§ Motion made, and Question proposed, That the sitting be now adjourned.—[Mr. Lammy.]
9.30 am§ John Mann (Bassetlaw)I should like to thank Mr. Speaker for timetabling this debate and agreeing to my request that it should last for one and a half hours. The number of hon. Members present indicates the interest in this matter, which, in recent weeks, has been raised a number of times on the Floor of the House in discussion and questions.
Hon. Members will know that I have made a fairly detailed analysis of heroin use in my constituency, but I do not propose to go through the 300-page background document, the 150 case studies or the 39 recommendations. All that is available and I believe that a copy has been sent to all hon. Members. Anyone who wants a copy is more than welcome to have one.
I want to take the opportunity to thank those who contributed to my public inquiry, for which I received a lot of local public support. Many hundreds of people contributed personally and many thousands contributed in writing. However, when dealing with one section of the community and professions—the health service—I sometimes wondered whether I was looking into dental services because obtaining information was like pulling teeth. That is why I called for this debate on treatment services for heroin addicts.
Until the Parliamentary Under-Secretary of State for Health, my hon. Friend the Member for Tottenham (Mr. Lammy) appeared at 9.25 am, I did not know which Minister would respond to this debate. I chose not to inquire because I did not want to skew my comments according to whether the response was coming from a Home Office Minister or a Health Minister. The provision of drug treatment services is a major issue and is a dilemma here and throughout Europe.
Yesterday I went to GOAN where I discussed CAD and the links between CDPs and DRGs under the auspices of DATS and, in Nottinghamshire, DAATS. GOAM is not responsible for the NTA so I did not discuss CDTs, but I could discuss DDTOs and the role of the LSP and the SRP of EMDA. SORTID and HETTIS may be interested, but Framework and Hope less so. Tomorrow, I shall be at the PCT. There are two PCTs involved and mine does not commission the DAAT. NCC chairs the DAAT but BDC chairs the DRG. GPs are covered by one strategic health authority and DAAT by another. Some GPs fall under a third PCT, but, thankfully, there is only one LEA and one police force, although that has two emergency numbers and two separate control rooms. Most people in those bodies want to discuss funding streams. I am a simple man and to me a stream is running water, although if it were left to the EA and NCB in my constituency, that 2WH might not be so. How on earth are we to tackle the problem of drug addiction with that plethora of semi-detached organisations?
In my area there are far more than I have listed. When we knew that my mother was terminally ill with cancer, we received a call and a visit from a Macmillan nurse, who dealt with the other organisations. I put it to the Minister that in drug treatment, someone fulfilling the equivalent of the Macmillan nurse's role would bring about a major breakthrough in handling the plethora of organisations involved. The fact that there is not someone like that in drug treatment has contributed to the frustration and anger that has built up in my community and others.
Let me set the scene. In my constituency most of the pits shut between the late 1980s and 1992. They provided the majority of jobs in many parts of the constituency. In some villages, every male was working, or had worked in the pits, usually from the age of 15 to 65. When the pits shut, there was nothing. There were attempts at regeneration and there still are. Some were successful and some were not. The certainty of life was removed. I accept that that certainty had some downsides in terms of aspiration. 'Pit fodder' is the term that was used in schools, and was still used when I entered the House 18 months ago and it showed how the kids in those villages were perceived by the educational establishment. However, they were certain of a job for life in the community, and it had become an increasingly well-paid job over its last 30 years. That was taken away and, as predicted in the House in 1992, there has been a rise in drug addiction, specifically heroin.
The comparison between the pit villages and the more affluent rural areas is quite stark. Less than 10 per cent. of the cases dealt with by the probation service in Retford, which is a predominately rural area, involve criminals addicted to heroin. In Worksop, that figure is 92 per cent, and accounts for two thirds of all reported crime. When I met the chief constable on Monday he agreed with me that drug addiction probably accounts for virtually all the unreported crime as well.
We do not have treatment services in my constituency; they are at a distance. The philosophy of the drugs treatment service is one of harm reduction. I will come back to that because I challenge the whole ethos of the National Treatment Agency, and the whole drugs treatment business. We know the results. I could give chapter and verse, and describe the individuals who inject into their eyeballs because they have no veins left that they can use. Women have given up their children for adoption because they cannot cope with heroin addiction. Large numbers of grandmothers are caring for children. I could go on and on. I could paint a more evocative picture of the real state of play because those examples are not isolated, but I will not do so because I do not have enough time. The vast majority of criminals in my constituency are addicts. Only a few clubbing drugs are used in my constituency; there is hardly any cocaine, or crack cocaine. The drug being used time and again, and in hundreds of cases, is heroin.
There are several things that I would like to be able to say to a Home Office Minister. I want to see drugs courts because many addicts are drugs criminals. Only one of the 150 people I met was not involved in crime. That one person had a partner who funded his addiction and had done for nine years. I want addicts to be given a choice: 3WH prison or treatment. That is what we recommended in our report. It is a false choice at the moment because treatment is not being provided.
Fortuitously, Professor Howard Parker of Manchester university has recently produced a new report—he has produced many over the years. I ask for your forbearance, Madam Deputy Speaker, and that of other hon. Members, while I explore the work of Professor Parker. There is a particularly poignant and important reason for doing so. His paper in Sociology magazine, which was released, I believe, on Sunday and which I accessed yesterday, is entitled "The Normalization of 'Sensible' Recreational Drug Use". According to the references, Professor Parker started writing articles on the normalisation of drug use in 1994 and he refers to Mr. Van Vliet of the Netherlands, who wrote of the concept of the normalisation of drug use in 1990.
In a wonderful throw-away phrase explaining why he did not get all the responses that he had anticipated from the young people he had studied, Professor Parker writes that of his cohort—his evidence base—"up to half" went away to university, which meant that he had some problems in getting them to respond to his survey. So by his own definition, up to half the young people he surveyed in the north-west went to university. That must play a part in the debate.
Professor Parker and others who write on the normalisation of sensible recreational drug use, talk time and time again of clubbing. Well, we do not have clubbing in my constituency. Virtually nobody goes clubbing because the clubs do not exist. It is 30 or 40 miles to the nearest one and the buses that go to the clubs in Doncaster and Nottingham are infrequent and increasingly rare.
Significant numbers of people in the mining villages and other parts of the community start by experimenting with cigarettes, alcohol and cannabis and then move on to experimenting with heroin, often realising too late that they are addicted. The vast majority move on to injecting eight times a day and their whole lifestyle is based around funding that addiction. The cycle cannot be broken without treatment. According to police estimates, if someone has a criminal income of £15,000, that translates to £70,000 or £80,000 worth of stolen goods. That is per person, per year. That means £20 million worth of stolen goods in my constituency alone. Yet treatment is still not being provided.
I want to move on to the reason why I referred to Professor Parker and made what I suppose was an attack on him. The people he studied were not the same as the people who live in my constituency, so perhaps attacking him is unfair in abstract. He studied students. However, his name was cited four times in evidence to my inquiry, so I had to find out who he was and what he stood for. His philosophy of harm reduction goes right to the core of the work of the National Treatment Agency. It is central to what is going on in drugs treatment services in my constituency and it is not acceptable.
It is unacceptable for professionals to say, "I am in favour of harm minimisation." People who are in favour of harm minimisation suggest that we need needle 4WH exchanges. Well, we do, but the national health service does not provide a needle exchange in my constituency. That was left to a homeless charity because the NHS did not get its act together. Together with the panel of five people from the church, the business community and the community who comprise my inquiry team—there were six of us in total—I have called for more needle exchanges. We have to cover 360 sq miles. I am not against harm minimisation or harm reduction, but I am against the whole philosophy that what is needed—to put it in the extreme—is to show people how to inject into their eyeball because they have no veins left. That is not a coherent approach or an answer to the drugs epidemic that we face. The fact that people such as Howard Parker have been cited by professionals—four times by four different people—is a very worrying sign.
I have taken the opportunity, and will do so again, to make comparisons with what happens abroad. Last week, I met the head of drugs co-ordination for the European Union to consider the evidence base. I am not a medical expert—I do not know what forms of treatment are most effective—but the research base says that different treatments work for different people. I, and others, have called for a menu of treatment options, but that is not available.
"Changing Habits", the Audit Commission report published in February, highlighted six weaknesses, the first of which was the difficulty of accessing drugs treatment. In my area, there are transport problems for people who want to go to Mansfield or Doncaster but have no money because they are spending it all on heroin. Indeed, the most common excuse used when tapping young people for money is, "Give me money for my bus fare or train fare." That happens all the time in my constituency—it is part of the daily intimidation of drug-free young people.
What is the role of general practitioners? There is a target stating that 30 per cent. of GPs should be trained in drugs treatment. That has not been met in my area of Nottinghamshire, and in Bassetlaw we are below the Nottinghamshire average. We need trained GPs. Some are good; some are brilliant—two of them took part in my inquiry and were happy to do so—but what about those who are bad? What sanctions are we applying to ensure that GPs have the knowledge base within their practice to deal with the problem? I want new clinics on a local base that can feed back into the National Treatment Agency.
Like me, the Audit Commission found that there were lengthy delays in treatment. That has been mentioned by other hon. Members, and I will allow them to present their own facts and figures. If I, a member of my family or any of my constituents have cancer, we should receive immediate diagnosis and treatment. I do not expect to be told to come back in six months or a year. One of the more puzzling, and prevalent, official phrases that I came across was "presenting". The addict must present himself, as if to say, "Here I am, sir: I have come to present myself because I want to come off this drug". If they do "present" themselves they are often told, "Go away sonny. Come back tomorrow and present yourself again, and again and again, to prove that you are genuine."
Let me describe the case study written up in my report as that of Miss A. I do not know whether Miss A was involved in prostitution, but my evidence base suggests 5WH that almost every young woman who is a heroin addict—there are more than 200 in my constituency—is so involved. Miss A's father buys her heroin because he does not want his daughter prostituting herself on the streets to get the money. She is in what I would call a relatively stable family situation. The mother and father are married and have been for a long time and they have other children. I listened to the answerphone messages that Miss A received from the treatment services, and frankly they were an absolute disgrace. Appointments were broken. One message said, "Meet us at Boots at 10 o'clock", but the drugs worker was not there at that time. Other messages said, "Meet us next week," "Meet us the week after" and "Oh, I'm going on holiday for three weeks." Because her phone was not on at 1 o'clock, there was a message at two minutes past claiming that she was obviously not serious about drugs treatment, so was not going to get it.
The parents of Mr. Y, who is from a stable family background, came to me just over a year ago. The father buys him drugs to stabilise his intake and to get him away from the criminals. He has spent more than a year trying to reduce his son's intake and has to take him to accident and emergency every time he overdoses, which is about once a month because the family are not professionals so are not managing matters properly. That is a great expense to the NHS. Those petrified parents wanted residential rehabilitation for their son. In the nine months before my inquiry, I could not find a single case of residential rehab in my constituency—not one. Amazingly, in the week after the inquiry, Mr. Y went into residential rehab. That was, of course, going to happen anyway, but I want to know on what basis decisions are being made, and who is making them. Those are real case studies.
The National Audit Office found, as I have, that assessment procedures are chaotic across the country. In some places assessments are made by a team, but in my area just one person seems to be making assessments on who should get what treatment, and there is no right of appeal.
I should like quantified statistics. What is the definition of treatment for the 118,000 people currently being treated in this country—that is the number according to the information that has been given? I should like to know how many in my constituency are being treated because I have not been given those statistics. I asked publicly for the figures, but they were not given, even when I asked again. What quantifies success? How many are going into residential rehabilitation and why? How many are being treated in the community, and how? How are we measuring success? I want to see comparisons of success, because it can be defined in different ways. For some individuals it might be defined as reducing heroin intake and stabilising. They might not ever be drug free, but might be stable for a long period of time, out of the crime cycle and fit enough to get back into work. For others—hopefully a majority—success means being drug free. That quantifying is not there in anything I have been given. Perhaps the Minister can help me on that.
Such comparisons are critical, and are needed across Europe. The Council of Ministers is meeting to discuss this matter on Thursday and Friday this week, and I believe that either the Home Secretary or a Health Minister is going to the meeting. There will there be a 6WH paper on the EU action plan on drugs. I should like to see consideration there of one of the six principles of the UN General Assembly's special session on drugs, which is
To increase substantially the number of successfully treated addicts".The quantifying of such success is missing in the EU action plan on drugs, although it has plenty on cross-border smuggling. I propose that the Government put the quantifying of success back into the plan. In its action plan the EU has signed up to the six principles of the UN General Assembly special session on drugs, so that quantifying should be part of its policy. There must be a follow-up to analyse what treatments work, and Europe seems a better data bank than Britain alone. Let us learn from best practice. I propose that that measure be built in for consideration at the Council of Ministers meeting on Thursday and Friday. It could then be passed on to the Heads of State, who meet in December, although I suppose the papers will go in front of them only briefly.I should like to see the database of the Exchange on Drug Demand Reduction Activities quantified. It is rather difficult to access it. That might just be because of my internet prowess, but I have been repeatedly unable to access the EDDRA database on drug demand reduction programmes. Certainly, the EU has been concentrating on supply.
As I have said, I should like to see the equivalent of a Macmillan nurse in drug treatment services—one person who is there to advise the families of addicts. I should like to see the notion of people having to "present" themselves for treatment knocked on the head. Treatment should just be made available.
My next comment is directed at the Home Office. I should like to see drugs courts and drug testing in the custody suites of my local police stations. Those measures have been piloted in Nottingham, and there is nothing wrong with doing things in the cities, but we want the same priority. I want to see those measures in my constituency.
More than 3,000 people have responded to my inquiry, and I have met 150 heroin addicts both on a one-to-one basis and in groups, which is a reasonable evidence base. I have written up the results and given the Department of Health and the Home Office CDs containing the case studies, in which we have masked the names to preserve confidentiality. The case studies follow a pattern, which is repeated and repeated and repeated, of low aspirations and mobility.
Young people who experiment with a range of drugs compare their control of taking cannabis with their initial control of taking heroin. That is what they said, not what I said, and they said it repeatedly. Young people who experiment with smoking heroin find themselves addicted and move on to injecting. Heroin was £5 a hit in September, but it is now £2, and one can get a free lump of crack with it, if one really wants it. Ironically, although it is free, heroin addicts are not taking it. Some addicts inject themselves eight times a day and there have been nine heroin overdoses.
Families are being torn apart, and large extended families in mining communities are being hit by crime carried out by their own family members—there is £20 million worth of drug-related crime. My drugs action 7WH team, along with others, has not even discussed the National Audit Office report of February 2002. The National Treatment Agency should come under the Department of Health rather than the Home Office, and I am pleased that a Health Minister is replying to the debate. In my community, we are not prepared to accept no provision of treatment services. We demand treatment services and we demand that their successes be quantified. The issue is not going to go away and I am not going to go away; my panel is permanently in situ, and we will hound Ministers. Hopefully, we will not need to do that because I hope that they are with us. We need to get on top of the problem to allow my community and addicts to get the chance that they deserve, in which case crime will come down accordingly.
§ Mr. Gary Streeter (South-West Devon)I commend the hon. Member for Bassetlaw (John Mann) for securing the debate, for the power and passion of his speech and for his commitment to the vital subject of drug addiction in our country. Although I cannot match his level of commitment in looking into the matter through his inquiry, none the less, I have started my own investigation into what I consider to be one of the most serious menaces to the coherence of our society. I strongly agree with him that one issue affecting efforts to tackle this big social problem is the incoherent approach to providing a response displayed by the Government, local government and health authorities.
I welcome my hon. Friend the Member for Billericay (Mr. Baron), whose first outing on the Front Bench this is. I am delighted that he is here, and having watched him in the Chamber on a number of occasions, I know that this will not be his last such outing. I am sure that I will be sitting behind him for many years to come.
At the beginning of this year, I decided to undertake some research into drugs and youth crime both in Plymouth, which is in my constituency, and in Vauxhall, which is the part of London in which I have my tiny accommodation. I thought that it would be good to balance two different communities in my investigation of drugs, crime and young people. I spent a number of months pottering around both places on my own, talking to local authority officials, the police, voluntary sector agencies—they do a great job trying to tackle the problem—and young people. I met some wonderful people: many of those working in the voluntary and charitable sectors trying to grapple with the problems of some of the most disturbed and troubled youngsters in this country are real heroes and an inspiration to all of us.
The one message that came out loud and clear from the police, local government and voluntary sector agencies was that when a heroin addict makes the brave decision to kick their habit, when they reach that low point in their life that I believe each of them reaches at least once, when they are so steeped in misery that they want to end their terrible addiction, there must be immediate access to help. That simply is not available at present. It is certainly not available in Plymouth, in parts of London or—picking up on what the hon. Member for Bassetlaw said—in many parts of the country.
8WH We know that drug addiction causes acquisitive crime—the police in Plymouth tell me that 80 per cent. of burglaries and thefts are drug-related. We know the human misery that is involved. We know that heroin addiction is a family breaker. All the agencies say that it is a massive social problem, but the response to it is incoherent. Immediate access to appropriate treatment simply is not available. It is very much a matter of catching the moment at which an addict decides to kick the habit, and help must be immediate. Six months later is far too late—six days later is too late. We must catch the moment.
In Plymouth, heroin addiction is now an enormous problem, and the police tell me that crack cocaine use is well on the way—in their words, not mine, "You ain't seen nothing yet." They believe that crack cocaine use in Plymouth will put heroin addiction in the shade. On the horizon is a massive problem for many parts of the country, and I call on the Government to come to grips with it now. They must improve their responses and try to solve the problem before it drags us down.
I began my personal researches a few weeks ago. As I started to talk about the issue through sections of my local media, a gentleman came to see me in my surgery to discuss a problem with one of his family members. We had a long session together and I asked him to go away and write to me with the details. If the Committee will forgive me, I shall read out part of his letter in which sets out his experiences, as it says everything that must be said about what is happening out there and the existing responses and available treatment.
I am a 59 year old great-grandfather, who on 20th August 2002 discovered that one of my granddaughters was appearing in court charged with theft. To my horror, on arriving at the Court, I was soon to find out that not only was she stealing, but she was doing it to fund her heroin addiction. My natural instinct was to help, but the only help that is wanted by an addict is the money to pay for the next fix and when you witness your own flesh and blood writhing on the floor in agony, the only option your emotions allows is to supply the cash. However, was not prepared to fund her habit and after some discussions we agreed together to find some help to start 'getting clean'.The family are standing together and embarking on what ought to be a straightforward approach to coming off heroin. The letter continues:Our first port of call was Narcotics Anonymous who advised me not to provide her with any money with which to buy drugs. They directed us to the Community Drugs Service (CDS).We then visited the CDS, who informed us that they could help if the addict is willing. My granddaughter categorically stated that she wants to be clean and we were then advised that the current waiting list to start a detox course is 6 months. We were further informed that the wait is due to current shortages in manpower and lack of funding. The local Harbour Centre is able to provide an instruction to GPs to prescribe the heroin alternatives, DFs and methadone. However, very few GPs are willing to do so because they don't want the addicts, with associated problems and disruptive behaviour, in their surgery. I was also told that 'Going cold turkey can and does kill addicts and is not to be entered into under any circumstances'. To my absolute amazement we were then given the only remaining option, which is apparently given to all addicts, 'Commit crime and get caught in order to fast track the system, as there is no treatment available in the short term'. Once within the legal system the Probation Officer can apply for a DTTO (Detoxification Testing and Treatment Order).The gentleman continues his letter by setting out the journey that they undertook together to get help, but as I stand here this morning, his granddaughter still has not received treatment.9WH I do not point the finger at the current Government any more than at past Governments. The problem has crept up on us in the past few years and has now become the biggest social problem that we have ever faced. We know that the cost of funding a heroin addiction can be as much as £100 to £200 a day. One remarkable man—Mark Williams, who works for Centrepoint—told me that many of the people he was trying to help were selling their bodies at night in Soho or committing burglary to raise money for their heroin addiction.
The problem is of huge importance and access to immediate treatment is the real solution, so the Government must redirect resources and move them upstream. Let us not debate whether I am calling for taxes to be increased—as it happens, I am not, but I would if it were the only solution to this massive problem. However, there are areas from which resources can be redirected: for example, in a sitting last week of the Select Committee on the Office of the Deputy Prime Minister, we realised that there was an underspend of £350 million. That would do for starters.
There are other avenues of action. First, what about insurance companies? We all know that they are struggling at the moment, and they would make a massive saving if some of these problems were nipped in the bud. Why do we not tap them for some funding? We must move resources upstream to ensure that money is available. Secondly, the Government must call a summit with all the treatment centres, including the rehab and detox centres in the voluntary and private sectors, to ask them how best to expand their capacity to provide sufficient access to treatment.
Thirdly, more coherence in the Government response is vital, in particular by having one funding conduit. I cannot tell hon. Members whether in Plymouth primary funding comes from the local authority, from the health authority or directly from the Home Office—there is real confusion. Likewise, I did not know which Minister would respond to today's debate, but I am delighted that a Minister is here.
We need more coherent funding mechanisms. I understand that one reason why there is such a delay in getting access to treatment in London is because local authorities bounce what we could call customers off each other. For example, if someone with a family home in Croydon is caught up on the streets of Lambeth and wants to access treatment, a debate takes place between Croydon and Lambeth authorities about which of them is to pay for it. That can take months to resolve, which is no good when that young addict has made the brave decision to kick the habit. Perhaps providing a central funding agency in London should be the Government's response.
We place a statutory duty on local authorities to house homeless people, so perhaps we should place a statutory duty on them to ensure that addicts who want to kick the habit have access to treatment. Someone must take responsibility for the problem. Local authorities should not be providing treatment; in my view, they should do almost nothing but act as enabling authorities. However, in the right climate, some wonderful organisations in the voluntary and private sector could expand.
My final point is really for another debate. It is that a great deal more international action could be taken to crack down on drug barons. Most policemen in this 10WH country will tell you that arresting a few drug dealers will not solve the problem. They say that access to treatment and education are the key weapons in this war. We see NATO out there looking for a role: perhaps declaring war on drug barons deserves higher priority.
The Government face no more important a task than to put in place a coherent and immediate system to tackle the problem of drug addition. The great advantage for any Government who made progress in that field is that, within a very short time, the crime figures would plummet—and the Government would get the glory.
§ Mr. Deputy Speaker (Sir Nicholas Winterton)Order. The matter that we are debating this morning is of immense importance, and a number of hon. Members want to speak. If they use considerable self-discipline, I might be able to call them all, but that means contributions of four minutes or less. I call the hon. Member for Rhondda (Mr. Bryant).
§ Mr. Chris Bryant (Rhondda)With that injunction in mind, I shall try to be concise, swift and brief. I commend my hon. Friend the Member for Bassetlaw (John Mann) not only for securing this debate, but for speaking with such eloquence on this and other occasions.
I am intrigued that a Minister from the Department of Health should be here today. I represent a Welsh constituency, and although the Minister will probably not be able to answer many of the issues that arise there because they are devolved matters, I intend to speak briefly about the scale and nature of the problem in Wales.
We have about 7,700 problematic heroin and crack cocaine users in south Wales. At least 270 young people died through the use of drugs in 2000, but we still do not have the figures for 2001. At least 28 young people in my constituency have died from drug abuse since I was elected 17 months ago. The market in heroin and crack cocaine in south Wales is worth about £130 million, so whatever resources the Government are able to throw at the problem, they will scarcely match the sums of money invested by dealers and pushers—especially those in the major markets in Liverpool, Manchester, Birmingham and Bristol, who are trying to invest in the new market that has developed in the south Wales valleys in the past five to seven years.
In November and December 2001, the vast majority of new prisoners in south Wales jails tested positive for either heroin or crack cocaine, and many of them would still have tested positive when they left—indeed, some would have tested positive on leaving prison who did not test positive on entering. Between 1993 and 2000, south Wales witnessed a 50 per cent. increase in drugs deaths, yet during that time the United Kingdom average fell by 8 per cent. However, I have a word of caution about the figures for drug-related deaths, because the coroners service has a considerable way to go before we can rely on what is counted as a drug-related death. Some coroners will count a death as drugs related only if the needle is stuck in the arm when the 11WH body is found, but others will be more liberal. As my hon. Friend the Member for Bassetlaw said, greater consistency is necessary, not only in the UK but throughout the European Union, if we are to gain a better understanding of the exact nature of the problem.
In the south Wales valleys—in the former mining constituencies—the problem is slightly different. We have close-knit communities where such deaths are not anonymous—everyone in the village knows the person who died and other members of the family. That is significant, not least because it means that everyone knows where drugs are available. Everyone in the community could say where heroin or crack cocaine can be obtained. That is different from what happens in the cities.
Few GPs in south Wales know enough about drug treatment, particularly for heroin abusers, to be confident of ensuring that their patients get the right treatment. The fact that about 40 per cent. of GPs will retire in the next few years will present us with another terrible problem, because many GPs have not been in close touch with the issue throughout their working lives. Ten years ago, only one of the police cells in the Rhondda would have had a note on the door saying that the occupant had a drug problem; now, every single cell door carries such a notice.
South Wales has specific problems and I hope that Ministers or the Welsh Assembly can solve them. There has been a significant increase in the number of my constituents who go to the local community drug and alcohol team and into treatment—indeed, the number is three times greater than in surrounding constituencies. However, the team was closed to new clients four months ago. The problem is not that there is a long waiting list for people in the Rhondda, but that those responsible for providing services have overspent and have been so successful at getting people into treatment that there is no waiting list. The challenge facing Bro Taf health authority and the Welsh Assembly is how to deal with that issue. There is an enormous lack of trust between public sector and voluntary sector agencies, and one does not need to study my constituency long to notice that.
The Prison Service does a good job of weaning people off their various drug dependency problems, but many still return to the community believing that their level of tolerance is the same as when they went into prison, when in fact it is lower. That results in many of the drugs-related deaths in our constituencies. I therefore hope that the Prison Service will build stronger long-term relations with the local health service so that people can receive ongoing treatment.
Some politicians in south Wales confuse the broader issue of treating heroin abusers—let us face it, they often abuse many other substances—and the specific issues of detoxification and rehabilitation. The main issue in my constituency is how to get people into treatment; when they go into detoxification and rehabilitation is a matter for another day.
At present, the major challenges relate to co-ordination between the Welsh Assembly and Westminster, and between the different agencies. It is shocking that Bro Taf health authority and the 12WH Rhondda Cynon Taff local authority still have no full, coherent strategy on bringing all the agencies together to deliver decent services. In the past few weeks, the Welsh Assembly has committed money, which is most welcome, but we must ensure that that money is spent on the ground. Every agency to which I have spoken has made it clear that one of the biggest challenges in the next five years will be to ensure that we have enough trained people to employ in the relevant services. It is a question not only of announcing new money, but of ensuring that it is spent.
Finally, housing is an issue. For £8,000, commercial landlords in my constituency can buy a house in a terrible state of repair. They do not do it up, but they move in families—particularly ones with drug dependency problems—who they know will bring in housing benefit at the rate of £4,500 a year. The state is subsidising outrageous, immoral and unscrupulous behaviour on the part of commercial landlords, and the people who suffer most are the families of heroin abusers.
§ Dr. Brian Iddon (Bolton, South-East)I congratulate my hon. Friend the Member for Bassetlaw (John Mann) on keeping this issue alive. It is important that we endlessly discuss the misuse of drugs and, in particular, heroin, which is one of the worst social problems facing Britain today.
The number of heroin users is increasing, prices are down considerably and, tragically, there are more deaths. I subscribe to the view that we need better statistics. Coroners' certificates are completely inadequate, and I understand that the Home Office will change them shortly. The number of deaths recorded for 2000 is 1,162. That figure was given in the Official Report, 29 October 2002. I think that that is a gross underestimate, and the figure is probably at least double that. Yesterday, I discovered that there have been almost 8,000 deaths across the European Union, so this is a tragic matter.
I congratulate my hon. Friend the Member for Bassetlaw on producing his report, which I have read two or three times. I agree with much of it, but I disagree with a point made on page one, which states:
We believe that only a policy of zero tolerance of drugs and crime will overcome this blight".We would all like to realise that ideal, but we are living in the real world, and I do not think that we will adopt zero-tolerance policies in this country. Certain countries, such as Sweden, have adopted zero tolerance, not only towards misuse of heroin and other illicit drugs, but towards alcohol. If one tries to buy decent alcohol in Sweden, one finds that what can be bought in bars and cafés is less than 1 per cent. proof and it is almost impossible to buy the hard stuff. Therefore, I believe that we would have to adopt the same approach towards alcohol and, as my hon. Friend the Member for Bassetlaw suggested, also towards tobacco.It is difficult to estimate the number of addicts in Britain. According to Home Office statistics, the figure is somewhere between 250,000 and 300,000, but I suspect that the true figure is higher. Before the National Treatment Agency for substance misuse was set up in April 2001, something that I very much welcomed, only 13WH between 6 and 7 per cent. of addicts were in treatment. That is a derisory figure, which has since increased and will continue to increase in future.
I could go on at length about the social consequences of drug misuse in my constituency, which, on all the social indicators, is deprived. In the red-light area alone, there have been three deaths in under nine months. Two young women, one of whom was pregnant and, a few days ago, a young man in my constituency, were murdered. The murders were probably all related to drugs in some way—the deaths of the two women certainly were. They were heroin addicts who were supporting their habit through street prostitution.
Because of the situation in Bolton, we have taken a hard attitude towards getting people into treatment. Political leadership is very important. Drug action teams vary throughout the country, but under Sandie Nesbitt, our very committed drug action team coordinator, we have one of the best DATs in the country. However, but for the fact that the chief executive of Bolton metropolitan council chairs the committee that drives the DAT forward in Bolton, it would not be so effective. If DATs are to operate effectively, they must be driven from the top, and chief executives can do that because they have the networks to be able to bring on board the health service, the probation service, the police and the voluntary agencies.
We have an estimated 2,500 drug addicts in Bolton, 84. per cent. of whom are heroin users. Almost half those known drug addicts—some 1,225—are currently in treatment in Bolton. There is an increasing demand for treatment, which I am also pleased about, but the effect is that the waiting list for treatment is getting longer. As my hon. Friend the Member for Bassetlaw said, we need to aim towards a situation in which no one has to wait for treatment. There should be an open door to treatment, so that when addicts feel that they want to give up the habit, they can receive treatment immediately. Furthermore, if they relapse after initial treatment, as many addicts do, they should not have to wait to receive treatment again. In some areas, drug users have to be out of the system for six months before they can get back in. That is crazy. During that intervening gap, some addicts die because of a lack of tolerance. They start taking doses of heroin that they were formerly used to and overdose. That is a tragedy.
Unfortunately, an increasing number of under-19s in Bolton are using drugs. About 40 schoolchildren in Bolton under the age of 16 have come forward for treatment, as well as 104 16 to 19-year-olds. That also includes the figures for alcohol abuse.
One of the gaps across the country is in treatment for young people under the age of 19. Bolton is getting better at that. I want to tell people about Project 360 Degrees. It has that name because it looks all around—in a circle—and takes on board children who are desperately seeking help for substance misuse, and their parents. The project covers alcohol as well as illicit drugs and has been quite successful.
There is controversy about drugs education. It can be good, but much of it is bad. We need to train teachers. People who know what is happening on the ground have to be brought into schools. Reading passages from textbooks is not enough. When people provide drugs education they have to know about drugs, their misuse 14WH and the harm that it creates. I do not object to bringing ex-users or even current users into schools to tell people the bad news; to tell them not only about injecting into eyeballs or other parts of the body when veins have run out, but about gangrene and the loss of legs.
Brighton and Hove has the worst drugs problem in Britain. I congratulate Professor Ghodse from St. George's hospital medical school, who controls the national programme on substance abuse deaths and publishes a document every six months. It is about not only drug deaths, but the worst places in Britain for drug misuse. Brighton and Hove has topped the list for several years. I urge the Minister to put more resources into places where drug use is prevalent.
There has to be a choice of treatment. If someone has been an addict for 20 years, he has to be given access to clinically pure heroin, which is diamorphine. People on that can be stabilised. The Government drugs policy debate will take place a week on Thursday on the Floor of the House. I hope that during that debate the Home Secretary will make announcements about heroin prescribing, because we need more of it.
Methadone has a role, but I am critical of how it has been used as a crime reduction drug rather than a harm minimisation drug. Other drugs should be considered. For three years, I fought with the Department of Health to get buprenorphine on board. Subutex is one of its trade names. It rather than methadone is the drug of choice in France and Australia. If it is given to fairly new heroin users, they can be helped out of addiction much better than through use of methadone. For many people, methadone is very addictive, and it has a narrow toxicity window.
A friend in Manchester is prepared to make L-methadone. Methadone has two molecules. One is toxic and the other has the desired effect. My friend wants to test L-methadone in clinics. I have put that to the Department, but it has not yet responded. I have also argued that LAAM—levo-alpha-acetylmethadol—which is used in America, should be available for some addicts in Britain. Another choice is abstinence and 12-step programmes, for when someone wants to come off heroin but not on to methadone and is willing to accept counselling instead. Why do we not have more abstinence programmes? The answer is not methadone, methadone, methadone. The choices suggested by my hon. Friend the Member for Bassetlaw should be available to all addicts.
Things can only get better. They have to, and soon.
§ Mr. Deputy SpeakerI am prepared to call the hon. Member for Newport, West (Paul Flynn), but I must ask him to keep his comments short. He is an expert on the subject, but if he speaks for only two or three minutes we shall not take up any of the time allocated for Front-Bench spokesmen.
§ Paul Flynn (Newport, West)Things have got better. I have attended debates on this subject since 1987. As recently as 1998, there was absolute unanimity among all the speakers from the three main parties when the 10-year strategy was introduced. Everyone agreed that that was the answer, and only one voice was raised in the Chamber that suggested that it was not. Today all hon.
15WH Members are talking about the almighty failure of our drugs policies—and I appreciated especially the contribution made by the hon. Member for South-West Devon (Mr. Streeter). Our drugs laws are not working.
I received a letter from the Gwent specialist substance misuse service that said that the average waiting list for that service is 11 months, and that the longest wait is 17 months. It is disgraceful that we have arrived at that position.
I disagree with the solutions proposed by my hon. Friend the Member for Bassetlaw (John Mann), although he has done a marvellous job in bringing the subject to the attention of the House. Those solutions have already been tried—we tried zero tolerance in 1971. We once had a system that worked well, in which there were fewer than 1,000 heroin addicts, whereas the number of people addicted to heroin and cocaine in this country is now 320,000. Deprivation may be one of the factors, and those who live in poor areas are far more likely to die from their addictions, but for those who can get clean needles the figures are similar, regardless of whether they live in a deprived or a privileged area.
I have studied figures on the subject from all over Europe. Those who can get clean needles and heroin of known strength can go on for a long time. There is the famous example of the writer of "National Velvet", who took prodigious quantities of heroin all her life. She died a serene and peaceful death, in her bed, at the age of 91. The problems with heroin use stem from the situation in which people take it. Two years ago, 50 deaths were caused by one batch of contaminated heroin in Ireland and Scotland.
No one should leap to instant conclusions. Zero tolerance was the answer in America, but in this country our harshest prohibition policies mean that for every 100,000 people, we have a prison population of 130. That is one of the highest prison populations in Europe—it is higher than Turkey's. In the United States, the prison population in that ratio is 700, which is partly the result of zero tolerance. The increased use of heroin is driven by the greed for profit; people make a great deal out of it, and many of the dealers are addicts and are dealing to feed their own addiction.
§ Dr. Evan Harris (Oxford, West and Abingdon)I understand that time is short, and I do not want to take up any of the time that the Minister and the Conservative Front-Bench spokesman need. The subject is one that Back Benchers should have time to discuss, and we all owe a debt of gratitude to the hon. Member for Bassetlaw (John Mann) for securing the debate. An hour and a half is not enough to discuss the matter, and I suspect that the time allocated on the Estimates day next Thursday will not be enough to deal with all the issues.
Rather than express a party position based on a paper that we have published, I want to take time to respond to the passion and content of the speech made by the hon. Member for Bassetlaw. It is a pity that Hansard will not reflect the passion with which he spoke, as it affected many of us here. He referred to the lack of coherence between the various agencies involved. That problem 16WH does not occur only in respect of drugs, and it represents another strong argument for not only joint working but bringing together health service commissioning with social services under the auspices of a democratically accountable local authority. That would do something to merge the alphabet soup of agencies to which the hon. Gentleman referred.
The hon. Gentleman rightly mentioned the huge cost of the problem. That will not be settled by requesting extra funding from the taxpayer. I do not think that that is necessary even though, sadly, the hon. Member for South-West Devon (Mr. Streeter) could contemplate it. For every person treated, there would be immense savings to the criminal justice system, the health service and the victims of crime, as reflected in insurance premiums. On any judgment, any investment is self-funding and releases far more resources—and that is quite apart from the increase in human happiness and the reduction in human misery for users, families of users and the victims of crime associated with the problem.
Many hon. Members said that there are difficulties accessing treatment. The hon. Member for Bassetlaw raised several issues. For instance, there is the question of transport. Treatment needs to be local, which is why general practice will always have a role, because that is the local, accessible service. There are issues about the quality of that treatment, particularly in general practice, and about delays, not only in terms of access, reduction programmes or acute detoxification, but in getting on to residential rehabilitation. That has been shown, at least for adult users—the evidence is very good—to stop people from simply returning to the position from which they started, by mixing with their old friends and the dealers they know, and going to the places where they had the lifestyle of injection.
I had the privilege of spending a few hours at the surgery of a GP in my constituency who takes a special interest in the treatment of drug users. It was fascinating to see him at work. I have encouraged him to do an audit of his results. However, although he had an interest, he was never funded to do that work. He had to do it in time that he could have spent doing other work in his practice. It was difficult for him to organise the practice because of the problem of people not wanting to share waiting rooms with drug users, an issue raised by other hon. Members and certainly by patients in the practice.
There is a strong argument for additional remuneration of GPs to encourage the best to do such work, not simply those who are committed. There is an argument about the quality of service provided by some GPs offering methadone. I do not think that sanctions are required. More resources are required for training and support. In addition to a GP, a counsellor and testing arrangements are needed to ensure that the contract that is entered into is kept to.
There is the issue of prostitution by drug users. The current restrictive criminalising laws on prostitution make it difficult to provide the help and access to treatment services needed by those involved in prostitution, particularly young women.
Clearly, there is not enough capacity in treatment services. It is not just a question of funding: there are not huge numbers of trained people waiting to fall off trees.
17WH We should have started to undertake the sort of measures that are needed some years ago. Funding has to be increased and we need proper data on outcomes.
The take-home message from the debate is that drug addiction should be seen as an issue for the Department of Health, not the Home Office. I am surprised that there was any doubt about whether a Health Minister would be answering the debate. The problem is that many people consider the issue in terms of crime. The idea that one has to commit a crime to get treatment is heinous. I am not sure that prison is necessarily the right way forward, and one is required to reach a threshold of criminality to access drug treatment and testing orders. The Government are bringing in drug abstinence orders and drug abstinence requirements, which are a lower tier. It might have been better to have done that earlier, alongside the drug treatment and testing orders. In my constituency, so desperate are magistrates to use drug treatment and testing orders that they are using them at a lower threshold, and they run out of money by at least mid-year.
We have to be careful about selective citing of the evidence base. There is now increasing evidence from overseas about the option of maintenance on heroin. We believe that the validity of clean injecting rooms—often called shooting galleries—should be explored. I hope that the Government will not rule that out completely, as I fear they might, because it is a way in which to reduce harm and ensure adequate access to treatment.
Professor Howard Parker will be able to speak for himself, and might write to the hon. Member for Bassetlaw now that his name has been raised. However, I am not sure that talking about the normalisation of sensible recreational drug use—whatever that is—is the same as showing people how to inject into their eyeballs.
We must not confuse—I do not think that the hon. Member for Bassetlaw did—the decriminalisation of soft drugs with the suggestion that hard drug use is in any way sensible or could be considered recreational. It is a health problem and we need health solutions. Sometimes criminal justice solutions prevent people from accessing the most appropriate treatment.
§ Mr. John Baron (Billericay)I, too, congratulate the hon. Member for Bassetlaw (John Mann) on having initiated the debate and on having spoken with such passion. The effects of heroin use are devastating and it is extremely sad to hear about their terrible consequences in his constituency. Having read his inquiry report, I offer him my best wishes in his efforts to address the problem.
All hon. Members who have spoken today agree that the issue is serious and requires urgent attention. However, all discussions about the drug, this one included, are hampered by a dearth of reliable research and data. I acknowledge the hon. Gentleman's point that there are few statistics available for his constituency, but there is a wider issue: there are many gaps in our knowledge of the national problem. Professor Neil McKeganey and Dr. Gordon Hay of the centre for drug misuse research at Glasgow university have said that, nationally, we have no drug survey, no assessment for problem drug use, no reliable record of the numbers in treatment, no school survey, no estimate of drug-related crime and no data on hepatitis C prevalence.
18WH Without reliable information and data, we cannot hope to administer the appropriate solutions. Will the Minister address the points raised by McKeganey and Hay, and tell us whether the Government intend to put right the situation with regard to the specific examples that they have given? If so, what are the expected timetables?
As a society, we must recognise the many harmful social effects of both heroin and drugs in general, of which the hon. Member for Bassetlaw spoke so passionately. They include marital breakdown, neglect and abuse of children, poverty and accidents, particularly road traffic accidents. In addition, the links between drugs and crime are widely accepted. It is estimated that the cost of hard-drug related crime is some £20 billion. The hon. Gentleman told us that some two thirds of crime in his constituency is drug related. The criminal justice system must clamp down on those who deal in drugs.
However, as has been said, simply addressing the issue as a crime problem is wrong. That is the fundamental flaw in our drugs strategy. There is a chronic and serious shortage of treatment services at every level and what services there are tend to be provided through the criminal justice system. As we heard from my hon. Friend the Member for South-West Devon (Mr. Streeter) and others, too many users are not helped until they enter the criminal justice system. Society must realise that drug use should not be simply a law and order issue, but should be addressed as a health issue.
The hon. Member for Bassetlaw agrees in his inquiry that we spend a fortune dealing with the costs of heroin-related crime—policing and imprisonment—yet we have no coherent treatment service. The Government appear to recognise that, albeit tentatively. However, there is inconsistency between localities in the scope, accessibility and effectiveness of treatments. There is also insecurity about levels of funding, as has been highlighted by nearly all who have spoken.
The Audit Commission report, "Changing Habits" points to the uneven availability of treatment services and the long delays that users face—something that many hon. Members have mentioned. The Home Affairs Committee's report on drugs also suggests the inadequacy of current treatment provision. There are simply too many organisations, methods of funding, bidding rounds and acronyms. That serves only to cause confusion, as the hon. Member for Bassetlaw has testified.
It appears that the Government realise that they are failing in the matters I have outlined. That is confirmed by the fact that according to paragraph 13.21 of the 10-year NHS plan the Government originally hoped to reduce the proportion of people under 25 who were using class A drugs by 25 per cent. by 2005 and 50 per cent. by 2008. That target has now been abandoned. What measures will the Government introduce to provide a seamless treatment service to get people off drugs? Such a service clearly does not exist at present.
There are too many organisations adopting too many approaches with too many different avenues of funding. That confusion needs to be dealt with by clearer communication, fewer organisations and a simpler funding stream. What are the Government going to do to put matters right, and what is the expected timetable?
19WH The Conservative party has set out proposals to tackle the problem, and they have been put out for consultation. We have suggested that the number of drug treatment places should be expanded tenfold to be able to offer a treatment and rehabilitation place to every young heroin and cocaine addict. We believe that the current de facto policy of ignoring such users needs to be replaced, and we have suggested that each young heroin or cocaine addict should be given the choice of undergoing treatment or facing criminal proceedings. Some welcome comments have been made about that proposal. The best way of instigating the programme would be through the community and voluntary groups that are active in the relevant context. I pay tribute to the sterling work of those groups, without which things would be so much worse.
However, while a more rounded approach to the problem—one that includes the health and treatment issue—is important, society can also help addicts by ensuring that the law stands firm against drug dealers and pushers. The inquiry into heroin in Bassetlaw heard from heroin users who demanded longer prison sentences to help them break their habit. Many people wrote demanding stronger action by the courts, particularly for dealers.
However, the Government are causing confusion about the law. The Home Secretary announced his decision to declassify cannabis from a class B drug to a class C drug in July. He also announced his decision to increase the maximum sentence for cannabis dealers from 10 to 14 years imprisonment—the same as for class B drugs. That incoherence in policy sends out mixed messages. That needs to be put right, starting in schools, as the hon. Member for Bolton, South-East (Dr. Iddon) explained.
Police officers certainly do not understand the policy and nor do young people. Indeed, the hon. Member for Vauxhall (Kate Hoey) believes that the reclassification of cannabis and the Brixton experiment have effectively handed drug policy and communities over to drug dealers in many areas of her constituency.
I focus on cannabis not only because it shows the incoherence of the Government's message about drugs, but because, according to the inquiry report, the issue was raised time and again by virtually every heroin user interviewed. Each heroin addict had used cannabis at an earlier stage. Heroin just seemed a natural progression. Many addicts informed the inquiry that they felt that they could control heroin use because they could control cannabis use. Those same addicts stressed the fact that the dangers of cannabis needed to be strongly restated.
How and when will the Government end the confusion? When will they send out the message that taking drugs is wrong, that it can destroy lives and that it harms society? The sooner the Government can end the confusion, the sooner lives will no longer be needlessly lost. I hope that the Minister will take the necessary steps today. Such a policy would help to free resources that could be better spent in providing treatment for heroin addicts—indeed, for all drug addicts.
We must significantly reduce heroin addiction in this country. The Government must identify the extent of the problem in order to be able to deal with it. They must 20WH provide a clear, coherent and seamless treatment service that is properly funded, end the mixed signals, which are causing confusion, and state loudly and clearly that drugs cause misery, cost lives and harm society. I ask the Minister to address those points.
§ The Parliamentary Under-Secretary of State for Health (Mr. David Lammy)I congratulate my hon. Friend the Member for Bassetlaw (John Mann) on raising this important topic and on the dynamic and passionate way in which he has presented the subject.
All our constituencies are touched by the serious problems of hard drug addiction. I am the Member for Tottenham in north London, and in the past few weeks I have been working with the police on the serious problem of heroin trafficking in this country, much of which emanates from my constituency. We all see the serious problems that affect families, young children and others in our constituencies. For me, crack cocaine in London is the problem. I am the youngest Minister in the Government, and my hon. Friends the Members for Bassetlaw and for Rhondda (Mr. Bryant) will understand that hard drug addiction, and particularly the problems of crack cocaine and heroin, profoundly affect my generation. The Government are seeking to deal with that problem, which we take very seriously.
According to recent research by York university, the annual economic and social costs of drug misuse to our society are between £10.9 billion and £11.8 billion. Problematic drug users, whom the study isolates, account for 99 per cent. of those costs, which is why getting the issue right matters so much. Examination of the evidence base shows us that treatment works. It reduces drug use and its associated personal and social harms and it reduces drug-related crime. The findings from the national treatment outcome research study show that every £1 spent on treatment saves £3 of expenditure within the criminal justice system. The hon. Member for Oxford, West and Abingdon (Dr. Harris) was right to raise the associated cost of treatment and its links with the criminal justice system.
Improving treatment for drug misusers was a major element of the 10-year national drug strategy, which was launched in 1998. The strategy was comprehensive and aimed to combat drug misuse in deprived and high-crime areas. At the same time, we set up the National Treatment Agency to drive forward improvements in the quality, availability, accessibility and effectiveness of drug treatment in England.
Much of what has been said this morning relates to greater and faster provision of drug treatment services. The Government accept that, and we are doing as much as we can to deal with the problem. However, we recognise the tremendous challenge ahead of us. Very rapid expansion of drug treatment services, particularly in those areas with the worst substance misuse problems, is required to achieve the targets that we have set. The background of historic underfunding and limited capacity in that area must be borne in mind when we debate the matter.
We must also bear in mind how far we are into the 10-year journey: we are four years into it and one year into a comprehensive system set up by the National Treatment Agency.
21WH We have made significant new funding available to address work force and quality issues in order to deliver successfully on our goals. Four years into the national drugs strategy, we have already made significant progress. Based on current performance, there is no doubt that we are delivering and are on course to reach the treatment target. I stand here today as a Minister in the Department of Health because the subject of the debate is drug treatment, and it is right that a Health Minister should respond. However, we co-ordinate closely with colleagues in the Home Office, and I will ensure that the debate is brought to the attention of the Parliamentary Under-Secretary of State for the Home Department, my hon. Friend the Member for Coventry, North-East (Mr. Ainsworth), who is responsible for drugs policy across Government.
Last night in the Library I read the comprehensive report of my hon. Friend the Member for Bassetlaw. It has also been read by the Parliamentary Under-Secretary of State for Health, my hon. Friend the Member for Salford (Ms Blears), who is the Minister responsible for public health. She has written to my hon. Friend and will be responding in detail shortly. We believe that increasing funding for the treatment of drug users is essential to combat drug use, to reduce crime and to make our communities safer. We have ensured that substantial extra funds have been made available for that through the drug treatment pooled budget. That budget now stands at £195.7 million, which allowed each health authority in England to receive an increase of at least 30 per cent. in April, compared to last year's allocation. However, my hon. Friend may be aware that the drug action team in north Nottinghamshire received a 42 per cent. increase in its budget during 2002–03. That has led to a figure for Nottinghamshire of £1.8 million, enabling the development of treatment services in Bassetlaw and the surrounding areas.
§ Mr. BryantAs the Minister knows, Bassetlaw and Rhondda are both former mining constituencies. Will he commit the Department to considering the similarities between former mining constituencies—perhaps alongside his Welsh Assembly and Scottish Parliament colleagues—to see whether there are specific needs that must be met?
§ Mr. LammyIn my view, the use and misuse of hard drugs such as heroin is a complex issue. Many hon. 22WH Members could make a particular case for the way in which drugs affect their constituencies. My background in Tottenham and Peterborough demonstrates the complexity of the problem. In Tottenham, we are tackling the challenge of drugs in the context of serious inner city deprivation. I visit friends in Peterborough, who talk about the challenges of dealing with heroin addiction in Grantham, and the problems faced in such cities. It is a complex situation, and it is right that we consider the whole picture.
§ John MannThe Minister mentioned the increase in budget. How many drug addicts in my constituency are receiving treatment, and how many have been successfully treated?
§ Mr. LammyIn his contribution, my hon. Friend raised the issue of successful treatment, and the different measurements of success. Success means different things to people with different types of heroin addiction. It very much depends on the starting point. Success for someone with a 20-year problem will clearly be different from success for someone who has a short history of heroin use and has been able to come off the drug quickly. The number of people in treatment will depend on the starting and end points of the year, but I shall write to my hon. Friend about the specific problem.
§ Mr. LammyI shall not be able to make progress if I give way.
My hon. Friend the Member for Bassetlaw referred to the drug action team, how it is made up and the contribution made by various agencies. That ensures a co-ordinated lead for the local drug strategy. It is important that it includes the police, the probation service, the health service through the PCTs and social service teams. He also referred to harm minimisation. It is vital to reduce the incidence of HIV/AIDS and hepatitis C. Harm reduction is not an add-on—
§ Mr. Deputy SpeakerOrder. I regret that we have run out of time. We thank the Minister for that part of his reply that he was able to give within the time limit. We now move to the next debate.