AIDS and Drug Misuse (Hansard, 29 March 1988)

§ Mr. Michael Forsyth

The Government take the problem of AIDS and drug misuse in Scotland very seriously. Of those who have chosen to be tested for HIV infection, over 50 per cent. are intravenous drug misusers, whereas the corresponding proportion for the United Kingdom as a whole is only 7 per cent.; and over 20 per cent. of those found to be infected in Scotland are women, the great majority of whom are intravenous drug misusers. We have taken a number of measures, and further measures are in hand, to tackle the related problems of AIDS and drug misuse in Scotland.

We have devoted considerable resources to our public education campaign on AIDS and drug misuse. One of the main themes of the AIDS campaign has been the dangers 407W of transmission of HIV infection by the sharing of injecting equipment, and the phase of the campaign running from September to December 1987 stressed this. Furture phases of the campaign will seek to reinforce this important message. In February, we launched a further stage of the information and education campaign against drug misuse in Scotland. Since its inception in 1985 about £1.4 million has been spent on the campaign which seeks to discourage young people from any involvement with drugs and to promote a healthier lifestyle. We shall continue to give a high priority to the campaign, an essential element of which is aimed at improving the knowledge and awareness of professionals who work with young people.

The incidence of drug misuse in Scotland increased rapidly in the 1980s and services for the treatment and rehabilitation of drug misusers have had to develop from a low base in response to the this problem. A wide range of mainly community-based services has developed quickly in the last three or four years, many of them with the support of central Government funds earmarked for the purpose. Over £1 million was made available in 1987–88 specifically for the support of drug misuse services and a similar sum will be made available in 1988–89. This includes an additional £300,000 in each of these two years specifically to take account of the extra demand on services caused by the spread of HIV infection.

We have also promoted the setting up of needle exchange arrangements on an experimental basis. Three schemes were set up last year in Scotland — in Edinburgh, Glasgow and Dundee—to provide counselling for drug misusers and clean equipment on an exchange basis in appropriate cases. The scheme in Dundee has been closed because of various difficulties, including trouble with clients, and the scheme in Glasgow has encountered local opposition and low take-up. The scheme in Edinburgh has been more successful. In the course of monitoring the experimental schemes, however, it has become clear that another possible approach to needle exchange is through sales by community pharmacists, a number of whom already sell equipment to drug misusers. Accordingly, I propose to approach the Scottish department of the Pharmaceutical Society of Great Britain in the near future to discuss with them the contribution which sales by pharmacists might make towards the wider availability of clean equipment. In pursuing this approach, we shall be bearing in mind the importance to pharmacists of having the support of health boards, both in relation to the medical and counselling support facilities for drug misusers, and in relation to disposal arrangements for used equipment.

As regards the two needle exchange schemes which are still in operation—those in Edinburgh and Glasgow—Lothian and Greater Glasgow health boards have been informed that, although central funding of the schemes will not continue beyond 31 March when the formal period of monitoring and assessment is due to end, they may continue to operate the schemes if they consider this to be appropriate in local circumstances. So far as further needle exchange arrangements by health boards are concerned, we are not yet in a position to reach general conclusions on whether any extension of the existing arrangements would be appropriate. However, if any health board considers that, notwithstanding possible 408W developments in the pharmacy-based field, there is a need for such facilities in their area, we shall be prepared to consider specific proposals.

My right hon. Friend the Minister for Health has set out today the Government's response to the main issues raised by the report on AIDS and drug misuse by the Advisory Council on the Misuse of Drugs.

The report expresses particular concern about the position in Scotland and makes a number of criticisms and recommendations about the provision of services for drug misusers and the measures needed to prevent the spread of HIV infection among and from this group. In my view the chapter of the report on Scotland does not give an entirely balanced assessment of the situation in Scotland nor does it take into account the different historical background to the drugs problem here. In particular, the report fails to acknowledge that many drug misuse services in Scotland have already adapted their approach in response to the problems presented by the spread of HIV infection among drug misusers. I am however sending copies of the report to health boards and local authorities and to various representative bodies. I also propose to hold early discussions with the Scottish division of the Royal College of Psychiatrists about the report including its recommendation on the need for increased input to the management and treatment of drug misuse by the psychiatric services in Scotland. A working group of the National Medical Consultative Committee is currently exploring the medical role in the prevention and management of drug misuse and is expected to report later this year.

I shall keep the position in Scotland under close review and, taking into account the advisory council's detailed recommendations, I shall consider what further action it may be appropriate for the Government to take.