Ms Brown
I absolutely do. It is quite clear that once someone is on a treatment programme it needs to continue seamlessly, because we all want people, when they leave prison and go back into our communities, to be able to do so free from drugs and addiction, and to start a fresh life. My hon. Friend is right, and I am grateful to him for bringing that to our attention.
I gently suggest that the statistics, and Government policy more broadly, might be improved if we stop pretending that prisoners do not start taking drugs while in prison, rather than always going into prison with an addiction. That is the truth of it. The whole system at the moment seems to be geared to discovering who has a pre-existing dependence on drugs and ensuring that they are in treatment, which is good. Do not get me wrong, that is essential, but for drugs such as spice, which has been very common in prisons, it is not the whole story.
There is a third pathway to treatment that we need to ensure is available: a pathway for those people who did not have a drug problem when they entered prison but who, tragically and unacceptably, acquired one while inside. They are the people the system is failing most—the people for whom the boredom and difficulties of prison life are alleviated by short oblivion through illicit drugs obtained inside. I am genuinely hopeful that the Bill will enable treatment for those people. If it does, that will be a massive benefit to communities and families.
I will quickly explore one other issue. The transition between custody and community is often a revolving door, especially for those with drug abuse problems. It may be especially important for spice users. It is very evident that spice is disproportionately used by two populations: prisoners and rough sleepers. We know from last week’s Public Health England substance misuse statistics that in 2019 almost half of those entering treatment for misuse of an NPS had a housing problem—the highest proportion for any category of substances. I suspect that if we accounted for those who use spice but who are not in treatment as well as for those who are, the proportion with a housing problem would be even higher. It is incredibly difficult to hold down a job, maintain positive relationships and a family life, and to keep the mind and body healthy while living on the street. That contributes to higher levels of imprisonment among those who sleep rough.
Homelessness for prison leavers, and what the charity Nacro calls cell, street, repeat, is a priority for us, and I am led to believe that it will be a priority for the Government to reduce reoffending rates in coming years. However, we need to understand how these issues are connected; how many people come into prison with a history of rough sleeping and associated use of spice in a year; how many receive treatment for substance misuse while inside; how many are still accessing spice or other harmful substances while they are inside; how many of these people, when released, go straight back to rough sleeping; and how many are going straight back to spice use if they managed to get clean inside. I hope the Minister will offer to take this issue away and consider whether there is a need for further research, which the Ministry could commission, and how it might best be achieved.
The other important transition is when people leave prison. We need to ensure that leaving prison means starting a new, changed life. It is good for the whole of our community that prisoners, when released, do not come out and reoffend. It is also important for the prisoner that they get a true second chance. Substance misuse treatment is a massive part of ensuring that that can happen. We need to ensure that information about people’s needs travels with them as they leave prison and that treatment is immediate and consistent when they arrive in the community.
There is, unfortunately, little point in people getting clean or stable inside prison if they immediately relapse when they are out, without enough support, in the chaos and confusion of the outside world again. In fact, as we know, after release is the most dangerous time for those using illicit drugs, with appalling proportions of overdose deaths occurring in the first few days after leaving prison, just when we are wanting people to have a sense of hope and rebirth. A Norwegian study found that 85% of all deaths in prison leavers in the first week after release were due to overdoses. A US study found that the risk of an overdose death was 12.7 times higher for a prison leaver in the first two weeks after release from the general population.
Most of these deaths after leaving prison are the result of opiate use—heroin, or even more, drugs such as fentanyl—rather than an NPS. People in prison with an opiate dependence are generally on a regulated dose of a replacement drug as a medication, but when they come out, if they do not have immediate access to continue that treatment, they turn to the black market. At that point, much higher and less reliable doses are sold, which can quickly overwhelm the body, and people die. So getting transitions from custody to community right is a matter of life and death for some, and an essential part of treatment.
A few weeks ago, I met with some amazing NHS staff who work with armed services veterans in custody at HMP Wandsworth. I was delighted to hear that the staff in the substance misuse team leave the prison when those in their care are released, and go with them to their first appointment for community treatment. That is exactly the kind of integrated working that we need, but we all know that it is far from universal.
Can the Minister tell us more about what the Government are doing to improve treatment through the gate, following the recommendations in the report from the Advisory Council for the Misuse of Drugs on custody to community transitions last year? I fully appreciate that she is unlikely to have detailed answers to all my questions at her fingertips, but I think that we, as parliamentarians, could do with them to help to design and monitor effective policy on issues that mean enough to us that we are sat here this morning.
This is an excellent Bill, whose purpose we support, but if it is not accompanied by effective, well-resourced Government policy its benefits will be limited. I am fairly certain that the right hon. Member for Chesham and Amersham would not be impressed by that at all. I will say more when we come to the new clauses.
The Minister of State, Ministry of Justice (Lucy Frazer)
It is such a pleasure to serve under your chairmanship, Ms Ghani. I will not detain the Committee long on the main points, but I will respond to the points that the hon. Member for West Ham raised. I, like others, give my wholehearted support to my right hon. Friend the Member for Chesham and Amersham for introducing this very important Bill, and to my hon. Friend the Member for North West Durham for acting as its sponsor on her behalf. I commend the excellent work that my right hon. Friend has done in preparation for the Bill, notwithstanding that she has been unable to participate in these proceedings.
Having the privilege of being the Minister responsible for prisons, probation and rehabilitation, I am acutely aware of how necessary the Bill’s provisions are. As the hon. Member for West Ham said, drugs fuel crime both in and outside prison. Moreover, new drugs are constantly emerging on to the market in prison, and criminals are tweaking the chemical compounds of existing psychoactive substances to avoid detection. The Bill ensures that drug tests are responsive to the latest challenges in prisons and young offenders institutions.
The Bill will future-proof the drug-testing framework by adopting the broader definition of psychoactive substances, prescription-only medicines and pharmacy medicines, and it will enable our prisons to start testing more immediately for new drugs substances. More than that, it will enable us to identify new and emerging trends and therefore react quickly to changes in drug use by adjusting the relevant security measures to find specific drug types or the appropriate medical response during an emergency.
There is also the issue of identifying prisoners or young offenders with ongoing drug problems. The provisions in the Bill will enable Her Majesty’s inspectorate of prisons to have a better understanding of which individuals are misusing drugs and therefore to ensure that they get the appropriate treatment, as well as providing evidence of what is possible in terms of prevention.
We have a multifaceted approach to tackling drugs, and the Bill will enable us to continue to enhance our ability to tackle the scourge of drugs in prisons. I am grateful to my hon. Friend the Member for North West Durham for taking the Bill through the House, and to my right hon. Friend the Member for Chesham and Amersham for introducing it.
I will deal with a few of the points that the hon. Member for West Ham raised. She put forward a range of issues, and I will deal with the largest ones. She asked whether we were satisfied with the definition of psychoactive substances. I would like to assure her that we are content that the Psychoactive Substances Act provides HMPPS with a sufficiently broad definition to allow for testing of any new or existing psychoactive substances that may be used in prisons now or in the future. Of course, it is theoretically possible that a substance will fall outwith the definition in the future, so the Bill is drafted to future-proof drug testing in the case of any such eventually. However, that is not an eventuality that we anticipate at this time.
Bambos Charalambous
The Minister mentioned having a multifaceted approach to substance abuse in prison. A couple of years ago her predecessor mentioned that there was going to be a £10 million investment in scanners and other equipment to detect drugs going into prison—that is the other side of the equation. Could she give us any updates as to what the Government are doing on that? I am sure that is something we would all be interested in hearing about, because we want to make sure that drugs do not get into prisons in the first place.
Lucy Frazer
I am pleased that the hon. Gentleman has raised that point. As he repeated, we do have a multifaceted approach, including limiting the supply—the measures he identified are to do that—limiting demand and providing treatment. He is right that we did a pilot programme in 10 prisons, and as a result of that and other work, we have put forward a £100 million security package, which includes the airport scanners to detect drugs that have been ingested before being brought into prisons. We also have enhanced gate security for visitors and staff, we have mobile phone blockers and we have beefed up investment in the investigation of crimes, so that we can bring people to justice if do the things the hon. Member for West Ham talked about so passionately. We need to stop the crime of supply within our prisons.
The hon. Member for West Ham rightly focused on how we limit demand and actually treat people in our prisons. We have a number of initiatives on that. She will know about Holme House—our first drug recovery prison. It is a £9 million project jointly funded by the Ministry of Justice and the Department of Health and Social Care. I am pleased to say that that programme will be evaluated early next year; the early signs are good, but the formal evaluation will take place next year. We also have that on a small scale in a number of prisons. We have enhanced drug-free wings. The hon. Lady rightly says that we should not be punishing and that we should be encouraging, and these drug-free units encourage and incentivise people to live a drug-free life. That is something we are very committed to increasing.
Treatment is very important, as the hon. Member for West Ham mentioned, and we need to help people get on treatment programmes. She rightly said that 90% of people coming into prison, where they are on those programmes, do have access to treatments within three weeks. In fact, 53,193 adults accessed drug and alcohol treatment services within prisons and secure settings between 2018 and 2019. I am pleased to say that 27% of those who were discharged after completing their treatment were free of dependence. The programmes that we are putting in place, having detected people who have problems, are therefore working, and I am pleased to say that that figure is an increase from the 24% who were successfully free of drugs two years earlier.
The hon. Member is right to point out that people sometimes turn to drugs in prison, when they have no hope and not much else to do. That is why we are committed to ensuring that we increase purposeful activity that will get people jobs when they come out. As evidence of that, she will know about our £2.5 billion spending programme for prison builds. We are absolutely committed to providing spaces where people can do good work and have good education in prisons.
Of course, we need to help those who unfortunately become addicted in prison. I do not shy away from the fact that that happens, but the measures in the Bill and all the other measures that I have identified will help us do that.
The hon. Member rightly talked about rough sleepers, and the link between them and prison. Around 60% of rough sleepers have been in prison in the last year, so there is a clear correlation between offending and homelessness. I have spoken previously about the close work that my Department is doing with the Ministry of Housing, Communities and Local Government to ensure that we take people out of rough sleeping and into homes. That will have an impact on turning around the lives of those people who would otherwise come into our institutions.
In the spending review, the hon. Member will have seen the commitment to £237 million that the Prime Minister announced for accommodation for up to 6,000 rough sleepers. She will also have seen a further £144 million for associated support services and £262 million for substance misuse treatment services, which, when fully deployed, are expected to help more than 11,000 people a year. The Ministry of Housing, Communities and Local Government, through our joint work, is not only taking people off the street, but giving them the treatment they need for their addiction. That spending is a 60% increase on the 2019 SR.
The hon. Member talked about other transitions into the community and between prisons. She is right to identify those points. We are already doing a significant amount of work on transitions into the community. She mentioned the important work that is being done in Wandsworth. That is not one of our RECONNECT programmes, but she will know that we have a RECONNECT service that the NHS is rolling out across the country. That is doing exactly what she identifies: ensuring that those who leave prison engage with community health services and supporting them to make that transition easier. Having spoken to the NHS and the Department of Health and Social Care regularly, I know they are committed to rolling that out in the coming years, in full, everywhere and to every prison in the country.
I agree that there is more work to do on transferring between prisons. That relates to healthcare, NHS records and the work that we need do in prisons, but we are committed across the board to joining up the prisoner journey, not only in healthcare, but in other areas such as education.
The hon. Member mentioned naloxone. That point rightly comes up often, because it is important that, when we release prisoners who are addicted, there are no drastic consequences. Public Health England monitors the number of eligible prisoners who are given naloxone. Currently, 17% of those who have an opiate dependency get naloxone, which is up on previous years. I recognise that it could be more and I know that PHE is doing a piece of work at the moment to monitor performance in relation to take-home naloxone across all prison establishments and to identify best practice. I have spoken to them and they have an ambition that everybody will get it.
I hope I have addressed the hon. Member’s points. The Government are pleased to support the Bill that my right hon. Friend the Member for Chesham and Amersham promoted and that my hon. Friend the Member for North West Durham introduced today, and I commend it to the Committee.
Mr Holden
I thank hon. Members who have taken part today, and I pay tribute to my hon. Friend the Member for Hitchin and Harpenden, who tried to introduce the measure in a previous Session as a ten-minute rule Bill. It did not quite reach Committee stage, but we are rocking on. I hope we can keep it going today. I thank the hon. Members for West Ham and for Enfield, Southgate.
Lucy Frazer
The hon. Member for West Ham has highlighted two matters in her amendment, both of which relate to reporting. I am very grateful for her having raised these very important matters, but I would like to reassure her that the amendment is not necessary, because sufficient procedures are already in place to measure and record what work will be done.
I would like to highlight, as the hon. Lady has, that making sure treatment is available is critical, and the first step is this one: identifying what substances are out there. The second step is identifying those people who we need to help, and the third is to give treatment. I hope that in the points I raised in response to her earlier speech, I have identified the considerable measures that we are taking to support people in their treatment, including the significant sums we are giving to rough sleepers—of course, there is an overlap there with prison leavers—and the RECONNECT service that the NHS links up with those treatments within prison and in the community.
I would like to go through the substance of the amendment. Through proposed new clause 1, the hon. Lady is seeking to expand the current scope of reporting by obligating an assessment of value for money after a year, so I will identify the structures that are already in place. As I said, the key objective is to ensure that people are identified, so that they can get treatments, and the effectiveness of that objective is continually reviewed as part of the national prison drugs strategy, which we published in April last year.
The Department also released an annual assessment, with accompanying statistics, as part of HMPPS’s annual digest. This provides a number of the items that the hon. Lady has enumerated in her amendment, including the number of tests conducted, the number of positive tests, and the number of psychoactive substances found. Furthermore, we believe that the contract for providing the drug testing service is effectively managed and reviewed by operational and commercial teams through regular formal contract meetings. To understand the capabilities of the various testing providers, HMPPS has undertaken extensive market engagement with potential suppliers, and it will do so again during future contract tendering processes.
In relation to the specific points the shadow Minister made about value for money, I can reassure her that the provisions in the Bill would contribute to value for money through drug testing in prisons and ensuring that complete information is routinely gathered relating to the misuse of substances in custody. This, as I said, will enable us to make the right operational responses, as well as ensure that we get the right interventions. I believe that there is scrutiny for drug testing in prisons, supported by existing processes, and we should not rush into legislating on this issue.
I would, of course, be happy to write to the hon. Lady when the annual digest is published—I believe the next one is due in July—to draw her attention to those matters, so that she gets that material as quickly and speedily as possible. Of course, I am always happy to engage with her when she has questions, so that we can resolve any issues that she feels have not been fully dealt with. I ask her to withdraw new clause 1.
10.30 am
In new clause 2, the hon. Lady is asking that the Advisory Council on the Misuse of Drugs make biannual reports to Parliament on substance testing in prisons—that is quite similar to new clause 1. As I have explained to the Committee, the effectiveness of drug testing is continuously reviewed and the contract in which it sits is already scrutinised.
Officials at the Advisory Council on the Misuse of Drugs have advised us that the council is not set up for the type of role proposed in the new clause, which appears to be about reporting on the operations and performance of the substance testing system. The council’s role is to provide independent science advice to the Government. That may involve, for example, synthesising advice based on evidence collected on misuse and societal harms. Its role is not to report on the objectives of specific drug testing programmes. I can reassure the shadow Minister, however, that the ACMD already has a role in making recommendations for action, but more broadly, under its role in the Misuse of Drugs Act 1971. The new clause would broaden those functions beyond their current scope.
I will address a few of the specific points that the hon. Lady made and I hope that I can alleviate some of her concerns. She identified and mentioned the significant investment that we are making in security—the £100 million investment to which I referred earlier when addressing the main clauses. In the course of that significant programme and of ensuring that we have funding from the Treasury for it, we have identified where we think, having done some work, the best value for money is. That is why we are pursuing those measures in the course of our programme.
The hon. Lady talked about the impact of covid on drug testing and the importance of lessons learned. I completely agree with her about the importance of looking at what we have learned in this period, and we are undertaking a broad study on that, with input from a wide range of people, including service users, third parties, and HMPPS itself. We suspended drug testing between April and June because of the social distancing measures and the lockdown within prisons, but under our current national framework prisons can reintroduce testing. Where that is done, prisons must take account of social distancing and cohorting measures. At the moment, it is too early to evaluate the impact of the changes on the drug testing programme, but we will of course be looking at all those issues in due course.
Rob Butler
On the point about the impact of covid, will the Minister join me in paying tribute to all the staff in HMPPS—the officers, the staff in prisons, the governors and those at HMPPS head office—for their tremendous effort to minimise and mitigate the effect of covid on the prison estate during the pandemic?
Lucy Frazer
I absolutely join my hon. Friend in that. He makes an important point: at HMPPS, the governors, prison officers and all the staff in the service have done such a remarkable job through extremely challenging times. The statistics show that we were looking at a significant number of deaths—2,500 to 3,500 deaths—and in the first wave, the death count was in the mid-20s. Although all those deaths are, of course, very sad, that figure is a credit to the joined-up working at every level, including with the POA. Again, I put on the record my thanks to them for the constructive way that they have engaged; I know that they are tired and that it is difficult.
I am very pleased with this morning’s news about the vaccine, because we can see some light at the end of the tunnel of this very difficult period. While many people will be celebrating Christmas, many of our prison officers will still be on the wings doing their work. I pay tribute to them for all the work that they have already done and for the work that I know that they will do, unrelentingly, over the next three months. May I say that I do not find that my hon. Friend the Member for Aylesbury only does PMQs? He is a regular participant in all justice matters, and it is a pleasure to see him serving on the Committee.
I make one last point to the hon. Member for West Ham. She made some important points about who we will give the information to and how it will be used. Like her, I agree that once we collect information, we should use it to our best advantage. We will look very closely at her suggestion that the information be widely shared and see what we can do to share that data within prisons.
My understanding is that we do currently share some of the prevalence data with the POA for substances that have already been tested for. Of course, we need to ensure that we respect security and that we do the right thing in terms of policy making, but that is something that I am very happy to look at further. She also mentioned sharing data with the NHS. We will, of course, be sharing our insights with healthcare providers so that they can quicker adapt their services.
I am always happy to engage with the hon. Lady, as she knows, on these and any other matters, but I ask her to withdraw the new clause.