Prison-based Addiction Treatment Pathways

(Limited Text - Ministerial Extracts only)

Wednesday 2nd March 2022 Westminster Hall

[The Minister for Care and Mental Health (Gillian Keegan)]

It is a pleasure to serve under your chairmanship for the first time, Dr Huq, and I look forward to doing so on many more occasions. I am grateful to the hon. Member for Liverpool, Walton (Dan Carden) for raising this important issue, which I know matters to us both. We come from a similar area and have seen similar challenges, which is probably one of the reasons why we are both here to try to help people live their best lives.

Addiction is a chronic condition with damaging and far-reaching consequences for individuals, their loved ones and wider society. A high proportion of the individuals who go into prison already have a substance misuse problem, but some may develop an addiction while in prison, as the hon. Member for Strangford (Jim Shannon) outlined. This Government are committed to ensuring that we take the opportunity while people are in prison to get them the treatment they need and to get them out of crime. However, tackling addictions in prison requires a collective effort at both national and local level. The Department of Health and Social Care is committed to working with partners across health and justice to ensure safe, timely and effective care that improves health outcomes and reduces health inequalities for prisoners, as well as reducing reoffending.

In prisons and in the community, the NHS is focusing on integrating substance misuse and mental health services, to ensure that we provide joined-up, trauma-informed care that addresses an individual’s complex and interrelated problems, as the hon. Member for Liverpool, Walton, pointed out so eloquently. This is an important blend—to ensure that the mental health services and support are there, as well as substance misuse support. Investment in those services in prisons has increased from £184 million in 2016-17 to £203 million in 2020-21, with NHS England and Improvement committing a further £21 million over the next three years.

The NHS has also just commenced the roll-out of something fundamental—the GP2GP functionality. This will ensure that 100% of GPs working in the adult prison estate will be able to transfer clinical records to and from GPs in the community, allowing greater continuity of care for people entering and leaving the prison estate, and safeguarding health gains made when people go to and from prison. Ensuring continuity of care is vital, but it does not happen well in all cases today. The roll-out is being made in six tranches, with all of the male prison estate to be completed by June 2022.

Providing appropriate intervention and treatment at the right time and in the right place is vital to improving outcomes for people with substance misuse and mental health problems. NHS liaison and diversion services work at police stations and criminal courts to identify and assess people with substance misuse issues so that they can be referred to appropriate services and, where appropriate, out of the justice system all together. We are working with health and justice partners to increase the use of community sentence treatment requirements, which can help to reduce reoffending and custodial sentences by offering drug or alcohol treatment as part of a sentence.

In February 2019, the Government commissioned Professor Dame Carol Black to conduct an independent review of the issues and challenges relating to drug misuse, which exposed the stark scale of the national challenge. The hon. Gentleman referred to that vital piece of work a lot. I thank Dame Carol for her thorough review and for championing this important agenda. The Government accepted all of her key recommendations and are committed to supporting individuals suffering from addictions in prison.

To that end, we recently announced a number of initiatives that focus on recovery and rehabilitation, some of which the hon. Gentleman mentioned. The new drugs strategy, “From harm to hope”, was published on 6 December 2021. It sets out how we will significantly increase the number of drug and alcohol treatment places, and therefore increase the number of people in long-term recovery from substance addiction. The strategy aims to reverse the upward trend in drug-related deaths and to bolster the crime prevention effort by reducing levels of offending associated with drug dependency. It is important work. The hon. Gentleman questioned whether the DHSC is in any way reluctant to carry out that work. Not at all; I am very committed to that outcome and, as far as I am aware, we are working well with partners across and in the community.

To deliver the strategy, we have made available an additional £780 million, which represents the largest ever single increase in treatment and recovery investment. Of the £780 million, £530 million will be spent on enhancing drug treatment services, while £120 million will be used to support offenders and ex-offenders to engage with the treatment that they need to turn their lives around. There is specific funding for that purpose.

The hon. Gentleman made a point about abstinence-based treatment versus methadone prescribing or other treatments. Both have their place. Not everyone’s addiction is the same and nor is their pathway to recovery. The clinical evidence guidelines—including National Institute for Health and Care Excellence guidance—and clinical consensus will support a balanced and integrated approach. Those bodies will be the ones deciding what is best for the individual concerned.

The prisons White Paper, which was published on 7 December 2021, has a specific focus on tackling barriers to rehabilitation and reform by deploying the full range of treatment options to support recovery from drug dependency. For example, we are exploring the benefits of making long-acting buprenorphine available to prisoners by assessing the impact on engagement with treatment, protection from overdose, and relapse after release. We are also supplying life-saving naloxone medication to staff in prisons and approved premises to prevent unnecessary deaths from opiate overdoses.

Crucially, we want continuity of treatment once an offender is released back into the community, so that they do not slip back into using drugs and into the life of crime that they have often followed. The NHS long-term plan introduced the NHS Reconnect service to work with individuals who would otherwise struggle to engage with community-based healthcare services. The service works with such individuals pre-release to ensure that there is no disruption to their care. Reconnect is the largest health and justice investment to be delivered by the NHS long-term plan, with an annual spend of £13.8 million in 2022-23, rising to £20 million in 2023-24.

As well providing health and care support, we need to tackle the wider issues that can hinder a person’s ability to recover and turn back the clock on their crime. Prison programmes for drug rehabilitation, skills and work will be more closely linked to the support services available in the community when offenders are released. We are working with the Department for Work and Pensions and the Ministry of Justice on that. Through those initiatives, we are ensuring that every day that an offender spends behind bars involves purposeful reform and rehabilitation to help them to recover and turn their life around, and to ensure that they have the building blocks in place to maintain that recovery and make a positive contribution to society after they leave prison.

Our focus on recovery is unprecedented in its ambition and in the level of funding backing that ambition, and it forms a key part of the Government’s plans to cut crime and make our communities safer as we build back better, stronger and fairer after the pandemic.

Question put and agreed to.