Prisons (Substance Testing) Bill

Bambos Charalambous Excerpts

Wednesday 2nd December 2020 Public Bill Committees

The first is after coming into prison from the community. We know that 90% of people who come into prison from outside and who go on to access treatment are into the treatment programme within three weeks, and 61% access it immediately. That sounds to me like a good statistic, but among people who are moving from one secure setting to another the numbers are a little worse: 41% of those who eventually access treatment after a transfer took more than three weeks to do so, which cannot be good, and just 15% started treatment immediately after their transfer. There is clearly a problem, and I really would like to hear from the Minister what she feels can be done to improve things.

[Bambos Charalambous (Enfield, Southgate) (Lab)]

I had the pleasure of visiting HMP Cardiff a couple of years ago with the Welsh Affairs Committee and the Justice Committee. That prison was getting prisoners from Bristol visiting them who were under different regimes—under a different nation’s schemes. That had an impact on the prisoners from Bristol and other areas. Does my hon. Friend agree that there needs to be a more joined-up approach in dealing with this?

[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.

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The hon. Lady asked what we will use the evidence we gather for. The key objective of the mandatory drug testing programme is to provide a means of identifying prisoners with ongoing drug problems to ensure that they are offered the appropriate treatment, and I would like to detail some of the work that we are doing on that. However, it is also right, as highlighted by my hon. Friend the Member for Aylesbury, who has such experience, that we need to tackle those who traffic, distribute and use illegal and illicit drugs, and prison governors should have appropriate sanctions available to them to discourage such offending. The hon. Member for West Ham is right that we need to treat people with drug use, but prisons must take a balanced approach that is consistent with that, and it is important that they have the tools available to them in appropriate places.

[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.