Cannabis

Dan Poulter Excerpts

Monday 12th October 2015 Westminster Hall

[Mr Peter Lilley (Hitchin and Harpenden) (Con)]

It is a pleasure to follow the hon. Member for Newport West (Paul Flynn), who for many years and with great consistency has pursued his campaign on this front and, sadly, has not yet achieved his objective.

Some years ago, members of the press asked Front Benchers from both parties whether they had ever consumed cannabis. I found that I was one of the very few who had never done so then, and I have not since. That may be why I had a clear enough head, when looking at the evidence, to conclude that we need not just to decriminalise cannabis, but to legalise its sale and use.

I duly wrote a booklet—it is still the definitive work on the subject—called “Common Sense on Cannabis”, which is available, I suspect, from the Social Market Foundation or free on my website and in which I advocate legalisation. I still believe that that is the right policy and I shall explain why. I believe that not because I am an advocate of the use of cannabis. I abhor the stuff and, as I said, have never used it. I am not an advocate of it except for medical use, and I am sure that we could all agree that cannabis and its derivatives should be made available for medical use when it can bring the relief that the hon. Gentleman described and that many of us will have heard about from our postbags. Even Queen Victoria allegedly used cannabis to relieve menstrual pain. If it is a Victorian value, surely it can be made more widely available.

There are practical reasons for wanting to move to legalisation. First, attempts to prohibit the sale and use of cannabis have failed. It is readily available and widely used. Until recently—it may still be the case—there has been a higher level of usage in this country, where it is illegal, than in Holland, where it is legally available. Nearly 30% of citizens of this country have at some stage or other used cannabis and few of them had any difficulty in obtaining it, so those attempts have failed. The second point is that they have failed despite the fact that 80% of the effort in the so-called war on drugs goes on trying to prohibit the use of cannabis. If we provided some legal outlets for cannabis, that enforcement effort, the treatment effort and so on could be diverted to tackling hard drugs, which really do harm people, enslave people and, sometimes, kill people.

Thirdly, keeping on the statute books a law that is widely ignored and impossible to enforce undermines faith not just in that law, but in law and the legal system more generally. Finally, legalisation would deprive the criminal world of a large and lucrative market. As the hon. Member for North Down (Lady Hermon) pointed out, that is particularly important in Northern Ireland, where that market is exploited by gangs—well, by and large by the IRA and other paramilitaries, who are likely to use that resource for the most odious and nefarious reasons.

Those arguments have led many to conclude that we should decriminalise cannabis; we should no longer make it an offence to possess or to use the stuff, but supplying or selling it should remain illegal. That is de facto the situation in some parts of the country, but I believe that as a policy it would be a mistake, and let me explain why. One of the key reasons used by prohibition advocates is that cannabis is a gateway drug. They say that once people have tried a soft drug such as cannabis, it awakens a desire for stronger drugs and leads them on to cocaine and heroin, so they must stop going down the slippery slope. There is no evidence for that at all. The truth is that it is only the criminalisation of the supply of cannabis that makes it into a gateway drug. Because cannabis users can obtain it only from illegal sources, they are forced into contact with the illegal gangs that will try to persuade them to move on to hard drugs. Prohibition of cannabis drives soft drug users into the arms of hard drug pushers. Only by providing some legal outlets for cannabis can we break the contact between cannabis users and those pushing cocaine, crack and heroin. In my view, such legal outlets should not be numerous and we should ban active marketing, sales to minors and use of cannabis in a public place.

I invariably find that most arguments against legalising cannabis are based on the supposed health risks. I entirely accept that heavy and sustained use of cannabis can be harmful, but at the time of writing my pamphlet, I quoted the Lancet review of all the medical evidence on the use of cannabis, which said that

“on the medical evidence available, moderate indulgence in cannabis has little ill-effect on health, and…decisions to ban or to legalise cannabis should be based on other considerations.”

I emphasise “moderate” and “little”. I am not saying that it has no effect or that heavy and sustained use is not harmful, but I specifically stated then that moderate and occasional use of cannabis has few ill effects on health. None the less, people constantly bring up the health arguments, and I notice that when they do, they always say, “Oh, there’s just been a study that counteracts all that went before.”

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

It is easy to quote studies, but the Royal College of Psychiatrists, which does not take a view on the criminality but takes a view on the medical evidence that is presented and gives people an option to make up their own mind, does point out that even moderate use in younger years can lead to increased risk of mental illness in later life.

[Mr Lilley]

My hon. Friend has not stated a specific study, but certainly that was not the view in the Lancet review of cannabis. I find that there is a searching around for evidence. It is policy-based evidence—evidence that has been looked for to justify a policy, rather than being found and leading to a policy. It is similar to the sort of thing we find in the global warming debate.

--- Later in debate ---

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

It is a pleasure to serve under your chairmanship, Mr Evans. I commend the hon. Member for Newport West (Paul Flynn) on bringing the debate to the House and on this grown-up, sensible discussion about a topic that is often taboo and should not be because it affects the lives of many of our constituents.

A number of issues have been covered, including the criminal justice system, which I will come back to. I will pick up on a couple of points made articulately by the hon. Member for Caithness, Sutherland and Easter Ross (Dr Monaghan) on the medicinal uses of cannabis. There are some issues with the current law that need to be looked at, which perhaps make the medicinal use and the research of medicinal use more challenging. I also want to touch on some medical evidence. My right hon. Friend the Member for Hitchin and Harpenden (Mr Lilley) made some compelling points during his eloquent speech for the legalisation of cannabis. I am not, unfortunately, able to support him and I hope that my discussion of some of the medical background will help to explain why.

I have picked many of my remarks from a balanced review by the Royal College of Psychiatrists, which I hope we all consider to be well-resourced and an appropriate source of material for balancing the medical evidence on the use of cannabis as it looks at not only mental health, but physical health. Most of my remarks will be based on the evidence that it has collated. The college does not have a view on the legal position but, none the less, it wants people to look at the evidence and make up their minds. I will give my view, having reviewed some of that evidence.

Although there has been a steady reduction in the use of cannabis since 1996, about 2.3 million of those aged 16 to 59 have reported using cannabis in the past year. Frequent use of cannabis is more than twice as likely among young people. In spite of many Government and media warnings about health risks, many people see cannabis as a harmless substance that helps people to relax and chill—a drug that, unlike alcohol and cigarettes, might even be good for their physical and mental health. I will come to the point that that is clearly not the case.

It is worth quoting directly from the Royal College of Psychiatrists about how cannabis and cannabis plants have evolved over the past few years. My right hon. Friend the Member for Hitchin and Harpenden said that drug use is very different from when he was at university. That may well be the case, but the evolution of cannabis and the increasing frequency of high-potency cannabis—skunk, as a number of types of stronger cannabis in general are often referred to—has changed some of the health risks associated with cannabis use. As the Royal College of Psychiatrists says,

“Over the last 15 years, skunk has invaded the street market and its THC content is about 2-3 times higher than the ‘traditional’ cannabis used in earlier years.”

I will come to THC content and the different chemical components of cannabis, but the royal college continues:

“In the UK, most sold materials is home grown because of a loop hole in the law making it legal to buy seeds over the internet.”

I have some sympathy with the points raised by my right hon. Friend the Member for Hitchin and Harpenden: there are some challenges in the law and, de facto, we effectively have decriminalisation of cannabis in many areas of the country. I would be interested to hear the Minister’s views on that. Does he see a clear distinction between legalising a drug that we know to be harmful and a more decriminalising approach with police discretion, as we have at the moment? I believe the approach we have at the moment is probably the right one, given some of the harmful effects that I will speak about.

[Paul Flynn]

Will not the hon. Gentleman respond to what was said by his right hon. Friend the Member for Hitchin and Harpenden (Mr Lilley): skunk—that expression is only used in this country because there are different strengths of THC—is a product of prohibition just as distilled spirit, the main killer drug, was in America? Does he agree that if we end prohibition and have a legal market, people will get to use the cannabis of their choice—not necessarily the one that the illegal market wants them to take?

[Dr Poulter]

I do not necessarily accept the view that stronger or different forms of cannabis are developed as a result of prohibition. Take Holland as an example: different varieties of cannabis are available in various cannabis coffee shops in Amsterdam. People there have an opportunity to decide which potency and strength they use. I do not necessarily accept that prohibition has driven a market towards creating stronger varieties of cannabis. We know that stronger types of cannabis, such as skunk, have a stronger correlation with psychosis and some of the harmful mental health effects that are linked with the use of cannabis and the chemicals it contains.

On that subject, there are about 400 chemicals in an average cannabis plant. The four main compounds are delta-9-tetrahydrocannabinol, cannabidiol, delta-8-tetrahydrocannabinol and cannabinol. Apart from CBD—cannabidiol—these compounds are psychoactive, the strongest being delta-9-tetrahydrocannabinol. The stronger varieties of the plant contain little CBD, while the delta-9-tetrahydrocannabinol content is a lot higher. We are talking about a number of psychoactive substances. The stronger plants and varieties tend to contain larger amounts of the more psychoactive components and compounds.

When cannabis is smoked, its compounds rapidly enter the bloodstream and are transported directly to the brain and other parts of the body. The feeling of being stoned or high—like my right hon. Friend the Member for Hitchin and Harpenden, I have not had the experience—is caused mainly by the delta-9-tetra- hydrocannabinol binding to a cannabinoid receptor in the brain. Most of these receptors are found in the parts of the brain that influence emotion, pleasure, memory, thought, concentration, and sensory and time perception. Cannabis compounds can also affect the eyes, ears, skin and stomach.

There are a number of effects, some of which people describe as pleasurable and some of which we know are harmful. I want to touch on the mental health problems associated with cannabis use in some detail. The Royal College of Psychiatrists has published information on the subject:

“There is growing evidence that people with serious mental illness, including depression and psychosis, are more likely to use cannabis or have used it for long periods of time in the past. Regular use of the drug has appeared to double the risk of developing a psychotic episode or long-term schizophrenia. However, does cannabis cause depression and schizophrenia”—

there is a legitimate discussion about reverse causality—

“or do people with these disorders use it as a medication?

Over the past few years, research has strongly suggested that there is a clear link between early cannabis use and later mental health problems in those with a genetic vulnerability”—

my right hon. Friend made that point—

“and that there is a particular issue with the use of cannabis by adolescents.”

On depression, the Royal College of Psychiatrists says:

“A study following 1,600 Australian school-children, aged 14 to 15 for seven years, found that while children who use cannabis regularly have a significantly higher risk of depression, the opposite was not the case—children who already suffered from depression were not more likely than anyone else to use cannabis. However, adolescents who used cannabis daily were five times more likely to develop depression and anxiety in later life.”

That covers the issue of reverse causality.

I particularly want to talk about psychosis, schizophrenia and bipolar disorder. The Royal College of Psychiatrists states:

“There is now sufficient evidence to show that those who use cannabis particularly at a younger age, such as around the age of 15, have a higher than average risk of developing a psychotic illness, such as schizophrenia or bipolar disorder.

These studies also show that the risk is dose-related. In other words, the more cannabis someone used, the more likely they were to develop a psychotic illness… a study in Australia recently showed that those who used cannabis could develop the illness about 2.70 years earlier than those who did not.

Why should teenagers be particularly vulnerable to the use of cannabis? It is thought that this has something to do with brain development. The brain is still developing in the teenage years—up to the age of around 20, in fact. A massive process of ‘neural pruning’ is going on. This is rather like streamlining a tangled jumble of circuits so they can work more effectively. Any experience, or substance, that affects this process has the potential to produce long-term psychological effects.

It is also known that not everyone who uses cannabis, even at a young age, develops a psychotic illness.”

My right hon. Friend articulately raised that point. The Royal College of Psychiatrists continues:

“The available research shows that those who have a family history of a psychotic illness, or those who have certain characteristics such as schizotypal personality, or possibly have certain types of genes, may increase the risk of developing a psychotic illness following the regular use of strong cannabis.”

Research increasingly shows that there is a strong link between psychosis and the use of cannabis, with young people having a particular vulnerability and susceptibility.

On physical health problems, the Royal College of Psychiatrists says:

“Even though the main risk to physical health from cannabis is probably from the tobacco that it is often smoked with, new research has found that the cannabis plant also contains cancerogenic mutagens that can affect people’s lungs.”

We now have evidence of potential physical harm caused by smoking cannabis, and the approach taken by this House over the years has been to discourage people from smoking and using substances that harm their physical health. There is emerging evidence of the physical harm caused by smoking cannabis, so there is a strong argument that we should be consistent by discouraging people, as much as possible, from smoking cannabis. That, as my right hon. Friend has said, could be done by legalising cannabis and giving people an open choice, but when there is compelling evidence of physical harm, it would be wrong to legalise a substance that we know to damage people’s mental health and, increasingly, their physical health.

Several issues have been raised about the medical use of cannabis. Cannabis is widely used by people who attend pain clinics—such people self-administer illegally obtained cannabis for symptom relief. At the moment, it is very difficult for medical researchers to research the potential benefits of some substances contained in cannabis in alleviating pain in palliative care or in other legitimate medical settings.

The hon. Member for Caithness, Sutherland and Easter Ross eloquently discussed Sativex, a drug used to treat multiple sclerosis. The drug remains a schedule 1 controlled drug, which means that under the Misuse of Drugs Act 1971 and in regulation there are no requirements on pharmacists to keep records or on the prescriber to write prescriptions in a form other than that required by the Medicines Act 1968—in other words, for prescription-only medications.

The Medicines and Healthcare Products Regulatory Agency has also issued the manufacturer of Sativex in the UK with a wholesale dealer’s licence and an importation licence for patients with MS. The Home Office has therefore been able to issue licences for such supplies, and has done so through a general licence that covers all doctors who apply on behalf of individual MS patients. Dispensing pharmacists are also covered by that licence, which is triggered by an application by the doctor to the Home Office Inspectorate. Supplies can be made directly from the company’s domestic stocks.

There is a challenging framework for the medicinal use of cannabis in this country, and it needs to be reconsidered. It was suggested earlier that we should consider changing cannabis from a schedule 1 drug to a schedule 2 drug, which would be consistent with opioids—doctors are able to prescribe, say, methadone as an alternative for someone who is being treated for heroin dependence. That merits some consideration, and I would be grateful if the Minister responded on that point. A number of studies in the United States have shown that cannabis has potential medicinal benefits for pain relief in palliative care, so will we in this country be able to consider some of those issues? If we can help patients use pain control better to manage the symptoms of terminal or progressive diseases or illnesses, that has to be a good thing. We would not want the unintended consequences of the current legal framework to get in the way of achieving that.

This is not a simple issue. I have looked at the evidence and, on balance, I am not currently persuaded that making access to a substance that is harmful to both physical and mental health legal, as opposed to decriminalised, would be a good thing. We need to make it easier to research the potential medical benefits of cannabis in pain control in terminal and progressives illnesses. Finally, there is a lot for us to do in the criminal justice system. There were encouraging words from the Secretary of State for Justice last week on the need to stop the cycle of reoffending by better supporting prisoners with mental illnesses or substance misuse challenges, including the misuse of cannabis and other drugs. We can help such people not by criminalising their activities but by supporting their rehabilitation and helping them to cope better with their substance misuse problems.

Oral Answers to Questions

Dan Poulter Excerpts

Tuesday 11th January 2011 Commons Chamber

[Mr Blunt]

The homicide victims fund is still in operation. I will write to the hon. Gentleman with the precise number and the details of how it will be funded next year.

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

T4. The plight and vulnerability of many of the UK’s sex workers and prostitutes was highlighted for the people of Suffolk by the tragic events surrounding the Ipswich prostitute murders. Does the Secretary of State agree that it is vital that we have in place a proper strategy to help the rehabilitation of sex workers when they are released from prison, particularly to break the cycles of abuse and drug and alcohol dependency, and to support those people with mental health problems? Will he also visit my—

[Mr Speaker]

Order. I am extremely grateful to the hon. Gentleman, but his first question was perfectly good enough. One will do.

Firearms Control

Dan Poulter Excerpts

Monday 20th December 2010 Commons Chamber

[Dr Thérèse Coffey (Suffolk Coastal) (Con)]

The events earlier this year in which two gunmen took the lives of 13 other people using shotguns were deeply tragic. The public interest in the two cases and the questions asked about the efficacy of our gun laws are certainly understandable, and I therefore welcome this debate. I also welcome the publication of the Home Affairs Committee’s report, although I cannot say that I agree with all its recommendations.

Seneca the younger once said,

“quemadmodum gladius neminem occidit, occidentis telum est”

or

“a sword never kills anybody, it is merely a tool in the killer’s hand”.

Almost 2,000 years later, the satirical Welsh rap group Goldie Lookin’ Chain brought the message up to date with their 2004 hit “Guns don’t kill people, rappers do”—and Chris Moyles took it even further with, “Guns don’t kill people, rabbits do”. Please be assured that I do not highlight the lyric as a slur on the rapping community, but rather in support of the message of the song, which is that each holder of a gun is responsible for its mode of use.

In this country, by and large, we have not historically seen widespread gun ownership, or indeed gun crime. As is the case under the American constitution, we originally had the right to bear arms, but that right was overturned by the Firearms Act 1920. Unlike our American cousins, however, the public have shown little appetite for domestic gun ownership—long may that continue—other than for use as a countryside management tool or among interest groups who use firearms in their leisure and sporting time.

My hon. Friend the Member for Bournemouth East (Mr Ellwood) has already mentioned page 10 of the report and the disproportionate focus on those who legally hold firearms as opposed to those who hold them illegally. In paragraph 12, on page 58, the Committee refers to the fact that there is no evidence of

“an increase in misuse of lethal firearms”

since the last review of holding the licence renewal period at five years rather than two. I am not suggesting that there has been a knee-jerk reaction, but that shows that we need to continue to be measured. I am delighted that my right hon. Friend the Minister said that he would do that.

Firearm control has been considered repeatedly for more than 100 years. The Pistols Act 1903 regulated the sale of pistols and later Acts placed conditions on the ownership of firearms—such as the need to apply for a certificate to own a firearm or shotgun. The Firearms Act 1968 forms the basis for our gun laws and has been amended 34 times since then, creating the confusing and complex system to which the Committee referred.

Shotguns were used by both Moat and Bird, the perpetrators of the crimes that took place earlier this year, and the latter was licensed to own his. Incidentally, in an interview given to the BBC, one of Bird’s victims who survived the incident, himself a shotgun owner, described the current gun laws as “rigorous”, an opinion shared by the independent inquiry into the incident. My right hon. Friend the Prime Minister also said:

“You can’t legislate to stop a switch flicking in someone’s head”.

Perhaps he, too, had been listening to Goldie Lookin’ Chain, but he was absolutely right. It appears—this seems to be the general consensus among those involved in the case—that no rule, regulation or more fierce application of the current processes would necessarily have prevented the tragedy.

It should be remembered that, although we share with many of our neighbours in Europe and the Commonwealth a comparatively low rate of gun homicide, we also have some of the most stringent gun laws in the world. A balance must be struck between legitimate use and safeguarding the public. I am not convinced that ever tighter regulation is likely to prevent each and every death caused by firearms, whether intentional or accidental, but it could prevent law-abiding, responsible citizens from using firearms in a legitimate, socially acceptable manner.

This morning the Home Affairs Committee released its report on firearms control. I agree with its conclusion that the legal construct of the various laws is rather complex and confusing. It recommends codification and simplification of the law, so that firearms owners and the police are clear about the circumstances of ownership and responsibilities. I welcome the proposals to try to simplify the law. I also welcome the potential inquiry into creating a single licensing system for section 1 firearms and shotguns.

In considering the role of GPs in the issuing of licences, I am not suggesting that simplification should be used as an excuse further to tighten already stringent regulation. The move to involve GPs in the process of awarding firearms certificates seems to be little more—dare I say it—than an exercise in bureaucracy. As my hon. Friend the Member for Hendon (Mr Offord) has said, there is strong evidence to suggest that one cannot necessarily predict somebody’s future capacity in terms of owning a firearm.

Firearms are used in 6% of homicides, and known licensed firearms are used in 0.6% of homicides, so the move to include GPs is quite interesting. The idea of tagging medical records has already been described as potentially draconian, particularly in the light of fears about the security of NHS medical records. I join the Committee in dismissing calls for mandatory medical checks, because we cannot look into the future, and because of the guidance that has been given, which I thought was stronger than that. I thought that GPs were already obliged to notify the police of people in their practices who are potential threats to the community. As the hon. Member for Kingston upon Hull North (Diana Johnson) said, there was no suggestion that Mr Bird had recently seen his GP, and there were only six people in a year with whom such checks by a GP might have had an effect.

Let me turn now to employment in the sector. If we choose to go down the route of investigating a simplification of the law, it is imperative that any changes proposed have at their heart ring-fencing the rights of legitimate users, as those people play an important economic and social part in our communities. In September 2004, a report was undertaken on behalf of the British Association for Shooting and Conservation, the Country Land and Business Association and the Countryside Alliance in association with the Game Conservancy Trust, entitled “The Economic and Environmental Impact of Sporting Shooting”. It found that some 70,000 people are employed by the sport shooting industry, and in my area, the east of England, £140 million was brought into the economy through the sport. Indeed, seven constituents wrote to me about this matter and told me how they wanted to be able to continue shooting, seeing it as valuable as pest control and also as a sport that they enjoy.

Nationwide, shooting is worth a total of £1.6 billion. That does not take into account other forms of shooting such as shooting in gun clubs, which are also popular and serve a social as well as an economic purpose. Felixstowe rifle club, for example, was first formed in 1900. More than 100 years later, it is still going strong and has formed links with a number of local charities and local schools. It offers lessons to a number of local children as part of the Duke of Edinburgh award, and is one of only a few clubs in the country that caters for blind shooters, which is interesting.

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

I am sure that my hon. Friend is aware that Suffolk has the lowest recorded level of gun crime in the United Kingdom. Does she agree that that is in spite of the fact that we have 97,000 licences for shotguns and firearms in the east of England, which suggests that the focus should be on dealing with unlicensed shotguns rather than licensed guns?

[Dr Coffey]

I could not agree more strongly with my hon. Friend and neighbour. That message is reinforced not only by my constituents who have contacted me but by patrons of my local, who are all regular shooters and wish not to be demonised for being so.

Felixstowe rifle club is one of many that had to adapt to the 1997 ban on handguns, which seems to have put an end to the sport of pistol shooting but done little to prevent the use of handguns in crime. Although legitimate handgun owners have given up their weapons, criminals show no sign of abating their use of them: in 1980 handguns were used in 529 robberies, and by 2008 the number had risen to 2,565 cases—down from a peak of 3,544 cases in 1992. In 2008 handguns were involved in 28 of the 39 firearms-related homicides that year—almost three quarters of all murders perpetrated using a gun. In contrast, only seven involved a shotgun and three a rifle. Rather than spending our time and energies picking off legitimate owners as easy targets—I include young people in that—we should be grappling with the more difficult, but much more important, question of how to tackle the criminal fraternity on the illegitimate use and manufacture of guns.

Young people have been mentioned, and although there is no connection with the recent incidents I take this opportunity to remind the House that 10 years ago the Government of the time said there should be no ban, and no minimum age for the issuing of licences, because supervised shooting is an important way of encouraging young people to use weapons appropriately.

The use of illegal handguns in our inner cities to commit crimes, including murder, has gone relatively unreported by the media, who seem happy to focus more on anomalous cases than on the real problem at hand. Some 55% of all firearm offences occur in just three police areas—the Metropolitan, Greater Manchester and West Midlands areas—and many involve handguns. Given that those weapons are already illegal, I reiterate that we should not legislate further to ensure tighter control of weapons but should ask ourselves, as has been mentioned in relation to air rifles, how we can better enforce current laws.

I hope that the planned introduction of a dedicated border police force will bring material results in reducing the smuggling of illegal weapons into England. I understand that there is a problem with the smuggling of illegal weapons, particularly from eastern Europe, but we also need to tackle the illegitimate use of guns already on our shores and the ability of criminals to manufacture guns by adapting decommissioned or other guns. This, in all likelihood, requires not the introduction of new laws or regulations but a range of measures and enforcement by the police.

With gun and knife amnesties our police forces have done good work in attempting to clear those weapons from our streets and take them out of the hands of youngsters who feel that they need to carry a knife to feel safe. Amnesties have taken place across the country and should continue; indeed, I call on people in my constituency and elsewhere who hold a gun in their house to ask themselves whether they still need it. However, it is equally important to look into the causes of gun crimes. What makes somebody pick up a gun or a knife before they leave the house, and what can we do to persuade them that they do not need to purchase an illegal weapon, let alone use it?

It seems to be an increasing feature of gang culture to use or brandish a firearm or to kill somebody with one as a way of going up the respect agenda. We need to cut that out of our culture, and I welcome some of the work that has been done on that.

--- Later in debate ---

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

It is a great pleasure to follow my hon. Friend the Member for South Derbyshire (Heather Wheeler), who talks from her own experience of holding a shotgun licence, and the excellent speech of my hon. Friend the Member for Carmarthen West and South Pembrokeshire (Simon Hart). Given that more than 700 people have died as a result of gunshot injuries and gun crime over the past 13 years, it is a great tragedy that we are having this debate only because it takes something such as the terrible events in Cumbria to bring this issue to the attention of the House. The work that the right hon. Member for Leicester East (Keith Vaz) has done with the Committee on this matter is greatly to his credit and is very valuable.

However, we need to highlight a few key issues and strands. First, the distinction has not always been made clearly in this debate between gun crimes perpetrated by people who were holding illegal weapons and those who hold legal weapons. Many of those 742 gun crime deaths were caused by people holding illegal weapons and not by people who have legal gun licences. I made the point in an intervention that Suffolk has the lowest rate of gun crime in the UK—we are very proud of that, notwithstanding those incidents involving air rifles in Lowestoft mentioned by the hon. Member for Derby North (Chris Williamson)—yet 97,000 gun licences are held by those in the east of England, which is a very high level. That shows that there is not necessarily a causal effect between owning a gun licence and committing a gun crime. We know that gun crimes tend to happen in deprived urban areas, where those who commit crime do not hold gun licences. The key thing is to draw that distinction, because if we are to legislate on this issue, we must ensure that it is effective and addresses the key areas.

One thing we must do is to broaden out this debate. It is about firearms control, not just the terrible events in Cumbria, Hungerford or Dunblane. We need to ensure that the legislation and recommendations passed in this House will make things better. It is very difficult, because we have not heard any conclusive evidence this evening that changing the legislation to deal with licensed firearms will make any significant difference.

We know that there are issues with tackling the gun culture in our inner cities. In dealing with that culture, we need to stop the illegal trafficking of guns in this country and the police need to deal with that trade effectively, including on our borders. In some inner cities, however, dealing with education in schools, particularly in deprived areas, and the police working with communities to highlight the problems of gun crime would be a far more effective way of dealing with illegally committed acts and with communities where there are problems with gun crime. In many rural communities, however, people hold gun licences and are very law abiding. Earlier in the debate I talked about Suffolk, where people use guns for pest control. I do not shoot—I have no interest in shooting—but we must accept that the number of law-abiding citizens who do not commit crime and who do not have any interest in misusing their guns use their guns for sport and for pest control. We must accept that legislation must be effective and targeted on the causes of illegal gun crime in this country. It should not be focused on a knee-jerk reaction to one or two terrible events that results in banning guns for those who use them for legitimate, law-abiding sport or pest control reasons.

Based on my experience as a doctor, I want to pick up on the issue of medical practitioners. Would it necessarily be useful for medical practitioners to have to tick a box every year for the 97,000 people in the east of England who have gun licences? Is it important that those medical practitioners should be consulted annually? Far too often in my professional life, I saw the pointless forms we had to fill in. We ticked the boxes but it did not improve patient care or make things any safer. It is important that we do not stigmatise people with mental health conditions. People are perfectly competent and able to make informed choices. They are not necessarily going to be more likely to run off and commit a gun crime than someone who does not have a mental health condition. We need to be careful not to draw that stigma into the debate. To be perfectly frank, a piece of paper signed on one day of the year does not necessarily mean that in three, six or nine months that person will not have seen their mental state deteriorate considerably. Ticking a box does not mean that we will make things any safer, and the case has not been proven.

We know that when medical practitioners have a serious concern about the conduct of a patient—for example, a fear that a patient is a paedophile or the knowledge that a patient might be a danger to themselves or to the public—they take it into their own hands to breach medical confidentiality. There are many such cases. They breach medical confidentiality because the duty to society is greater than the duty of confidentiality. We have to trust them—we should not put an onerous burden on medical practitioners that will not necessarily be effective.

[Simon Hart]

If there was a situation in which my hon. Friend was required to make such observations and somehow failed to pick up on a patient’s mental health, which led to a dreadful tragedy, what would be the legal and professional implications for his trade?

[Dr Poulter]

There is always a blame culture, and we would have to be careful that a simple form that a doctor had to sign on one day of the year could not be used as a sledgehammer to hit that doctor or medical practitioner over the head later on because somebody perpetrated a bad act. As I have said, and as I think my hon. Friend accepted in making his point, someone’s mental state can deteriorate quickly—a switch can be flicked in someone’s mind and it is impossible to legislate for that. Simply involving a doctor in this process will not make that any less possible.

It is not only with gun crime that a switch can be flicked in that way, as we saw in north Wales with the Peter Moore case. In 1995, he killed four men with a knife in a random rampage. It is not just with gun crime that people temporarily lose control and go on a rampage—it happens with other weapons. In America there have been cases with samurai swords. We have to be careful not to legislate on the basis of one or two terrible tragedies, such as that in Cumbria. That is an important point for the House to consider.

[Sir Alan Beith]

I am interested in this argument and I agree that a box-ticking exercise is no use, but GPs in rural communities will often be aware if patients are gun licence holders and might well pass on information if they are seriously concerned. The question is what to do in urban communities in which GPs might be unaware who is a gun licence holder. As my hon. Friend says, the problem is often the illicit gun holder who does not have a licence anyway.

[Dr Poulter]

My right hon. Friend makes a very good point. Let us consider how effective that piece of paper—that box-ticking exercise—would be in an urban community. The turnover of patients in most GP practices in areas such as Camberwell, where I was a medical student, is a third of patients every year. Therefore, such a measure might not work because, with such a high turnover, it is not easy to keep track of patients who move and migrate around London and fall in and out of registers. As my right hon. Friend said, the people we are dealing with in urban areas are not those with licences but those who possess handguns illegally. Community engagement and education in schools is so important in addressing those issues.

We have had a very good debate and I will not talk for much longer. Members need to ask whether further legislation that would give doctors more onerous responsibilities to fill out forms, and that would make it more difficult for people to have gun licences, would make anybody safer. I think the answer is conclusively no. We cannot legislate for terrible tragedies such as that in Cumbria. Unfortunately, they will happen no matter what we do. It is easy, as the right hon. Member for Leicester East said, for us and the media to get the retrospectoscope out and judge things retrospectively in the hysteria of political debate. We need to legislate for the reality, which is that law-abiding gun owners who have a licence do not tend to misuse them. For the reasons I have given, I do not think that there is a conclusive case for strengthening the legislation.

Oral Answers to Questions

Dan Poulter Excerpts

Tuesday 19th October 2010 Commons Chamber

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

12. What recent discussions he has had with ministerial colleagues on the provision of training for prison service staff on the management of offenders with mental health conditions.

[Andrew Jones (Harrogate and Knaresborough) (Con)]

18. What recent discussions he has had with ministerial colleagues on the provision of training for prison service staff on the management of offenders with mental health conditions.

--- Later in debate ---

[Mr Clarke]

That is precisely what we want to do, and my hon. Friend’s approach is very much in the right direction. Much reform will take place in the Department of Health, including obviously the commissioning of services for mental health. It is important that account is taken of the need to commission proper services of all kinds for prisoners, and that is being taken on board by my right hon. Friend the Secretary of State for Health and his team. We will work closely with them. The present prison population includes people whose criminality goes alongside a definite need for support—in this case for mental health problems—which, if tackled successfully, might reduce their liability to reoffend.

[Dr Poulter]

Does the Secretary of State agree that the treatment of prisoners with mental health problems does not just end when they leave prison but continues far beyond? Will he please outline what steps the Government plan to take to support prisoners with mental health problems after they leave prison?

[Mr Clarke]

I agree entirely. It is all part of what we hope to do on rehabilitation. In addition to tackling prisoners’ problems inside prison, we have to look ahead and almost certainly join up with the community mental health services providing support for prisoners when they are released. That will be an important part of ensuring that the reforms we are carrying out to the prison service and the criminal justice system are properly tied up with my right hon. Friend the Secretary of State for Health’s important reforms to the future shape of the NHS.