Prisons (Substance Testing) Bill

Debate between Bambos Charalambous and Lyn Brown

Committee stage & Committee Debate 2 December 2020: House of Commons
Wednesday 2nd December 2020 Public Bill Committees

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

[Ms Brown]

Prisons (Substance Testing) Bill

Debate between Bambos Charalambous and Lyn Brown

Wednesday 2nd December 2020 Public Bill Committees

[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.