Dangerous Drugs

Dan Poulter Excerpts

Tuesday 12th September 2023 Commons Chamber

[Chris Philp]

My hon. Friend is right to point to Dr Nicholl’s work, and I thank him again for his campaigning on this issue, without which we possibly would not be here today taking this legislation through Parliament. The evidence we have seen about the neurological damage caused in particular by large-scale consumption of nitrous oxide is very worrying. Neurological units around the country have seen cases of people who have been paralysed and suffered really quite serious consequences. The numbers are not enormous, but they are extremely worrying, and the severe cases, including paralysis, are deeply concerning. I agree completely with what my hon. Friend just said.

[Dr Dan Poulter (Central Suffolk and North Ipswich) (Con)]

I draw the House’s attention to my declaration in the Register of Members’ Financial Interests: until recently, I was an acting consultant addiction psychiatrist. On the point about other uses of nitrous oxide—legitimate medicinal and industrial uses—moving it away from the psychoactive substances regulations to the Misuse of Drugs Act puts a number of limitations on its use in its current settings. What consultation has my right hon. Friend or his Department done with the medical sector as a whole, and also with other commercial providers or users of nitrous oxide, in advance of laying these regulations before the House?

[Chris Philp]

We have conducted further engagement and consultation with the ACMD and others in industry to understand the implications of this move. I am jumping ahead a little, but we intend to table a further statutory instrument that will take effect alongside this one, which will make it clear that the sale and use of nitrous oxide for legitimate purposes will not be criminalised in any way—it will continue to be permitted. The definition of legitimate use will be very broadly drawn in that SI, because nitrous oxide is used for a wide range of medical research and commercial purposes, and we are not going to try to comprehensively list those purposes. A wide-based exemption for legitimate use will be put in place to make sure that we do not unintentionally stymie either medical research or commercial use of this drug.

It is worth saying that the use of nitrous oxide is quite widespread. Among those aged 16 to 24—

--- Later in debate ---

[Chris Philp]

The hon. Gentleman will be aware that the consumption of beer does not, generally speaking, lead to severe neurological damage and paralysis in the way that the consumption of large amounts of nitrous oxide does.

[Dr Poulter]

I do not wish to be disobliging to the Minister, but the ACMD was very clear that it did not believe that the medical harms of nitrous oxide pose anything like the significance of those caused by many other street drugs, or indeed alcohol. Alcohol-related brain damage causes much more neurological harm than many street drugs do, so I think it would be helpful for the Minister to correct the record on that point.

[Chris Philp]

I have referred to the ACMD advice before, and the ACMD did note the anecdotal reports of severe paralysis caused by excessive nitrous oxide consumption to which I have referred already. On this occasion—rarely, but not uniquely, disagreeing with ACMD advice—the Government, as we are entitled to do, took a broader view. We thought about the association with antisocial behaviour and about the fact that among 16 to 24-year-olds nitrous oxide is the third most used harmful substance, and that is why we took the step we did. Of course, I acknowledge that, as my hon. Friend said, alcohol can have an adverse effect as well, but we feel that in this particular case the misuse of nitrous oxide merits action. Many Members have raised concerns about the effect it has had in their communities, and we are responding at least in part to the concerns that Members have raised.

Nitrous oxide is currently regulated under the Psychoactive Substances Act 2016. It is not, of course, currently an offence to possess nitrous oxide; it is only an offence under the PSA to knowingly or recklessly sell it for personal consumption. So by controlling nitrous oxide as a class C drug under the Misuse of Drugs Act, it will not just be an offence to recklessly or intentionally sell this substance for personal consumption, but be an offence to possess it except for the legitimate use exemptions I mentioned earlier. As I said in response to my hon. Friend’s earlier intervention, we will be bringing through a further SI to set out the definition of those legitimate uses. As I said a moment or two ago, those will be extremely wide-ranging to make sure we do not inadvertently stymie legitimate commercial, medical or research use.

In summary, it is clear that drug misuse ruins lives. In the case of nitrous oxide, it also contributes significantly to antisocial behaviour. The Government have listened to the public and to parliamentarians who have been speaking for their constituents, and that is why we are taking this action.

--- Later in debate ---

[Dr Dan Poulter (Central Suffolk and North Ipswich) (Con)]

It is a pleasure to follow the SNP spokesperson, the hon. Member for Glasgow Central (Alison Thewliss). I do not disagree with much of what she said. I believe the Government will achieve very little through these measures, except perhaps to cause considerable disruption to industry and the medicinal use of nitrous oxide. I am far from convinced by the changing reassurances given by the Minister at the Dispatch Box in that respect.

I once again draw the attention of the House to my entry in the Register of Members’ Financial Interests. I am a practising NHS psychiatrist. Until recently, I was working as an acting addictions consultant psychiatrist and I have dealt with the misuse of drugs extensively throughout my medical career.

I believe in an evidence-based approach to policymaking. This issue has been examined by the ACMD at the request of the Government. The ACMD suggested very clearly that this was not the appropriate legislative vehicle to deal with nitrous oxide. It made that recommendation for two reasons. First, we already have the Psychoactive Substances Act 2016, so if we want to deal with the illegitimate sale and supply of nitrous oxide there is already legislation in place to do that. Secondly, we have other laws that can be used, for example to deal with the unacceptable littering that sometimes occurs with the canisters used in the recreational use of nitrous oxide.

[Mark Garnier]

Is my hon. Friend aware that the ACMD was asked many years ago to opine on exactly this point and it was chased up by two Home Secretaries to try to get a response? It was not until this statutory instrument was first talked about earlier this year that the ACMD got around to answering the Government’s request to make a judgment.

[Dr Poulter]

I am aware that it takes some time to compile ACMD reports. The reason is that the ACMD likes to look at the evidence in the round. There are a number of issues to look at here, such as harms of use. There is relatively limited evidence and data to suggest that nitrous oxide is substantially more harmful than many of the substances we use daily, such as caffeine. Using caffeine to great excess has very profound and immediate health consequences, as does alcohol. The point was made by the hon. Member for Brighton, Kemptown (Lloyd Russell-Moyle) about the Notting Hill carnival and the number of beer cans and other forms of rubbish left there. If we look at the social and health harms of alcohol, which is a legal drug and one that is misused legally, they are considerably more profound than what we are talking about or indeed many other street drugs.

[Sir Greg Knight (East Yorkshire) (Con)]

Can my hon. Friend clarify to the House what his conclusion is on this matter? Is he saying that he opposes the measure, or is he saying that if the measure goes ahead he wants the Government to keep the matter under review?

[Dr Poulter]

If the House divides this evening I will be voting against the measure for the further reasons I am about to outline.

I think it would be helpful to remind the Minister what the ACMD actually said with regard to legislation:

“Based on this harms assessment, the Psychoactive Substances Act 2016 remains the appropriate drug legislation to tackle supply of nitrous oxide for non-legitimate use. There is, however, a need for enforcement of the Psychoactive Substances Act 2016 to be supported by additional interventions designed to reduce health and social harms. Based on this harms assessment, nitrous oxide should not be subjected to control under the Misuse of Drugs Act 1971 for the following reasons”.

Those reasons have been drawn out to some extent during the debate, but they are neatly summarised by the ACMD in its recommendations to the Government in its report.

First,

“Level of health and social harms”,

which is relatively limited, and

“current evidence suggests that the health and social harms are not commensurate with control under the Misuse of Drugs Act 1971.”

Secondly,

“Proportionality of sanctions: the offences under the Misuse of Drugs Act 1971 would be disproportionate for the level of harm associated with nitrous oxide and could have significant unintended consequences.”

Thirdly,

“Impact on legitimate uses: control under the Misuse of Drugs Act 1971 could produce significant burdens for legitimate medical, industrial, commercial, and academic uses. The current scale and number of legitimate uses that stand to be affected is unknown but is estimated to be large.”

I think it is fairly clear that the Government did not carry out a proper impact assessment before bringing this measure to the House.

[Bob Stewart (Beckenham) (Con)]

I thank my good friend for allowing me to intervene. Does that mean that he thinks we should do nothing at all?

[Dr Poulter]

No, I do not think it means we should do nothing. I think that if we believe, as I think many of us do, that we should control the illegitimate supply of nitrous oxide, we should look at existing legislation, such as the Psychoactive Substances Act 2016, which was designed and taken through its stages by my right hon. Friend the Member for Hemel Hempstead (Sir Mike Penning). This point was discussed at some length during its passage. The focus was not on criminalising use and the potential users, but on controlling the supply: a clear distinction was drawn. The Minister may correct this view, but the ACMD made it clear in its report that better enforcement of that existing legislation to control illegitimate supply would be a much better and more proportionate way of dealing with the issue at hand, and the same was suggested more broadly in the evidence supplied to the ACMD while it was compiling its report.

So there is already a legitimate means of dealing with this, but unfortunately there is the potential for unintended consequences, and I was not reassured when the Minister said earlier that the Government would introduce another measure—which no one in the House has seen as yet—to ensure that there would be no such unintended consequences. If a Government are introducing two good pieces of legislation, they should introduce both of them together so that the House can consider them in the round. My concern is that primary legislation such as the Misuse of Drugs Act is tightly drawn, and unless it is amended, it is difficult to introduce another measure to sit beneath it and mitigate its provisions. I am therefore not reassured by the Minister’s comments, but in any event it is not good or effective government not to present the two measures at the same time so that we could consider the issues in the round.

Because I believe that there is already legislation in place which needs to be better enforced to deal with illegitimate supply, and because I do not believe that the Government have given adequate weight or consideration to the potential unintended consequences for legitimate users of nitrous oxide—which the Minister effectively admitted in his opening comments—I believe that the Government are in the wrong place at present, and that it would have been better to produce a proper impact assessment of the legitimate uses to sit alongside this measure before bringing it to the attention of the House. For all those reasons, I will vote against the order if it is put to a vote.

Population Growth: Impact of Immigration

Dan Poulter Excerpts

Tuesday 27th June 2023 Westminster Hall

[Sir John Hayes]

Of course, when people arrive in the country, there is no accounting for where they choose to go. They will typically go to places where there is work, understandably; we would, too, after all. When I speak of these general numbers, the impact in certain parts of the country, as the hon. Gentleman suggests, has been much more profound than in others.

To go back to my point about change. The ability to cope with that level of change economically, socially and culturally has placed immense burdens on those communities that have enjoyed the greatest levels of migration. The population of this country grew by 606,000 last year. The fact that that is unprecedented is a matter of fact. The fact that it is unacceptable is obvious. The scale of growth will put unbearable pressure on already stretched—

[Dr Dan Poulter (Central Suffolk and North Ipswich) (Con)]

Will my right hon. Friend give way?

[Sir John Hayes]

I will be happy to do so in a second, but I just want to illustrate my point.

My hon. Friend may have been about to intervene to tell us this, but last year, we built around 180,000 houses. Bear in mind that the population increased by 600,000. We did not, and could not, build enough surgeries, clinics and hospitals to cope with more than 600,000 additional people. We cannot build enough new railways and roads to deal with the extra demand. We are simply adding 600,000 people to an infrastructure already in desperate need of being upgraded. The pressure on the NHS, which my hon. Friend will know a great deal about, is immense. There were 700,000 new GP registrations last year by people entering the country.

[Dr Poulter]

I thank my right hon. Friend for giving way. I wonder whether he might reflect that last year was slightly unusual in that this country rightly took in approximately 130,000 Ukrainian refugees. There was also a net inflow of about 90,000 British citizens returning. There were other refugees from Afghanistan and Hong Kong to whom we rightly held out our hand as a country to give refuge.

On a wider point, my right hon. Friend is at slight risk of suggesting that immigration per se is bad, when we recognise that people who come here and work hard for the NHS can make a great contribution to our country. Frankly, a number of our public services could not operate without them.

[Sir John Hayes]

People come with an economic need as well as providing an economic benefit. There are costs and benefits to every individual in this room and every person who arrives in the country. The degree of cost they bring will depend on their circumstances. If someone comes who is sick, elderly or infirm, their demand on the NHS will be much greater. If someone comes who is young and fit, economically active and skilled, their contribution to the economy will be much greater.

My hon. Friend is right that last year was exceptional, for the reasons he gave. When I spoke of a typical figure over the period of 250,000, he will understand that that is the size of several substantial cities. Just housing those people alone is proving impossible. The biggest single driver of housing demand is migration, and has been for a very long time indeed.

My hon. Friend is also right that our health service benefits immensely from people born overseas. Both of my sons were delivered by people born overseas. I have been treated by all kinds of specialist doctors, nurses and others born overseas, as have members of my family. I thank them for that service, and fully recognise and appreciate the contribution they have made.

Drug Crime

Dan Poulter Excerpts

Wednesday 20th April 2022 Westminster Hall

[Robbie Moore (Keighley) (Con)]

I beg to move,

That this House has considered the matter of tackling drug crime in local communities.

It is a privilege to serve under your chairmanship, Mr Pritchard. I am grateful to every hon. Member who has come to participate in this debate. I am well aware that the issues we are discussing affect not only my constituency in Keighley and Ilkley but constituencies across the country. I welcome the fact that Members are here from different parties, communities and areas, all coming together to share their thoughts on a real challenge in our communities and to come together to deliver progressive change.

As MPs we want to sing from the rooftops what is so great in our communities, but it is important that we also tackle the darker issues, such as drug crime, that have plagued our cities, towns and rural communities for far too long. Drug crime is a real problem across the country. Last year there were 72,024 arrests for drug offences in England and Wales—up from the previous year, and the highest total in more than five years. It is estimated that one in 11 adults—more than 3 million people—took an illicit drug last year. It is alarming that 2% of adults are classed as frequent drug users. There are more than 300,000 heroin and crack addicts in England, who between them are responsible for nearly half of all burglaries, robberies and other types of crime.

Sadly, those issues are prevalent in my constituency. There is a strong chance that someone going for a walk in some parts of my constituency will see drug crime and drug distribution taking place. Drug crime is happening in all parts of my town.

[Dr Dan Poulter (Central Suffolk and North Ipswich) (Con)]

I fear that this is an issue on which my hon. Friend and I might have different views. He talks about the challenges of illicit drugs in his constituency and the impact they have, but has he assessed the impact of legal drugs, such as alcohol, by comparison?

[Robbie Moore]

I absolutely have. Alcohol abuse is very much an issue in my constituency and in other areas of the county, but what must be tackled—I have seen this time and again—is the misuse of illicit drugs, from cannabis to class A drugs. It is vital that we take a hard-line approach to dealing with such criminality.

[Robbie Moore]

I thank my right hon. Friend for his intervention, and I do agree. We have to take a hard-line approach to those evil members of society who get involved in drug distribution and supply. However, we also need a twin-track approach, which is what the Government have provided through the plan they announced last year—I will come on to that—where we provide support to individuals who get trapped in the system and those who need it.

In my constituency, there have been many instances of drug crime over the past few months and incidents where the police have got involved. Just this morning Sergeant Dave Purcell from our local neighbourhood policing team, along with his colleagues, carried out an early-morning raid and seized cannabis seedlings from an address in the Highfield area of Keighley with an estimated street value of £130,000. That is not the first instance where that has happened; in one instance last year, six men from Keighley were arrested and five cars and £10,000 in cash were seized, as well as weapons such as CS spray and knuckledusters. A staggering 500 wraps of class A drugs were found on those individuals, which they wanted to sell to good people in my constituency who were getting trapped in the system of taking drugs.

Of course, we must also focus on drug distribution. Last year, I was contacted by two constituents who informed me that they had video evidence of one of our local taxi firms using its network to distribute drugs. I went to meet them after a surgery meeting and saw that video footage for myself before passing it on to West Yorkshire police. That illustrates that drug distribution is an organised crime that is happening right across my constituency and the wider country. On the point about taxi firms being used for drug distribution, I pay tribute to my hon. Friend the Member for Darlington (Peter Gibson) for his Taxis and Private Hire Vehicles (Safeguarding and Road Safety) Bill, which contains vital measures that will help restore better licensing provisions, which will operate across the country, as opposed to local authorities dealing with licensing through a siloed approach.

Those examples show that there are undeniable issues in my constituency, which are all related to drug crime. Some local factors exist, some of which are related to geographical area. Keighley is right on the periphery of West Yorkshire, bordering North Yorkshire, and on the periphery of three different local authorities. We closely border North Yorkshire, Lancashire and Calderdale, meaning that county lines drug gangs are a real challenge for my constituency. Because we border two local police areas, drug gangs can use our geographical position to get away with drug dealing undetected, or are not as easily detected, by the police. In one instance, a county lines gang was found to be using rail network links, using Keighley train station to ferry drugs across the border into Skipton.

Often, the evil leaders of supply operations exploit hapless addicts of class A drugs to ensure they have street runners to sell drugs for huge sums, in return for drugs to feed those addicts’ habits or even for a reduction in their debt for the drugs already supplied to them. Innocent people can be drawn by gangs into these bad habits from a very young age, and have their lives ruined by their involvement in this criminal activity.

Drug dealing links to other crimes: members of these gangs are often the same people who are the perpetrators of gang-related grooming and child sexual exploitation—an issue that has haunted my constituency for far too long, and one that I will continue to talk about. They blackmail their victims by exposing them to this criminal activity of drug dealing, which fuels other forms of antisocial behaviour, some of which I have already described.

Violence involving drug gangs has caused disorder and criminal damage in particular areas of Keighley, such as Westburn Avenue. We have two predominant drug gangs within Keighley, who will openly challenge and take one another on in broad daylight. Unfortunately, residents of Westburn Avenue have been exposed to that behaviour, but it is not restricted to that area: it happens in the Highfield area, the Showfield area, and the Lawkholme Lane area of Keighley as well.

That makes people afraid and puts them off coming into Keighley, which is a really good, attractive place. We want to encourage more people to come into Keighley, but we have to address some of these darker, underlying issues. In one tragic case, a man was stabbed to death after challenging a teenage drug dealer to his face about what he was trying to do—selling drugs to a 14-year-old boy. Urgent action and urgent change are needed for the sake of my town and, I am sure, the constituencies of other Members present. We need to talk about this and make sure that when announcements are made at a national level they filter down to our constituents and that our constituents then see real change being delivered at a local level.

Of course, these issues are not just restricted to urban environments; drugs are very much an issue in our rural settings as well. I represent a very urban fringe seat with some really rural parts to it, and I know that drug dealing happens in some of the remotest parts of my constituency as well.

It saddens me to say that when I was first elected to this place, one of the first constituency meetings I had was with a father who came along to tell me that his 13-year-old son had come home from school one day saying, in all innocence, “Dad, I know exactly what I want to do when I’m older,” and that was to become a drug dealer. That was not because his 13-year-old did not know the difference between right and wrong but because he thought drug dealing was something good to aspire to, because he had seen people driving around Keighley in blacked-out, fancy cars. We all know what those individuals are driving and we know where the money comes from to facilitate this activity.

That father was heartbroken that he was coming to me to raise those concerns, but that story gets to the bottom of this issue. This is about raising aspiration for communities such as the one I represent, so that we are not only taking a hard-line approach against drug dealing and providing the necessary support for those who get into the unfortunate situation of taking drugs, but ensuring, alongside all of that, that when we talk about levelling up we are raising aspirations for our constituents and their young families as well.

I was pleased to welcome the Home Secretary to Keighley only a week or so ago. I had had many conversations with her myself, and she met my local neighbourhood policing team to discuss some of the very open challenges we have on the ground. It was great for her to meet Inspector John Barker, as well as some of our police community support officers and members of the police team who are doing incredible work in Keighley.

I welcome the work the Government are doing to tackle this issue, because they want to tackle it head-on. At the end of last year, I was pleased that they unveiled a 10-year plan to clamp down completely on drug crime in our cities, towns and villages, backed by millions of pounds of investment. Of course, that involves a plan to stop the cycle of crime that is driven by addiction, to keep violence out of communities and to save lives by reducing the number of drug-related deaths and homicides.

The Government will also target the violent county lines gang-related issue, which I have already mentioned, making sure that the UK has a strategy that can be adopted by our police forces to make sure that we tackle some of the issues that exist in communities that are geographically challenged, with different police forces, different local authorities and different organisations working cross-boundary. I was also pleased to see that a new commission will be set up to rebuild drug treatment and recovery services to help those who have fallen into this dire situation.

Perhaps most importantly and most encouragingly, though, the Government will put in place a strategy that will educate children comprehensively about the dangers of getting into drugs, and that needs to happen at an early age. Interventions will happen to stop young children from getting dragged into the dangerous life of drug crime.

All the points that I have picked up on are very much to do with the Home Office, the Department for Education and, of course, the Department of Health, but what work is being done at Government level on collaboration between those three Departments, to ensure that when a national policy is announced an average constituent of mine will really feel a tangible change?

[Dr Poulter]

My hon. Friend is making some interesting points, and I should quickly draw attention to my declaration in the Register of Members’ Financial Interests as a practising NHS doctor. On the issue of cross-Government working, it seems extraordinary that most drug treatment services are commissioned not by the NHS but by local authorities. That leads to fragmented care and a lack of direct health involvement in drug treatment. Does my hon. Friend agree that we should ask the Minister to look at this issue, take it to the Department of Health and bring drug treatment commissioning back to the NHS?

[Robbie Moore]

My hon. Friend obviously knows what the next paragraphs of my speech are. In terms of that collaborative approach, we need to give the Department of Health more freedom to instigate some of the measures needed to help those who get driven into this cycle of drug addiction, and to ensure that more support is provided in the treatment sphere as well. Coupled with that, we have to have the right strategy, which involves taking a hard-line approach with those involved in the drug distribution network and those supplying illegal drugs and bringing them into our communities.

I want to give a good example of a very local initiative that has been utilised in Keighley and that is working incredibly well. Driven by the Home Office and initially branded Operation Springhaven, it specifically targeted a small part of my community—an area in Keighley—that was known for having horrendous issues with drug distribution and dealing. Initiated by the Home Office, it took a partnership-led approach and was worked on in collaboration with West Yorkshire police. It brought the local authority, local community groups and the town council onboard. When we took a targeted approach to a specific area, it was not only about tackling drug crime but about being aware of where the drug dealing happened: low-lit back streets that often had overgrown vegetation. All those organisations could work together to try to remove the drug dealing that was taking place. It was done with the point of providing a lot more reassurance to residents living in that area, and involved a lot of door knocking and getting residents to take ownership and buy in to the strategy. It worked incredibly well. I ask the Minister whether that strategy could be adopted and rolled out beyond the initial pilot scheme we had in Keighley.

I conclude by saying that drug crime is dark and horrendous and impacts every level of society, from more affluent areas all the way down to the most deprived areas. It is a dangerous, dark crime that relies on the most evil in society exploiting the weakest. I commend the Government for the work that they are doing, but I would like to understand how we can make sure that the announcements that were made at the end of last year can be delivered as quickly as possible to communities such as those I represent across Keighley and Ilkley.

--- Later in debate ---

[Robin Millar]

The hon. Member makes an interesting suggestion, which I will return to later in my speech. It would be remiss of me to give the great reveal now.

I have the very great privilege of representing a beautiful part of the world, Aberconwy in north Wales. Two thirds of the constituency lies within Snowdonia and the rest is on the coast. We have the walled, medieval town of Conwy and we have Llandudno, which many people probably know is the largest resort in Wales, and it is a beautiful place. Unfortunately, in common with many other, often very beautiful, coastal communities, it also has problems with poverty, deprivation and drug abuse. How often do we hear about poverty and drug abuse together, and about the associated crime?

We have heard about the terrible problems that come with that, and I do not want to dwell on them, except to say that the involvement of children and young people, particularly through the phenomenon of county lines gangs that has grown across the UK in the last decade, is quite awful. Things once attributed to the despicable behaviour of adults are now attributed to children. The age of children doing those things, carrying weapons, and being involved in and exposed to that deprivation, is ever lower. I pay tribute to my hon. Friend the Member for Keighley for bringing this debate forward and allowing us to address these issues.

I pay tribute to the brave police officers in north Wales who are working around the clock to disrupt and break up many county lines operations—in particular, the astonishing work of the intercept team that covers the whole region and was set up to clamp down on organised crime and drug gangs throughout north Wales. The team use innovative technology to ensure they are able to intercept and disrupt criminals, making north Wales a hostile environment for crime groups to operate in. Since their inception in February 2020, they have recovered controlled drugs, tens of thousands of pounds in cash, mobile phones and weapons such as knives, Tasers and worse, and they have made hundreds of proactive arrests.

In March this year alone, the team made 16 arrests for a range of offences and seized more than 100 wraps of class A drugs, 40 bags of class B drugs and £5,000 in cash. The officers have carried out warrants, stopped vehicles and made arrests linked to possession of controlled drugs, drink and drug driving, and other driving offences. It takes courage and dedication to deliver that kind of performance. Th team’s protection of the public is invaluable and they are a credit to the communities they serve in north Wales. I dare say other Members here can say the same of forces operating in their areas.

I turn to the importance of the community and community groups in dealing with this issue. As I and the hon. Member for Inverclyde (Ronnie Cowan) suggested, the first action of the sheriff was to gather a posse; the key point was that the community did not lose ownership of the problem. In western civilisation, we live in an atomised society. We are individualist in our approach and become very transactional in our relationships, and as a result we tend to say, “That is their job.” In debates about litter, I have often heard people say, “I am not picking up that piece of litter because it would cost someone their job—someone is paid to do that.” There is a strange tension in our society that means that we start to have a dissociated view of each other and the different things that happen, and yet in that lesson of the posse, even though the town had hired and paid the sheriff and the deputies, it still had the responsibility.

I will highlight that idea in a couple of comments with respect to poverty. Poverty and drugs exist in almost a death spiral, with the two locked together. Which comes first? It is a case of cause and effect. Very often, they are a cause, but equally those who are locked into poverty are preyed upon by criminal gangs. Some years ago, the Centre for Social Justice produced some thought-provoking work about pathways to poverty, which included drug abuse, educational failure and family breakdown.

The idea of pathways is helpful because, as other hon. Members have mentioned, there are sometimes entry points to these pathways through socially acceptable behaviour. Alcohol is a socially acceptable drug, yet it can become an entry point into harder drug abuse, as can prescription medication. We should not be ignorant of that or imagine that problems with illicit drugs exist in isolation.

At one scheme—I will not mention where it is, except to say it is in north Wales—I spoke to veterans of special forces who in effect used a cocktail of alcohol, across-the-counter and prescription medicines, and illicit drugs, to manage the highs and lows, the uppers and downers, of the post-traumatic stress disorder resulting from some of their experiences in the service of this country. That is just one example of how this kind of problem can develop.

[Dr Poulter]

My hon. Friend has rightly brought the debate on to people who are dependent on alcohol and street drugs. In that respect, I am sure he is aware of schemes operated in countries such as Portugal where drug possession has been decriminalised and of how that has improved access to drug services for many people, who in this country would otherwise be criminalised. It has also reduced drug-related deaths. Is it worth us at least looking into that in this country?

Drugs Policy

Dan Poulter Excerpts

Tuesday 23rd October 2018 Westminster Hall

[Dr Dan Poulter (Central Suffolk and North Ipswich) (Con)]

It makes good sense, and is soundly medically based, to give people who may take an overdose a way of correcting that overdose with a lifesaving intervention. That has to be a good thing to do. I understand that there are tensions with the SNP on this issue, but it is considered good medical practice to do exactly as is being recommended in Scotland and in England.

[Douglas Ross]

I know that my hon. Friend and I disagreed in our last debate on UK drugs policy in Westminster Hall. These are not my conclusions, but those of a national report that has looked into the policies of the Scottish Government and said that, however well-meant the policies are, they have

“not prevented substantial increases in opioid-related deaths in Scotland.”

--- Later in debate ---

[Dr Dan Poulter (Central Suffolk and North Ipswich) (Con)]

I congratulate the hon. Member for Inverclyde (Ronnie Cowan) on securing this debate, and I am sympathetic to many of the points he made. He rightly highlighted the links between the use of drugs, drug dependency and deprivation, the challenges that many people who are dependent on drugs face, such as in housing and employment, and the fact that the current criminal justice approach does not work as we would like. We should help people with drug dependency to access the appropriate health and care support they may need, and we must think seriously about whether the current prohibition on drugs is the right way forward.

My hon. Friend the Member for Moray (Douglas Ross) made a factual point about naloxone and drug use. The policy is widely used in England, Wales, Northern Ireland and Scotland, and all over the world. He might be interested to read a 2017 review paper by McDonald, Campbell and Strang, entitled “Twenty years of take-home naloxone for the prevention of overdose deaths from heroin and other opioids—Conception and maturation”. That paper effectively concludes that take-home naloxone coverage is insufficient—that may chime with something my hon. Friend said—and that greater public investment in such schemes is necessary if we want them to succeed. Opioid deaths and their causes are multifactorial, and a considerable body of international evidence suggests that if naloxone is given to people who are at risk of an overdose, it can save lives; many review and study papers indicate that. I believe it is a step in the right direction for the Scottish Government to confront that issue and to say that there is a good body of evidence, but unfortunately dealing with opioid deaths is not as simple as just handing out naloxone, which we know is in itself an effective measure.

The hon. Member for Strangford (Jim Shannon) made the case against the end of prohibition on drugs. If we look at the wider public health issue, it is fair to say that if something is decriminalised or legalised, more people may well use that substance because it could be seen as something that is okay or acceptable to use, but I do not think anyone in this debate is suggesting that if there was a broader approach to the decriminalisation or legalisation of drugs, there would not be a public health campaign, just as there is with legal drugs such as alcohol and nicotine, to suggest that there are adverse health outcomes associated with use.

Many substances that are classified class C or even class A have a lower public health burden than alcohol—for example, MDMA or ecstasy. Alcohol, the legal drug that many people—not me—in Parliament and elsewhere consume, is the substance that causes the biggest public health burden. We must be realistic and recognise that if we move to a position where people are able to make a more informed choice about whether they want to consume drugs in the future, that informed choice involves telling people that taking certain substances has consequences, as we do with alcohol and cigarettes today.

On the current approach to drugs, I would like the Minister to pick up on a couple of points. First, there is the challenge of improving the care that we provide for people who are dependent on drugs. This is not an issue for this Minister, but it may be a conversation to be had with the Department of Health and Social Care. The current commissioning landscape in England for drug and alcohol services is fragmented and completely divorced from mental health. We have to recognise that mistake, which we made in the Health and Social Care Act 2012. That needs to be addressed if we want to improve the quality of care available to people who are dependent on opioids in particular, as well as alcohol or any other substance.

It is important to recognise that improving care for people who are dependent on substances is about taking a holistic approach. It is about law enforcement working together with healthcare, housing and social care, and about finding employment and retraining solutions for people. The way existing law is framed, alongside the criminal justice prism through which drug laws are seen and enforced, often drives a wedge between different agencies, preventing them from working together effectively for the benefit of people who are dependent on illicit or street drugs. I hope the Minister can look at that point. Many opioid users are struggling to get treatment. In recent years, there has been a rising trend in the number of opioid deaths, yet the number of people with addiction to heroin and opioids accessing treatment has fallen in the last 10 years or so. There is a problem here that needs to be addressed.

We often talk about being tough on crime and tough on the causes of crime—I think a former Prime Minister said that, and it is something we can all agree with. What good treatment for people affected by substance misuse is not about is being tough on crime and being tough on addicts. That does not work, it has not worked, and it is driving a wedge between the health system and the people it is trying to support. I hope that we can recognise in our broader discussions about prohibition that the current policies are a barrier to people with drug dependence receiving the care and support that they need.

[Mrs Madeleine Moon (in the Chair)]

I am keen to make sure that everyone gets a chance to speak. I suggest that people have a self-imposed speaking time of three minutes. That will leave a little less time for the Front-Benchers, but I would like to make sure that everyone gets the chance to air their view. I call Jeff Smith.

--- Later in debate ---

[The Parliamentary Under-Secretary of State for the Home Department (Victoria Atkins)]

It is a pleasure to serve under your chairmanship, Sir Edward. As I have previously stated on the record, owing to the potential for a conflict of interest, with my husband’s business interests, I have recused myself on issues relating to cannabis and synthetic cannabinoids. I therefore will not respond to those points during this debate, but will ask the Policing Minister, who deals with these matters, to write to Members on those points.

I congratulate the hon. Member for Inverclyde (Ronnie Cowan) on securing the debate. His debates on drugs always seem to be interrupted by numerous Divisions, so I am delighted to have reached the point where I have a little time to sum up.

This Government recognise the serious harm that drugs cause, not only to individual users but to their families, children and local communities. Drugs have been identified in the recent serious violence strategy as a major driver of the recent increases in serious violence. Drugs cost more than £10 billion a year to our society, over half of which is attributed to drug-related acquisitive crime such as burglary, robbery and shoplifting. We remain ambitious and committed in addressing these problems. That is why we committed to further action on drugs as part of the serious violence strategy.

Our policy on drugs is anchored in education to reduce demand, tough and intelligent enforcement to restrict supply, evidence-based treatment to aid recovery, and co-ordinated global action. I will deal with the global picture first. The UK is driving global action to tackle drug harms. Genuine international challenges include the increased production and purity of cocaine in Colombia, and the problems of fentanyl use in North America. International co-operation is key. We continue to strengthen controls at our borders, share information and understand global trends. Last week, I met people from the International Narcotics Control Board who had come to view our work on tackling drugs. We will continue to work closely with our international partners to share best practice and achieve the best possible outcomes for all those at risk of harm from drugs.

The national picture, Government are already delivering a range of action is that through the 2017 drugs strategy to prevent drug misuse in our communities, support people to recover from dependence on drugs, and support law enforcement to tackle the illicit drug trade.

[Dr Poulter]

On reducing drug dependency, is the Minister aware that generic buprenorphine is no longer available from the manufacturer? As a result, drug treatment uses the Subutex brand, which costs £3,000 per patient per year and is becoming increasingly expensive. Will she look into that? It is proving financially difficult to support patients with opioid-substitution therapy.

[Victoria Atkins]

I will of course look into that, and I will ask a Health Minister to write to my hon. Friend.

The drug strategy recognises that we must reduce demand by acting early to prevent people from using drugs in the first place and to prevent escalation to more harmful use. We are taking action to build resilience among young people, alongside a targeted approach for groups at particular risk. Well-off recreational drug users must also recognise the part that they play in funding the criminal networks that supply their drugs and the violence that those crime gangs use.

My shadow, the hon. Member for Swansea East (Carolyn Harris), has already mentioned the issue of county lines. Yesterday, we had a meeting of the serious violence taskforce. It is absolutely clear that the illicit drug market is a major driver of the rise of serious violence, which is why the police must work with our health professionals to tackle it. Schools play a vital role in that, helping children to understand the risks of illicit drugs and build their resilience and ability to say no. The Government are making health education compulsory, as well as funding Mentor UK’s Alcohol and Drug Education and Prevention Information Service to provide practical advice to teachers.

Tough enforcement, however, is fundamental. We are restricting the supply of drugs, adapting our approach to changes in criminal activity, using innovative data and technology, and taking co-ordinated action to tackle drugs alongside other criminal activity. Through the Psychoactive Substances Act 2016, we have choked off the supply of so-called legal highs. More than 300 retailers throughout the UK have closed down or are no longer selling psychoactive substances. Police have arrested suppliers, and the National Crime Agency has ensured the removal of psychoactive substances from sale on UK websites.

Psychoactive Substances

Dan Poulter Excerpts

Wednesday 23rd May 2018 Westminster Hall

[Dr Dan Poulter (Central Suffolk and North Ipswich) (Con)]

It is a pleasure to serve under your chairmanship, Sir Christopher.

I congratulate the right hon. Member for Delyn (David Hanson) on securing the debate, which is a welcome opportunity to review a piece of legislation that was not uncontroversial when it passed through the House a couple of years ago. I shall touch briefly on a couple of points that he made and pick up on the issue of research, in particular, which was something that I raised during the passage of the Bill.

The then Minister, my right hon. Friend the Member for Hemel Hempstead (Sir Mike Penning), recognised some of the challenges and barriers to effective research that might arise from the Bill—research not only into psychoactive substances and their effects, but into finding effective treatment for people who become physiologically addicted to such substances or dependent on them in other ways.

I shall press the Minister on research, because it is important for us to facilitate research and treatment in this area and to have a joined-up approach. It is no good just having punitive regulations and laws unless we also find a way to help people who are in need of help because they are using these substances. I am sure that everyone in the Chamber agrees on that.

I shall also touch a little more on the need for more joined-up working and on the focus on prevention, which was another issue raised during the passage of the Bill that led to the Psychoactive Substances Act. Too often after criminal justice legislation has been passed, we forget that we want to avoid the need to enforce these laws and that we want to help people to make informed and better choices in the first place. The right hon. Member for Delyn was right about the challenges to having a joined-up and effective approach across local authorities, the NHS and the police in many areas of drugs policy.

The changes introduced by the Health and Social Care Act 2012 fragmented healthcare provision in substance abuse services, making local authorities the primary commissioners. That has not helped the police or others much in the task of providing effective and joined-up preventive care or in improving education for people about the choices that they make when they take psychoactive substances or other drugs.

On research, a number of researchers and research institutions are clearly somewhat confused by some aspects of the law. The way in which the 2016 Act is drafted means that we are potentially criminalising what would otherwise be legitimate research. That was my reading of the legislation as it passed through the House, and there are still concerns in the research community. As drafted, the law makes it difficult to perform legitimate research on, for example, methods of treating people who develop a physiological dependence on spice, which is a topical new psychoactive substance and cannabinoid on which an estimated 15% of users develop a physiological dependence—a higher figure than for those smoking skunk, because of the nature of the substance and its ingredients.

To help people with a physiological dependence—for example, people with an opioid dependence—we have drugs such as methadone and buprenorphine. Over time, those drugs have been put through clinical trials, and they have been used to support people who are addicts—who need, for example, to be treated to come off heroin. The concern is that, while we recognise that some of the new psychoactive substances have the potential to cause higher levels of physiological dependence than some other drugs that we recognise from the past—I used the example of spice compared with cannabis that is smoked—it is difficult under the 2016 Act for researchers necessarily to research effective ways of dealing with that physiological dependence.

Drugs that can be used include the benzodiazepines, but it is difficult to research such use. The barriers to research put in place by the Act, and indeed the Misuse of Drugs Act 1971, have not helped. Those barriers make it difficult for researchers to research effective medications to help people who are addicted. The Government need to look at that, not only because reducing addiction and dependency is important, but because the then Minister, my right hon. Friend the Member for Hemel Hempstead, said during the passage of the Bill that he would take the issue away and look at it. I would be grateful for an update on what the Department has done during the intervening time to look at this.

I took Professor Sir Robin Murray to meet the Minister to discuss more broadly some of the barriers to research on cannabis, such as the need for a Home Office licence. We were not talking about therapeutic treatment for people with physiological dependence, but the principle is the same, and it is one I hope the Department is able to look at, because it is about improving the health and wellbeing of people who often have a multitude of health and complex social issues to deal with. That is something we need to address if we want to deal with addiction and help researchers develop effective treatments for people who have addiction to new psychoactive substances.

The second point I wanted to raise briefly, which picks up on a point raised by the right hon. Member for Delyn, is the need for a broader focus on prevention and, more generally, for more effective joined-up working between the police, health services and the Prison Service. We know about the problems that many prisoners face and about the high number of deaths there are among prisoners with heroin addiction on leaving prison, due to their reduced tolerance, and there is a spike in the first two weeks after they leave prison. More broadly, we know that new psychoactive substances such as spice are widely used in prison. It has been made an offence to use new psychoactive substances in prison, but that does not deal with the fundamental issue of how we help people to make better choices and how we help those with addiction to engage more effectively with the NHS and healthcare services.

Whatever treatment may be available in prison, the problem is that there is not joined-up working when people leave prison, partially because NHS care for addiction is now commissioned by local authorities. That care is incredibly fragmented, and there is not the national focus that the NHS could bring to the issue. I urge the Minister to have further discussions with the Department of Health and Social Care. We have to revisit the 2012 Act, which has done a great disservice to substance misuse services. It has resulted in fragmentation, which we see very vividly in the context of prisoners leaving prison and more broadly in the variability in commissioning. In tightened economic times, the variability of resources means that different local authorities commission in incredibly different ways—some more effectively than others.

The lack of joined-up working I have outlined between local authorities and prisons, and between the NHS and local authorities in engaging wider mental health services with substance abuse services, is a real issue. I hope the Minister will take that away from the debate and discuss it with the Department of Health and Social Care. It would be a disservice to some very vulnerable people if he did not do so, and I am sure he will look into this.

With those two points—on the potential barriers to research into therapeutic treatment and the need for a more collaborative and joined-up approach between prisons and the criminal justice system and, more generally, in the health service—I will bring my remarks to a close. I hope that the Minister will take those points in the constructive tone that has been set in the debate, look at them and recognise that improvements are needed if we are to make the Government’s policy on dealing with new psychoactive substances more effective.

[Several hon. Members rose—]

Drug Consumption Rooms

Dan Poulter Excerpts

Wednesday 17th January 2018 Westminster Hall

[Douglas Ross (Moray) (Con)]

It is a pleasure to serve under your chairmanship, Mrs Ryan. Thank you for understanding that I am unable to stay until the end of the debate and still calling me to speak.

I congratulate the hon. Member for Inverclyde (Ronnie Cowan) on securing the debate, but I must say from the outset that I am against the introduction of these facilities. The problem with support for drug consumption rooms is that it is based on a faulty assumption that the issue with class A drugs is the circumstances in which they are consumed. It is true that many users of class A drugs are killed, injured or exposed to infection by particularly unsafe means of consumption, such as dirty needles. However, the answer is not to create state-sanctioned drug consumption rooms, but to address the real issue: the consumption itself. Our efforts must be focused on getting people off these drugs. Diversions such as drug control rooms only serve to distract from that purpose, or even make matters worse.

[Dr Dan Poulter (Central Suffolk and North Ipswich) (Con)]

I congratulate the hon. Member for Inverclyde (Ronnie Cowan) on introducing the debate. My hon. Friend makes a point about helping people to get off drugs. Surely the first step is engaging those people with medical services? The purpose of drug consumption rooms is to do exactly that, and to help people to engage in a safe way. That can be the first step to getting them off the drugs.

[Douglas Ross]

I agree that engagement is important; I disagree that the only place in which that engagement can take place is in these drug rooms. I stick by what I said earlier. We really have to ensure that we do not go down this route, because there is ultimately no safe way to take class A drugs—that is why they are classified as such.

--- Later in debate ---

[Crispin Blunt (Reigate) (Con)]

I am delighted to follow the hon. Member for Inverclyde (Ronnie Cowan) and I congratulate him on securing the debate. I recognise that we have a shared interest in the work that we jointly do as officers of the all-party parliamentary group on drug policy reform.

The hon. Gentleman will be unsurprised that I largely agree with his analysis. My hon. Friend the Member for Moray (Douglas Ross) might be a little more surprised about that, but I congratulate him on his speech and on taking part in the debate and representing a view that appears to represent the majority in Parliament. That is an example of the challenge one faces in getting consideration of this issue into the era of evidence and in getting it addressed around the issue of public health.

The Under-Secretary of State for the Home Department, my hon. Friend the Member for Louth and Horncastle (Victoria Atkins), who will reply to the debate for the Government, is entirely typical in that in nearly all the nations of the world drugs policy sits in an interior or Home Department where drugs policy sits. That is frankly wrong. It ought to be sitting in Health. We are dealing with a very serious health issue.

It would be very nice if the world’s objective to deliver detox and abstinence, as elucidated by my hon. Friend the Member for Moray, was realistic. The world has been trying to do that collectively for nearly 60 years, and the position continues to get worse and worse. The criminal justice consequences of this policy are utterly appalling, and I speak from experience, having served as the Minister responsible for prisons, probation and criminal justice for two and a half years. That is just in the United Kingdom. Half of acquisitive crime is driven by addiction, and if we cannot do anything about addiction, we should be not remotely surprised that the cost to our country of the criminal justice impact is in the order of £13.5 billion, which I think was the figure given in the Government’s latest drug strategy.

From a criminal justice perspective, I would have traded the massive savings we make in criminal justice to get this issue out of criminal justice and into public health. As I have got into this issue and understood it better, I see that these two things go hand in hand. We would get a significant public health advantage by being more transparent and open about our treatment of addiction. Even if a country was not prepared to go outside the global convention and global policy on the war on drugs—to go as far as Portugal has gone—and simply decriminalised low-level use, it would see a massive improvement in its public health outcomes.

[Dr Poulter]

My hon. Friend is making a characteristically constructive and well-informed speech about a matter he knows well. One of the problems with the current approach is that by punishing people who, through addiction, are medically unwell—that is the way I see it, as a doctor—we are worsening the ability to engage with them effectively in healthcare terms and worsening the spiral of addiction through debt and the criminal justice consequences. Does he agree that that needs to change?

[Crispin Blunt]

I wholly agree. My hon. Friend, with his medical background, speaks with authority on this matter. Drug consumption rooms plainly, on the basis of evidence around the world, ought to be part of our attempt to treat people who find themselves in the wretched position of being addicted to the most difficult and dangerous drugs. It is simply about the evidence. No one has died globally in a properly overseen drug consumption room, and yet in our country, 1,707 people died as a result of illicit heroin use in 2016. The extraordinarily stark contrast between the figures in Portugal and Scotland alone ought to make all of us think very carefully about the implications of our current policy.

Mental Health Act 1983

Dan Poulter Excerpts

Tuesday 11th July 2017 Commons Chamber

[Sir Paul Beresford]

The other four officers stood on tip-toes waiting to catch the young woman on each occasion when she looked as if she was going to dive through the window. Fortunately, they managed to stop any action. In the meantime, contact was made with St George’s Hospital’s psychiatric unit to seek urgent hospital psychiatric assistance. After some considerable time, the appropriate psychiatric individual arrived with an ambulance and crew. This immediately inspired further alarm, rejection and, ultimately, a huge struggle. In due course, a sad young lady was transported to the hospital as the designated place of safety, and we had prevented the suicide.

The whole pantomime had occupied five officers and three NHS staff, and took about four hours to sort out. It was obvious from the very beginning that the police themselves could have taken care of the young lady quickly, as indeed they did after instruction from the NHS staff. Immediate action by the police would have taken the lady into care quickly, thus reducing the continuing risk over those four hours, and saving the police and NHS staff a large number of man hours. Under section 136 of the Mental Health Act, the police would have been able to act promptly if this pantomime had taken place in a public place. However, the incident took place at the young lady’s mother’s home. That was deemed, correctly, to be a private place, which meant that no direct police action was legally possible. I have had discussions with officers in the Met, and I have found that this was not an unusual case.

A more tragic case was the death of Martin Middleton in 2010. He was taken to a Leeds police station by officers who had visited him at home, having been made aware, and then seeing for themselves, that Mr Middleton was making serious preparations for committing suicide. The officers incorrectly believed that they could arrest Mr Middleton and take him from his home under section 136. When they arrived at the police station, the custody sergeant refused to detain Mr Middleton as the arrest had taken place in his home. The officers were therefore required by the custody sergeant to return Mr Middleton to a relative’s home, hoping that that was some form of safety. Sadly, Mr Middleton still managed to hang himself there.

At the inquest, the coroner had no hesitation in agreeing with Professor Keith Rix, who was called to give expert evidence, that Mr Middleton fell into a category of mentally disordered persons for whom there is no provision under the 1983 Act. Subsequent to raising the issue, I have heard from many frontline police officers, including those who have campaigned on the issue, and I have also had extensive conversations with Professor Keith Rix, who is an academic psychiatrist and an expert in this area. I am reliably informed that the Garda in the Republic of Ireland have a clear operational advantage over our police because, under section 12 of the Irish Mental Health Act 2001, they can act promptly, even in a private residence.

As the all-seeing Minister will be aware, over the 10 years between 1997 and 2007, admissions to hospital as a place of safety went up from 2,237 to 7,035—those are the latest figures that I have been able to get. The Minister is quick with arithmetic, so she will be able to note that that is a threefold increase. The difficulty facing the police is that the powers on which they can act are limited to persons found by the police in a public place. There is ample anecdotal—and perhaps stronger—evidence that the police in desperation sometimes persuade a person to leave their home, or contrive to remove them to a public place so that they can use the section 136 powers of arrest. In fact, one London-based social services authority’s audited figures estimated that 30% of section 136 arrests were recorded as having been made at or just outside the detainee’s home. The police do that in sheer desperation to save the individual’s life, which would be lost unless they acted. Put bluntly, a tiny adjustment to the legislation would allow the police to act in a private home, as they can in a public place. That would save an enormous amount of time and, potentially, a considerable number of lives.

In my discussions about this, it has been suggested that the police already have sufficient powers—they do not. The second argument is that an amendment would extend the right of the police to enter private properties—yes, it would. There are many legal reasons for the police to enter a private property; perhaps the most obvious and linked one is that if the mentally ill person was threatening, or in the process of murdering, somebody in that private place, rather than killing themselves, the police could act immediately.

There is a simple solution to this: amend section 136 by simply removing the words

“in a place to which the public have access”.

When I raised this issue in the Adjournment debate about a year ago, the Minister’s predecessor gave a clear indication that change was being considered. He gave me a commitment that if the Government could not get this right using the measures they were considering, an amendment to section 136 might be exactly what was required.

[Dr Dan Poulter (Central Suffolk and North Ipswich) (Con)]

My hon. Friend is making an important and thoughtful speech. Does he agree that it is possible at the moment for a mental health professional who wants to put someone under section 2 or section 3 of the Mental Health Act to gain entry to their house with the police and a locksmith? It therefore seems strange that the police do not have powers to deal with a very similar situation when they have concerns about someone’s mental health and believe they need to exercise section 136 powers.

[Sir Paul Beresford]

I thank my hon. Friend, who is, of course, on his way, with a bit of luck, to being a very senior academic psychiatrist in a couple of years. He is right. In situations such as this, no one rings up St George’s Hospital in Tooting and says, “Please could I have a psychiatrist?” They ring the Met police, who then have the difficulty of dealing with the situation, and who stand there holding the detainee in the private home while the psychiatrist is brought in from the hospital.

I shall be grateful if my hon. Friend the Minister will at least be prepared to meet me and Professor Rix to discuss how this difficulty can be sorted out. If necessary, I am prepared to resort, as I have in the past, to the ten-minute rule Bill procedure to bring about this tiny change.

--- Later in debate ---

[Sarah Newton]

My hon. Friend makes a very good point and he will be pleased with recent legislation that has reduced that timeframe from 72 to 24 hours. That is a big step forward. Whether an incident happens in a public place or in someone’s home, we are working towards a situation where a mental health professional will be with the police when they attend. That means that there will be no delay similar to that described so vividly by my hon. Friend. I think that some of the examples he gave happened some time ago. As a result of investment, particularly in the work of the crisis care concordat, which has created the framework for police forces to work with mental health services in their community, all kinds of innovative measures have been introduced to ensure that resources, including mental health nurses routinely working with police officers on the beat and specialist back-up to deal with situations similar to those we have heard about this evening, are planned and delivered locally. That is how we want things to happen.

As I have said, we are putting the resources in place. Although these services are working in most of the country, additional investment is being provided where that is not the case. There is also support through the crisis care concordat to fill those gaps and to ensure that everyone everywhere has the same experience.

[Dr Poulter]

My hon. Friend is making some thoughtful and good points about the extra resources that are going in to support people with a mental illness. On section 136 powers, the mental health professional who accompanies the police is often a nurse, and they do not have powers to section people. A section 12-approved doctor who accompanies the police, however, does have powers to section people, and the same is true under sections 2 and 3 of the Mental Health Act. I think that is where my hon. Friend the Member for Mole Valley (Sir Paul Beresford) is coming from.

[Sarah Newton]

I thank my hon. Friend for his contribution. The point I was trying to make is that a range of health professionals are working alongside the police in different settings to make sure that their response is appropriate. Sometimes it is mental health nurses who will be on the beat with police officers. My hon. Friend the Member for Mole Valley said that the police were called because somebody was in a very aggravated and stressful situation and they might have been prepared to take their own life. A call handler at the emergency centre would triage that situation, understand its severity and send the appropriately qualified medical professional so that they can make those decisions.

I think we are largely in agreement on the progress we have made. I want to focus on my hon. Friend’s key point, which is that he does not think that the police have sufficient powers to act quickly in relation to people in private homes who are mentally distressed. I have read through his previous contributions and I am sympathetic to his point. I appreciate how utterly frustrating it must be for police officers who find themselves in a situation where they feel helpless to take action in a reasonable amount of time when they would have those powers if they were in a public place. Having read previous debates and contributions, however, I think it is right that we consider somebody’s home differently from a public place. For most people, their home is their refuge. It is a special place. We allow people to do all sorts of things in their homes that we do not allow them to do in a public place. We have to reflect carefully before taking more powers on the state to allow us to intervene in people’s private space. We seek to strike the right balance so that we can intervene to keep people safe and ensure that they get access to services without violating their privacy. We have consulted quite widely on the matter, and we considered it when we were looking at a review of the legislation. There was a lot of discussion about it, and the view was that we had struck the right balance and did not need to take the extra step that my hon. Friend wants us to take.

New powers have been introduced, as I mentioned, in the Policing and Crime Act 2017, and we are monitoring how they are working. I reassure my hon. Friend that if that monitoring suggests that we can or should do more, we will take further action. We expect to see a lot more data from the police this autumn about how sections 135 and 136 are implemented on the ground. We will be analysing the results of a new annual data return to establish whether there are any new trends or patterns that need further response. We will have the opportunity to consider the whole issue in the round as we look, as promised, at the Mental Health Act.

I am happy to meet my hon. Friend and any other colleagues who have a close interest in this policy area, along with Professor Rix and officials from the Department of Health and the Home Office, to make sure that we have this absolutely right. We want to join up mental health professionals and police professionals appropriately to prevent the sorts of situations that we have heard about this evening. I look forward to building on the good progress that we have made, and I will continue to work well with my hon. Friend to make sure that that happens.

Question put and agreed to.

Prevent Strategy

Dan Poulter Excerpts

Wednesday 1st February 2017 Westminster Hall

[Lucy Allan]

I completely agree with the right hon. Gentleman. I am delighted that he made that point, and that he made it so eloquently, because he has helped to articulate my argument.

Under the Counter-Terrorism and Security Act 2015, Prevent moved from being a co-operative and voluntary action by the community to being a statutory duty, and therein lies the problem. A failure to meet a statutory duty can have negative consequences, for example for teachers in schools. Ofsted assesses whether the duty has been met and delivers a grading for the achievement of compliance with it. The grading will be reduced if a school has not complied with the duty. As a school governor, I have seen the incentive to make referrals under Prevent. If we do not make them, we might feel that we will get into trouble, or that there will be a negative impact on the school or a teacher’s career.

That approach has led to an exponential increase in the number of referrals since Prevent became a statutory duty. One child a week under the age of 10 is being reported to Prevent—I use the word “reported”, but perhaps I should use “referred” instead.

[Dr Daniel Poulter (Central Suffolk and North Ipswich) (Con)]

My hon. Friend is making some good points about concerns in certain communities, particularly the Muslim community. Does she accept that one issue is that of miscommunication? My understanding is that Prevent is not only about the Muslim community, which seems to be the focus for a lot of the discussion; it is also about the real danger from right-wing extremist groups. Prevent is focused on training people to understand that as well.

[Lucy Allan]

My hon. Friend is absolutely right. I have not so far mentioned, and I think I will not mention at any point, the Muslim community specifically. However, I will mention some use of Prevent to tackle the far right, which is a good point and one we should all take on board.

--- Later in debate ---

[Lucy Allan]

I thank the Minister for his intervention. What is important about what he said is that although the incident was not referred under the Prevent mechanism, the same actions were taken. The teachers concerned would have been trained in Prevent and alert to this whole issue. Although they did not formally trigger the Prevent mechanism, they still called the police about an issue that might otherwise have been to do with extremism. It is important to bear that in mind.

From what I have seen, when schools look for signs of extremism, they do not really know what they are looking for. They often come up with suggestions for things that might be grounds for referral that have no possible connection at all to extremism. I have sat in governors’ meetings where teachers who want to comply have openly discussed scenarios such as a child coming into school and saying that he has been on a Fathers 4 Justice march or a march to protest against badger culls. To me, Prevent is certainly not intended to tackle that. There is no indication that that type of activity would lead to extremist or terrorist behaviour. It is greatly concerning that people are sitting around in schools thinking, “What possible scenarios can we come up with?”

More and more public sector workers are being trained in how to report under the Prevent duty, but that does not make me feel any more comfortable. I believe that some 600,000 people are now trained to refer people under Prevent for the purposes of re-education and religious guidance. That does not give me confidence at all; it actually makes me feel more concerned. We should not, as a matter of course, have people sitting and waiting to spot signs when, if there had been grounds to report them, their own good judgment may have kicked in and enabled some less intrusive, less authoritarian approach to be taken to deal with the issue.

[Dr Poulter]

My hon. Friend might be aware that I am one of those public sector workers when I am not working as an MP. May I reassure her that a lot of work on Prevent goes on, particularly in psychiatry, and we use clinical judgment in exercising our duties? Referrals are rarely made to Prevent through mental health services unless there is a reason for doing so. Referrals are usually made due to the exploitation of an individual by other people, and it is those people who end up being referred and engaged in the Prevent process, not the individual themselves.

[Lucy Allan]

My hon. Friend makes a good point.

Children and young people will always test boundaries, and playground banter and bragging must not be seen as potentially sinister things where children must be watched. That breeds fear, suspicion and mistrust, which concerns me.

My hon. Friend the Member for Banbury (Victoria Prentis) raised safeguarding. I want to challenge the way that Prevent is packaged as a safeguarding measure. In effect, we are told, “Prevent must be a good thing, because it is intended to keep us safe.” It is depicted as offering support and advice to ensure that susceptibility to radicalisation is diminished. It is a real concern that that is how the Government perceive Prevent, because that perception is out of step with how Prevent is interpreted and perceived by those affected by it. In the context of Prevent, safeguarding is often about forcible state intervention in the private life of an individual when no crime has been committed, and that is inevitably experienced in a negative way.

It is important to understand that families subjected to safeguarding measures will, in any event, experience them as frightening, shaming and stigmatising. Someone in a position of trust—whether a teacher or a doctor—is used to gather and share data, often about young children, without consent, investigations are conducted and the police are involved. That process is anything but supportive and helpful; it destroys trust. A less heavy-handed approach would be far more constructive. Calling that approach safeguarding, and conflating counter-extremism measures and safeguarding, is quite dangerous.

--- Later in debate ---

[James Berry]

That is right, but that is certainly not an argument for getting rid of Prevent. There are countless other cases in which the Prevent duty would result in issues being picked up. That is why there have been 1,000 voluntary referrals to Channel, where people have been channelled away from any risks. That is what the Contest strategy does.

This hypothetical was tested when the Home Affairs Committee went on a trip to the USA. Two members of the Committee who went on the trip are in the Chamber today. We asked the Americans what they did about domestic counter-terrorism prevention and whether they had a Prevent type of programme. The answer was no, they did not have such a programme. They recognised that that was a gap in their toolkit and they were actually looking at the British system, although the Committee members did point out some of the deficiencies and gave them some advice. Of course, the trip took place under the Obama regime before Donald Trump became President. If only President Trump were focusing on domestic terrorism, which is where the threat actually comes from, rather than banning people coming from seven countries with currently no risk of terrorism on American soil. However, the Americans are looking at a strategy because they do not have a system like Prevent on their soil at the moment.

I will turn to the two main objections. The first is that Prevent targets Muslims. It is right that 70% of those who have been directed to Channel for voluntary referrals have been Muslims and 15% have been far right extremists who are not Muslims. That fact does not mean that the Muslim community is being targeted, but I understand why members of the Muslim community, including the young people we met on the trip organised by the hon. Member for Bradford West (Naz Shah), felt that way. It is right that the Government should do more to publicise the cases of far right extremists who have been dealt with under the policy, because the people we spoke to on that trip simply were not aware of them, even though the cases were well publicised.

Equally, we have to guard against the reality that some groups such as Cage, a disgraceful organisation that gave evidence to the Home Affairs Committee, would make sustained efforts to undermine any replacement of the Prevent programme, just as they have done with Prevent. They have spoken out, criticised and been involved in threats against Muslim groups who stand up and support Prevent or elements of Prevent. They do that because they do not even accept that a problem exists that needs tackling by something such as Prevent in the first place.

[Dr Poulter]

My hon. Friend is making a very good speech. Does he agree that one of the successes of the Prevent programme has been—for example, in the health service—raising awareness of people who may be vulnerable? People with mental illness are particularly susceptible to adverse influences and potentially susceptible to extremists of all different types exploiting them. The programme has also helped to encourage partnership working between the NHS and the police, because there is often strong clinical judgment exerted and used in such cases.

[James Berry]

I agree with everything that my hon. Friend said. That brings me to the second main criticism of Prevent—that it puts undue pressure on teachers, doctors and social workers. It is true that they are not policemen and are already under huge pressure—I know that teachers are, because my mother was one—because of all sorts of duties of the kind, besides their core one of teaching. However, they are the people with day-to-day contact with young people and they have the opportunity to notice what others, including the police, may not. That is why they have similar duties to report child abuse, female genital mutilation, forced marriage and the like. We rely on them to pick up things that others might miss or parents would not report.

Migration into the EU

Dan Poulter Excerpts

Wednesday 10th February 2016 Westminster Hall

[Dr Daniel Poulter (Central Suffolk and North Ipswich) (Con)]

It is a pleasure to serve under your chairmanship, Mr Rosindell. First, I pay tribute to my hon. Friend the Member for Gravesham (Mr Holloway) for securing this debate. As always, it is a pleasure to speak after the thoughtful and well-considered comments of the hon. Member for Strangford (Jim Shannon).

In this debate, we have touched on the European Union. One thing I said before I became an MP was that I would not talk about the EU in debates unless it was absolutely necessary, but it is necessary in the context of this debate. As we often find with debates on the EU, polarised viewpoints have been put across today, but the point is that whether or not we are in the European Union, the world as a whole—Britain, the EU and the world—is facing a forced migration crisis, the like of which has not been seen for a generation.

Of course a legitimate discussion can be had about whether membership of the European Union is beneficial in tackling the crisis and the humanitarian challenges that it throws up; but it would be simplistic and wrong to say that not being a member of the EU would make the crisis go away for Britain. We need to be clear about that, because sometimes in these discussions it appears that some of my colleagues think that it would be a magic wand to make the problem go away. The problem is not fundamentally about membership of the European Union; it is about a number of push factors that are due to the humanitarian situation in a number of countries in Africa and the middle east. That is clear from the evidence.

The countries where the majority of migrants come from—particularly when we look at Italy and Greece, the two countries on the frontier of the EU that receive the greatest number of migrants—are Eritrea, Nigeria, Somalia, Sudan, Syria, Afghanistan, Iraq and Greece. Those are the main sources of migrants going into the countries in question. Many of the countries that the migrants come from have serious humanitarian issues or are in war-torn areas. As the hon. and learned Member for Edinburgh South West (Joanna Cherry) pointed out, because of terrible domestic circumstances in those countries a large number of people legitimately and rightly come to claim asylum. We have a proud tradition in this country and in the European Union generally of granting asylum to people in genuine need.

[Jonathan Lord]

My hon. Friend is right to draw attention to the horrific humanitarian crisis. I am pleased to say that in Woking we have, under the Prime Minister’s scheme, taken families from the Syrian camps. My hon. Friend talked about push factors; but surely there are also important pull factors at large. If the German Chancellor says she will take 1 million people and the EU also says it will allow people to stay in Europe, is not that a potential pull factor for economic migrants as well as genuine refugees?

[Dr Poulter]

My hon. Friend makes a good point about what the Government are rightly doing in Woking, in Suffolk and elsewhere, in accepting 20,000 refugees during the lifetime of the Parliament, and in their commitment to deal with the tragic circumstances of child refugees. We should be proud of that. It is a good thing that the Government and those local authorities are doing.

On the point that my hon. Friend raised—also an important one—it would clearly be a pull factor to accept migrants into the European Union unconditionally. It is not my understanding that other EU countries—or indeed Britain—are accepting migration unconditionally. However, there is acceptance that we have an international duty to respond to humanitarian crisis. That is why we are accepting 20,000 refugees. We have a proud tradition of doing that, which we have heard about, going back to the second world war, Uganda, the Vietnamese boat people and the Kosovan and other conflicts. We should be proud because this country has always been a home for people in genuine need fleeing persecution. We should never shirk that, and the Government’s current response to the crisis is the right one.

However, we should also make the distinction that others have made during the debate, that, while we have a humanitarian responsibility to people seeking asylum from persecution, we clearly cannot have an open door to mass migration. The country’s infrastructure would not accept that. At the same time, when people have settled in the UK migration has almost always been hugely beneficial to our country. We are very proud of the multicultural NHS that we have, where 40% of the workforce are from outside the UK. In my part of the country, migrant workers come across for the summer period to work in the agriculture sector. Agriculture needs those workers to support the picking of crops, and do other essential work. It would be wrong to lump all migration together as a bad thing, because it has so often been beneficial to the British economy, and if people want to come here and work it can be a very good thing. The NHS would not function today if it were not for migrant workers who have come from Australia, New Zealand and all over the world, as well as the EU, to support it.

I want finally to highlight some possible solutions. Whatever the rights and wrongs, and the terrible record of the Gaddafi Government in Libya, agreement was reached in 2010 with the Libyan regime to work to reduce the flow of migration through that country and across the Mediterranean. Clearly, there is war and a terrible situation in the country. A process is going on at the moment in Algiers to bring the two sides together and I hope a resolution to the conflict can be found. That would be to the benefit of the people of Libya, and it might also make it possible as part of the reconstruction to reinstate an agreement and look at the migrant flow through Libya, as has happened in the past—when it worked to reduce migration.

There are issues involved that we cannot deal with just as Britain. At the EU-wide level, benefits are gained from working together and from supporting Italy and Greece and other frontier states in tackling the problem. That is something that the British Government support, and put money towards, rightly. Both unilaterally and with our European partners we must continue to take in genuine asylum seekers and refugees, and do our best to mitigate the push factors by providing support in the form of humanitarian aid in Syria and elsewhere. We should be proud of the Government and what we are doing on the issue, and of our past and present humanitarian record.

Oral Answers to Questions

Dan Poulter Excerpts

Monday 6th September 2010 Commons Chamber

[Mr Speaker]

Order. I am grateful to the Minister. “The Daily Politics” is a fascinating programme, but I do not want to hear about the dilations of Opposition spokesmen on it, because the purpose of Question Time is to hear about the policies of the Government.

[Dr Daniel Poulter (Central Suffolk and North Ipswich) (Con)]

10. What discussions she has had with the Secretary of State for Health on steps to ensure that the standard of English required of migrant health professionals is adequate for the purpose of safe clinical practice.

[The Minister for Immigration (Damian Green)]

I have regular exchanges with my colleagues on matters relating to migration policy. The Government are committed to seeking to stop foreign health care professionals working in the NHS unless they have passed robust language and competence tests. Migrants coming in under the points-based system are already required to meet language tests. The specific criteria for eligibility to practise medicine in the UK are a matter for the Secretary of State for Health.

[Dr Poulter]

Is the Minister aware of British Medical Association research showing that 60 to 70% of medical personnel employed by medical locum agencies are recruited from overseas and that many do not have English as a first language? We have already seen the tragic consequences of that in the east of England, with the case of Dr Daniel Ubani. Can the Minister assure me that he will work with the Department of Health to ensure that medical locum agencies take a much more robust approach to recruitment in future?

[Damian Green]

I am indeed aware of the problem to which my hon. Friend refers, a problem that has an immigration aspect and, obviously, an aspect for the Department of Health. Non-EU workers who work as agency workers would not normally qualify under tier 2 —the work-based route of the points-based system—as they would not be filling a substantive vacancy. Such workers may have arrived here by other routes, such as tier 1 of the points-based system, in which case their language skills would be checked, or as a spouse, in which case they would not. The problem illustrates why efforts to check the language skills of health professionals need to be focused on those who employ them, which is precisely what my right hon. Friend the Secretary of State for Health is doing.