NHS: Contaminated Blood

Debate between Baroness Chisholm of Owlpen and Baroness Meacher

Thursday 20th July 2017 Lords Chamber

[Baroness Chisholm of Owlpen]

As regards the set-up of the inquiry, no final decisions on how it will be have been made. That will be taken into account following the consultations. As the noble Baroness said, there are two possible ways of doing it, either by a statutory inquiry, which involves a judge and means witnesses can be ordered to appear, or rather like the Hillsborough panel, which is more “families first” but cannot force witnesses to appear. No decision has been made. It will all be part of the consultation over the summer before a decision in September.

As for the other queries mentioned by the noble Baroness, I do not now want to go into what happened before. This Urgent Question is about how the inquiry will be set up. However, I understand the noble Baroness’s concerns about the consultation. I do not know the date yet. When I go out, if I find the date has been agreed, I will make sure I write to the noble Baroness.

[Baroness Meacher (CB)]

My Lords, I declare my interest as president of the Haemophilia Society. The Minister will be aware that the Haemophilia Society and others boycotted the meeting this morning to discuss the remit of the inquiry because of the involvement of the Department of Health. The Department of Health will be the main subject of this inquiry. For example, why did the Department of Health continue to allow contaminated blood to be given to patients when it was known to be unsafe? Which documents were shredded by Department of Health officials and why? It is surely preposterous for the Department of Health to be able to restrict the inquiry by being involved in setting the terms of reference or the remit. It gives it enormous power over something where it should have no power at all. Will the Minister ensure that the decision on the remit of this inquiry will not involve the Department of Health at all and that the inquiry will be a statutory inquiry to ensure that witnesses can be required to give evidence so that justice can finally be given to these innocent and badly affected victims?

[Baroness Chisholm of Owlpen]

I thank the noble Baroness for the question. We are very aware of the worries that various Members involved in this have. That is why an early consultative meeting was scheduled for today at the Cabinet Office. As I said in the Statement, the Secretary of State and Ministers hope to understand further the important views of those affected about the shape and establishment of the inquiry. It was the first of several meetings. Over the summer, following the responses as a result of the letters, we will be going forward, listening to what everyone is saying and making a decision. I can guarantee that.

Psychoactive Substances Bill [HL]

Debate between Baroness Chisholm of Owlpen and Baroness Meacher

Tuesday 14th July 2015 Lords Chamber

[Baroness Meacher (CB)]

My Lords, I shall speak to Amendment 56, which refers to Clause 56(2)(a). It is a probing amendment along similar lines to Amendment 21. As there are three different ways in which possession can become a criminal offence, the aim of the amendment is to clarify with Ministers the circumstances in which possession is not a criminal offence and those in which it is. I thank Mr Fortson QC for his briefing on this issue.

The Government have emphasised that the Bill does not make simple possession of a psychoactive substance a criminal offence, and I and many others certainly welcome that important step forward in the Bill. We know from the lengthy experience in Portugal, for example, that decriminalising possession there and investing more resources in treatment and less in prisons has resulted in fewer young people being addicted to drugs. That is surely one of our primary objectives. I find it enormously positive that the Government understand that issue and are taking it forward in the Bill.

As I said, there are three situations in which possession can become a criminal offence. If a person produces a psychoactive substance at home, for example by cooking something up in the kitchen, and they intend to consume it purely by themselves, they will have committed an offence. I want to make clear to your Lordships that I am not suggesting that anyone should cook up a psychoactive substance in their kitchen, albeit I have a number of friends who do just that—they create interesting and highly intoxicating alcoholic beverages in their kitchens. It is very easy to be rather hypocritical about these issues. Nevertheless, I wanted to make the point. It is not that I am promoting the idea of young people getting into the kitchen and creating these things. However, one has to think about the inconsistency.

If a young person is thinking about getting hold of a psychoactive substance and goes out to a dealer, buys a substance and goes home, they will not be committing a criminal offence if they are found with the substance in their hand. If they are found to have created, or are creating, the substance at home, they will be committing a criminal offence. It is possible to say that it could be very much safer for a young person to take a substance when they know its ingredients, rather than go to a crack dealer. I gather that that is what has happened in Ireland. As the head shops have closed, young people have gone to the crack dealers, who are doing a nice business with these psychoactive substances. One has to think of the incentive effect of these kinds of inconsistencies.

It is not only a criminal offence to create a substance in your kitchen. It is also a criminal offence, as the noble Lord, Lord Paddick, said, to import a substance for your own consumption. It is also a criminal offence if you export a substance for your own consumption—which might seem a slightly peculiar idea, but it is in the Bill. To illustrate the point, if someone has a psychoactive substance in their pocket, they are not committing an offence if they are at home. However, if they go on holiday with the substance tucked away in their pocket because they have forgotten it is there, and if it is still in their pocket when they come back, they will have committed two offences: importing and exporting a psychoactive substance. I know that that sounds a ludicrous example but one has to be conscious of the kinds of things that arise out of inconsistencies in legislation.

I understand from Mr Fortson QC—I would not have been aware of it otherwise—that this issue is of some importance. The offences to which I have referred are apparently described as lifestyle offences. Therefore, they trigger the most draconian provisions of the Proceeds of Crime Act 2002. Either the prosecutor or the court could initiate confiscation proceedings under POCA for one of these offences of possession of a psychoactive substance. That would seem, certainly to Mr Fortson QC, to be an entirely disproportionate response to what appears to be a rather insignificant offence. It was he who suggested that I should at least raise this matter in the House and seek the agreement of the Minister to ask her officials to look into these inconsistencies and to explore whether there is a way of finding a resolution that would feel somewhat more comfortable.

[Baroness Chisholm of Owlpen (Con)]

My Lords, as the noble Lord, Lord Paddick, has indicated, Amendment 21 seeks to exclude from the importation offence in Clause 8, the importation of a psychoactive substance by a person for their own personal consumption. Amendment 56, in the name of the noble Baroness, Lady Meacher, aims to do something similar in that it seeks to exclude production for personal consumption from the scope of the offence in Clause 4.

The Government do not accept that there is an inherent contradiction between, on the one hand, making it an offence to import or produce a psychoactive substance for personal use and, on the other, not criminalising personal possession. The Bill is about tackling the trade in psychoactive substances, whatever form it may take, both domestically and internationally. The importation of psychoactive substances, particularly by post, is indisputably a key form of supply. To exclude importation for personal consumption, even assuming you could neatly carve such conduct out of the importation offence, has the potential to drive a coach and horses through the ban on importation. It would be an open invitation for individuals to import numerous small quantities, which they could then combine together for onward supply.

It is also important to mention that the proposal would impose a near impossible task on Border Force customs officials and National Crime Agency officers in policing the importation ban. It is obvious that it would be very difficult and time consuming for them to determine whether a particular consignment of psychoactive substances was for onward supply or for personal use. For example, a person could import a significant quantity of psychoactive substances at one time, claiming that it was a year’s worth of supplies for their personal use.

With a blanket ban, the Border Force will have a clear mandate to seize any substance likely to be consumed by any individual for its psychoactive effects, and where the importation is not for an exempted activity. This will enable it to stop these potentially dangerous substances entering the country. In fact, between 2014 and 2015, more than 3.5 tonnes of new psychoactive substances were seized by Border Force officers. This was a 75% increase on the previous year.

Once the Border Force has identified a consignment, it can then simply invoke its seizure powers and the substances will be subject to a forfeiture process. In appropriate circumstances, the National Crime Agency will wish to investigate further and seek prosecution of an individual for a Clause 8 offence.

I can assure noble Lords that, as for any offence, a prosecution for an offence under Clause 8 would be pursued only if the public interest test is met. This is clearly set out in the Crown Prosecution Service’s Code for Crown Prosecutors. The sort of questions that the prosecutor must ask him or herself when considering the public interest test include: “Is prosecution a proportionate response?”, “What is the impact on the community?”, and, “Was the suspect under the age of 18 at the time of the offence?”. I hope this reassures noble Lords that decisions to prosecute for any offence in the Bill will not be taken lightly and a number of factors will be considered.

Interestingly, the national policing lead has advised that the long-term focus of enforcement action will be on those sources of supply which caused the most harm to communities in terms of crime and disorder, or where they are connected with organised crime. Some of these considerations apply equally to Amendment 56, to the extent that it could open up a significant loophole which could be exploited. More to the point, I put it to the noble Baroness, Lady Meacher: do we really want to encourage people to manufacture psychoactive substances in their garden shed, or, indeed, their bath? I suggest not. Production is clearly a critical link in the supply chain and we should not tolerate it on any level, whether it is on an industrial or cottage-industry scale.

The purpose of the Bill is to clamp down on the supply of NPS, not to criminalise young people. A range of civil sanctions is available to law enforcement agencies which offer an alternative route to criminal proceedings as a means of tackling the production and supply of psychoactive substances. The use of these sanctions will enable law enforcement officers to take action swiftly to nip a problem in the bud or to adopt a more proportionate approach to low-level offending. It will be a matter for the relevant law enforcement officer to determine the most appropriate course of action.

I hope that has reassured noble Lords—

Psychoactive Substances Bill [HL]

Debate between Baroness Chisholm of Owlpen and Baroness Meacher

Tuesday 14th July 2015 Lords Chamber

[Baroness Chisholm of Owlpen (Con)]

I thank noble Lords for all their points. As discussed in Committee, there is common ground between these amendments and the Government’s position. As I said in Committee, it is the Government’s absolute and determined objective that bona fide medical and scientific research should be untouched by the provisions of the Bill. We will deal with the issue of research on cannabis when we reach Amendment 25.

It is already the case that broad swathes of research involving psychoactive substances fall outside the blanket ban. If a substance is not intended for human consumption for its psychoactive effects, it will not be caught by the Bill. Paragraph 3 of Schedule 1 exempts investigational medicinal products used in clinical trials. However, I understand, and the Government fully accept, that this exemption does not go far enough. This is an issue of some concern for the academic and scientific community. The noble Baroness, Lady Meacher, referred in Committee and again today to the letter in support of her Amendment 12 sent to my right honourable friend the Home Secretary by the Academy of Medical Sciences and five other leading scientific institutions. My noble friend Lord Bates responded to that letter yesterday. I shall read out the critical paragraph in that response:

“We have now had some further discussions with the Department of Health and the Medical Research Council. In going forward, we need to ensure that any amendment to the Bill satisfies the scientific community as represented by the Academy of Medical Sciences and your co-signatories, as well as our own policy and legislative requirements. For this reason, we intend to develop this work in the coming weeks with a view to introducing an amendment when the Bill is considered by the House of Commons. To help achieve this I would value engagement between your representatives and officials from both the Home Office and the Department of Health to reach a common understanding and satisfactory outcome in the next few weeks”.

I hope that that will reassure noble Lords that we are firmly committed to bringing forward an appropriate amendment on this issue, but it will take more time to get it right in consultation with the Academy of Medical Sciences, the Advisory Council on the Misuse of Drugs and others. We need to ensure that bona fide medical and scientific research is excluded from the ambit of the Bill, while not creating a loophole for others, whose only purpose is the recreational use of psychoactive substances, to exploit.

Amendment 11 is on a different point raised by the noble Baroness, Lady Meacher, in seeking to expand the definition of medicinal products, and therefore the exemption for such products, in paragraph 2 of Schedule 1. The noble Baroness is pushing at an open door here. As I also indicated in Committee, this is another area we are considering further with the Department of Health and the Medicines and Healthcare Products Regulatory Agency.

We are conscious that the Bill as drafted does not include unlicensed medicines for human use known as “specials”. These are lawfully manufactured, imported, distributed or supplied for the treatment of individual patients after being ordered by a range of healthcare professionals, not just doctors. As such, they need to be taken out of scope of the definition of a psychoactive substance.

In its letter to the Home Secretary, the Advisory Council on the Misuse of Drugs specifically raised concerns about the scope of exemption for herbal medicines. The European Herbal & Traditional Medicine Practitioners Association has also flagged a need to ensure that the exemption for medicines includes herbal medicines used by practitioners on a named-patient basis. This is another area where we are actively reviewing whether we need to adjust the current definitions in the Bill.

Medicines legislation is a complex area, as I know noble Lords are aware, and defining bona fide research is not as straightforward as one might imagine. We have certainly not so far been able to identify an off-the-shelf definition in existing legislation which we can readily apply. It is regrettable that we have not been able to table amendments in time for the House today, and I fear we will not be in a position to do so for Third Reading next Monday. I ask noble Lords to bear with us. We will use the time over the Summer Recess—no holidays for us—to bring forward appropriate amendments in the Commons. I will ensure that noble Lords taking part in this debate have sight of those amendments. Your Lordships’ House will then have an opportunity to consider the issue further when the Bill returns from the Commons in the autumn.

I hope that, in the light of that commitment, the noble Baroness, Lady Meacher, will be content to withdraw her amendment.

[Baroness Meacher]

My Lords, I thank noble Lords who have spoken in this debate. I thank the Minister for her reassuring comments, her assurance about the Government’s commitment to ensuring that all bona fide medicines and research will fall outside the scope of the Bill, and her assurance that the Government will consult key experts to ensure that the Bill is right in this respect. On that basis, I beg leave to withdraw the amendment.

Psychoactive Substances Bill [HL]

Debate between Baroness Chisholm of Owlpen and Baroness Meacher

Tuesday 23rd June 2015 Lords Chamber

[Baroness Chisholm of Owlpen (Con)]

I am grateful to the noble Lord, Lord Howarth, for his explanation on these amendments. Before I start, I was very rude earlier when I did not thank him for the kind words he said at the beginning of this debate and I feel very honoured to be taking part. I agree that a joined-up approach in departments is a very useful point. Also, I feel extremely privileged to be able to learn from my noble friend Lord Bates about how these things are conducted. The noble Lord has asked that, before this Act comes into force, the Home Secretary must issue guidance on how users, enforcement authorities and others can identify individual psychoactive substances, the degree of the psychoactivity, their safe uses and their relative harms.

I can certainly understand the sentiment underpinning at least part of Amendment 11. I acknowledge the importance of the effective implementation of the provisions in the Bill by enforcement agencies and the crucial role played by the Home Secretary in ensuring that this takes place.

I emphasise that we are working closely with enforcement agencies—the police, the Border Force, the National Crime Agency and the Local Government Association—to ensure the successful implementation of the Bill. All the agencies, supported by the Home Office, will produce guidance for their own officers that will address issues such as those raised by the noble Lord. For example, it seems sensible that the College of Policing, with the national policing lead on drugs policy, is best placed to produce the guidance for police officers, along with our input, as I have said. Similarly, the Local Government Association is well placed to produce tailored guidance for local authorities.

We are also working with other bodies, including the British Retail Consortium and the Association of Convenience Stores, to produce targeted guidance for their members. It is also important to discuss with the Welsh and Scottish Governments and with Northern Ireland’s Department of Justice what guidance is needed to address their national needs. Any guidance for prosecutors in England and Wales is a matter for the Director of Public Prosecutions.

However, I have grave concerns about issuing guidance to users of psychoactive substances on how they might identify such substances, along with their degree of psychoactivity, their safe uses and their relative harms. I have the same concerns about Amendment 12, which states that the Government must establish a network of centres where drug users can get their illegal drugs tested. Although this is doubtless well intentioned, I fear that such approaches could have the opposite effect to that intended. Such initiatives could actually serve to promote the availability of psychoactive substances and encourage their use, which is clearly contrary to the purpose of the Bill. A better approach is to highlight the harms of such substances, alongside wider efforts at prevention.

[Baroness Meacher]

The Minister referred to testing centres possibly having the opposite effect to that intended. In the Netherlands, where such centres have been in operation for some time, they are actually rather successful. For example, there have been, I believe, no deaths resulting from psychoactive substances. Rather than worry about whether they might have the opposite effect to that intended, I suggest that the Government check with the Netherlands how those centres are working, because they would find that they were working well.

[Baroness Chisholm of Owlpen]

I will certainly take that forward. However, with regard to testing centres, the Dutch model sits within a more tolerant drugs policy that the Netherlands has. Our key message is that there is no safe dose of these drugs, and they should not be taken. Any move towards such a scheme would undermine that message and could encourage drug use, contrary to government policy. This proposal would also cover drugs controlled under the Misuse of Drugs Act, not just those covered by this Bill. That would undermine our intentional obligations as a signatory to the UN conventions, and no clear public protection case has yet emerged for such a testing centre.

There is a well-established system for issuing a national alert. Any intelligence that Public Health England receives alerting it to identifiable problems, such as a batch of drugs likely to cause significant risk in England, is acted on.

Psychoactive Substances Bill [HL]

Debate between Baroness Chisholm of Owlpen and Baroness Meacher

Tuesday 23rd June 2015 Lords Chamber

[Baroness Chisholm of Owlpen]

The noble Lord is right: I was rather remiss in not saying that I was sympathetic to his views on this issue, and I apologise. We will certainly consider it between now and Report.

[Baroness Meacher]

I just want to explore the point in Amendments 4 and 6 that, because there is only a single market that incorporates all the controlled drugs under the 1971 Act and psychoactive substances, post-legislative scrutiny will not make any sense unless it looks at the overall impact of this Bill. For example, what we can expect to happen is that if you ban synthetic cannabis, people will move straight over to the cannabis controlled under the Misuse of Drugs Act. If you ban a substitute for cocaine, people will move straight back to the natural cocaine, if you like, that is controlled under the Misuse of Drugs Act. In order to assess the impact of the Bill, it will be essential to look at the overall consumption of illegal, banned drugs and the deaths from those drugs. The deaths may move across from one type of drug to another, as would the harms and so forth. It is essential that the Government begin to look at this as a single, illicit market for banned substances. Does the noble Baroness agree that, therefore, post-legislative scrutiny has to look right across the piece?

[Baroness Chisholm of Owlpen]

I thank the noble Baroness for her points, and I agree with her. However, it is important that we do not tie the hands of the committee. It is up to it to review, going forward, and we have to let it decide what it feels is right.

--- Later in debate ---

[Baroness Chisholm of Owlpen]

I thank the noble Lord. I have a lot of sympathy for what he said, and I think that it is right for us to go away and reflect on this and come back at Report. Of course, the Home Office has every intention of reviewing the Bill once it is implemented. We just do not feel we should put such a commitment in primary legislation. It is in our interests to consider the impact of this Bill and how the psychoactive substance market is changing to ensure that both our legislative and non-legislative responses are as effective as possible. Having said that, of course we will go away and think further on this.

[Baroness Meacher]

My Lords, I thank noble Lords who contributed to this debate, particularly the noble and learned Lord, Lord Mackay of Clashfern, for his helpful proposal that there should be post-legislative scrutiny by a Joint Committee. I hope that that can come about. I agree with the noble Lord, Lord Howarth, that that sort of scrutiny does not detract from the need for the Government’s post-legislative scrutiny, so I think that we are all going in roughly the same direction.

I was very pleased with the noble Baroness’s response about the recognition of the single market for these illegal drugs, because it would be an enormous step forward if we stop seeing these things as separate and start examining what is going on across the piece. That has all been extremely helpful. The timeframe is an issue: three to five years seems an awfully long time particularly as some of us do not really expect this legislation to work, especially bearing in mind the Irish experience. It is a great pity—Ireland is now four years on and still wondering what to do.

Given all of that, this is Committee and we have had a useful debate on this issue. I look forward to meeting Ministers between now and Report. On that basis, I am more than happy to withdraw the amendment.