Dame Carol Black’s Independent Review of Drugs Report

Yvonne Fovargue Excerpts

Wednesday 27th October 2021 Westminster Hall

[Yvonne Fovargue (in the Chair)]

Before we begin, I encourage Members to wear masks when they are not speaking, in line with current Government guidance and that of the House of Commons Commission. I remind Members that they are asked by the House to have a covid lateral flow test twice a week if coming on to the parliamentary estate. That can be done either at the testing centre in the House or at home. Please also give each other and members of staff space when seated, and when entering and leaving the room.

[Dan Carden (Liverpool, Walton) (Lab)]

I beg to move,

That this House has considered Dame Carol Black’s independent review of drugs report.

It is a pleasure to serve under your chairmanship, Ms Fovargue. I refer Members to my entry in the Register of Members’ Financial Interests. The damning conclusion of part two of Dame Carol Black’s review, setting out a way forward on drug treatment and recovery, was that

“the public provision we currently have for prevention, treatment and recovery is not fit for purpose, and urgently needs repair.”

I have called today’s debate because the report’s recommendations are too important to be left gathering dust on ministerial bookshelves. I want Dame Carol’s words ringing in ministerial ears. She says:

“Government faces an unavoidable choice: invest in tackling the problem or keep paying for the consequences. A whole-system approach is needed…This part of my review offers concrete proposals, deliverable within this Parliament, to achieve this.”

Of the review, Dame Carol says:

“It calls for significant investment, but the payoff is handsome: currently each £1 spent on treatment will save £4 from reduced demands on health, prison, law enforcement and emergency services. I am hopeful that the recommendations will be welcomed by this government as they strongly support its crime reduction and ‘levelling up’ agendas.”

The 32 recommendations are a gift to the Government, and should be a moment for change. It is fitting that the debate falls on Budget day. The economic cost of drug misuse is upwards of £20 billion each year; yet the spending on prevention and treatment stands at just £650 million. The recommendations give hope that real change is possible. Addiction is a national crisis. Drug and alcohol-related deaths are the highest on record, at the very moment that treatment services are most ill-equipped to deal with the soaring need.

Forward Trust estimates that more than 2 million people are in need of help with alcohol, drugs or gambling, and its recent YouGov poll showed that 64% of people said that they knew someone personally struggling with addiction. Since I talked openly about my personal experience of addiction and recovery, I have been over- whelmed by the thousands of people who have reached out to tell me their personal stories—of the horror of addiction, and the blessings of recovery. The tragedy is that addiction is everywhere, yet remains so hidden.

In 2019 Dame Carol was commissioned by the then Home Secretary, the right hon. Member for Bromsgrove (Sajid Javid), to independently review illicit drugs in England. I thank her for her commitment and dedication over the last few years, and all those who contributed to this groundbreaking report. Most of all, I hope that my contribution today does justice to the absolute clarity that Dame Carol brings to these incredibly complex matters. Part one of her review was published on 27 February, and made for uncomfortable reading. The unflinching analysis detailed the extent of drug-related harm and the challenges posed by drug supply and demand, including the ways in which drugs fuel serious violence.

The Department of Health and Social Care swiftly commissioned Dame Carol to produce part two of her independent review, which focused on how to improve the funding, commissioning, quality and accountability of drug prevention, treatment and recovery services in England. Part two of her report, published in July, pulls no punches either. It says:

“Funding cuts have left treatment and recovery services on their knees. Commissioning has been fragmented, with little accountability for outcomes. And partnerships between local authorities, health, housing, employment support and criminal justice agencies have deteriorated.”

The report goes on:

“The workforce is depleted, especially of professionally qualified people, and demoralised. Vital services have been cut back, particularly inpatient detoxification, residential rehabilitation, specialist services for young people, and treatment for cannabis and stimulant users.”

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[Several hon. Members rose—]

[Yvonne Fovargue (in the Chair)]

A number of Members are waiting to speak. I am not imposing a formal time limit, but please keep contributions to four minutes or others will lose out. I call Rachael Maskell.

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[Yvonne Fovargue (in the Chair)]

I will be calling the SNP spokesperson at 5.10 pm.

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[Jonathan Ashworth (Leicester South) (Lab/Co-op)]

It is a pleasure to see you in the Chair, Ms Fovargue. I commend all hon. Members who have spoken, with great insight and authority. They made many serious points, which I hope the Minister will respond to.

I pay particular tribute to my hon. Friend the Member for Liverpool, Walton (Dan Carden), for not only his superb presentation of the issues in the Black report but for the way in which he spoke with great eloquence and bravery about his personal story of addiction. I am not ashamed to say that it moved me to tears. I, too, have spoken about how addiction has affected my family and what it meant for me as a child growing up with a father who had a serious drink problem. I know that thousands of people who are, struggling with addiction, or see a loved one doing so, will have heard my hon. Friend’s speech. Although they may never get in touch with or meet him, his speech will have been a tremendous comfort to them, and we should all thank him for his bravery.

I will focus on the addiction crisis that we face as a country. I commend Dame Carol on her excellent report. Her 32 recommendations should be taken forward by the Government, and we need to hear from the Minister exactly what their attitude is to them. I offer to work with her on a cross-party basis on this public health crisis. In the last year, more than 7,000 people in England and Wales have died from alcohol-related causes. Alcohol-related liver disease is increasing. More and more people are dying from drug poisoning across England and Wales. There are, of course, particular issues in Scotland, which Members who represent Scottish constituencies rightly raised.

We are at risk of our society falling into a situation where deaths among those in their 40s and 50s are increasingly either the result of suicide or are drug or alcohol-related. They are called deaths of despair. For quite some time, this been a well known and tragic phenomenon in the United States, and we are at risk of seeing it become a feature here in the United Kingdom. My hon. Friend the Member for Liverpool, Walton is right that addiction is a national crisis, and spot on when he says that it is everywhere but well hidden.

We are having this debate on the day the Chancellor has presented his Budget, but even though this is a public health crisis, and we are still experiencing another public health crisis, public health did not feature in the Budget. As a number of Members have quoted, Dame Carol says:

“Government faces an unavoidable choice: invest in tackling the problem or keep paying for the consequences.”

The Chancellor ducked that choice today, and public health did not get the substantial increase in funding that it needs. As my hon. Friend the Member for Luton South (Rachel Hopkins) said, the Budget comes after real-terms cuts in recent years of £800 million to £1 billion, depending on how we calculate the figures. Those real-term cuts mean that drug and alcohol addiction services have lost £122 million in recent years—a 15% cut.

The Health Secretary likes to use Blackpool as an example of why we need to level up, pointing out the stalling life expectancy there. Blackpool, which has the highest mortality rate in the country for alcohol-related deaths and has the thirteenth highest number of deaths from drug poisoning, has had a £43 per person cut to public health funding in recent years. Manchester, which had the fifth highest number of deaths from drug poisoning in 2020, has had a £33 cut per person in public health funding in recent years. In 2020, Liverpool had the joint highest number of deaths from drug poisoning, with 89 people losing their lives, yet the city has had a £34 per person real-terms cut in public health funding. We look forward to the Minister telling us how local authority drug and alcohol addiction services are expected to cope if the cuts are not reversed—

[Yvonne Fovargue (in the Chair)]

Order. I am afraid I have to call the Minister.

[Jonathan Ashworth]

Will the Minister respond on the public health cuts? When will we see the investment in drug and alcohol addiction services that Dame Carol Black’s report calls for?