My Lords, I support the probing Amendment 242 from the noble and learned Baroness, Lady Butler-Sloss. As the Minister referred to “juvenile” earlier, I remind the Committee of his views on heavy drinking: that it can be either a civilising force or the bane of civilisation. In society today, particularly in those who offend, it might be the latter.
The Liberal Democrats have long believed that the best treatment for drug and alcohol addiction is to treat it as a health emergency for the individual and society. As the noble and learned Baroness, Lady Butler-Sloss, outlined, there are already interventions in prison for those with addictions, whether drug or alcohol. But many are talking therapies, many of which, as a result of the pandemic, remain on the phone or on Zoom, and it is certainly true that we are hearing that offenders are finding that less effective.
The noble and learned Baroness, Lady Butler-Sloss, is right: a custodial sentence is the right time to think about dedicating time and energy to a residential rehabilitation course, where there are no distractions or problems of cancellation or changes of prison where you cannot continue with the same course. The NHS Integrated Substance Misuse Treatment Service in Prisons in England report, published in 2018, says:
“The purpose of health care in prison, including care for drug and alcohol problems, is to provide an excellent, safe and effective service to all prisoners equivalent to that of the community—whether the aim is stabilisation, crisis intervention or recovery from dependence.”
The guiding principles are “Recovery”, “Reducing harm”, “Reducing deaths in custody” and “Reducing reoffending”.
Recovery is key, but the reality is that the numbers are not good. The last report from the Ministry of Justice Alcohol and Drug Treatment in Secure Settings: 2018 to 2019, shows that the current arrangements have mixed results. It reports that of 53,000
“adults in alcohol and drug treatment in prisons and secure settings”
in that year, around 65% started treatment and just under 60%
“left treatment in secure settings.”
The report says that only just over a quarter of those who were discharged after completing their sentence were free of dependence. The figures for young people receiving treatment, principally for alcohol and cannabis problems, are not dissimilar. Of those young people who left secure settings in 2018, under 30% completed their treatment successfully.
Continuity of care between treatment services is absolutely vital, and the proportion of adults successfully starting community treatment within three weeks of release was only a third. The intensity and focus of residential courses for people addicted to drugs and alcohol already has a higher success rate, and if attended near the start of their sentence could well mean that they have a real opportunity to learn to live with recovery.
Public Health England’s evidence review of drug treatment, published in 2015, says:
“The costs to society are significant. Latest estimates by the Home Office”,
in 2013,
“suggest that the cost of illicit drug use in the UK is £10.7bn”.
Of those costs, NHS costs are 1%, enforcement costs 10% and drug-related crime costs 54%. Public Health England’s review notes that, in all, around 50,000 people received drug treatment in prison in 2015-16. Nearly one-third had also received drug treatment in the community. The numbers are stuck. They are not improving.
The review makes two key points: waiting times to access a course and active steps taken to prevent a drop-out are significant in achieving a good outcome. This amendment proposes a mechanism that would not only prove beneficial to the offenders attending it, with a higher rate of success than the range of other interventions currently used, but would serve society and significantly reduce the costs of drug-fuelled crime.