Human Medicines (Amendment) Regulations

Debate between Lyn Brown and Philippa Whitford

Monday 18th March 2019 Commons Chamber

[Dr Whitford]

That is the key thing: they do not have the patient’s records and they do not know what problems a drug may have caused in the past.

This change could have a real impact on epileptics. It brings the danger of a fit, and the fit itself may be a threat to them. Obviously epileptics are exposed to sudden unexpected death in epilepsy and can suffer from trauma, depending on where they are when they take the fit. They can even lose their driving licence for a year because they have one fit. The social impact of that on epileptics is enormous.

It says in the explanatory notes that, because of that, epilepsy drugs and biological drugs would not be considered suitable for the protocol. However, it does not say that in the SI—they are not excluded. It is important that such people are protected.

[Lyn Brown (West Ham) (Lab)]

I have been listening closely to the hon. Lady. This is already happening. A friend of mine went to her chemist to pick up some drugs and the dosage was halved by the pharmacist, not by her doctor. She had enough drugs to keep her going until she went to the doctor again, who reinstated the original drug. I just think it is really scary at the moment; people do not understand why this is happening. It cannot be about Brexit, because it is happening now.

[Dr Whitford]

I am just coming on to that issue. I reiterate that it is the strength, rather than the dose, so I imagine the hon. Lady’s friend would be expected to take two smaller tablets, not to reduce her dose.

As I have said, the obvious thing would be to share the protocol with the prescribers, not to aim it at the pharmacists who are right at the end of the process.

Why is it that we are seeing the shortages now? Quite simply, there are two ways to stockpile: either by forcing increased production, which it is not necessarily within the gift of the Department or even the Secretary of State to do, or by setting aside some of the drugs within normal production. When I talk to my GP friends, they talk about a massive surge in shortages over the past nine months. That coincides almost exactly with the acceleration of stockpiling. My concern is that drugs are being set aside into the stockpile and that is causing shortages right now.

There should be publication of the list of drugs that are at risk of shortage, so that a GP can say, “For this lady or gentleman it is not that important, so if it is a shortage drug I won’t use it, but for this other patient I will have to use it.” Apparently, that is currently hidden behind commercial sensitivity.

It is important that a consultation and an impact assessment are carried out. I was shocked that the BMA was given a week to respond and the General Medical Council was not even consulted. This statutory instrument totally reverses medical and prescriber legal responsibility, so who is legally responsible? How do pharmacists feel about the fact that they might be held answerable for changing the drug, or will the Government underwrite that? I think that this has been appallingly handled and has been snuck in with no scrutiny and no debate.

The hon. Member for Leicester South (Jonathan Ashworth) talked about cost and time saving for GPs and, secondary to that, the impact on patient safety. If we look at the basis for the review in a year, it says that No. 1 will be the function of the market and that No. 2 will be the impact on patients, so again we see that patient safety is not being put at the heart of this. This proposal has not been properly thought through, particularly if it is envisaged as a long-term solution to drug shortages. No deal should now be off the table, as of last week. There should be time to look at this issue properly, consult properly and come up with something that will not endanger patients.

Psychoactive Substances Bill [Lords]

Debate between Lyn Brown and Philippa Whitford

Monday 19th October 2015 Commons Chamber

[Lyn Brown]

I accept what the hon. and learned Gentleman says, but one of the things I find particularly repulsive is that our young people see these head shops in front of them on the high street, and then think that the shops are legal and safe because if they were not, the police would have come along and nabbed them. I will answer him later because we do need to think about what happens with an underground market.

This Bill sends out a message to young people who are unaware that these substances are dangerous. Many of those that are sold in the shops are illegal now, let alone before we ban the lot of them. As I support the aims and general approach of the Bill, I want to ensure that it is drafted and implemented as effectively as possible, so I will press the Government on several issues and worries. I hope that the Minister will take my recommendations and concerns in the constructive manner in which they will be intended.

My first point is about education. The Bill is an appropriate way to try to tackle the supply of dangerous psychoactive substances, but we need to reduce demand. Unfortunately, there is a load of misinformation about psychoactive substances. Research by the Royal Society for Public Health found that a quarter of young people aged between 16 and 24 believed that so-called legal highs were safer than illegal drugs. This is a dangerous misunderstanding, because some of the new psychoactive substances have gone on to be controlled and designated as class A, indicating that they were some of the most harmful drugs around before they were controlled. Passing this legislation has the potential to put to bed the dangerous myth that psychoactive substances are safe, but the measure will do so only if it is supported by a concerted communication and education strategy.

The Labour Administration in Wales have shown us how that can be done by putting education at the forefront of their drug prevention strategy. There is now a core substance misuse education programme in 97% of Welsh primary and secondary schools to ensure that almost all Welsh schoolchildren receive accurate, consistent and credible information about the potential harms of drugs, rather than having to rely on myths and guesswork. Labour Members have consistently emphasised the role of PSHE—personal, social, health and economic education—in reducing drug use. I have voted to make PSHE compulsory in schools, and that needs to be considered again.

[Dr Philippa Whitford (Central Ayrshire) (SNP)]

This aspect did not go to the Advisory Committee on the Misuse of Drugs and has therefore been put together without its advice. The use of illegal drugs has been going down not because of locking people up and criminalisation, but because of education. We all want these chemicals not to be used, but we must not overreact and not use education enough, because it is a key tool.

[Lyn Brown]

The hon. Lady is absolutely right; I completely and utterly agree. Education is the key to this. We need to reduce the demand for the supply.

Thus far, a mere £180,556 has been spent on education programmes on new psychoactive substances, as the Minister told the House in a written answer on 2 June. Sadly, the Government rejected Labour’s amendment to the Bill in the Lords which would have placed a statutory duty on the Secretary of State to increase public awareness and help schools to educate children about the dangers of these drugs. Let me say gently that that is a wholly inadequate response given that the Government themselves recognise that these drugs are a serious problem. If we want young people to have the resilience, the confidence and the knowledge to say no, we have to be fully committed to a comprehensive education programme across the UK.

The next area where the Minister needs to exercise care and caution is proportionality of sentencing. Under the Misuse of Drugs Act, sentences are linked to the harm caused by the drug possessed, supplied or produced—the more harmful the drug, the harsher the maximum sentence. Of course, there is judicial discretion in applying individual sentences, but the general approach of linking to relative harms is important.

The Bill represents a radical departure from previous attempts to control drugs, because it legally decouples controlled substances from an independent and objective assessment of the harm they cause. We understand why that may be appropriate. The process by which the ACMD determines the harm of a substance can be lengthy and resource intensive, which is precisely why the Home Office cannot keep up with the illicit market. It is difficult to introduce the concept of harm to the Bill without denying the Home Office the tools it needs to deal with that central problem.

It is because this Bill suggests such a radical change that we need carefully to consider the impact it will have when implemented. I am worried that we might end up in a situation where someone who is prosecuted for selling a weak psychoactive substance faces the possibility of the same seven-year custodial sentence as someone who sells a very dangerous substance. The Bill contains no classification system to differentiate between those two crimes. I fear that the proposed laws could lose the confidence of the public and the judicial system if the issue of proportionality is not looked at carefully. As the Minister will be aware, the issue has exercised the Home Affairs Committee.

I am particularly worried about the proportionality of sentencing for young people involved in social supply. It is not unusual for a number of young people to club together and for one person to buy substances off the internet and distribute them among friends, or even for one individual to sell a small amount to a friend. The Bill makes no distinction between those people and large-scale importers. We need to look at that.

Has the Minister considered providing credible measures for a relatively harmless substance to be excluded from the controls, if that is deemed appropriate? Conversely, if a new psychoactive substance proves to be particularly harmful, surely it should be removed from the scope of the Bill and controlled under the Misuse of Drugs Act. Reviewing that may be an appropriate responsibility of the ACMD.

Another issue that needs careful consideration is how the police and prosecutors can both determine and prove that a substance is psychoactive. I am sure the Minister is aware that Professor Iverson, chair of the ACMD, has previously written to the Home Secretary warning her that we will have to rely on proxy measures of psychoactivity, such as in vitro neurochemical tests, in order to prove psychoactivity, but that they may not stand up in court.

We should take Professor Iversen’s warnings seriously. Although similar legislation in Ireland appears to have been broadly successful—given the statistics I quoted earlier—there have been only five successful prosecutions. Police in Ireland have admitted that that is because they find it difficult to prove the psychoactivity of substances. We want sellers to stop selling psychoactive substances voluntarily, and for consumers to stop purchasing the drugs. However, it is hard to imagine that that would work without any prosecutions at all. The law simply would not provide a credible deterrent.