Drug Treatment Services

Debate between Jeff Smith and Jim Shannon

Tuesday 16th July 2019 Westminster Hall

[Jeff Smith (Manchester, Withington) (Lab)]

I beg to move,

That this House has considered drug treatment services.

It is a pleasure to see you in the Chair, Mr Hollobone. This is a very timely debate, because today we learned shocking new figures for drug-related deaths in Scotland. There were 1,187 drug-related deaths last year, which is an increase of 27% on the previous year and the highest drug death rate in the EU. We await the 2018 figures for England and Wales without much hope for better news or an improvement.

Today also sees the launch of a new report called “Towards Sustainable Drug Treatment Services” by the research-led biotech company Camurus, which has done some extremely interesting research on the state of drug treatment services, including anonymised surveys of 22 directors of public health in England. I thank Camurus for sight of that report and thank those who have sent me briefings from other organisations, including the Hepatitis C Trust, Release, the Alcohol Health Alliance UK, the Local Government Association, Humankind and the Royal College of Psychiatrists. I will not be able to refer to all those briefings in this relatively short debate, but a couple of themes emerge from most if not all of them.

First, there is worry across the sector that the whole drug treatment services system is under pressure—some would say under threat. Since around 2012, Government cuts have squeezed treatment services so much that they are under strain and struggling to cope with demand. In 2010, the coalition Government inherited one of the best drug and alcohol treatment systems in the world, with over 250,000 people treated every year. Drug-related crime was decreasing, HIV and AIDS were under control, and tens of thousands were overcoming addiction through opiate substitution or abstinence-based programmes. The Labour Government prioritised that sector in the late 1990s as part of their social exclusion agenda, and raised treatment budgets from around £200 million per year in 1998 to more than £1 billion by 2003.

When the coalition Government’s austerity really began to hit public services, the hardest-hit area was local government. When local authorities became responsible for the funding and commissioning of drugs services under the Health and Social Care Act 2012, they were already struggling with the reduction of approximately 37% in central Government funding between 2010 and 2016. Between 2014 and 2019, net expenditure on adult drug and alcohol services decreased by 19% in real terms. In 2017, the Advisory Council on the Misuse of Drugs warned that local authority funding would prioritise mandated services over non-mandated services, such as drug services,

“particularly if service users are stigmatised or seen as undeserving.”

All the stakeholders who contacted me have expressed their dismay at the impact of the cuts in recent years. More than a third of the public health directors surveyed by Camurus believe they will be unable to keep up with demand for substance misuse services in the coming year.

[Jim Shannon (Strangford) (DUP)]

I thank the hon. Gentleman for giving way and for bringing this important debate to Westminster Hall. The figures for Scotland are horrendous, but the figures for the United Kingdom, including Northern Ireland, also show a rise. Does he agree that the current system is not equipped to deal with the level of drug abuse and need for treatment, and that the waiting times for dedicated facilities leave people without support for too long, which inevitably leads them back to their coping methods and further addiction? Those facilities need to be upgraded and made more available.

[Jeff Smith]

I agree with the hon. Gentleman; not for nothing is the UK labelled the drug-death capital of Europe. That should worry us across the UK.

The second theme that emerged from the reports is the real worry about the future of services after 2020 if the ring-fenced public health grant for local authorities ends and funding moves to general local authority funding. A report by the Select Committee on Health and Social Care showed that public health budgets have been cut every year since 2013, with alcohol and drug treatment services facing the biggest cuts. Councils have reduced spending on adult drug misuse by an average of 27% since 2015-16, and almost one in five local authorities have cut budgets by 50% or more since then.

The highest cuts have been disproportionately concentrated in areas with high rates of drug-related deaths, according to the Camurus report. More than half of the directors of public health surveyed believe that the removal of ring-fenced public health grants will result in further cuts. Service providers are struggling to maintain their current offer, and have even less capacity to make additional outreach efforts that are needed, such as offering proactive early prevention measures or engaging under-represented groups and communities who come less into contact with available services.

I wish I had more time to talk about hepatitis C, which is a really important issue. Stuart Smith, the head of community services at the Hepatitis C Trust, said:

“I walk into many drug services around the country and it’s chaos. They’re being asked to do so much with so little resource. I’m not sure how many of them can even feasibly have it on their priority list to discuss hepatitis C with clients.”

Hepatitis C is a very harmful condition but it can be prevented and cured if we have the resources to do so.

This is another story of austerity hitting the services that are most needed by the most vulnerable in society, but—this is the third theme that emerges from the sector responses—it is also a story of false economies. Spending on the recovery and reintegration of people who struggle with drug and alcohol dependency is one of the smartest spend-to-save investments that a Government can make. Strong evidence suggests that properly funded drug treatment services help to drive reductions in drug deaths, crime, and rates of blood- borne viruses. Research that the Government themselves commissioned concluded that drug treatment can “substantially reduce” the social costs associated with drug misuse and dependence, with an estimated cost-benefit ratio of 2.5:1. Depending on the breadth of the definition of “social costs”, that ratio could be calculated far more favourably and take into account factors such as lower crime, fewer health problems, less benefit dependency, lower social services spending and so on. Public Health England estimates that for every £1 invested in drug treatment services, there is a £4 social return.

Drug treatment and harm reduction services are cost-effective and offer good value for money, so this is a classic example of funding reductions in one part of the public services leading to spending increases in another. To quote Ron Hogg, police and crime commissioner for Durham and Darlington, who in my view is one of our most progressive PCCs:

“As PCC, I have concerns regarding the future allocation of public health funding in Durham, via the Public Health Grant, and the knock-on effect for policing. I am fearful that I will face the triple whammy of a reduction in police funding, a further reduction due to changes in the funding formula, and the consequences of a decrease in public health funding. The consequences of these changes are likely to include a significant increase in crime in County Durham and Darlington.”

We know that half of acquisitive crime in the UK is directly related to drug dependency.

Five Year Forward View for Mental Health

Debate between Jeff Smith and Jim Shannon

Tuesday 30th October 2018 Westminster Hall

[Jeff Smith (Manchester, Withington) (Lab)]

I beg to move,

That this House has considered the five-year forward view for mental health.

It is a pleasure to serve with you in the Chair, Mr Hollobone. The key purpose of the debate is to represent the recent report of the all-party parliamentary group on mental health, of which I am vice-chair. We published “Progress of the Five Year Forward View for Mental Health: On the road to parity”, which is a report on the progress of the five year forward view at the halfway stage.

I pay tribute to the cross-party group of MPs and peers who took part in the inquiry, particularly the hon. Member for Faversham and Mid Kent (Helen Whately), who is the chair of the APPG; she is with us in this debate and I think she will make some remarks. I also pay tribute to Rethink Mental Illness and to the Royal College of Psychiatrists, which provided us with excellent secretariat support and supported us throughout the inquiry. I thank the Secretary of State for Health and Social Care, who attended the parliamentary launch of the report and engaged in a very helpful question and answer session.

The report is a summary of more than 70 pieces of written evidence, two oral evidence sessions, a focus group of service users and carers, and a visit to a mental health trust. It is a serious and informative piece of work that could help to make a difference in informing the NHS’s long-term plan. There are three main sets of recommendations in the report, including some important ones on joining up work with other services, particularly social care and housing, but this is quite a short debate so I will focus only on two questions.

I am interested to hear from the Minister about the Government’s plans to support people with severe mental illness. The report shows that adults severely affected by mental illnesses such as schizophrenia or bipolar disorder are left behind. We saw no consistent and coherent approach on how to support people diagnosed with personality disorders. The inquiry heard that there are no targets for how long adults should have to wait to access eating disorder services. Those illnesses have a severe impact on people’s day-to-day lives and can be lifelong conditions. It is not acceptable that people who are the most ill often wait the longest to get care.

[Jim Shannon (Strangford) (DUP)]

I congratulate the hon. Gentleman on securing the debate. Although I appreciate, as he will, how big a task this is, I welcome the Government’s commitment to mental health funding in the Budget. But I am concerned that we are getting nowhere in reaching parity of esteem. The number of children and young people experiencing mental health problems has risen sharply, and they often go to A&E for help. Does he share my view that funding is needed to ensure that children and young people suffering with poor mental health have safe places in the community to turn to for help and support, without having to rely on A&Es, which are already under duress?