent clients know that some come off drugs spontaneously without help and a further minority is able to come off fully with help. However, I suggest they do so only at the right moment for them. There appears to be a natural duration of drug addiction with a mean of about 10 years with a gaussian distribution. Some abusers have a much shorter span of addiction of between three to five years, while some are addicted for a longer period of 20 years or more. There is a natural rate of cessation of addiction of about 5 to 10 per cent. per annum. It is against that figure that the success of any programmes must be measured. To try to take people off drugs before they are ready is, in the opinion of many drug workers, largely a waste of time and money and is expensive if it entails a residential course.
The present situation of prohibition—the noble Baroness, Lady Seear, has referred to this point—artificially induces scarcity and high prices and perpetuates the desperate but exciting lifestyle of drug addicts. That lifestyle is largely responsible for our present rise in crime which is causing such havoc for our law enforcement agencies.
As has been mentioned, a high proportion of drug addicts are small-time pushers. They wheel and deal. A 1 gram heroin habit per day costs about £100 per day. (I believe it only costs £80 per day in London.) To finance this a user buys 5 grams for £500, for example. This is then "cut" or adulterated, usually with glucose but sometimes with more harmful substances, and the user sells it on to five or more other users for £100 a time while keeping his own purer 1 gram.
The Institute for the Study of Drug Misuse reports that seized heroin averages just under 40 per cent.
736
purity. However, one of my former addict patients says that 20 per cent. purity is nearer the mark by the time it reaches the average user. Hardened pushers need to attract new young people into the system. They will often sell heavily cut or adulterated drugs near schools and in clubs or pubs at a cheaper rate as a "loss leader". Those at the bottom of the pile who need £100 of drugs daily resort to stealing, but a "fence" who buys from them will only give 20 per cent. of the real price of the goods stolen. Therefore the non-dealing user has to steal £500 worth of goods every day to finance his habit. If we suppose that only 10,000 are stealing this amount daily in Britain, that amounts to £5 million per day or £1.5 billion per annum. That is a sum not dissimilar to that mentioned by the noble Lord, Lord Mancroft, of £1.8 billion. That sum amounts to £30 per person in the population per annum. To put this in context I should say that in my own case over the past two years goods costing nearly £4,000 have been stolen from my house or car after break-ins. It is no wonder that insurance premiums are rocketing in London.
I shall turn from the effects on the community to the effects on users. The health effects on the intravenous heroin user are caused not so much by the heroin itself but by the adulterating substances with which it is mixed before it is injected which can cause abscesses. However, in contrast, if the heroin is unexpectedly pure, it can lead to an overdose. American drug addicts who are used to only 20 per cent. pure heroin find that when they go to Amsterdam the heroin on offer there is 40 or 50 per cent. pure. A number of them succumb to overdoses as a result. I am told by those who are experienced in this area that White Thai heroin is particularly potent and nice!
Dirty or shared needles can also cause abscesses, septicemia and, of course, hepatitis B or HIV infection. Hence there is an urgent need to persuade injection users to make use of needle exchange centres. In prisons needles and syringes are in shorter supply than drugs. At least one of my three known patients with HIV infection contracted his infection in prison by sharing needles. We have heard discussions about supplying condoms to prisoners. We should also seriously think about supplying syringes and needles because prisoners are extremely ingenious at getting drugs into prisons by all sorts of rather nasty routes.
Many young female drug abusers get their money from prostitution—or "pulling tricks" as it is known in the prevailing jargon. In the United Kingdom they are the main source of heterosexually transmitted HIV infection.
The present system of prohibition encourages the scene that I have described and there are the bigger operators behind the scenes. Many people have suggested that in order to break the evil cycle all drugs should be legalised—the noble Baroness, Lady Seear, raised that question—made more freely available and taxed like cigarettes or alcohol. The gangsterism of the alcohol prohibition era in the USA in the 1920s and 1930s is cited in comparison with the drop in crime

737
which followed when prohibition ended. However, alcohol has led to its own problems in the USA, here and on the Continent.
As has been mentioned by many speakers, alcohol is misused by very large numbers of people. I would agree with the figure of 700,000 mentioned by the noble Lord, Lord Mancroft. The social effects of alcohol are very serious. They include accidents, violence, family breakdown, physical and mental health problems, absenteeism from work and poor work performance. The same might well occur if heroin, cocaine and other Class A drugs became freely available.
Nevertheless, there is a very strong case for allowing much more liberal but highly disciplined prescribing of drugs to dependent users on a long-term maintenance basis through drug dependency units. I suggest that such units must be available in every health district. I should like the noble Lord, my namesake, who is to reply to tell us that that will be the case and that health authorities will be required and be given the funds to provide adequate drug dependency units everywhere, and more than one in those districts where the drug problem is most serious.
I should like to mention the experience of Merseyside where a regime such as I have described is in operation. That system should be studied very seriously. While crime rates have been rising inexorably in nearly all other parts of the country, on Merseyside they have been falling despite the fact that it is an area with a greater than average rate of unemployment and social deprivation—factors which normally correlate closely with crime and drug abuse, as my noble friend Lady Ewart-Biggs said. The management of Marks and Spencer in Liverpool was so impressed by the fall in shoplifting offences that it agreed to finance a national conference on harm reduction earlier this year. If the system were adopted countrywide we could well see the demand for illicit drugs fall dramatically. Pushing and stealing would no longer be necessary for addicted users. The price of illicit heroin would probably fall and illegal importation would be less profitable. I do not suggest that it is a panacea but I believe that a great reduction in social and individual harm would result.
I am sorry that I have spoken for longer than my allotted time, but I noticed that a number of noble Lords spoke for a little less than their full time so perhaps I may say a last word, about cannabis. Cannabis has been mentioned by a number of noble Lords. It is a Class B controlled substance —a soft drug. In 1988 26,000 people were charged with or cautioned for cannabis offences but fewer than 2,000 for heroin offences. Yet, compared with heroin, cannabis is a comparatively safe and harmless drug.
It is administered by mouth or smoked. Its effects are very similar to those of alcohol but less damaging socially. It is not responsible for accidents or violent behaviour. Rather the reverse. It induces mental calm, relaxation and a feeling of good will to one's neighbours. Of course, like alcohol, it can be neurologically and psychologically damaging if taken
738
to excess. As the noble Lord, Lord Hunter, said, other countries, particularly Denmark and Holland, have adopted a much more liberal policy towards the substance and no harmful results have been noted. If cannabis were legalised, taxed and controlled the police would be freed for more important work such as mopping up the pockets of heroin and cocaine use not contained by the new-style drug dependency units that I have advocated.
5.15 p.m.
Lord Russell of Liverpool: My Lords, your Lordships' House is greatly indebted to the noble Lord, Lord Rodney, for giving us the opportunity to debate in some detail a subject which stubbornly and continuously fails to respond to the spasms of attention and money which are expended upon it.
My interest in the subject stems from several factors. The first is my age. As a product of the late 1960s I found that drugs were already quite commonly in currency and were difficult to ignore. I know full well that the problem will not be made to go away by pretending that it does not exist. That is a point which was made very forcefully in a notable speech by the noble Lord, Lord Mancroft.
Secondly, I am the father of three very small children and I regard it as one of my fundamental parental duties to equip them with the knowledge and decision-making skills to enable them to respond intelligently and realistically not so much if but when they are presented with choices regarding potentially harmful substances, be they legal or illegal.
Thirdly, my membership over the past five years of the All Party Group on Drug Misuse has left me with decided views on the reasons underlying our failure as a society to arrive at carefully thought out, long-term, planned, adequately funded and imaginative programmes that will enable us to be less stupidly self-destructive.
Two points in particular have become clear to me during my attendance at sessions of the all party group. First, faced with a plethora of conflicting demands for money, governments will invariably decide to direct funds towards those areas which promise the greatest short-term results. That means that funds are directed to choking off the supply of illicit drugs by means such as doubling the Customs and Excise budget, creating drug task forces, helping to defoliate drug production centres overseas and confiscating dealers' assets.
Unfortunately I feel that the sum effect of all that is severely limited. John Maynard Keynes taught us some time ago that the supply and demand mechanisms cannot be treated in isolation from one another. It is the demand for drugs which has so much influence on the availability of supply. If the demand remains high the supply will get through regardless of attempts to discourage it because the resulting change in the price mechanism will mean that it becomes worth the dealer's while to get it through whatever the obstacles. One must act to reduce demand. That is not easy and it is anything but short term.
The second point that came home to me firmly while attending meetings of the all party group is that

739
drugs is an issue which is regarded with the most profound distaste by many Ministers and their advisers. The all party group has been addressed by several Ministers who know very little about the problem and who have almost confessed to us that it was not a subject about which they wished to know more. Those views are not peculiar to Whitehall and Westminster. Many teachers, general practitioners and parents share very similar views. The drug support services often seem to devote more of their energies to fighting one another for limited funds than to thinking about the problem at hand.
The truth is surely that there is no easy solution. The problem is simply not going to go away. However, there are sensible steps that any government can take to try to equip all of us, but most particularly the generations of potential users to come, with the knowledge and skills to reduce our propensity to inflict self-damage.
I should like to concentrate on one particular area which is the work of an initiative called Life Education Centres, mentioned during the speech of the noble Lord, Lord Rodney. That organisation is doing some extremely important work in our nursery, primary and secondary schools. Life Education Centres originated in Australia; specifically in the King's Cross area of Sydney, which is the worst area. In the early 1970s a Methodist minister got sick and tired of finding 14, 15 and 16 year-old drug addicts dead in the porch of his chapel. Rather than make a knee-jerk response to it he devoted a great deal of thought to the underlying reasons and the momentum which made these young people wish to self-destruct. He came up with what was rather like the Jesuits' solution—to get the children extremely young. I will go into the details of that in a moment. Suffice to say that Life Education Centres are now established all over Australasia.
So impressed was His Royal Highness the Prince of Wales on his visit in the mid-1980's that, on his personal initiative, he invited the Rev. Ted Noffs, who founded Life Education Centres, to this country in order to persuade people to establish the organisation here. Five years after the Prince of Wales brought Ted Noffs here Life Education Centres are currently teaching 100,000 children in this country per annum. They have a demand from schools which contain a further 90,000 children who have requested that they come to their premises. Unfortunately, they are currently unable to meet that demand because of lack of funds.
There are four keys to the success of this programme. I have already alluded to the first—the Jesuit principle of getting them young. All experience, both subjective and what I have read, suggests that by the age of about 10 most children have already decided pretty much what their world view is; what sort of people they are, what sort of things they will react positively to and what sort of things they will not even bother to listen to. Many efforts in the past have been devoted to pubescent and post-pubescent teenagers, in terms of trying to teach them of the problems, when all the evidence suggests that by then it is too late. One's natural instinct at that age is to rebel, particularly if one is given good advice. Life
740
education normally starts with children aged 5 in the first year of primary school and continues through to the completion of the programme at the age of about 11 or 12.
The second key point is that it is a very child-centred approach. It is not judgmental and does not say, "These things are bad, you must not do them" but "Your body is an extremely intricate mechanism which in its particular form is unique to you as an individual and is so complicated, and in some instances so sensitive, that it is important for you to know how it works and how the different things you put into it, or what you do to it, will affect that delicate mechanism".
Children are told of the effects of breathing normal air, of cigarette smoking, of drinking alcohol, and eating chips at McDonalds—everything. It is basically good education on how your body works. Having gone through that the question is put: "If you have such and such a substance, what do you think it will do to your body?" In the case of tobacco, the child will probably say that it is not frightfully good for you. The important thing is that it is the child who has to come to that conclusion; not the adult telling the child what the effects will be. It is the child, on the basis of the knowledge it has acquired, coming to the conclusion that that is what will happen. When the child is faced with the decision on whether or not it wishes to smoke at least it will do so in the full knowledge of the likely effects. That would seem to be a fairly straightforward educational purpose.
Thirdly, Life Education Centres closely involve parents and teachers. Most of us in this country are woefully ignorant about the way in which our bodies work. I have the privilege of being married to an Italian lady and her views about the British level of knowledge of how our bodies work would be unrepeatable in your Lordships' House. Suffice to say that when she goes to her general practitioner she quite gaily interrogates him about why he is prescribing such and such a substance, what are the alternatives, why he is prescribing one treatment rather than another, and what are the likely side effects. Most British people would find that rather alien, not least because our lack of self-confidence in interrogating doctors would perhaps place us in a difficult position.
The fourth key point about the programme is that it uses highly specialised, dedicated teachers who do nothing but this. They are trained to cope with discussions with 6 or 7 year-old children. They raise issues like parental alcoholism, child abuse, drug abuse and bullying. Those are not easy subjects. For the Government to expect teachers to be able to cover such situations, given their degree of sensitivity, on top of all the other duties and demands upon them, is in my view unrealistic.
LEC in Australia is now part of the Australian national curriculum. It has been active in Australia since 1979; long enough for some early research studies to measure its medium-term effects. What they show is a consistently higher knowledge of both body

741
facts and drug information among students who have been through Life Education Centres. Other statistics show that fewer smoked, or intended to start smoking.
In our part of the world the entire primary school population of the Isle of Man is currently served by an LEC unit, and the Manx Government have just authorised the provision of funds to enable the entire secondary school population also to be served by LEC. In its first year of operation, the Birmingham LEC unit has seen 14,000 children and 400 teachers. Wales is about to acquire its third unit. As I mentioned earlier, there are approximately 90,000 children in schools which have asked for visits by LEC units but which LEC are currently unable to meet due to lack of funds.
I urge the Government to think hard about several matters: first, to recognise the crucial importance and potential of early prevention initiatives in the demand reduction strategy. I think most of us still have a slightly queasy feeling about the Jesuit analogy that I used earlier. We would like our children or grandchildren to live in a Mabel Lucie Attwell world where they do not have to be confronted with these aspects. Be under no illusions. The feedback I get from LEC teachers is that the kind of knowledge that 5, 6 and 7 year-olds have, sometimes misguided, is quite horrifying. Many parents and teachers are unable to cope. The children are not innocent at that age. They are increasingly becoming less innocent at that age. We have to face up to that.
Secondly, I ask the Government to recognise that to be successful a demand reduction programme must involve parents and win their confidence. They should also recognise that demand reduction programmes cannot and must not be taught by any teacher who—perhaps quite understandably—has a strong distaste for the subject. Highly specialised and sensitive teachers are necessary who teach nothing else and who are trained to work closely with other teachers and parents.
Finally, I ask the Government quite specifically to look carefully at LEC and what they have achieved. I ask Ministers to visit Wales, the Isle of Man, Birmingham, Bradford and the county of Essex. I ask them to go down to Dorset to see some of the initiatives in terms of working in the Borstals; to see how parents, teachers and, perhaps, most important of all, the children themselves feel about its work. I have seen its work over the past five years and I am deeply impressed; for what is most encouraging about its work is that it is successful.
5.31 p.m.
Lord McNair: My Lords, I am grateful to the noble Lord, Lord Rodney, for enabling us to debate this very important subject about which I too feel deeply. First, I should like to spend a few moments on the question of definition. There can be several different definitions of the word "drugs". The definition chosen depends on one's viewpoint. Some people —I hope most—would include alcohol within the definition. The educational charity TACADE, of which I am
742
proud to be a patron, includes in its logo the words, "fighting the misuse of alcohol and other drugs". I agree.
Other people, perhaps on the basis of their partiality for a favourite tipple, would regard as normal what I call moderate to heavy alcohol consumption. In fact, I would say that there is a pervasive "cultural alcoholism" which dulls most people's awareness of the seriousness of this particular problem. We tend to regard someone who drinks heavily as having a problem only when his or her addiction causes a disruption to family, job or health whereas the drug addict is seen as having a problem the moment that his or her friends or family discover the addiction. I must admit that my meagre consumption of alcohol would bring desperate cries of, "We must diversify" from the lips of shareholders in the alcohol industry if it were to be universally adopted.
However, as one who was the victim of a car accident, which fortunately was not too serious but nevertheless frightening and painful and which was caused by a man who had simply had too much to drink, I take the problem seriously. From another point of view some people would say that only street drugs should be regarded as a problem. I feel that some medically prescribed drugs can be just as damaging and addictive. I was interested to hear what some noble Lords had to say on that matter. I spoke about TACADE (The Advisory Council on Alcohol and Drug Education) in our education debate a few weeks ago. I should like to bring your Lordships up to date with its progress.
TACADE's skills-based programmes promote positive and healthy behaviour and place a particular emphasis on fighting misuse of alcohol, solvents and drugs. They provide a practical, structured, relevant programme that has components for use with pupils as well as support material and training components for teachers, parents and school governors. The outcome of the programmes is increased knowledge and awareness and the development of personal and social confidence. They enable and encourage young people to contribute individually and socially to the well-being of self and society, particularly in the fields of positive healthy behaviour and avoiding misuse of drugs.
The first programme from TACADE, called "Skills for Adolescence", for 11 to 14 year-olds, was launched in 1986. Since then over 7,500 professionals, both teachers and LEA workers, have attended the training programme and over 3,500 schools in 90 per cent. of our local authorities have included the project in their curriculum. In some form it has reached about half a million school children. "Skills for Adolescence" is reported to have had a range of positive effects on pupils, teachers, parents and the whole ethos of the school community. It has resulted in an increase in positive behaviour, a decrease in ill-disciplined behaviour, and improved relationships and communication between staff, students and parents. It has enhanced motivation toward academic achievement. Those effects are intrinsically linked with improved

743
self-confidence and self-esteem. Research shows that drug abusers and alcoholics generally have low self-esteem.
The ability to say "no" to peer group pressure and still feel good about oneself is the single most important social skill which a young person needs to protect himself or herself against becoming involved in substance abuse. We could all benefit from greater moral courage and we must do all that we can as parents, grandparents, or teachers, to develop that trait in our young people.
The second programme, "Skills for the Primary School Child", was launched in November 1990. This programme is aimed at 4 to 11 year-olds. It aims to promote the protection of children and covers a range of issues vital to that age group, again with a focus on alcohol and drug abuse. It includes training material for teachers, parents and governors as well as material for use with the pupils. It leads into the "Skills for Adolescence" programme at 11 to 14 years.
"Skills for the Primary School Child" has already been positively received throughout the United Kingdom because it offers a vital element in the curriculum for that age group. I am happy to report that SPSC has recently received further significant support from both the Department of Education and the Home Office to fund a study to evaluate the effectiveness of the programme. A smaller but nevertheless welcome amount was also received from Marks & Spencer plc.
I should like to thank the Ministers and officials involved in such a rapid recognition of TACADE's continued value to the nation. Its aim is to be able to offer a developmental programme of its skill-based educational resources for all children between the ages of 4 and 18. It now seeks to develop a 14 to 18 year-old programme. That will provide continuity with the 4 to 10 year-old and 11 to 14 year-old programmes as well as meeting the requirements of current needs within the National Curriculum.
That development will have five stages: first, research and development; secondly, review and evaluation of the 11 to 14 year-old programme; thirdly, writing and trialling; fourthly, publication and dissemination; and fifthly, evaluation. Stages one to four will take approximately two years and will begin as soon as funds are available. In view of the urgency of the problems that we face in reversing the unhealthy trends in society, I hope that Ministers will look favourably on TACADE's requests for funds for this project. Now that we have come so far along the road, it would be only common sense to complete the job as soon as possible.
Shortly before Christmas I had a meeting with Mr. Price, the national drugs intelligence co-ordinator. After showing me round and explaining the modus operandi he said that all that the unit could hope to do was to slow down the spread of drug abuse. He also said that intelligence gathering had been found to be the most productive activity in which to invest because it paid far greater dividends than a similar amount invested in direct enforcement. But he went on to say that the greatest needs were effective education against substance abuse and effective drug rehabilitation.
744
I mentioned the work of TACADE in this field. The result is that on 13th February Mr. Jeff Lee, TACADE's chief executive, will address a meeting of a sub-committee of the Association of Chief Police Officers and make a presentation of its work. That is greatly welcomed by senior policemen in this country who have been very keen to find some form of effective drug education. Your Lordships may also be pleased to note that Mr. Lee is spending part of February in the Virgin Islands and Belize—not on holiday but at the request of the ODFA to work on demand reduction initiatives in that area.
Mr. Price emphasised that inebriated young people running riot in town centres on Friday and Saturday nights are just as much a problem for the police as tracking down drug dealers. In fact, he pointed out that police forces throughout the land have to schedule an absurd quantity of man hours for six to 10 hours of their working week to cope with widespread misuse of alcohol.
I should now like to concentrate on the situation in the Netherlands and to illustrate why I take issue with my noble friend Lady Seear and with the noble Lord, Lord Rea, on the legalisation of some or all illicit drugs. I do so despite the noble Lord's many wise words. It is common knowledge that the Netherlands is soft on soft drugs. It has a long association with parts of South America and the Far East and that, together with a tradition of toleration and hospitality, has brought together a cosmopolitan population among which the potential drug trafficker has been able to prosper. The huge ports of Rotterdam and Amsterdam, the open borders with fellow signatories of the Schengen Agreement, the major international airport at Schiphol and an advanced commercial infrastructure in a major trading nation give the drug trafficker considerable opportunities to pursue his or her trade.
This inevitably means that many large drug seizures are made but major problems remain for the Netherlands in this field. Officially drugs are banned and their possession is punishable with a fine, though in practice it is rare for a fine to be imposed. The smoking of cannabis has become widely tolerated. That is due to an attempt by the authorities to wean young people away from the hard drug dealers operating in the black market. Possession of less than 30 grams of cannabis has been decriminalised—a horrible word. The authorities keep an eye on the various shops and cafes that sell cannabis and if trade becomes too brisk they are meant to close them down.
The Dutch Government's drug policies have attracted some criticism. The idea that one can separate the trafficking of illegal drugs from their abuse is, to say the least, highly questionable. Although the motivation was humanitarian the results were not what was hoped for. This has led to a defensive stance by the Dutch Government and sensitivity to outside criticism. They state that the distinction that has been made between hard and soft drugs has enabled them to concentrate on the worst aspects of the problem and that the distinction helps in preventing soft drug users from turning to hard

745
drugs. There is also the contention that their liberal policies have made soft drugs less glamorous and less fashionable. Despite that the Government have tightened up some drugs loopholes because public concern has increased about the growing law and order problem. There has been some admission that the use of profits derived from soft drugs to assist trafficking has been underestimated. This may well be the case.
If apologies are necessary for digressing beyond our shores I do, indeed, apologise. But the drugs trade has become so internationalised that truly, to paraphrase John Donne, no island is an island unto himself. I cannot support moves to decriminalise all or part of the drugs scene. Returning to my concept of cultural alcoholism, it seems a nonsense to me to say that marijuana is less dangerous than alcohol and that therefore we should legalise it. I should not have been any more or less pleased to have had my car written off and myself and my passenger injured if the driver of the car that ran into the back of us was stoned on marijuana rather than under the influence of alcohol. If a substance adversely affects mental functioning it is a bad thing. That has to be the starting point for a rational policy on substance abuse.
Several noble Lords have spoken about rehabilitation in general and about certain methods of rehabilitation in particular. I endorse every word that was said by the noble Lord, Lord Mancroft, and add that several established rehabilitation programmes are available to addicts. I am sure that attempting to separate alcoholism from drug addiction is a waste of time. I do not know from experience but I suspect that, while many alcoholics do not use other drugs, most users of drugs also use alcohol.
I am sure that the way forward is for the Government to carry out an extended evaluation of all the treatments available. It may well turn out that some treatments work for some people while other methods work best for other people. As was pointed out by the noble Lord, Lord Mancroft, the amount of space devoted to rehabilitation in UK Action on Drug Misuse is relatively small. I hope that in future publications those proportions will be reversed, reflecting a similar change in the Government's priorities.
Once the evaluation of the methods that I have suggested has been completed the next stage will be for the treatments found to be effective to be provided free and on demand across the country. By "effective" I mean really effective. The treatment described by the noble Earl, Lord Longford, involves an individual returning for treatment upwards of 20 times. That is hardly "effective" in the normal sense of the word. "Effective" should mean enabling the former addict to lead a stable, happy, drug-free and crime-free life.
Following on from that idea, I ask the Minister to be kind enough to tell the House how much government money has been made available to SCODA and Alcohol Concern during the past five years? Furthermore, what is the precise function of
746
each body and, in terms of the definition that I have given, what has been the success rate of both organisations?
I noted what was said by the noble Lord, Lord Hunter of Newington, about addiction to tranquillisers. That is a terrible problem. Surely we must find other and better ways of dealing with people's fears and tensions. I cannot help feeling that such addiction is an awful indictment of the National Health Service, and, of course, it goes against the doctors' dictum, "at least do no harm". Perhaps individual doctors could have been more alert to the growing problem. But surely the companies producing these drugs should be encouraged to carry out longer-term trials of their products with the specific requirement that the drugs' addictive qualities should in some way be tested before they are released on to the market place.
Let us hope that having discussed these desperate problems in this debate new initiatives will be taken which in combination will eventually reduce substantially the problems that we face.
5.47 p.m.
Earl Attlee: My Lords, I wish to concentrate on young children and drugs. I am against anything that affects young children, and drugs certainly do that. I was once on a flight from Scandinavia to Heathrow Airport in London. I sat next to a writer—I shall not dignify her by calling her a journalist—who was boasting that she did not tax her car, had no insurance, and so forth. She thought all that was rather clever. I said, "Are you smuggling some drugs today?" She asked me why. I said, "Because if you are, when we land I shall shop you to the Customs". That was in the old days when there was no green exit and everyone was stopped. She said, "You wouldn't do that". I said that I would; and again she asked why. I said, "Because I have two young children". After going through Customs she turned to me and said, "What would you do if I now told you that I have smuggled some drugs through?". I said, "I shall go straight over to that policeman and tell him". She could not understand that.
I and my first wife brought up two children who are now aged about 30. Neither smokes, and they drink only in moderation. They have never touched drugs. My son spends all his money on his great passion: heavy goods vehicles. My daughter is a qualified midwife and she knows the effects of drugs. Unfortunately, she must occasionally deliver the babies of mothers who are drug addicts.
The noble Lord, Lord Rodney, said that if there were no demand, there would be no problem with drugs. I heartily agree with that remark. I had hoped that in the debate today someone would come up with an answer to the drug problem because I certainly do not have one. The noble Lord, Lord Rodney, and other noble Lords have tied together smoking and drugs. I know that tobacco and alcohol are drugs; but, as I have said before in your Lordships' House, if one starts smoking cigarettes, one can only move on to a pipe or cigars. However, all the evidence that I have read shows that children start on so-called soft drugs, almost certainly somewhere along the line someone

747
will say, "Look, try this. Try a real drug". Before the child knows it, he is on to hard drugs. That is the road to hell.
An important aspect of the drug problem is that children ape their heroes. The other day my wife asked me whether I had noticed a lot more children spitting in the street. I said, "Probably, yes". She said that she had just seen two children spitting in the street. I wondered why that was. The children watch football on television and see their heroes spitting. They copy them. Therefore, when pop stars and actors and actresses quite openly admit that they take drugs, then the children say, "Well, if our heroes do it, then we shall".
One noble Lord mentioned dealers standing at school gates. They do that. I am sure that they sell the drugs at a very reduced price with the object of ensnaring the children. I have been told that some dealers give away the drugs. What could be worse than encouraging small children to take drugs? That appalls me.
The noble Lords, Lord Hunter of Newington and Lord McNair, and other noble Lords, mentioned tranquillisers. Years ago I heard a doctor asking a man who had tried to commit suicide whether he was taking tranquillisers, and the man replied that he was. The doctor said, "I thought so". That has been known for years and yet, so far as I can see, nothing has been done by the doctors to curb prescriptions or by the drug companies to take the drugs off the market or do something about the problem. In that respect, that shows the medical profession in a very poor light. I say that only with regard to tranquillisers because I have the greatest respect for the medical profession.
Apart from crack, modern drugs have names which I cannot pronounce, let alone spell. However, whether or not the names are complicated, the drugs are filth.
Drugs require hard cash. The noble Lord, Lord Rea, gave us some figures. Therefore, young children commit burglary and muggings for one reason only; that is, to obtain cash with which to buy drugs. One noble Lord mentioned that a judge had said to a pusher that his crime was like firing a loaded gun into a crowd. The noble Lord rubbished that idea. However, in one way it is because children commit crimes to obtain money and the chances are that they will end up in prison, possibly for murder.
The Earl of Longford: My Lords, is the noble Earl seriously saying that someone who imports drugs is committing murder in the same way as a person who fires bullets into a crowd? I have too much respect for the noble Earl to believe that he can talk such nonsense.
Earl Attlee: My Lords, I am sorry to disappoint the noble Earl, but I am saying that a person who imports drugs is killing people. It is as simple as that. Deaths have occurred among people on hard drugs. They may not be numerous, but they are still dead from drug overdoses.
The noble Lord, Lord Rea, also mentioned that one problem is that if the police or customs find a huge haul of hard drugs, then those drugs become scarce on the market. Therefore, the remaining drugs are
748
adulterated even more than usual. That means that the people taking the drugs increase their intake to compensate for the additional adulteration. A big consignment then gets through, there is less adulteration and overdoses are taken. I do not suggest that we should not confiscate the hauls. We must do that. I do not know the answer. In the ideal world, all imports of drugs would be prevented.
In a newspaper this morning I read about a case of two people being found on a cargo ship. They were hiding in the area of the propeller shaft and were intending to import drugs into the country. One reads of cases where customs officers search a big lorry and find false floorboards, and the same applies to ships. I do not know whether customs officers receive tip-offs. However, whatever steps we take, it is certain that we can never stop the importation of all drugs. We know how they are imported. I remember very clearly when we were discussing the Police and Criminal Evidence Bill that we gave to the police the right of an intimate body search under exceptional circumstances. One such circumstance was when it was believed that the suspect was carrying a condom full of drugs.
Mention has been made of the Minnesota scheme in the United States. I do not know about that, but I was very impressed when I saw a film on television about Betty Ford. I thought it was wonderful of her to set up a clinic and for that clinic to be called the Betty Ford Clinic. That shows a terrific amount of guts.
I listened to the noble Lord, Lord Rea, with great interest because he has dealt with drug addicts. When I was at sea in Singapore I saw people who were drug addicts killed accidentally, and I have seen one crew member die from drug addiction. However, that is rather different.
As I say, I wish that a noble Lord had found the answer to this problem which this or any other government could adopt because I am appalled and terrified by drugs. I would never try any drug hard or soft, because I am terrified that if I did, I would become addicted in the same way that I am addicted to cigarettes.
5.59 p.m.
The Earl of Stockton: My Lords, I declare an interest in that I am a trustee of the Chemical Dependency Centre, a London-based halfway house charity on the Hazeldon model as well as a member of the all-party drug misuse group.
I start by taking up a point made by my noble friend Lord Rodney in his opening speech in this important debate; that addiction should be seen and understood for what it is—an illness and not a criminal tendency or a manifestation of moral turpitude. Research on both sides of the Atlantic has established that approximately 10 per cent. of the population has the congenital predilection towards addiction. To the addict the choice of or preference for drugs is secondary to the maintenance of the high or, as the noble Baroness, Lady Ewart-Biggs, referred to it, the altered state of mind. The noble Viscount, Lord Falkland, gave to your Lordships a masterful

749
exposition of the ramifications of compulsive behaviour. There are many among our acquaintance who show those compulsions.
Medical research in the United States is close to identifying the physical mechanism which means that one individual possesses an in-built tendency towards the addictive state of mind. I am not a scientist but I understand that there is an identifiable difference in the amino acid which acts as the link between certain parts of the brain in the addict and in the non-addict. That difference appears to inhibit the mechanism of self-control and self-preservation that in the non-addict stops a sociable drink in the pub from becoming a headlong rush to oblivion. Researchers are hopeful that it will soon be possible to test for that amino acid difference and thus identify in individuals the sensitivity towards the illness of addiction. The implications of that are vastly important and very helpful.
The addictive personality does not stem only from such physical mechanisms but also from heredity. It may even be that those mechanisms are genetically inherited and can be passed on. But in the same tragic way that battered children themselves in turn batter their own children, the patterns of lack of self-worth, self-abuse and addiction develop in the children of addicts however greatly they may have suffered from their parents' addiction.
To be able to help the spouses and children of addicts through counselling or group support, as well as education, is one way to break the cycle of the visitation of the ills of the fathers on the children—for if there is one sad certainty in modern society it is not whether our children or grandchildren are exposed to the risk of drugs but when they are exposed to that risk. The certainty of exposure is here. It is through education, example and experience that we can hope to prevent exposure becoming involvement.
The figures given by my noble friend Lord Mancroft are disturbing, though I am not sure that a mere 10 per cent. of your Lordships being addicted to some mind-altering substance was altogether a generous estimate. In a typically courageous speech my noble friend laid out his inescapable conclusion, with which neither I nor the Government could disagree. The success of treatment as the main plank of the Government's policy on demand reduction cannot be emphasised too highly. The success of what is known as the Minnesota Model, including the Betty Ford Clinic mentioned by the noble Earl, Lord Attlee, is now beyond question.
In the United States many large companies, government departments, the armed services and law enforcement agencies support individuals in treatment programmes lasting from 28 days to sometimes several months. Their experience has been that the disease of addiction frequently affects the brightest and the best. It is a sense of vested interest as much as altruism that motivates that involvement. When I was in treatment at Hazelden in Minnesota there were among my
750
fellows a sheriff, an army colonel, a truck driver, a concert pianist, a murderer and a state senator; even politicians in the United States do not escape.
I am sure that we all thank my noble friend Lord Rodney for the opportunity to discuss this tragic, urgent and catastrophic problem. But discussion is not enough. Action, further action and further funding is needed. I trust and pray that the Minister will be able to tell us what action is forthcoming and that it will be maintained.
6.4 p.m.
Baroness Masham of Ilton: My Lords, I thank the noble Lord, Lord Rodney, for introducing the debate. It is important because drug taking and the amount of illicit drugs coming into the country has not lessened. The problems are still increasing. Perhaps it is due to the ever increasing cloud of the horrendous problem of AIDS that the press have been very quiet about the problems of drug abuse, and the publicity campaigns have not been highlighted of late.
It is tragic and expensive when people become addicted. Many drugs cause addiction and no doubt if they disappeared others would emerge. Only last night I heard about fire extinguishers causing the death of children who sniffed the contents.
Illicit drugs are a problem, but so are alcohol, tobacco and even coffee if taken in excess. Glue and butane gas sniffing are a specific problem as so many young people become involved in that. Some of the greatest problems for women are the prescription drugs such as tranquillisers, as has been mentioned, one of which is amphetamines, which can be either prescription or illicit. I am told that many amphetamines are manufactured in Holland and come over illegally as there is a better market for them in Britain. Perhaps the Minister would tell us whether we are attempting to tackle that problem with the Dutch Government, and whether there is cooperation between our Customs officers and theirs. If something is not done about the matter now, the situation will surely worsen next year when European borders disappear.
Many of our young people are involved in some sort of drug abuse. The tragic problems which result are the ruination of many young lives. When serious addiction takes place on average one out of three will die. In recent years the Winston Churchill Memorial Trust has given travelling fellowships to several keen, motivated people to study the problems of drug misuse. Two excellent high class members of the police who were involved with drug problems came back from America where they had been looking at the work of the police and Customs. Both men, having witnessed problems worse than our own, said when they returned that education plays a vital part in reducing the demand for drugs. To reduce the demand our children and young people must realise how much better it is to have a healthy body which can do healthy things, and that they can get achievement and self-esteem from playing games and other healthy activities.

751
When one looks at some of the schools, one may ask whether the right encouragement is being given to our children. Last year I visited Herefordshire and I was told that none of the maintained schools played cricket matches as it was considered to be too competitive. We live in a competitive world, whichever country one lives in. When I visited Barbados, I saw happy children playing cricket with home-made bats. Are we giving children confused messages?
Two organisations are doing excellent work in the field of health education for children, and both have been mentioned. One is the Life Education Centre. To reduce demand the Life Education Centre, as mentioned by my noble friend Lord Russell of Liverpool, aims to target children and instil in them a feeling of well-being, of future and worth. The issue of abusing something as special as oneself will become unthinkable.
The reduction in demand for drugs via the education of young children has not yet been taken seriously in Britain. There is no national cohesive drug initiative aimed directly at primary school children. Once children reach the challenging teens that kind of education may be useless. Children, parents and teachers all need involving in this education. All too often parents know less about the risks than their children.
Another organisation dealing with this vital education programme is TACADE—The Advisory Council on Alcohol and Drug Education—whose mission it is to educate and fight the misuse of alcohol and drugs. I attended a presentation of its work before Christmas. It has developed some useful up-to-date teaching packs for teachers. I received a letter from TACADE dated 10th January saying that once again it had been unsuccessful in obtaining core funding support for its work through the Department of Health Section 64 grant scheme. They are the leading national non-government organisation working in the field of alcohol and drug education, training and prevention work. I know that there are so many demands on the Section 64 grant scheme. Competing for funds is difficult for TACADE as educating for health and fighting alcohol and drug misuse is a long-term solution. This is an investment for the future.
In some cities in the United States of America there is the Drug Abuse Resistance Education programme (DARE) undertaken by the police in some schools. For example, in San Diego in May 1987, a police sergeant was trained and he evaluated the DARE programme in Los Angeles. A pilot scheme was implemented in 36 San Diego city schools in 1988. It is hoped to extend that programme in every elementary school in the city and expand to other schools. The prevention programmes deal with peer pressure resistance techniques, decision-making skills, problem-solving exercises, positive lifestyles and alternatives to drug use. There seems to be a high degree of success. The Americans have a worse problem than ours. They say that law enforcement continues to attack the supply side of the growing drug abuse problem but with limited success.
752
Implementation of the DARE programme in San Diego is an opportunity to address the demand side of the problem with a programme of demonstrated, positive results.
When I heard about this education programme undertaken by the police, I thought that it was interesting as this must give a good community relations side to police work. It was a police officer from Britain who was very impressed with DARE and who told me about it. We have never been as good as we should be at prevention. We have tried to put the matter right, but very often it is too late. We try to shut the stable door once the horse has bolted. We need better integrated health education throughout the school timetable. It was at 5 a.m. that I moved the amendment on that subject in your Lordships' House. Perhaps if a few more noble Lords had been present, that amendment might have got into the core curriculum.
We have to tackle the ever-increasing problem of cocaine. Half a tonne was seized in Scotland. I think I am correct in saying that that exceeded the rest of last year's seizures put together. It is frightening to think how much must be coming in which does not get picked up. I asked a supplementary question to a Starred Question last year about how many sniffer dogs there are. The noble Earl answering for the Government was going to write to me with the answer; but I am still waiting. Perhaps this time I shall get an answer from the noble Lord, Lord Reay.
We must be not complacent over this matter which will not go away. This is a world problem. Drug traffickers seem to have a very clever way of targeting their goods and of knowing who the vulnerable likely buyers are. I am told that "acid", (LSD) and "ecstasy" are again increasing. Drug addicts seem to have a drug of their choice. Often it is heroin or cocaine, but often they use a selection of drugs mixed with alcohol. Many families in Britain know the problems that drug abuse inflicts on them and society at large involving lying, mood swings, deviant and unsocial behaviour, unreliability and getting into debt. All these problems go with drug addiction.
I believe that in 1989 at the Conservative Party Conference, the Home Office drug prevention teams were announced. I think they were set up in seven areas. Can the Minister say how they are progressing? Can he say how many there are now? How effective is their work? What response has there been from the communities in which they operate? The Member for Lewes, Tim Rathbone, and I, as officers of the All-Party Parliamentary Drug Misuse Group, attended as observers the world ministerial summit to reduce demand for drugs and to combat the cocaine threat. That was held last April. I congratulate the Government for hosting such an interesting and well-organised summit. There were over 130 countries represented.
I now wish to bring to the attention of your Lordships two items from the UK Drug Services' statement because there is growing anxiety about the

753
confusion of funding of some of the voluntary or non-governmental service provision. The statement says:
"We believe that the threat of the spread of HIV infection and AIDS is such as to make the prevention of drug abuse even more important than before. Faced with that threat, we believe that more strenuous efforts must now be made by all countries to draw greater numbers of drug abusers, particularly those who inject, into contact with treatment services and agencies. Such services can include both drug-free and methadone maintenance programmes".
The Alternatives to Prison organisation said:
"We will intensify our efforts to provide suitable alternatives to prison for drug-abusing offenders who wish to undertake treatment. Given the ambivalence of many drug abusers regarding giving up drugs, such alternatives should be carefully monitored and contain appropriate safeguards to protect the community against the consequences of relapse. We will also strengthen provision within prisons to provide counselling and treatment for drug abusing offenders and to ensure continuing support on release from prison".
Are these just words or has some improvement taken place? As the noble Baroness, Lady Ewart-Biggs, said, in women's prisons there are no services. The taking of illicit drugs in prison is very worrying. That so many drugs seem to be entering many of the large prisons where people are contained with many prison staff in the establishment, illustrates just how difficult this problem is to control. One hears of inmates being involved in drugs once they are in prison having been clean before sentence.
It seems that Edinburgh, which has a serious HIV problem among drug abusers, is taking a much more enlightened attitude to HIV inmates than England. Perhaps the Home Office will discover what Scotland is doing which England is not. There is more integration of inmates in Scottish prisons. A medical consultant working for prisoners with AIDS in London was dismissed by the prison service because he spoke out on television saying that much more had to be done for the patients concerning their treatment. It is a pity that the prison service took a closed view of criticism which was no doubt well-founded.
Lord Campbell of Croy: My Lords, I am grateful to the noble Baroness for giving way and for what she has said about Scotland. The answer may be because there is only one department in the Scottish Office which is the Home and Health Department. The Department of Health does not deal with health in Scotland. The home part of the Home and Health Department deals with home affairs in Scotland. There may be many arguments within that department, but it may be an advantage that it is under one roof.
Baroness Masham of Ilton: My Lords, that may well be. It may also be because Scotland is a pioneering country. Both Phoenix House, the drug rehabilitation service and Turning Point services for people with drink, drug and mental health problems are concerned about the community care services because there seems to be confusion about future funding. For example, the Home Office is relying on the Department of Health and local authorities to fund these through community care contracts. The probation service and the Home Office provide very
754
little in the way of funding for services that they currently use. The whole question of Home Office funding and community care plans is very muddled, particularly so when one considers the question of discharged prisoners. For instance, who will pay for a prospective resident coming to Phoenix House from Wandsworth Prison? It seems unlikely that the local authority, or for that matter any other local authority will take on this responsibility. If the Home Office is serious about its intention to provide more non-custodial measures, there should be a properly funded system.
On a wider issue, the Department of Social Security is currently tightening up the arrangements for the registration of care homes in the voluntary and private sectors. This may affect the eligibility of the clients to claim the higher rate of income support payments before 1993. The issue is that the DSS seems to be saying that if a resident in a registered voluntary sector home is sponsored by a statutory authority or his care in the home has been arranged by the authority—for example, through a mechanism like a service agreement or contract—then that person may now not be eligible for the higher rate of income support which is currently the case. We need an assurance on this point and we need to know how the drug and alcohol grant will work in 1993.
What is becoming more evident is the chasing of funders. If residents are not funded at the place where they receive help, each residential service will be forced to spend huge amounts of time and resources chasing funding from each local authority across the country. Quite a few drug addicts, some of whom are HIV positive, come to Britain from Ireland and Italy. What will happen concerning their funding?
So many parts of the world have a problem with drug trafficking. It is hoped that places like the West Indies, the United States and Britain work closely together. When one looks at the little islands spread around one realises how difficult is the problem of control. Facilities such as small aeroplanes are needed; otherwise the drug traffickers will he better equipped than the enforcement agencies.
The preliminary figures for 1990 published last week indicated that seizures of all drugs had risen considerably, with a particularly sharp rise in heroin seizures. One realises that Britain is still being targeted. We should not cut back on any of the services; but efforts should be intensified in policing, education and caring, thus reducing the scope for profiting on the part of drug dealers who live from the human misery they create.
6.24 p.m.
Lord Richard: My Lords, this has been in many ways a rather remarkable debate. The House should be grateful to the noble Lord, Lord Rodney, for introducing the subject as he did in a pithy and condensed way. It was a very interesting speech with which to start the debate. It has been a remarkable debate and we have heard some remarkable speeches. The noble Viscount, Lord Falkland, warned us of the dangers of compulsion in respect of many areas of

755
activity. I assure him that my predisposition to exercise is not, I fear, very great and that my addiction to jogging is minimal.
To be serious, I think we have had four remarkable speeches in the course of the debate. From the right reverend Prelate the Bishop of Newcastle, speaking from his own experience in that great city, we heard of the importance of education and indeed of the voluntary sector. From the noble Lord, Lord Mancroft, we heard a speech which I personally found extremely moving, courageous and perceptive. He told us that the chances of an addict getting proper treatment in Britain in 1991 were no different from what trey were in 1981—and the chances then were pretty minimal. If that is so—I invite the Minister to comment on it—it is not a reflection on contemporary society of which we should be proud.
We heard a remarkable speech too from the noble Earl, Lord Stockton. He underlined the theme which has run through this debate. The fourth speech I pick out—I do so with no disrespect to those I miss: I am trying to isolate the themes running through our discussion today—is the speech of my noble friend Lord Rea, which I found thought provoking and full of insight. I learnt something from it which I did not know before. He indicated an almost cyclical pattern to addiction and to its treatment. He suggested that it is perhaps a 10-year problem rather than a lifetime's problem. He said that there is a natural period of addiction which should be carefully and clinically controlled and that at some point in that cycle—if that is the right way of putting it—there is a natural and appropriate moment at which treatment may be successful. He further suggested that until then it is likely to be ineffective. I hope I do not do my noble friend a disservice in condensing into a few sentences his interesting speech.
At some stage—I do not suggest that the Minister can do it tonight—I should like the Government to tell us whether what my noble friend has suggested is scientifically correct. A remarkable and heartening feature of the debate is the fact that most speakers said that treatment under controlled circumstances can be successful. If treatment can be successful, the Government and the country must face the following questions. What kind of treatment should be provided; in what circumstances and to which addicts; and for how long?
The noble Baroness, Lady Seear, referred to decriminalisation, an issue which has been discussed for some time. I agree with her that it is perhaps time to have a serious look at the effects or the possible effects of decriminalisation.
I should like to refer to the speech of the noble Lord, Lord Hunter of Newington. He made one point with which I totally agree. He said that the treatment of serious addicts demands support. Clearly, that is true.
In looking at the themes of the debate it is remarkable and good that there has been such little emphasis on the supply side of the equation. That has been helpful. We have heard a great deal about the
756
supply side—where the drugs come from and what is being done to halt that supply—but we have not over the years heard quite so much about the demand side. That is why I was particularly grateful to the noble Lord, Lord Rodney, for the terms in which he put down his Motion.
One speaker referred to the stick and the carrot. Perhaps I may refer to the stick. I am worried about the number of drug users in prison and the way in which they are treated or not treated. In 1988, the latest year for which figures are available, 81,000 people received custodial sentences of one kind or another. Of those, 3,523 were guilty of an offence under the Misuse of Drugs Act. Three-quarters of those offenders were found guilty of trafficking; and approximately one-third of the offences involved heroin. The overwhelming majority of the offenders received their sentences at a Crown Court. I accept that we are not today discussing the Criminal Justice Bill but we have from time to time talked about consistency in sentencing.
Perhaps I may give the House some figures on what is likely to happen to someone who comes before a Crown Court and is found guilty of one of these drugs offences. I have figures from about a dozen Crown Courts on the use of custody. In Preston, 41 per cent. of offenders receive a custodial sentence; in Liverpool the figure is 68 per cent.; in Aylesbury it is 78 per cent.; in Croydon, 81 per cent.; in Kingston 44 per cent.; in Reading, 72 per cent.; in Wood Green, 42 per cent.; in Worcester, 40 per cent.; in Derby, 70 per cent.; and in Portsmouth, 69 per cent. However one looks at those figures, the range in the use of custody for drug users and drug offenders is between 40 per cent. at Worcester and 81 per cent. at Croydon. However one looks at it, it is difficult to comprehend. There does not seem any pattern in the way that the courts and the criminal justice system are approaching this difficult problem of what to do with a drug user. Whether a drug user is imprisoned for a drug related offence appears to depend partially on where the offence was committed. That is something which I hope the Government will address.
Last year, 1,159 prisoners were notified to the chief medical officer by prison doctors as being addicted to drugs. Police surgeons notified the chief medical officer of a further 696 drug addicts who were held in police cells. In 1989, the total number of new and renotified addicts for all drugs increased by 17 per cent. to nearly 15,000 within the community as a whole. We know that the Minister of State at the Home Office, as he then was, David Mellor, estimated that the true number of regular drug users is between 75,000 and 150,000. What is the true number of drug users who are actually in prison? It is likely to be, I suppose, between five and 10 times the official notification. Certainly the National Association of Probation Officers believes that it is somewhere between 9,000 and 18,000 prisoners per annum, and inevitably a large number of drug users go undiscovered.
I do not want to weary the House with too many statistics, but not only are there those drug users who

757
have gone to prison but there is a considerable amount of evidence that drugs are being taken while individuals are in prison. There is certainly evidence to suggest that drugs are intermittently available in prisons during a sentence or period on remand. One can see that from two figures. One is the number of prisoners who are disciplined for the possession of unlawful drugs. In 1986 the figure was 1,630, in 1987 it was 1,540 and in 1988, 1,974 prisoners were disciplined for being in possession of drugs. Since 1986, 11 prison staff have been suspended or disciplined for drug related offences. A Parliamentary Answer revealed that 617 needles or syringes were found in prison by staff between 1987 and 1989. On top of that, you have not only the availability of drugs inside prisons but also the possibility of the spread of the HIV virus or AIDS. This is a problem which exists and which so far as I know is not being addressed at the moment. I should be obliged if the Minister could say something on this aspect of the matter when he comes to wind up.
The other problem is whether we are achieving anything by putting so many drug users in prison. We are certainly not making them more equipped to cope with the addiction that they had before they went in, because the amount of treatment that they receive while in prison is indeed minimal.
I was very grateful indeed for what the noble Baroness, Lady Masham, said a few moments ago. She had the advantage, which I do not have, of reading carefully what is said at Conservative Party conferences. The quotation which she gave was apposite and pointed and I shall be interested to see how the Minister evades it.
But if the stick side is the prison side, what about the carrot side? As I said earlier, I am very interested indeed in what has been said in the course of this debate. The theme running through it is that addiction is basically treatable if it is done in the right way and at the right time. The corollary that follows from that as inevitably as night follows day is the question of funding. It is impossible to say that treatment is available and then at the same time to say, "We are terribly sorry but we cannot afford it".
SCODA, of which the noble Lord, Lord Rodney, has intimate knowledge, produced a briefing—I suppose that one could call it that—for the debate today and I was very grateful to receive it. It said:
"The debate focuses on reducing the demand for these drugs in our society. Whilst this is a laudable sentiment the definition of demand as described to date is limited either to prevention through education or criminalisation by increasing police activities. In order to fully address the issue of demand reduction one has to understand the reasons why people use drugs including the social and psychological context in which they are used. It is then possible to develop a strategy that is targeted at those reasons. This strategy should include the following elements.

Building a healthy public policy.

Creating supportive environments.

Strengthening community action.

Developing personal skills.

Reorienting services".

758
I hope that the Government have a strategy for dealing with this part of the drugs problem. I shall be very interested to hear what the Minister has to say about the way forward.
6.36 p.m.
Lord Reay: My Lords, I should first like to thank my noble friend Lord Rodney for having giving your Lordships the opportunity to debate the problem of drug misuse—a problem which is one of the most difficult and serious facing society today. Drug misuse undermines health, wrecks families and can lead to death. I wish that I could give your Lordships precise figures on the extent of drug misuse, but I cannot. It is a hole-in-the-corner activity and reliable information is hard to come by. But we have for some time believed that the number of misusers of heroin and cocaine in this country may lie between 75,000 and 150,000. There may be a similar number who misuse a variety of other illicit drugs, excluding cannabis, the most widely misused drug of all.
The Motion that we are debating rightly emphasises the importance of reducing the demand for drugs. But I want to stress that action to reduce supply and action to reduce demand are interdependent. Neither makes sense without the other. The Government are committed to a wide range of policies to reduce drug misuse, and we estimate the total cost of implementing them at around £400 million a year. These policies fall under five main headings which together comprise our anti-drug strategy.
The first element in our strategy is international action. Britain has played a leading role in the efforts of the world community to tackle this global plague. That was recognised by my noble friend Lord Rodney. In April last year we hosted in London, in association with the United Nations, a very well-attended international conference—the world ministerial summit to reduce the demand for drugs and to combat the cocaine threat. We are engaged in a variety of other actions both bilaterally and multilaterally on the international scene.
The second element of our strategy is more effective enforcement action to deter and detect drug traffickers. Here I should like to pay tribute to the co-operation between our police forces and the Customs service, which has helped to produce ever greater seizures of drugs in recent years. The huge increase in Customs preventive and investigative posts over the last decade, with more than 1,000 additional preventive staff, underlines the importance we attach to stemming the flow of drugs into this country. The 40 per cent. increase in police force drug squads since 1983 demonstrates our commitment to targeting traffickers operating within this country.
The third element of our strategy is the combination of deterrent sentences and tight controls over the legitimate medical uses of drugs. This Government increased the maximum penalty for trafficking in Class A drugs to life imprisonment. We have also brought in tough legislation giving the courts new powers to trace, freeze and confiscate the proceeds of drug trafficking, thereby hitting those who

759
ply this wicked trade where it really hurts—in their pockets. In the Criminal Justice Bill, now before the other place, we plan to make community penalties available for drug misusers more credible, particularly by enhancing courts' powers to attach conditions of treatment to probation orders.
We certainly do not want more drug users sent to prison than is strictly necessary. We also believe that the Criminal Justice Bill, by providing a coherent framework for sentencing, will help with another matter raised by my noble friend Lord Rodney and taken up by the noble Lord, Lord Richard; namely, the desirability of seeing that the courts sentence consistently and appropriately in all cases.
The fourth and fifth elements of our strategy—prevention and treatment—bring me to the main thrust of today's debate. Tackling the demand for drugs is crucial. Where does this demand come from? Not, all the evidence suggests, from children at school; rather from those in their late teens and young adults. Yet, as school is a preparation for adult life, so we must teach our children about drug misuse and how it can destroy young lives. We must prepare them for the pressures that my lie ahead—indeed, will lie ahead, to follow the precautionary assumption made by the noble Lord, Lord Russell of Liverpool. Those pressures all too often are from friends who have already succumbed to the temptations of drug misuse.
How can we equip young people to resist these pressures? First, they need to be well-informed about the tragic physical and social consequences of misusing drugs. The new national curriculum requires that all children, primary as well as secondary pupils, should learn about the effects and dangers of drug misuse and those associated with solvents, tobacco and alcohol.
Secondly, and equally importantly, they need to acquire the attitudes and skills to put such information into practice. In the broader context of health education, pupils learn how to resist peer group and other pressure to experiment—how to say "no" to drugs just as they need to be able to say "no" to the first cigarette or to the stranger offering a car ride.
The noble Earl, Lord Attlee, spoke eloquently of the threat which drugs can pose to young people. I am sure he would agree with what I have just said. Perhaps I can say to the noble Viscount, Lord Falkland, that, despite his experience of unimaginative drug education in schools, we are now seeing educational material developed which is interesting and innovative.
Local education authorities are helped in their promotion of drugs education by specific grant from the Department of Education and Science. Since 1986, the department has supported over £13 million of LEA expenditure on drugs education and professional training in schools, colleges and the youth services. In particular it has supported the work of over 100 health education co-ordinators, one for virtually every local education authority, with a special responsibility for
760
promoting drug education. A further £7 million of expenditure on preventive health education is being supported in the current year, and again in 1991–92.
Once children have left school, the media provide our best hope of communicating the anti-drug message to young people. Your Lordships may have seen the television and cinema advertisements which the Department of Health has run annually since 1985 with some success. The impact of the campaigns is carefully evaluated. They have been supplemented by advertising on radio, in the youth press and by poster campaigns. More recently, funds have also been provided for regional campaigns using a variety of means to tackle particular problems.
While national media campaigns are a crucial part of our preventive strategy, it is also important that the local community is actively involved. Churches, businesses, schools, clubs and, perhaps most important of all, families have a role to play alongside the recognised statutory and voluntary agencies working specifically in the drug misuse field. It was with this in mind that the then Home Secretary announced in October 1989 the Home Office's drugs prevention initiative. Under the initiative, 20 local drug prevention teams, each with three full-time staff, will be established with the aim of mobilising and sustaining efforts by the whole community to resist drug misuse. Six of the teams are already in place.
I can tell the noble Baroness, Lady Ewart-Biggs, that we are providing a budget of £5 million in the coming financial year for this initiative. The noble Baroness expressed concern that these teams might not be flexible enough to respond to the changing patterns of drug misuse, but I can assure her that they will. It is an essential part of their job to develop community strategies against all forms of drug misuse. The noble Baroness, Lady Masham, asked me how the teams were doing. It is a little early to report on their achievements but I can say that the first team set up is well into its task of drawing up an action plan for its work in the coming months.
Prevention is obviously better than cure. But, as my noble friend Lord Stockton emphasised so strongly, treatment and rehabilitation services are vital for the individual misusers and for helping to prevent further drug misuse. In this area above all, the work of the voluntary sector is an integral part of the provision of services for drug misusers. My noble friend Lord Mancroft, in a remarkable and interesting speech, and the right reverend Prelate, in his fine speech, strongly emphasised the importance of the voluntary sector and its funding needs.
The Government have continued to invest increasing sums in the voluntary sector. Leading voluntary organisations have benefited from government funding in the form of Section 64 grants towards their headquarters costs. In 1990–91 over £713,000 was awarded to organisations in the drugs field. In addition to these funds, the Government have since 1986–87 made increasing sums available to regional health authorities for the expansion of services for drug misusers. In 1990–91 this funding totals £15.5 million.

761
Your Lordships will no doubt be aware of a new specific grant which will be available during the years 1991–92 and 1992–93 to assist local authorities to develop the voluntary sector's contribution to improving the adequacy, quality and suitability of the social care elements of services for alcohol and drug misusers where they fall short of requirements. The new grant is part of a wide-ranging government commitment to improve services for drug misusers. It is additional to the allocations made to health authorities for the expansion and improvement of services for drug misusers, which I have already mentioned.
This grant should enhance and complement the overall strategy for alcohol and drug services locally, and the Department of Health will expect to see that the local authority making the bid for the grant has consulted both the organisations which are to benefit from the grant and the other statutory bodies concerned, such as the health authority, and that they are broadly in agreement with the proposal. Final decisions on the objectives and scope of the specific grant for 1993–94 onwards have not yet been made but they are likely to take into account the changes in income support arrangements planned for April 1993.
The Government acknowledge the key part played by the voluntary sector in the provision of services, and here I should like to acknowledge the work of SCODA—the Standing Conference on Drug Abuse—which, under the chairmanship of my noble friend Lord Rodney, co-ordinates the views of the non-statutory organisations working in the field of drug misuse in England and Wales.
I cannot agree with the noble Lord, Lord Richard, or with my noble friend Lord Mancroft that facilities for treatment have not improved since 1981. The Department of Health central funding initiative provided an extra £17.5 million of new funding for drug treatment and although funding responsibilities have now passed to health authorities the benefits of that initiative are still with us.
As your Lordships are well aware, a new dimension has been added to the problem of drug misuse in recent years with the spread of HIV and AIDS, caused to an alarming extent by intravenous drug-taking. It is more important than ever to encourage misusers to come forward and make contact with treatment or counselling services.
In seeking to do this, pragmatic and realistic policies of harm minimisation have been adopted, including the setting up of many needle exchange schemes, to prevent the spread of HIV infection through the constant re-use of needles. I was grateful for the endorsement of that policy made by the noble Lord and all-but-namesake, Lord Rea. For example, over one-third of misusers attending needle exchange schemes had never previously received treatment for their drug problems. Schemes have proved particularly successful in bringing into treatment such clients who are not reached by other services. We all hope that greater contact between helping agencies and drug misusers, as well as the freer availability of clean
762
injecting equipment, will check the spread of HIV and other diseases such as hepatitis B among drug misusers and beyond.
A totally drug-free life-style remains the ultimate goal but our policies reflect our awareness that this may not be attainable in one step. Where that cannot be attained, at least in the short term, much good work can still be done to minimise the harm that misusers do to themselves and others. We have therefore adopted a hierarchy of goals with the aim of harm minimisation. Those who are not using drugs should be helped not to start; those who are misusing should be persuaded away from particularly unsafe practices such as injecting; and those who do inject should be encouraged to use clean equipment and never to share needles. Collectively these harm minimisation strategies are intended to lead where possible to cessation of drug taking or at least to safer, controlled use of drugs which can be tackled by the drug treatment and rehabilitation services. The Government welcome this approach.
The noble Baronesses, Lady Ewart-Biggs and Lady Masham, and the noble Lord, Lord Richard, asked what was being done for drug misusers in prison. Much work is being done to improve services for drug misusers in prison. With considerable help from outside experts, the prison service is building on guidelines which were first issued in 1987. One of the most important tasks is to create a climate in which drug-misusing prisoners will identify themselves and seek help. To bring that about, the prison service will continue to do all that it can to promote enlightened clinical intervention where appropriate and to step up the contributions which community-based agencies can make within prisons and after prisoners are released.
My noble friend Lord Rodney asked about the science curriculum. I was not entirely sure about the point that he made. I should like to look into it and then write to him.
The noble Baroness, Lady Ewart-Biggs, asked about cautioning. We welcome the cautioning of drug misusers wherever prosecution is not necessary. We have recently issued a new circular to the police in an attempt to bring about greater consistency in the use of cautioning. She also asked what steps are being taken to deter potential drug smugglers from becoming involved in that dangerous trade. I can confirm that we are planning a publicity campaign in some of the major transit countries so as to bring home the serious risk which drug couriers are running.
My noble friend Lord Mancroft asked about the study visit to Minnesota by officials from the Department of Health and whether it has taken place. I am afraid that I cannot give him an answer to that question, but I shall look into it and write to him.
The noble Earl, Lord Longford, asked about the pan-Thames funding initiative which involves all four regional health authorities covering the London area. That is a matter for the health authorities themselves to decide, but I shall ensure that the noble Earl's concerns are brought to their attention.

763
The noble Baroness, Lady Seear, ploughed a lone furrow—I believe that she knew she was doing so, although in the latter stages she received some support from the noble Lord, Lord Richard—in arguing for a re-examination of whether legalisation/decriminalisation of some drugs might be an answer to the problem. Her case was closely argued, and in the time available to me I cannot put forward a full case against it. I can say that calls for the legalisation or de-criminalisation of any illicit drug seem to us to be based upon a profound misreading of the realities of drug abuse. Even putting the suggestion in the most favourable light, no one can deny the possibility of a huge increase in consumption as a result. Even if we limited that step to cannabis, what would be the likely consequences? Increases in road and industrial accidents and lower achievements by our school children are obvious and frightening possibilities.
The Earl of Longford: My Lords, perhaps I may ask the Minister a question. Can we have a ruling once and for all as to whether legalisation and de-criminalisation mean the same?
Lord Reay: My Lords, legalisation is generally considered to mean the complete abolition of the criminal offence in question, whereas decriminalisation means the lesser step of allowing a crime to be dealt with administratively rather than through the courts, as with parking fines.
I shall revert to what I was saying in response to the noble Baroness's argument. How, I should like to ask, could any responsible government contemplate taking the risks I have mentioned? For that reason I cannot agree that we need a government-sponsored inquiry into the issue.
Lord Rea: My Lords, I thank the Minister for allowing me to intervene. Have the Government studied the situation in Holland and Denmark where there has been considerable liberalisation with regard to the availability of cannabis?
Lord Reay: My Lords, I do not have the details but the experience of other countries has been that one cannot successfully isolate cannabis from other drugs by legalising it.
The noble Lord, Lord Hunter of Newington, asked whether the Government consider that the prescription of tranquillisers commonly leads to addiction. Prescriptions of tranquillisers have fallen from their peak of 31 million in 1979 to 21 million in 1989. That suggests that doctors are much more aware of the dangers of the indiscriminate prescribing of drugs. He also asked whether rewards might be offered to those who turn in drug traffickers. I draw his attention to the scheme known as Drug Command which was launched last year and which does exactly that.
My noble friend Lord Campbell of Croy asked whether the Customs was aware of the opportunities for smuggling afforded by fishing fleets off our coasts. I know that his words will have been carefully noted by those who are responsible for safeguarding this country against drug traffickers. He also asked whether the Government were considering creating a criminal offence of failing to report suspicions that
764
funds deposited in banks were derived from drug trafficking. That proposal has been made by the European Commission and is now being considered by the Government.
My noble friend also asked about crack, as did the noble Lord, Lord Hunter of Newington. Crack is the name given to a highly addictive form of cocaine suitable for smoking. Although the number of crack seizures remains comparatively small, 258 seizures were reported in the first nine months of 1990 compared with 139 in the whole of 1989, 27 in 1988 and 12 in 1987. That portrays a worrying trend. Bearing in mind the severe problems caused by crack in the United States we are taking the threat seriously.
The noble Lord, Lord McNair, asked about the funding for SCODA and Alcohol Concern. Since 1987–88 the Government have provided £997,000 to SCODA and £2.2 million to Alcohol Concern. The noble Baroness, Lady Masham, asked about the number of sniffer dogs, a question to which she said she had been awaiting the answer for a long time. Customs and Excise now has 63 sniffer dogs which are trained by the RAF and can detect a wide variety of drugs. She also asked about co-operation with the Netherlands. Co-operation with law enforcement agencies in the Netherlands is important because a large volume of drugs reaches this country from Dutch ports. Our Customs and police have close working relationships with their Dutch counterparts, and those are supplemented with regular meetings between Ministers and officials.
It has sometimes been suggested that the cause of drug misuse lies in social deprivation; but the reality, as always, is more complex. There are studies which suggest that in the North of England and Scotland young unemployed males in the most disadvantaged areas are most at risk from drug misuse. Other studies indicate that the high status accorded to misusers in some communities is a more significant factor than unemployment. Be that as it may, we shall continue to apply our resources to combat drug misuse wherever they are most needed.
I hope that I have said enough to indicate that this country's strategy to combat drug misuse is a balanced one. We must enforce our laws against drug misuse vigorously, but we must recognise that action to reduce demand is just as important. We have grounds for guarded optimism. The crack epidemic which some commentators foresaw has not reached this country, or at least not reached it yet. One would be foolish not to remain fully on one's guard against that threat. Heroin use seems not to have escalated among the young as was feared a few years ago, and the profile of the addict population now seems to be ageing. Those are good signs upon which we can build. But we shall succeed in the long run only by resolutely applying the whole range of our policies. As so many speakers in the debate have reminded us, demand-reduction policies must be an essential part of our strategy.
Lord Rodney: My Lords, I think your Lordships will agree that we have had an interesting and

765
constructive debate. I thank all those who have taken part and particularly my noble friend the Minister for his reply. We have heard many different opinions and points of view, most of which I am happy to support although I take exception to one or two. However, this is not the moment to do so and perhaps at a later date I may have a discussion with the people concerned.
I suggest to Her Majesty's Government, having heard many different points of view, that it might be worthwhile considering a review of all the practices and policies that are at present in vogue. Some approaches to the problem have proved successful, as we heard today; others have not been so successful.
Over the years we have amassed considerable expertise and experience. Perhaps we should ask: where do we go from here? Which practices should we continue and which should we examine, modify or abandon? I urge my noble friend and the Government at some stage to undertake a review. We may then come to the conclusion that some courses should be abandoned and some continued.
This is not the time or place for me to try to review what has been said. That has been ably done by the Minister. I beg leave to withdraw my Motion for Papers.
Motion for Papers, by leave, withdrawn.

Road Traffic (Amendment) (Northern Ireland) Order 1991
7 p.m.
The Paymaster General (Lord Belstead)The Paymaster General (Lord Belstead) rose to move, That the draft order laid before the House on 18th December 1990 be approved.
The noble Lord said: My Lords, this order introduces amendments broadly in line with provisions already put into effect in Great Britain by amending the Road Traffic (Northern Ireland) Order 1981. The order deals mainly with two subjects: driver licensing and drinking and driving.
The order is in two main parts. Articles 3, 4 and 5 in Part II pave the way for a new unified driver licensing system in Northern Ireland. As your Lordships may be aware, drivers of motor cars, heavy goods vehicles and public service vehicles at present require separate licences for each class of vehicle. Ordinary car licences are issued by the Driver Licensing Central Office in Coleraine, while separate, so-called "vocational licences" to drive heavy goods vehicles and public service vehicles are issued through the Vehicle Inspection and Driving Test Headquarters in Belfast.
This means that there are effectively two driver licensing systems in operation in Northern Ireland, each with its own legislation and rules. Drivers seeking licences to drive heavy goods vehicles or public service vehicles must pass a special test and meet tougher medical standards than for ordinary licences. Those additional requirements will continue under the proposed arrangements.
At present, one professional driver could have two or even three separate licences authorising him to
766
drive an ordinary car, a heavy goods vehicle and a public service vehicle. This multiplicity of licences can be confusing, particularly when lorry or coach drivers take their vehicles abroad. By contrast, most of the other European Community member states have a single licence showing all the driving entitlements. It is updated as any changes in the licence occur.
The new system which will be introduced by the order will include a single licence document showing all driver licensing entitlement. From 1st April, all driving licences will be issued centrally from Coleraine when they become due for renewal. These arrangements should offer considerable scope for making the system more cost-effective This should be good news for drivers since the costs of issuing vocational licences are reflected in the fees charged. In addition, drivers who go abroad will have the benefit of an internationally recognised single licence. This will be of particular benefit to lorry and coach drivers who will no longer have to explain in other countries the significance of their supplementary PSV and HGV licences.
The move towards a unified driver licensing system is not only desirable in itself but it is necessary to enable not only Northern Ireland but the United Kingdom as a whole to meet their commitments under the law of the European Community. The first step was taken in 1980 with the publication of the first directive on driver licensing, which required all driving licences to follow an EC model—namely, a single document showing all driving entitlement. A second directive is expected shortly from the Commission to put the finishing touches to the process. Negotiations are continuing on the second directive, but the provisions of this order will facilitate any changes that may be required.
Part II of the order also introduces compulsory training for all new riders of motorcycles and mopeds. These vehicles make up a small percentage of road traffic, yet quite a large percentage of all road deaths and serious injuries are to motorcyclists, many of whom are still in their teens, and they are therefore one of the most vulnerable groups of road users.
At the moment there is no requirement at all for motorcyclists in Northern Ireland to take any training. Learners can ride for the 10-year duration of their provisional licence without any requirement for them to pass a driving test. In practice, that means that many riders never take the test; they simply give up riding after a period of time or after they have a serious accident. So Article 7 in Part II prevents a provisional licence taking effect unless the holder has successfully completed the prescribed training course or is undertaking training on the road.
Article 8 of Part III of the order deals with drinking and driving. It introduces new provisions for driving or being in charge of a motor vehicle when under the influence of drink or drugs. With three exceptions, these provisions are similar to the existing arrangements in Great Britain. This will be the first major change in over 20 years to Northern Ireland's drinking

767
and driving provisions and will scrap the present two offences or "major and minor" offences as provided in the 1981 order for Northern Ireland.
The present disqualification of not less than three months for the minor offence will be scrapped. This will be replaced by one single offence of driving or being in charge of a motor vehicle with an alcohol concentration above the prescribed limit of 80 milligrams of alcohol in 100 millilitres of blood or 35 micrograms of alcohol in a 100 millilitres of breath. A hand-held screening device is being introduced in order to indicate whether motorists are over the prescribed limit. The equipment will be used in conjunction with the evidential breath testing equipment and will greatly enhance the Royal Ulster Constabulary's operational effectiveness in the detection of motorists for the offence of being drunk in charge of motor vehicles.
The three exceptions to which I referred earlier are that in contrast to Great Britain, where evidential breath tests may be conducted only at a police station, this order will provide for evidential breath tests to be carried out at the roadside or at a police station. Different penalties are being introduced and the so-called "hip-flask" defence will not be included.
The RUC traffic division is equipped at present with mobile evidential breath testing machines and has asked that the facility to conduct the roadside testing should be continued. The RUC has used this facility for the past 20 years and I can see no valid reason for denying its use now. That is the first of the differences between Northern Ireland and Great Britain.
Secondly, in Northern Ireland new penalties for those found guilty of driving while under the influence of drink or drugs will be introduced by this order. Disqualification for holding or obtaining a licence or a provisional licence will be for a minimum period of 12 months. A person so disqualified will at some time after the expiry of the period for which he is disqualified have to pass a test of competence to drive. As all newly qualified drivers in Northern Ireland have to comply with the same conditions, he will then be subject to the "R" plate provisions in Northern Ireland and will have to display an "R" plate for 12 months and not exceed 45 miles per hour. Disqualification and endorsement are obligatory in such cases. Therefore everyone convicted of driving when under the influence of drink or drugs will have to pass the test of competence to drive and will have to display "R" plates for 12 months. That shows that the penalties will be more stringent in Northern Ireland than in Great Britain.
Thirdly, the proposal for a draft order had included the "hip flask" defence. This is similar to the provisions of Section 15 of the Road Traffic Offenders Act 1988 and permits a drinking and driving suspect to explain away part at least of the alcohol content of his specimen by claiming it was due to drinking after he had ceased to drive. The consultation exercise in Northern Ireland raised strong opposition to the inclusion of this defence and it has been removed from the draft order. These proposals on drinking and driving have received widespread support during the
768
consultation exercise in Northern Ireland. Drinking and driving is a major cause of Northern Ireland's road casualties and the department is determined to effect measures which will help reduce those casualties.
Article 9 of the order gives effect to the provisions of Schedules 4 and 5 which respectively set out minor and consequential amendments and repeals. I beg to move.
Moved, That the draft order laid before the House on 18th December 1990 be approved.—(Lord Belstead.)
Lord Prys-Davies: My Lords, I thank the noble Lord, Lord Belstead, for the way he has guided us through the articles of this order. We on these Benches consider the order to be non-contentious. The noble Lord has explained that the thrust of the order is to bring the law in Northern Ireland more into line with the corresponding provisions that apply in England and Wales and with the requirements of the European Commission directives, both current and prospective. I am particularly grateful that the Minister has fully explained the law relating to drinking and driving in Northern Ireland and why it still differs from the corresponding provisions in Great Britain. I am sure that the explanation which he has given will be helpful.
I do not propose to detain the House for more than one or two minutes. However, I have two straightforward points I wish to put to the Minister, mainly for confirmation. First, as regards Part II of the order and the extent to which it will require more drivers to take tests of competency to drive large goods vehicles, passenger carrying vehicles and motor cycles, will the Minister confirm that the department is satisfied that it has adequate testing facilities and staff to meet any such demand?
Secondly, Article 6 in Part II deals with the licensing of taxi drivers. An applicant for a taxi driver's licence has to satisfy the department that he is a fit and proper person to hold such a licence. An aggrieved applicant can appeal to the magistrates' court against the department's decision. I now appreciate—that was not the case when I first read the document—that the term "fit and proper person" is often used in this kind of legislation. However, unless I have missed the relevant paragraph, the order does not itself specify a time limit within which the aggrieved person must lodge his appeal. I am sure there must a time limit and perhaps the Minister can tell us what it is. I shall not detain the House any longer. I look forward to hearing the Minister's comments on those two small points.
Lord Holme of Cheltenham: My Lords, we on these Benches do not feel the need to detain the House too long on this matter. I wish to thank the Minister for his extremely clear and cogent presentation of the contents of the order. We particularly welcome it as it brings us into line with the EC and with legislation in England and Wales.
I wish to support the order in the sense that it deals in a clear and firm way with the serious problem of drinking and driving. However, I too have one concern which relates to the concern expressed by the noble Lord, Lord Prys-Davies. I seek a reassurance from the Minister that the changeover will be as

769
smooth as possible, not only in respect of the testing but also as regards the processing of licences. We know that changeovers of this magnitude involving computers —we experienced this many years ago at Swansea—can be disruptive and can cause great personal inconvenience to drivers. I hope the Minister can give me an assurance that the computer system and the back-up facilities at Coleraine are adequate so that they will not impose undue inconvenience on drivers in Northern Ireland. With that one reservation or query, I confirm that we support the passage of this order.
Lord Belstead: My Lords, I am grateful to both noble Lords for their reception of the order. I shall endeavour to answer the questions that the noble Lord, Lord Prys-Davies, asked me. The noble Lord, Lord Holme, also added his voice to the matter of testing. We consider that we have made adequate facilities available in anticipation of an increased demand for tests. That matter has been considered and we believe it has been dealt with adequately.
The noble Lord, Lord Prys-Davies, was good enough to give me notice some days ago of the fact that he wished to raise the matter of taxi drivers. They are mentioned in Article 6. I do not need to go into that article in any depth as it does not change the law. However, I have two comments to make in that regard. I make the first comment possibly for my own benefit as I believe that the noble Lord has satisfied himself on the point. When the term "fit and proper" is used in connection with taxi drivers, it means that they are subject to the same conditions that apply to any other drivers of public service vehicles in respect of being required to declare all driving and non-driving convictions. It is on that requirement that the use of the term "fit and proper" relies.
However, the noble Lord further asked me whether there was a time limit for appeals on the part of taxi drivers who feel aggrieved at the refusal of a licence. The answer is that there is no time limit on the period during which such drivers may submit an appeal.
Secondly, the noble Lord, Lord Holme, asked me an important question. Obviously there are persuasive arguments for placing all the driver licensing facilities in one place and introducing a composite licence. By doing that we shall be in line in Northern Ireland, as in the rest of the United Kingdom, with what is going on in the European Community. However, as the noble Lord obviously knows, Coleraine has a computer facility which we consider to be adequate. But it is important to emphasise that drivers of public service vehicles, heavy goods vehicles and ordinary vehicles will not be thrown into confusion by this measure. Their licences will be dealt with at Coleraine only when they become due for renewal. Therefore the new facility at Coleraine will be introduced on a phased basis. I hope that with those remarks the House will accept the Motion.
On Question, Motion agreed to.

Health and Personal Social Services (Northern Ireland) Order 1991
7.20 p.m.
Lord Belstead Lord Belstead rose to move, That the draft order laid before the House on 22nd January be approved.
The noble Lord said: My Lords, in broad terms the order does for Northern Ireland what the National Health Service and Community Care Act has achieved for the rest of the United Kingdom. As such it is the most significant item of legislation in this area since the Health and Personal Social Services Order of 1972.
The main purpose of the order is to build on the strengths of the existing system in Northern Ireland and to give the highly trained and dedicated people working within the services concerned greater freedom to use their skills to the benefit of patients and clients. It seeks to do that by introducing a new flexibility into the system and by delegating responsibility as much as possible to those directly involved in providing care.
At the heart of the order are the provisions which will allow the Department of Health in Northern Ireland to re-define the responsibility of health and social services boards. That power will be used to direct that the primary functions of the boards should include providing, directly or through contracts, services for their resident populations. That change is central to the Government's reforms and will allow the development of a system of contracting through which boards, by commissioning services, will secure those services from a range of providers. In future the primary responsibility of boards will be to identify and make arrangements through contracts to secure access to a comprehensive range of good quality, value-for-money services which will best meet the needs of their resident populations.
To facilitate that, the order makes provision for health and social services contracts. Those contracts will be analogous to the contracts in Great Britain. They will enable boards and other health and social services bodies to make agreements with each other for the provision of services to agreed standards in return for money. They will allow much greater flexibility in the provision of services and will remove one of the major problems of the present system. At present a hospital which improves efficiency and effectiveness and attracts more patients can find itself in financial difficulties because budgets have been set on an historic basis. In future money will follow patients and the successful hospital will be resourced according to the work it is doing.
The order also provides for the reconstitution of the health and social services boards. It will allow the department to appoint smaller, management-oriented boards comprising an equal number of executive and non-executive members and a non-executive chairman. At present boards are unwieldy bodies comprising up to 30 members or more. The new smaller boards, with no more than 12 members and a non-executive chairman, will have a membership which we believe will reflect the skill and experience required for the efficient and effective planning and

771
delivery of health and personal social services. In the case of the Eastern Board one of the non-executive members will be drawn from the Queen's University medical school. The boards will not include direct nominees or representative members. Thus the boards will be better placed to fulfil a strong executive role which will be to plan and obtain the optimum range of services for their local populations.
Undoubtedly, the new, smaller health and social services boards will need advice from the public and from users of the services. To that end the order requires the department to set up four health and social services councils, one relating to each board. They will replace the existing structure of 16 district committees.
Plans for health and social services councils have attracted the most attention during the consultation period. After careful consideration of the comments we have received the order provides that each board, in its role as a commissioner of services, must have a single, coherent source of strong public and consumer advice. It will be the duty of the four individual councils to ensure that they retain strong ties with users and the public. They will be able to do so through publicising their activities and providing the necessary means of communication. They will also be able to set up committees, which could be either on a geographic or subject basis, and will be able to co-opt people to them.
The order does not include an advisory tier at regional level but the new health and social services councils will be able to co-operate with one another and will be free to form an association if they wish to do so. To put that beyond any doubt the order includes a specific provision enabling councils to collaborate freely with one another. The initiative for such collaboration must come from the councils themselves but the Government are committed to ensuring that they have the necessary resources to develop an association if they wish.
During consultation we have been reminded of the importance of ensuring that the new councils get into their stride as quickly as possible. Therefore, initially the department will appoint the chairman of each council. However, it is our firm intention that in future chairmen should be elected by the members, and that will not be prejudiced by the regulations.
The order will also allow the creation of health and social services trusts. Those bodies are a practical expression of our determination to delegate responsibility to those directly involved in the care of patients and clients. The hospitals or facilities which opt for self-governing status will remain firmly within the health and personal social services. The freedom they will be given will be a freedom to manage. It is for that reason that they will be outside the direct management and control of the boards. Their freedom will include an ability to create their own management structures, to determine the terms and conditions of staff, to borrow money within limits and to acquire, own and dispose of assets to ensure that the most effective use is made of them.
Despite that managerial freedom they will be required to continue to play their part within the health service. For example, they will be required to participate fully in medical and other education and research. There will be powers to ensure that they continue to provide services which must be available locally. The department will be able to step in if there is evidence that the freedoms are being abused. However, in practical terms the main control will not be departmental diktat but the fact that the success of self-governing hospitals will depend on their ability to meet the needs of health boards which will be the main purchasers of the services they provide. There will be no virtue in trusts concentrating exclusively on high cost, high turnover services as has been suggested. Instead, they will have every incentive to provide the wide range of services which boards require.
Trust status is voluntary, but hospitals and services which aspire to it will need to meet strict criteria. They will need to be able to demonstrate that they have the management ability, the professional involvement and the financial capacity. Most importantly, they will have to demonstrate that genuine benefits and improved quality of service will flow from trust status.
The order will also enable certain large general medical practices to opt to have their own practice funds. That will allow them to buy services on behalf of their patients, including a defined range of services direct from hospitals. The scheme will be entirely voluntary and practices that have joined will be free to leave at any time.
The funds will be set at a level which will ensure that patients get the services they require. As an additional safeguard there will be an upper limit of £5,000 on the cost to a practice fund of hospital treatment for an individual patient in any one year. Fund-holding GPs should have no good reason, as some have suggested, for keeping certain patients off their lists.
Complementary to that provision, the order will also enable boards to give all general medical practices which are not fund-holding practices an indicative prescribing amount. The aim is to make GPs more aware of their prescribing practices and to eliminate wasteful prescribing. The scheme will be administered in such a way as to ensure that patients will always get the drugs they need. Furthermore, indicative amounts themselves will be adjusted where necessary to take account of patients with special needs for medication.
During consultation on the draft order considerable public attention was given to the proposed power to restrict the overall number of general medical practitioners in Northern Ireland, which will only bring Northern Ireland into line with the rest of the United Kingdom. I assure your Lordships that the power that we intend to take is a reserve power. If at some future date there were to be a disproportionate growth in the number of doctors entering general practice the department would be able to make regulations limiting the number of GPs entering the list. In the meantime, boards already exercise control over the distribution of GPs and that should be sufficient for the foreseeable future.
Finally, perhaps I may say a word about the community care services. The draft order contains only a small number of community care provisions designed to achieve the Government's policy objectives for developing and improving community care services. The reason for the order's comparative silence on this enormously important part of the whole subject is that since the reorganisation of local government in Northern Ireland in 1973 there has been a fully integrated structure for the delivery of both health services and personal social services by the four health and social services boards. There is therefore no need in this order to make new or special arrangements for co-operation, communication and joint planning between the health service and the social services.
There is also no need to make separate provision in the order to require boards to undertake certain duties, such as the assessment of care needs or the establishment of complaints procedures. Unlike local authorities in Great Britain, the four boards in Northern Ireland are already agents of the DHSS, and the department already has wide powers of delegation and direction in regard to them.
When implemented, the new provisions will significantly enhance the role of the boards in the development and funding of community care services. Their role will change from being primarily the direct providers of some community care services to being orchestrators of all such care services. They will also become the holders of the community care budget. In effect, a framework will be created within which boards will assume direct responsibility for assessing the total health and social care needs of individuals and for strengthening co-operation between themselves and other public, voluntary and private organisations involved in the provision of community care services.
I believe the draft order ensures that the health service in Northern Ireland will remain a comprehensive service funded primarily from general taxation and that that will continue to be the guiding principle of the health and personal social services in Northern Ireland in future. I commend the order to your Lordships' House.
Moved, That the draft order laid before the House on 22nd January be approved. [Lord Belstead.]
7.30 p.m.
Lord Prys-Davies: My Lords, I must thank the noble Lord, Lord Belstead, for his clear and comprehensive explanation of this complex and extremely important order which reforms the NHS in Northern Ireland broadly along the lines of the NHS on the mainland. The order consists of 35 articles and six schedules which will provide the framework for the new services. In addition, according to my count, at least 20 important matters within that framework will be governed by regulations subject to negative resolutions. Of course we have not seen the details of those regulations.
774
Moreover, the order gives wide order-making powers to the department. There are about 200 pages of notes on articles. Clearly, this is a very large subject. There can be few Northern Ireland orders coming before your Lordships' House that are more important than this one, and I am sure that that would be the evidence of my noble friend Lord Fitt and my friends on the Liberal Benches. It will affect everyone in Northern Ireland because everyone is a patient or potential patient. We say that to introduce this legislation, of all legislation, by an Order in Council instead of a Bill is totally inadequate. The procedure does not give the House the opportunity to give the legislation the detailed and careful consideration over two or three days which it warrants. No improvements can be made because amendments cannot be tabled. Our task is indeed a frustrating one. All we can do is attempt briefly to highlight what we see as the principal changes which are a cause of concern.
I am very grateful that the noble Lord, Lord Belstead, on two occasions in the course of his speech admitted that there had been concern on certain matters. We can ask for certain matters to be clarified. Surely in a democratic society there must be a better way of dealing with Northern Ireland legislation. It seems to me that the political parties in Northern Ireland should not remain silent on this issue for much longer.
Regrettably, there is another preliminary point which it is my duty to make. We were not told until last Thursday afternoon that this order would be discussed tonight. Although the department was able to give us at least 14 days' notice of the Road Traffic (Amendment) (Northern Ireland) Order 1991 which we discussed earlier this evening, seven days' notice for an order of this magnitude is far too short for the debate. I know that the notice came too late for some noble Lords to rearrange their timetable, and that explains their absence from the House tonight. I do not blame the Minister at all. We have always had an excellent relationship with Northern Ireland Ministers. But I believe that this failure to give adequate notice of the debate perhaps draws attention to difficulties within the department itself which may deserve urgent examination. I do not have the evidence to go any further than that. Perhaps I may thank the noble Lord, Lord Belstead, for making available to the Opposition parties the extremely helpful 200 pages of notes on articles when he became aware of our difficulties last Thursday afternoon. Tonight the Minister spelt out the main objectives of this order: to introduce flexibility into the service, to delegate responsibility, to improve services to patients, to promote better value for money and to improve the management of health services. Who can disagree with those objectives? I believe they are and should be the objectives of every hospital, surgery and clinic in Northern Ireland.
The NHS is a big business and, like any other big commercial undertaking, should manage its resources with the greatest possible effectiveness. I accept that there are many competent and imaginative managers in the NHS in Northern Ireland, but it could be

775
argued that to some extent in the present system the quality of management of the NHS in Northern Ireland is more at fault than the administrative structure itself. Yet the new structure, as the consultative documents and notes on articles make clear, will require even more sophisticated managers than the present one. Is the department satisfied that by 1st April it will have in post the senior staff and middle managers fitted for these difficult tasks? It would be helpful if the Minister could tell the House what will be the cost of introducing this new structure in the Province and indeed how much has been spent already on preparing the way for the changes.
I referred to the similarity between the NHS and large commercial undertakings. On the other hand, unlike other large-scale undertakings, the distinguishing characteristic of the National Health Service is that the work done in clinics, wards, hospitals and surgeries is person work. It is people and not chattels or goods that are being treated. It is the patient or, in the ca se of a severely disabled or child patient, his representative who decides when and to whom he presents himself for treatment and how much treatment, if any, to accept. It is the patient who knows best how well the system is working or is not working at the point of delivery. So in a sense the patient himself is a potential manager. Yet the role of the patient is almost overlooked in the structure that is assembled by this order, so that, notwithstanding the rhetoric, the problem of making the service accountable to patients will remain.
I noticed that under Article 5 there will be representative committees of the GPs of the area, the opticians of the area, the dentists of the area and the pharmacists of the area. But having rightly recognised the role of certain professions, why is the role of patients not recognised in a similar fashion in Article 5? The Minister will recognise that I am now developing a point which has powerfully and vigorously been made to the department by the Association of District Councils, but it may have been too imaginative for the authors of the consultative papers to grasp its significance.
I accept that the personnel who are active patients vary all the time. I appreciate that patients as such are not organised. But within the body of patients and potential patients there are many health voluntary organisations as well as charitable organisations which could form an electorate.
Although I very much regret that the opportunity to set up a representative committee of patients under Article 5 has been lost, it may still be possible for the board itself to establish a sub-committee representative o r patients under paragraph 5 of Article 3 (or perhaps it is Schedule 3). I should be grateful if the department would consider that possibility. Indeed, in introducing the order the Minister spoke of the power that is vested in the boards to appoint sub-committees. I urge them to appoint sub-committees which will be representative of patients.
There has been a long tradition of lay involvement in the running of hospitals which pre-dates the creation of the NHS. It is clear that the role of the
776
layman will be substantially reduced in the new structure and that has given rise to widespread concern, if not anger. I believe that the Minister has acknowledged that concern. To a large extent the order rests upon the notion that the voice of lay opinion has been too strong within the NHS. I have no evidence that the development of the NHS has been retarded because of the presence of strong lay opinion. Indeed, without strong lay opinion would many of the existing hospitals of Northern Ireland ever have been built?
Lay opinion has been substantially undermined by this order in two ways. First, as the Minister explained, the new area boards will be smaller bodies consisting of executive members, including the chief officer of the board, and certain non-executive members. There is no requirement that at least one member shall be a district councillor and another a trade unionist. Indeed, there is no requirement, apart possibly from the north eastern board, that one member shall be associated with the universities. I quote the words current in departmental circles:
"The new boards will no longer have representatives of bodies which have traditionally been hostile to government policy".
If the department has experienced hostility from district councillors and trade unionists, surely the safe inference that the Government should draw from that has to do with the failure of the Government to design policies which retain the confidence of elected members and trade unionists. The evidence should certainly not be used to silence their voice or to silence honest criticism at board level.
Again, lay opinion will also be substantially weakened when the present 16 district advisory committees are abolished and replaced on 1st April with four area advisory councils, with one council for each board and each council consisting of about 24 members appointed by the department. So overnight the number of lay persons involved in the advisory health machinery in Northern Ireland will be reduced from about 300 to about 100. We think that that is disturbing.
We hear a great deal from health Ministers about the need to devolve power and decentralise units of administration at the unit level. As the district is the lowest level at which it would be possible to make a comprehensive assessment of the health needs of the community and to plan and deploy the range of health services required to meet those needs, why does the district in Northern Ireland not continue as a point of accountability to the people of the district? We suggest that responsibility to the people who live in the district seems essential if officials are to be aware of the beliefs, feelings and experience of people concerning the way they are being treated in surgeries, in clinics and hospitals.
In our view it is also to be regretted that the opportunity has not been taken to establish in Northern Ireland a health advisory council. I am grateful to the Minister for having explained the potential in this order for the area councils to collaborate together to that end. But there has been

777
and is a demand for a Northern Ireland health advisory council. I am sure that the Minister will know that that demand has been voiced by the Northern Ireland Consumer Council and the Association of District Councils in Northern Ireland. But in so far as there is to be a regional voice, it is left, as the Minister explained, to the four area councils to collaborate together under paragraph 2(f) of Schedule 1. That is at best second best, and some would say that it is a poor second best.
We take that view because the area councils will be concerned mainly with the ongoing day-to-day operations and the planning of the service for their areas. Surely, what is required at the Northern Ireland level is an advisory body, supported by a research and intelligence unit, to monitor the service, undertake or commission research and advise the Secretary of State about priorities and future changes. Although that is missing from the order, I hope that the department will encourage the area councils to collaborate and co-operate to provide a regional advisory service, even though it will be a second best service.
Before leaving the subject of the area health councils I wish to ask the Minister questions about two of their functions. I note that members of the area council will have the right to enter and inspect NHS premises. But that right is subject to such conditions as may be prescribed. Can the Minister say whether it is intended that the council members should not have the right to make unannounced visits? I should be concerned if they were prohibited from carrying out an unannounced visit. However, if council members are to see what surely goes on at the point of delivery in hospitals, clinics and surgeries, it is important that their visits should be unannounced.
There is a second point on which I should be grateful for clarification. In a speech made on 23rd January the Health Minister said that a health council will be able to act on behalf of patients and clients in connection with complaints. I have searched for the statutory basis of that statement. It seems to me that I have searched in vain. I have been unable to find a specific reference to the council's right to assist complainants to lodge a complaint. Is there a specific reference or a specific statutory authority? If so, where is that authority? It would also be helpful if the Minister could clarify the significance of his colleague's reference to "clients". What is the distinction between a patient and a client?
Time does not permit me to deal at length with NHS trusts for self-governing hospitals. However, I must record the deep concern felt by Members on this side of the House about that development. We are worried that NHS trusts could lead to a two-tier service, and not merely a two-tier service but one being inferior to the other. If that were to happen it would undermine one of the fundamental principles of the NHS. We on this side of the House trust that the proposal will not be implemented until there has been an opportunity to evaluate experience on the mainland and until appropriate safeguards are introduced.
778
The major risk that we see with a fundholding practice is that over time it could damage the doctor-patient relationship of trust. It was the late Lord Cohen, the eminent medical Peer, who spoke of the doctor-patient relationship of trust. It is essential to the overall relationship. If the patient came to believe that in prescribing treatment his doctor was influenced by what his budget could afford rather than what was best for the patient that trust would be undermined. On the other hand, I am not so worried about indicative budgets for drugs provided that they remain as guidelines to help the GP to monitor and examine his prescribing practice, as was indicated by the Minister.
I wish to raise one issue about voluntary contributions. I welcome the new powers contained in Article 23. However, as I understand the article, a condition imposed by a donor and attached to a gift can be overridden or overreached by the department. If that is a correct interpretation of one of the paragraphs of Article 23, is it wise that the department should exercise that power unless it is clear that in the circumstances the condition has become unreal? Usually donors intend that an attached condition to a gift shall exist in perpetuity. However, if a department were too easily to override a condition, that could discourage people from making substantial conditional donations in future.
I have been keeping my eye on the clock but I do not believe that I alone have spoken for 36 minutes. Although we can approve the main objectives spelt out by the Minister, for the reasons that I have given we cannot approve many of the major proposals introduced by the order. The service exists for patients and I must hope that it will bring benefits to the people of Northern Ireland.
8 p.m.
Lord Holme of Cheltenham: My Lords, I wish to associate Members on these Benches with the expression of gratitude to the Minister for his clear introduction of the order. However, I too must express regret at the extremely short notice given to the House on this important matter. The Minister could not have been more courteous in his personal expressions of regret and he has done everything possible to compensate but, in my view, the House should not be treated in this cursory manner on such an important matter.
This is a very dense order with profound implications for the health of the community in Northern Ireland. It is based on an Act to which we on these Benches were opposed. Therefore, the Minister will not be surprised to hear that we do not like the proposals in the order any more than we liked many of the proposals in the parent Act. Nor, it should be said, are we alone in our reaction. As a result of this measure the Government can claim the extraordinary achievement of uniting all parties in Northern Ireland against them. The consensus that this is not the right way for the health service to go in Northern Ireland is extraordinarily broad-based and impressive. We in

779
this House must give voice to that and, even now, ask the Government to think hard about the way in which they handle implementation of the order.
There are many proposals, some of which are radical. One can understand why the Government have proposed them; they fit in with their general approach. However, where the Government are producing radical new initiatives I urge them to experiment with pilot and test schemes. They should not rush wholesale into their general imposition, for ideological reasons, of every single line in the order. I should like to concentrate on Articles 3 and 4 to which the noble Lord, Lord Prys-Davis, gave specific attention. I question the composition of the boards and councils and their connection with the local communities of Northern Ireland. The boards are now to be overwhelmingly managerial in composition. They will no longer have that broad-based representation of trade unions, local authorities, and interested groups, with government appointees.
As regards the councils which shadow the boards and replace the district committees, the connection which the district committees had with the local communities will disappear both because the councils are much larger bodies covering much larger areas and because they will not have that representation of local people and patients. For example, will representatives on those new health and social security councils have the time to visit local facilities, to take up individual cases and have that close and intimate connection with the services offered which is so important to good health care? I am extremely sceptical. One effect of the order which must be feared is that it will end up cutting off services from close connection to the local community.
Your Lordships will recall that in the original White Paper one of the criticisms of the district committees was that they had a localised focus. That is one of the advantages of the present system; it has a strong localised focus. If we lose that in the provision of health care, we lose a great deal.
On the whole, our anxiety is that the composition of the new bodies will mean too little representation of consumers, communities and carers and too much representation of bureaucrats and businessmen. I am not opposed—nor are other noble Lords on these Benches—to good managerial experience on the bodies. That will be an asset. However, it should be recognised that management does not stop short at techniques of management, but embraces fully understanding the people who work in the service, the people who are the patients of the service and, most notably, the wishes of the local communities. I fear that we shall lose accountability through the implementation of these proposals.
Considerable responsibilities are to be exercised by the new boards and their shadow councils. They have very considerable powers. In our opinion, it would be much better if those powers were more directly accountable to the local community. I am sure all sides of the House want every effort to go into fostering those elements in Northern Ireland which represent a civic society and encouraging institutions where people come together and work together locally for
780
matters of local importance. Therefore, we must regret the replacement of the present work able system of district committees by a managerial imperative and larger, more distant bodies.
Finally, I hope that we shall recognise that the Government have a duty when implementing the order to ensure that they do not throw out the baby of human contact and care with the bath water of inefficiency.
Lord Fitt: My Lords, I welcome the noble Lord, Lord Belstead, in his new role as spokesman for Northern Ireland. I remember him when he first came to Northern Ireland after the imposition of direct rule in 1972. As he has rightly said, we are discussing the major reform of a state of affairs which has existed since 1972. The reform brings with it a great deal of anxiety as to how health and social services are to be operated throughout the 1990s.
Northern Ireland is a small geographical area. Elected representatives have a very close relationship with their electorate. When I was an elected representative I recall that 60 or 70 per cent. of my constituency surgery activities were related to health and social services and every aspect of them in relation to sickness, social security benefits and so on. I can tell the Minister that there is a great deal of anxiety as to what the proposed changes may mean in relation to community involvement which has existed hitherto in Northern Ireland.
When I was a Member of the Stormont Parliament, we discussed contentious issues dating back to the formation of the state and, indeed, before that. However, if there was one issue on which we could find substantial agreement across the broad political divide—and there were serious disagreements on many other matters—it was in relation to health and social services. On those matters we could overcome our political differences.
As my noble friend on the Front Bench said, were any other political system in operation, a major piece of legislation would be called for. We should be having a First Reading, a Second Reading, Committee and Report stages. However, because of the vacuum which now exists in Northern Ireland, the only way in which this matter can be dealt is by an Order of Parliament.
I do not blame the Government for that because a good deal of responsibility for the present impasse must rest on the shoulders of elected representatives of the various political parties in Northern Ireland. It must be said, even though I am in total agreement with them in opposition to the order, that if a form of local administration could be agreed upon, then responsibility for this type of legislation would be taken away from this House and given to those elected representatives.
What is the answer? Is political opposition within Northern Ireland so deep that the parties are prepared to continue with a system which allows for an order such as this? Or are the parties prepared to find a political accommodation which would make the order totally unnecessary?
The noble Lord, Lord Belstead, will be aware of the political atmosphere in 1972 following the abolition of Stormont. As regards the present situation, there

781
seems to be no great political advance. Stormont has gone. There was an Executive in 1974 for a few months. Since then no possible opportunity of agreement to bring about devolved government has appeared on the horizon.
The elected representatives are finding unanimous support among political parties in their total opposition to the way in which this legislation is brought about. Therefore, would it not be possible to form a committee in the other House, whether or not it be a Northern Ireland committee? At least that would allow more time to discuss and amend, if necessary, legislation such as this before it becomes law in Northern Ireland.
That suggestion, I realise, is loaded with dynamite. One of the main political parties in Northern Ireland—the SDLP —would regard the setting up of such a committee as being a step along the road to integration. In that situation, that party would have its friends. The representatives from the Irish Government on the Anglo-Irish intergovernmental council object to such a step being taken. They do not want a committee set up at Westminster to discuss this type of legislation. Therefore, as has rightly been said, a good deal of unanimity has been found in opposition. However, the means of doing away with orders such as this lies with the Northern Ireland elected representatives. I do not believe that the Government can be blamed for persisting with this type of legislation in the absence of agreement in Northern Ireland.
When the Government bring forward an order such as this there is justification for so doing in the absence of agreement in Northern Ireland. But they say, "We have consulted all the interested bodies. We have discussed the implementation of the order, and after listening to all the representations we now introduce the order". However, the Government have not done that. They have not consulted with any of the interested parties. Interested bodies such as the local community group, trade unionists—some people may ask what trade unionists have to do with health and social services; they have a lot to do with them because all their members at one time or other will be in receipt of them—Churches and all other interested groups have made representations. But they have not been listened to.
The Government cannot have it both ways. They cannot say that they have listened to representations from interested parties and have produced legislation which was agreed when they have introduced legislation in the face of total opposition from elected representatives right across the political spectrum in Northern Ireland. They cannot have listened to the elected voice of the communities under which the legislation will be imposed.
I wish to highlight that point. The noble Lord, Lord Skelmersdale, was the spokesman for health and social services in Northern Ireland last year. Many representations were made to me regarding a hospital in a constituency that I did not represent: the Moyle Hospital in County Antrim. At the time a proposal existed—and still exists—to remove the acute services
782
from the hospital in County Antrim and transfer them to another hospital to be built in two stages in Antrim, in an area in an entirely different part of the county. The first stage would be completed in 1994 and then the second stage would be built.
When the proposal first became known to the people in East Antrim all the community groups referred to by my noble friend voiced their opposition. They included Catholic and Protestant Churches, Catholic and Protestant churchmen, Catholic and Protestant schools, social community groups, industrialists and trade union groups in the area. The hospital had existed for many years, and from 1984 to 1988 there had been an increased number of acute operations which had taken place there. The figures produced by the hospital were justified.
Those groups made representations but realised that they were not being heard. I asked the Minister in this House whether he would be prepared to meet a deputation representative of those groups to hear the case why the hospital should continue to provide acute services. The Minister said that a sub-committee of the Northern Ireland board had been set up to hear objections. The personnel of that sub-committee consisted of four members, each with an interest in ensuring that Moyle did not retain those acute services; in ensuring, in fact, that the acute services were transferred to the new hospital.
I do not regard that as listening to the anxieties of the people in the area. All the people in the area were so concerned that they obtained a grant from the council. In a roundabout way the money came from the ratepayers. Under a regulation which exists, where there is anxiety in regard to any given subject, a proportion of the rates can be given to the local authority to carry out their own inquiry. A proportion of the rates was given and money was obtained from voluntary sources. A total amount of £40,000 was obtained.
So concerned were those people that they commissioned a report from an eminent company in Britain, Touche Ross, which has vast experience in the administration of hospital care on the mainland. They paid £40,000 to carry out an inch by inch investigation into the anxieties of the people in East Antrim. After making all the necessary inquiries with all the experience at its disposal and all its administration experience, Touche Ross came to the conclusion that the people of East Antrim were right to voice their concerns; there was no justification to take away the acute services from Moyle Hospital and transfer them to what the people of East Antrim regarded as a totally inaccessible place in Antrim.
My noble friend on the Front Bench said that it is patient care which must be paramount in legislation of this type and that some means should be found to organise patients. How much better organised could those people have been? They included every community group in the East Antrim area—the Churches, the schools and the trade unionists. After failing to make successful representation themselves they commissioned an eminent organisation to

783
produce a report, and the report fully supported the anxieties expressed. The ministry did not even look at it. It did not even ask to see the report.
That was totally different from the attitude that was taken in relation to another acute appraisal taking place in another part of Northern Ireland in Coleraine. An organisation was set up to investigate the commissioning of a new hospital in Coleraine at the cost of £100,000. It involved far more personnel, and 14 people from the local area were involved also. That was very different from the consideration given to the Moyle Action Group's report, where four people with a direct vested interest in promoting the transfer of the services were the people who made the decision not to listen to the Moyle Action Group.
I make an appeal to the Minister, and I do not think I ask a great deal. In his new resurrected role as Minister for Northern Ireland would he be doing any harm if he were to meet a delegation from the East Antrim area and discuss with them the recommendations made in their Moyle Action Group report in association with the report commissioned from Touche Ross? It will not cause any delay in implementing the present proposals. It may mean that after listening to the concerns of people who will operate the health and social services in that hospital and in that area there will be no necessity for stage two of the. Antrim development.
Health and social services are personal to the people of Northern Ireland; it is something about which there is very little, if any, political disagreement. The fact is that all the representatives in another place, and Members here, have voiced their opposition to the way in which this legislation has been brought before us. It is totally wrong that an order of this description should be brought before us on a take-it-or-leave-it basis and that it cannot be amended. Its contents are of vital importance to the people of Northern Ireland concerning their health and many other aspects.
I have illustrated the case of the Moyle hospital to show how its representations have been totally disregarded. Its representatives were not given the opportunity of putting their case to the Minister. They prepared the Moyle Hospital Action Committee report. Representations were made by all the community groups, but they were totally cast aside. That is a very bad way to plan for the future of health and social services in Northern Ireland. Many representations have been made to the noble Lord on all aspects of this order. Before making a final decision on the dispersal of the acute services from that hospital it would be in the Minister's interests, besides those of democracy and democratic accountability in Northern Ireland, if he were to meet representatives of the Moyle Hospital Action Committee to see whether at this late stage some other decision can be made.
Lord Belstead: My Lords, although considerable criticism has come during the remarks of noble Lords who have spoken on this order, nonetheless I wish to thank your Lordships for the care which you have taken in speaking about an order which the noble Lords, Lord Prys-Davies, Lord Holme and Lord Fitt, have quite rightly said is extremely important. The fact is that we are the prisoners of the constitutional
784
position in which we find ourselves. Your Lordships would not thank me if I expanded one that except to say this evening that the noble Lord, Lord Fitt, mentioned one possible way in which an order of this kind might be dealt with in another place. However, in the same breath he said that he thought it probably would not be a way forward because it would be resented and disliked by one of the political parties.
I shall not say anything further about that. We have the order under the legislation of 1974 and we have to deal with it in that way. I unreservedly give an apology to the noble Lords, Lord Prys-Davies, Lord Holme and Lord Fitt, and to your Lordships' House that there was such short notice. Once again I thank noble Lords for the way in which they couched their criticisms on that matter.
Having said that, I shall endeavour to answer some of the points which have been put to me. The noble Lord, Lord Prys-Davies, asked me a direct question about the cost of implementing the reforms, particularly the changes in management structure. The cost will not be at the expense of patient and client care. We have already spent an additional £3.5 million in the past financial year on implementing the health reforms. We have allocated no less than £7 million this year so far. We hope that further resources will be available. Unit general managers have been in post since 1st April 1990.
I now move on to the point made by the noble Lord when he asked whether people of the right quality will be there. Unit general managers have been in post since 1st April of last year bringing the health and personal social services in Northern Ireland into line with the health service in Great Britain. That will provide effective management of resources at unit level. It has cost £250,000 in a full year. Four boards only have already recruited about 200 additional staff this year in key areas such as finance, personnel, needs assessment, medical audit and contracting at a cost of £3.5 million. I hope that that goes some way towards meeting the points which the noble Lord made on that matter.
The structure of the reforms has come in for considerable criticism this evening from the noble Lords, Lord Prys-Davies and Lord Holme, when speaking about the boards and the health and social services councils. I say on behalf of the Government that it is a plus that we are going to have the appointment of executive members, including actual managers, on the boards for the very first time. It is right that they should at least be represented as executive members on the new boards given the background of what I have said about having tried to build up in a sensible and prudent way at considerable cost in order to achieve exactly the same objective as that which the noble Lord, Lord Prys-Davies, put to me across the House; namely, that the management needs to be first-class.
The noble Lord then moved on to talk about representatives of the general public and asked about the patients and the general public at large.
Lord Prys-Davies: My Lords, I spoke specifically about representation by the patients, or the users as they are described by the Association of County

785
Districts, and whether there could be a representative committee for them in the same way as there is for doctors, chemists, pharmacists and dentists. That is one issue. There is also the broader issue of the representation of the public generally.
Lord Belstead: My Lords, I shall do my best to answer that very simply. As the noble Lord himself recorded, there is the right to appoint sub-committees and the right to co-opt. I believe that this right will be used. I shall be extremely surprised if it is not. We shall also find on the social services councils the kind of representation which the noble Lord has spoken about. Both the noble Lord and the noble Lord, Lord Holme, were also critical of the fracturing, as they saw it, of the link with the local community by the removal as of right of district councillors from the boards.
I do not believe that community links are going to suffer as a result of these reforms. The area health and social services councils on which district councillors will have an important role will represent the interests of the local community. It is worth bearing in mind that in Northern Ireland health services are not organised on a district basis. Having said that, perhaps I may briefly give chapter and verse. For example, it is envisaged that the council for the eastern board will have about 30 members after April. The other three boards will have 24 members. Forty per cent. of the membership of each council must be reserved for district councillors. One member must be appointed on the nomination of each district council. I believe I am right in saying that that will be done by regulations.
This is a serious attempt to ensure that the district councils are well represented and fully representative, with no exceptions, on the new health and social services councils. The noble Lord finished that part of his remarks by asking about an association. I wish to repeat what I said when I moved the order. I said that the Government are committed to ensuring the necessary resources for the formation of an association of councils if that is what the councils feel that they want once the reforms have come into effect.
The noble Lord moved on to talk about the trusts. He made the familiar criticism that there is the danger of a two-tier service. Although trusts will be run by their own board of directors independent of other tiers of health service management and will have wide-ranging freedoms not available to units which remain under board control, they will be absolutely required to comply with certain departmental guidance on ethical, public health, patient health, patient safety and emergency and contingency planning issues. I cannot say it too frequently: they must continue to provide free care at the point of delivery.
The noble Lord also asked me a number of technical questions. He said that he could not find anywhere in the order the provision for the assistance by councils with complaints. This will be contained in regulations to be made under paragraph 2 of Schedule 1 to the order. The noble Lord also asked about the the difference between patients and clients.
786
Technically, "clients" cover those in receipt of social service functions; "patients" are those in general receipt of health care. The noble Lord also asked me whether health and social services councils should have the right to make unannounced visits. The noble Lord has a great deal of specialist experience of public matters and quite rightly said that an unannounced visit is probably worth 10 times as much as an announced one. I must just say that the councils are not inspectorial bodies. It is not appropriate that they should have powers to visit unannounced. There are, as I think the noble Lord will well realise, other ways in which inspection of high standards in the health service is undertaken, but it is not through unannounced visits of the health and social services councils.
In answering these questions about district councillors and about the representation of patients and of the public at large, I should have mentioned more frequently the name of the noble Lord, Lord Holme, as it was he who also directed most of his remarks to the way in which the new boards and indeed the councils will be structured. I hope that I have covered most of the points raised by the noble Lord. If I find I have not, I promise to write to him.
That leaves me with one last point. The noble Lord, Lord Fitt, spoke at some length about a matter of which the noble Lord knows at first hand. I refer to the future of the Moyle hospital and proposals for the dispersal from it of acute services. I am aware that there has been a considerable amount of feeling which has resulted in a campaign of opposition in the area to any plans to remove acute services from the Moyle hospital. The report of the Moyle Hospital Action Committee which is presently being considered by the northern board and the Department of Health and Social Services is the culmination of that campaign. The board has deferred making a decision about the pattern of services to be retained at the Moyle after 1993 and has given a commitment that for the time being it will seek to maintain the services at present provided there. Final proposals for future services will be subject to the approval of the department and the action committee will be afforded an opportunity to make any representations which it considers appropriate.
I give the noble Lord an undertaking that I shall draw to the attention of the department and the Minister who is responsible for the department the speech which he made this evening. What the noble Lord said was important and we should take it seriously. But this evening I can go no further than that. I commend the order to the House.
On Question, Motion agreed to.

Health and Personal Social Services (Northern Ireland Consequential Amendments) Order 1991
8.33 p.m.
Lord Belstead Lord Belstead rose to move, That the draft order laid before the House on 22nd January be approved. [8th Report from the Joint Committee].
The noble Lord said: My Lords, as a result of the changes proposed in the order to which your Lordships have just agreed, there are amendments of a purely consequential nature and concern. They are
788
not made, as I understand it, under the Northern Ireland Act 1974 and therefore technically speaking have to be the subject of another order. It is an entirely technical order which consists only of technical consequential amendments of changes to legislation as a result of the order which we have just agreed. I beg to move.
Moved, That the draft order laid before the House on 22nd January be approved. [8th Report from the Joint Committee]. —(Lord Belstead.)
On Question, Motion agreed to.
House adjourned at twenty-six minutes before nine o'clock.