Immigration Bill
Baroness Meacher Excerpts(10 years, 2 months ago)
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Baroness Meacher
“Domestic abuse and female genital mutilation
No charge may be imposed for health services—(a) relating to injuries sustained as a result of domestic abuse as defined in Home Office Circular 003/2013 “New government domestic violence and abuse definition”, or(b) relating to injuries sustained as a result of female genital mutilation as defined in the Female Genital Mutilation Act 2003.”
Baroness Meacher (CB)
In moving Amendment 62, I shall speak also to Amendment 62A. The purpose of Amendment 62 is to ensure that treatment for any injury resulting from domestic abuse or female genital mutilation is exempted from NHS charges even if the victim does not have permanent leave to remain, or indeed if her immigration status is not clear. I should explain at the outset that these are probing amendments and I understand from the Minister that these matters will be dealt with by the Department of Health in regulations. Having said that, this amendment provides an opportunity for this House to try to influence those regulations. I think that I am right that there will be no further opportunity to do that.
Clause 34 defines for the first time the term “ordinarily resident”. If the person is not ordinarily resident they may be charged for health treatment. If they have paid the surcharge they should be covered for health services but many other people are already living in this country—I understand in the realm of about half a million—who have not paid the surcharge and are eligible for NHS charges. Further, Clause 34 brings ordinary residents into line with permanent residents. That means that instead of being here with a visa for a settled purpose such as a job, a university course or to reunite with a spouse for a minimum of one year, an immigrant will need to be here for a minimum of five years in most cases before they are fully covered for healthcare. This is why Amendment 62 is important and relevant to health charges, as I understand it.
In his letter of 12 March, the noble Lord, Lord Taylor, said that short-term visitors and those without lawful immigration status will,
“continue to be liable to pay overseas visitor charges for secondary care treatment under NHS regulations”.
This is similar to the letter from the Minister for health quality, who said that,
“illegal non-EEA migrants and short-term visitors (under 6 months) will continue to be liable to NHS treatment charges as they are now”.
I am told that this is not precisely the case, as the National AIDS Trust’s excellent briefing points out. In fact, the Government plan to introduce new charges for primary care, apart from GP and nurse consultations, and for A&E services for this group and for any migrant who cannot show that they have paid the levy. The need to assess patient entitlement in primary care or A&E would be an unhelpful distraction in an emergency situation. This might be done after someone receives treatment—but that, too, is an alarming position for someone who may have little or no money.
In his subsequent note and his latest briefing, the Minister gave assurances about a number of vulnerable groups who will not be subject to the surcharge or charges for treatment under the NHS charging regulations. There is no mention of the victims of domestic violence or FGM in relation to either. Do the Minister and his colleague, the Minister for Health, intend to exclude these two groups from the surcharge and, in the case of those already here without permanent residence, from NHS charges? If not, it is a matter of great concern that the moral and humanitarian case previously accepted concerning these groups appears to have been set aside.
As to the practical difficulties in determining who the exemptions for domestic abuse and FGM would apply to, I understand that medical checks would be needed if these groups are to be exempt from the surcharge. I appreciate that could be problematic in the circumstances, but in the case of NHS charges for failed asylum seekers, irregular or undocumented migrants, short-term visitors and others without permanent residence, does the Minister not agree that if a patient in any of these groups has been domestically abused or damaged by FGM, they should not be charged for treatment? It would be helpful to have clarification on this point on the Floor of the House, if the Minister is able to give it, albeit that such provisions would ultimately be made in Department of Health regulations.
If irregular migrants and refused asylum seekers who would not have paid the surcharge cannot access primary care services, apart from GP and nurse consultations to address comparatively minor health problems, they will eventually present elsewhere—probably at an A&E department—at much greater cost, as I referred to in relation to an earlier amendment.
A different but important point is whether the NHS will be expected to report back to the Home Office if a patient’s migration status requires them to be charged for NHS services. There is a concern about this in view of the comment of the Home Office Permanent Secretary to the Home Affairs Select Committee that the Home Office intends,
“to improve its radar screen into the NHS”.
I find that rather chilling. If it became known that a visit to the doctor could lead to a report to the Home Office, people could be deterred from seeking healthcare. Can the Minister assure the House that this will not be the case?
The Government have previously recognised the important role of the NHS in identifying victims of abuse and helping them to recognise, consider and exercise their option to escape from that abuse. Also, in the case of FGM—where we have not had a single prosecution—the NHS is seen as probably the best hope of identifying perpetrators and providing evidence to support the prosecution case. I look forward to hearing the Minister’s view on that.
On Amendment 62A, the Government have agreed that no charge will be made for health services to victims of human trafficking. I am dealing with this issue separately because, in a sense, these people are in a different situation. The aim of the amendment is to put this commitment in the Bill and to require the Government to produce a strategy and procedures to ensure that the victims of human trafficking are promptly and effectively identified for the purposes of the clause. This is a probing amendment which I hope the Minister can endorse, thus assuring the House that there will be regulations in place to achieve its aims so that victims receive the necessary medical treatment. The UK would thus satisfy our international obligations.
According to the Catholic Bishops’ Conference, the UK Human Trafficking Centre shows that more than half—54%—of trafficking victims were not recorded by the national referral mechanism in 2011. UKHTC notes that people who have been trafficked are often treated as irregular or illegal migrants. They may, of course, have been given false, stolen or genuine but fraudulently obtained identity documents. They will most likely then be treated as immigration offenders despite not acting under their own volition. This is quite understandable but it will need attention to avoid this kind of thing happening.
As the Bill is currently worded, these victims would not be exempt from the charges for health services if they are in one of these obscure groups. Also understandably, people who have been trafficked and coerced into criminal activities are often treated as offenders rather than victims. They are unlikely to benefit from exemption from health charges. A 2013 report by Anti-Slavery International highlighted a lack of awareness of trafficking indicators among authorities. If these victims are not identified, they are likely to get a criminal record, go missing, be deported and be retrafficked. They become victims a second time round.
All this will increase the fear of victims and their suspicion of the authorities. Help with later investigations is less likely to be forthcoming. At the moment, the authorities rely on those who are trafficked to disclose their status quickly or face detention—and, for obvious reasons, often that does not happen. If not identified immediately on arrival, trafficking victims are unlikely to be identified subsequently, and hence the importance of subsection (2) of the amendment. There is a need for,
“a strategy and procedures to ensure that victims of human trafficking are promptly and effectively identified”.
We are particularly concerned about trafficked children. I understand that at the moment social workers receive no mandatory training in identifying a trafficked child. We know that in the context of the draft Modern Slavery Bill there is a commitment to roll out specialist training and other measures. Can the Minister give the Committee a commitment that rigorous enforcement of health charges will not be introduced until the safeguards associated with the Modern Slavery Bill are rolled out?
Let us get things in the right order. Does the Minister agree that before the planned safeguards are introduced, they will be put before the modern slavery commissioner, who is to be appointed under the modern slavery legislation? Indeed, to clarify these matters, can he provide the Committee with information about the planned timing of the introduction of the new enforcement rules for health charges and of the implementation of proposals in relation to the Modern Slavery Bill? I beg to move.
Baroness Finlay of Llandaff (CB)
My Lords, my noble friend Lady Meacher has introduced this group of amendments with great clarity. I have added my name to Amendment 62 and I will speak to Amendment 64. Other Peers who have added their name send their apologies for not speaking at this late hour. I do not want to add much more to what has been said about domestic abuse and female genital mutilation except to say that I have a major concern as to how this will actually work in practice unless these groups are exempt.
What happens if a girl comes into the country, her status is not established, and she has infected wounds? What happens to the girl who has been mutilated and has urinary and voiding difficulties or suffers chronic pain? What happens during pregnancy, when delivery can be incredibly complicated? If it is not properly managed, a woman may literally burst because scar tissue is not elastic. We recognise FGM as an absolutely awful form of abuse and it is shameful that there have not been prosecutions already. If we put these women into the charging category, we will almost reverse the message we have sent to society about this terrible act.
The other problem arises with domestic abuse. If a woman arrives at A&E with severe facial injuries including fractures to the bones of her face or her chest wall, they may be life-threatening. If her ribs have been stoved in, it may be a life-threatening injury such as a pneumothorax and treatment will have to begin straightaway. Emergency service personnel are going to be put into a terribly difficult position. Another problem is that, in the societies from which many of these women come, sadly they are not afforded the rights they have in our society, and they are not given the respect they deserve. I am fearful that there may be a tendency to blame the woman if attempts to stay fail because she is a burden on the man, thus making it more difficult for him to stay.
Amendment 64 is about people who are released from detention. Currently, people can receive treatment while they are being held in an immigration detention centre and the course of treatment will be ongoing when they leave, but this may not be the case in the future. The consequences will be particularly acute in the area of mental health. It is well documented that the experience of an immigration detention centre is damaging to the mental health of many detainees. Without ongoing support, those mental health problems will be exacerbated rather than ameliorated at the point of release. The problem we are faced with is where to set the boundary and how it will actually be implemented.
These are probing amendments, but when regulations come before the House we will not be able to amend them. We will be faced with either accepting or rejecting them. That is why we need to tease out these issues very carefully at this stage.
Baroness Meacher
I am sorry to interrupt the Minister. He understandably said that this was a matter for the Department of Health and therefore not really appropriate for discussion here. Can he assure the Committee that we will therefore have another opportunity to influence the design of these regulations, which will indeed determine whether people suffering with FGM, domestic violence and so forth will be excluded from health charges or not? That is a matter of great concern to many of us. If we cannot discuss it here, will there be another opportunity?
Lord Taylor of Holbeach
That is why I am going to try to address some of these matters. It is right to seek to do so, allowing for the limitations of my knowledge in this area, which I hope that noble Lords will understand.
This House has a good reputation for debating these sorts of things not, if I may say so, through the statutory instrument process so much as generally. I am absolutely certain that my noble friend Lord Howe would be quite prepared to come at a suitable point during the consultation to discuss the basis of changes that would be made. I am sure that I am not losing a friend for life by committing him to do just that.
As if to show that I need to brush up a little bit, apparently I may not have said, through mis-speaking or a slip of the tongue, that the Home Secretary announced the review of the NRM. I thought that I had implied that, but if I had not, I should have done so. Let us hope that I do not fall out with another friend for not crediting the Home Secretary.
The noble Baroness, Lady Meacher, asked about training for the enforcement of new NHS rules, and also about the Modern Slavery Bill which, as noble Lords know, is in pre-legislative scrutiny. The Department of Health will publish its implementation plan on the health service rules during the course of this year. The Modern Slavery Bill will be a fourth Session measure. I must not anticipate the Queen’s Speech, but the fact that that Bill is going through pre-legislative scrutiny rather suggests that it will be in the fourth Session legislation.
The noble Baroness, Lady Finlay, asked about a victim of FGM who has infected wounds. Under the NHS charging regulations and policy, immediate necessary treatment is not held up because of charging. I think that the noble Baroness has enough experience of how the health service operates charging principles, and I do not think that that is likely to change. GP care is not charged for, as I have said. The Department of Health is reviewing provisions for vulnerable individuals under these NHS regulations.
The noble Baroness asked why we were planning to charge migrants for accident and emergency services. Surcharge payers will obviously not have to pay for A&E services. The Department of Health has indicated that there is a good case for introducing overseas visitor charges for A&E, for those short-term visitors and illegal migrants who do not pay the surcharge. It is giving this detailed consideration, but will not make any changes unless it is confident that the new systems will work well without compromising rapid access to emergency care for those in immediate or urgent need, which will never be withheld or delayed pending payment. However, as I said, that is not a matter for the Bill. It is part of the review into regulations which is going on at the moment.
My noble friend Lady Cumberlege asked whether those exempted from the charges will be exempted from NHS charges. Our policy intention is that those who are exempt from the surcharge will also be exempt from subsequent National Health Service charging for health services under NHS regulations. However, obviously they will be liable for dentistry; as I mentioned before, at the moment that is not free other than in exceptional cases.
Under the Bill it is possible for surcharge payers to be charged for certain expensive discretionary treatments —I think we have discussed that already. However, we have made it clear that we intend that no such additional charges will apply when the surcharge is introduced. The Department of Health has made it clear that it would consider those in the future only in the event of any exceptional and compelling specific justification for health purposes, and, as I have already said, any changes would need to be put before Parliament.
My noble friend welcomed the exemptions, but those refused asylum will face charges, as will most victims of trafficking who are not recognised through the national referral mechanism. I emphasise to my noble friend that refused asylum seekers will not pay a surcharge. Health charging for refused asylum seekers is a matter for the Department of Health and the devolved health administrations within its remit. We have already confirmed that trafficking victims will not have to pay the surcharge.
The NRM is the only process by which an individual can be formally identified as a victim of trafficking and matched with appropriate support. Someone who has not been identified as a victim through the NRM and who is an illegal migrant or visitor would not be covered by the exemption for NHS charging under the existing regime. However, the NHS can write off NHS debts if individuals are subsequently identified as victims of trafficking, so there is a retrospective exemption in that regard.
The Department of Health has committed to give further thought to strengthening exemptions in the current NHS charging regulations for vulnerable groups, including victims of trafficking. We want to make sure that the NRM works effectively, which is why the Home Secretary has commissioned the review.
My noble friend asked whether those who come on a visa, pay the levy—or the surcharge, as it is properly called—and are later refused an extension will still get free NHS treatment while waiting for an administrative review decision, and asked about a period for which the paid levy has expired. This is about people and their leave to remain. Those individuals will continue to receive free NHS treatment as part of the conditions of their extant leave. Where individuals had leave, alongside which they paid the surcharge when they applied for an extension and applied for an administrative review within the specified time limit for doing so, their leave will be extended on the same conditions under Section 3C of the Immigration Act 1971 until their administrative review is decided.
My noble friend asked what would happen if their review is refused and they bring a human rights appeal. Once an administrative review is refused a migrant will be liable for NHS overseas visitor charging unless they fall under one of the exemptions set out in NHS charging regulations. That will be commensurate with their immigration status.
A number of noble Lords were concerned about GP consultations being free—I think that that is widely understood—but what about treatment? We intend for surcharge payers to receive most treatment free, as would any other UK citizen or person with indefinite leave to remain. We have made that clear in all the responses that I have given. They will be charged only for services for which permanent residents are also charged. As part of its work to reform the charging regime in England, the Department of Health has signalled an intent to extend charging for short-term visitors and illegal migrants to some primary care services, excluding GP consultations. It is carrying out a detailed analysis to inform decisions in this area, and any agreed changes will be put to Parliament.
I was asked by my noble friend Lady Cumberlege to give an assurance that the Home Office would not be permitted to use access to healthcare as a means for it to identify and take action against those subject to immigration controls. Healthcare staff are not routinely required to inform the Home Office on issues to do with individuals’ immigration status, and there is no plan to change this. However, there are circumstances where it is appropriate for the NHS to pass information to the Home Office, such as for enforcing the NHS debtors rule, which is a current rule under which migrants who have run up an unpaid debt of £1,000 or more are not given permission to enter the UK while the debt remains unpaid.
Finally, I hope that I have answered the questions posed by my noble friend Lady Barker on mental health and such matters. She made a valuable contribution to the debate.
I turn to the challenges presented by the noble Baroness, Lady Smith, who asked, “What is success?” Success might be the £2 billion surcharge income for the NHS, which is a large sum of money even in a health service budget running to several hundred thousand million pounds. An additional £500 million will be recovered in treatment charges each year through better administration, plus the surcharge, and vulnerable groups will be protected and treated. Part of the consideration of the NHS review and the provisions of the Bill are to ensure that vulnerable groups are protected. There is no adverse impact on public health, and there is a fairer set of rules and arrangements, which command public support. Those are the basic challenges that face us in seeking to reform charging within the health service.
I reiterate that the introduction of the surcharge in the Bill will give those who are obliged to pay it—and they are obliged to pay it—the peace of mind that they will receive comprehensive NHS treatment when needed. But charging for short-term visitors and illegal migrants remains the responsibility of the Department of Health, and it is not dealt with in the context of this Bill.
Lord Taylor of Holbeach
I give that commitment. I will, of course, write on that. I will also go through the debate as other questions may have not have been answered, for which I apologise. The noble Baroness, Lady Finlay, nods, so I clearly forgot to answer one of hers. However, I will go through the debate and answer all the questions as best I can. Indeed, my officials will talk to officials at the Department of Health as some of these matters are the responsibility of that department, as we have already discussed. I thank the noble Baroness, Lady Barker, for her kind words.
Baroness Meacher
My Lords, I thank the Minister very much for his thoughtful response. He was able to give us some reassurance on some points. I think that there are still a lot of gaps, but I am sure that the Minister will respond to some of the points in writing. I am very grateful to him for his kind offer in regard to his colleague, the noble Earl, Lord Howe, meeting us. I assume I am right in saying that the Minister’s office will be in touch with the office of the noble Earl, Lord Howe, to set up such a meeting because I think that it is only in that forum that we can achieve clarity about some of the most important and concerning issues to do with health charges and these vulnerable groups. As the noble Baroness, Lady Smith, said, we are talking about the victims of criminal offences.
There is much to thank the Minister for, but we will have to read the debate carefully and think about Report. With that, I beg leave to withdraw the amendment.
Immigration Bill
Baroness Meacher Excerpts(10 years, 2 months ago)
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Baroness Meacher (CB)
My Lords, Amendment 66 requires information outlining details of health charges for health services applicable to the individual to be given at the point of an application for immigration permission or upon request. One of the biggest worries about the health service clauses in Part 3 is that they could create confusion and wrongly discourage some migrants from accessing free healthcare to which they are entitled. According to the Catholic Bishops’ Conference of England and Wales, for whose briefing I am most grateful, there is already a notable lack of understanding about how the charges for health services will work among both individuals and healthcare professionals. Even more worrying, there has also been inconsistency in how charges are implemented.
Most welcome is the exemption from charging for the treatment of diseases which present a public health risk. However, public confusion could result in delays in people presenting themselves and therefore in diagnosis. Already in 2012, 47% of adults newly diagnosed with HIV were diagnosed late. I am not sure what percentage of those late diagnoses would be attributable in any way to confusion. Overall, 81% of AIDS-related deaths in England and Wales in 2012 were attributable to late diagnosis. There is an issue about timing.
Equally, unless people are made aware of their entitlement to health treatment right at the start of their application for immigration permission or when they request it, they are likely never to sort this out or to become clear about the services to which they are entitled. From the taxpayers’ point of view, it is crucial that those entitled to free GP consultations are aware of it. The risk is that fear of being charged for a visit to the GP may result in people not doing that and later needing an A&E appointment. The cost differential between these two options is £90 per patient and could over time add up to quite a bit for the taxpayer, quite apart from the detriment to the patient.
Does the Minister agree that readily available information accompanying any changes to the healthcare charging system or to the collection of charges—I understand that is going to be much tougher in future—is essential to prevent public health risks and unnecessary costs to the Exchequer? I hope the Minister will inform the House what assessment the Government have made about the current level of public understanding about healthcare charges and exemptions for specific groups and what steps they have taken or will be taking to improve awareness among healthcare professionals and members of the public.
Baroness Lister of Burtersett
Following what the noble Baroness, Lady Barker, said about the importance of the evidence base, I take us back to our debate on Monday. In that debate, a number of noble Lords questioned the evidence base for the claim that there is a problem of so-called health tourism in this country. They asked the Minister what the evidence base was for that claim and questioned the Department of Health’s report on it. The Minister had an awful lot of points to make in his summing up speech and, after about 30 minutes, he quite understandably thought that he had had enough and probably everyone else had, too. Although he has already helpfully circulated a letter following our first day, I could not see anything in it that responded to the concerns raised on all sides of the House. I use this opportunity to invite the Minister to respond on that this evening.
Lord Taylor of Holbeach
I would not wish to get involved in hearsay or gossip or, indeed, the suggestion that some of this stuff is just newspaper chat. I will get back to the noble Baroness, Lady Lister, with a reasoned reply explaining the Government’s analysis of the situation. However, the purpose of this measure is not to do with health tourism at all; it is to do with providing a charge whereby people who stay here for more than six months make a contribution to the NHS. It will make it more difficult for people who are not entitled to access healthcare to do so, but that is a secondary purpose.
Baroness Meacher
Perhaps I might ask for clarification on one point. The Minister skated rather quickly over that fact that “it” will be explained on the visa application form. I wonder what “it” refers to. Will it spell out clearly that all health services freely available to permanent residents will also be available to the applicant as somebody who has paid the surcharge?
My second question concerns people with infectious diseases who may not have paid the surcharge but who will be entitled to free treatment for an infectious disease. What sort of action will the Government take to inform them of their entitlements?
Lord Taylor of Holbeach
The latter point is more difficult to answer positively; it is something which my noble friend Lord Howe would be in a position to reply to with authority. On the first point, I think that the wording which the noble Baroness suggested is particularly good. It sums up the policy as I have tried to describe it to the Committee.
Immigration Bill
Baroness Meacher Excerpts(10 years, 2 months ago)
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Baroness Lister of Burtersett (Lab)
My Lords, I support the amendments in the name of my noble friend Lady Smith of Basildon and with regard to clause stand part. I made clear my opposition to this part of the Bill at Second Reading on the grounds of its impact both on migrants and on black and minority ethnic citizens. I raised the concerns in the report of the Joint Committee on Human Rights, and we returned to the issue in our second legislative scrutiny report in which we welcomed,
“the Government’s indication that the Secretary of State, when exercising her residual discretion to grant permission to occupy premises under a residential tenancy agreement, will take into account the best interests of any child involved, in accordance with the duty in s. 55”.
By acknowledging the relevance of Section 55 in this context, this goes beyond the general indication already given by the Government, welcomed in our first report, that,
“nothing in the Bill is intended to change or derogate in any way from the children duty in s. 55”.
The committee said:
“However, we remain concerned about whether it will be sufficiently clear to front-line decision-makers that the s. 55 duty applies to significant functions such as the Secretary of State’s discretion to grant permission to occupy residential premises. Under s. 55(3) of the 2009 Act, a person exercising any of the Secretary of State’s functions in relation to immigration, nationality and asylum must, in exercising the function, have regard to any guidance given by the Secretary of State. We recommend that the Secretary of State issue new guidance specifically on the s. 55 duty, explaining clearly to front-line decision-makers exactly how that statutory duty applies in relation to functions conferred by or by virtue of this Bill”.
I invite the Minister to give that assurance.
With regard to piloting, the subject of Amendments 50 and 51, at Second Reading I asked what steps would be taken to monitor the impact from the equalities and human rights perspective. The Minister kindly referred to this question in his written response on Second Reading issues, so I eagerly looked for an answer first in the commentary and then in the factsheet to which we were referred for answers, but answer came there none. Therefore, I would be grateful for an answer this evening on the record.
I welcome the fact that the draft code of practice was published with the factsheet, but given the 36 pages of the code of practice plus 16 pages of the anti-discrimination code, I could not help but wonder how many landlords are going to read, learn and inwardly digest all the contents of those codes? I fear that, even without any discriminatory intention, landlords—this point has already been made by, for example, the noble Lord, Lord Best—will simply avoid letting to anyone who looks or sounds like a foreigner. This is in the context of a housing market where we know that, particularly in London, landlords are getting increasingly selective about whom they will rent to. For example, housing benefit claimants are finding it increasingly difficult to get private lettings. As has already been said, the danger is that people are then pushed into having to rent from rogue landlords. The Migrants’ Rights Network raises particular concerns about women who may have insecure immigration status and how this provision could make them very vulnerable to physical or sexual exploitation.
At Second Reading the noble Lord, Lord Cormack, asked about a possible exemption for small landlords. The written response given afterwards was that the Government did not consider this to be appropriate. I realised only the other day that lodgers are included in this provision. This will mean that people subjected to the bedroom tax who are taking in lodgers because they want to stay in their home and they cannot afford to pay their rent because their benefit is being cut will be treated as landlords. These people never wanted to be landlords; they have been pushed into it. The noble Lord, Lord Best, talked about amateurs. These really are amateurs. Are we really saying that someone who has been subjected to the bedroom tax could be fined up to £3,000 if they get this wrong? It is appalling. I hope that at the very least the Government will think again about lodgers. Like my noble friend, I would prefer it if we could remove this nasty clause from the Bill altogether but, if not, at the very least we need firm assurances that there will be a genuine pilot from which lessons will be learnt and which will monitor the equalities and human rights impact.
Baroness Meacher (CB)
My Lords, I, too, wish to put on record my concerns about the proposed use of landlords as unpaid immigration officials. My preferred option, too, would be for the Government to drop Clause 15 altogether, although I do not expect the Minister to be thrilled at that idea. Therefore, as a second option, I would very much support a single pilot, which is evaluated and has an evaluation report put before Parliament before—this is very important—any attempt is made to roll out these provisions beyond that single pilot. That is, as others have said, totally different from what the Government are currently proposing.
I, too, do not believe that the system will work and it is therefore better to find that out before it happens all over the country. As other noble Lords have said, landlords will find ways to avoid entering into a tenancy agreement with anyone who may not have a legitimate right to remain and anyone who may bring into the household others who may not have a right to remain. As the noble Baroness, Lady Lister, has said, this could involve a considerable number of people.
Landlords do not keep a close eye on who is staying in each of their properties from week to week and month to month. The tenant may indeed have a visa, a job and all the necessary papers in order to remain in Britain, but if he brings over relatives to live with him, it must be for the immigration authorities to ensure that those relatives return home or obtain the right to remain. It cannot be right that the landlord can be penalised to the tune of initially £1,000, and then £3,000, for not being aware of this. Is he supposed to undertake an inspection of each of his properties each week or month? What kind of police state are this Government thinking of introducing?
An additional concern is that landlords are generally very anxious to remain on good terms with their tenants, and for good reasons. If tenants are threatened with a report from the Home Office or the results of such a report, they could well leave the property trashed, at considerable cost to the landlord and considerable inconvenience.
The Minister’s briefing says that if a tenant has no documents then they must, in order to rent a property, produce a police letter confirming that this has been reported. Does the Minister believe that this is realistic? What will be the cost to a landlord of undertaking or paying an agent to undertake the necessary checks, getting all these documents and police papers? I should be very interested to hear the Minister’s response.
The Minister’s briefing dismisses the exemption of students from the landlord provisions on the grounds that it would be complicated for landlords to keep records on only some of their tenants. I do not know. In my experience, most students live together in student accommodation of one sort or another, such as a student house. I hope the Minister will reconsider that point.
Then there is the experience of the former Minister Mark Harper, which has been referred to. The implications of landlords’ fears of inadvertently falling foul of the law and being penalised for an understandable error are considerable and will have huge implications for many communities. As Liberty argues:
“The net impact of the policy may well be to push those with irregular status further under the radar, increasing vulnerability and exploitation by creating another black market in private rented property”.
As the Home Affairs Committee put it, these new housing measures must not drive,
“more people into the twilight world of beds-in-sheds and overcrowded houses in multiple occupation”.
Does the Minister agree with those concerns—and if not, why not?
If the Government insist upon going ahead with these provisions, does the Minister accept that the requirements of the landlord must be minimal and very straightforward. The Minister’s briefing note says:
“Where a variety of documents are presented as evidence, it will be good practice to check that the names, photographs and dates of birth are consistent throughout”.
In fact, the wording behind that paragraph makes it clear not that that would be a good idea but that the landlord must do so. Can the Minister confirm that the landlord should not be penalised if his agent simply confirms that records have checked and are there, but that subsequently inconsistencies are found? Surely the landlord cannot be found responsible. If landlords are penalised for this sort of thing, landlords simply will not let a property to anyone whose documents are not or might not be straightforward. Landlords simply do not want to become immigration officers. Why should they? They have not gone into that profession in the first place.
Also, do the Government have any evidence at all that these measures would work? Finally, what will be the effect on ethnic minorities in general living in this country? Does the Minister have any concerns about the wider societal implications of these provisions?
Immigration Bill
Baroness Meacher Excerpts(10 years, 3 months ago)
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Baroness Meacher (CB)
My Lords, the economic and human rights issues raised by this important Bill have been effectively examined by noble Lords today. However, I and others well understand the Government’s need to find ways to reduce the impact of illegal migrants upon our hard-pressed health services and upon the British taxpayer. I also welcome the Government’s adjustments to the Bill following representations made over recent months. Particularly welcome are the exemptions for asylum seekers, refugees and victims of human trafficking.
Other noble Lords have spoken eloquently about the importance of perception and the need to avoid sending a message to the world that Britain is closed for business. I also want to refer to the powerful arguments against the creation of stateless persons; I simply endorse those contributions. I will touch only briefly on the provisions for private landlords and the NHS charging issue raised in Part 3. My aim is to raise a number of questions in the hope that the Minister can clarify the points raised before Committee, so that we might cut down some amendments that would be unnecessary in the debate at that point.
We need to understand the relationship between the existing system within the NHS to charge non-EU visitors to the UK for certain services and the combination of the proposed surcharge, payable before entry to Britain, with the plan to continue charging non-EU migrants for expensive health interventions. It seems that the Department of Health has been unable to assess fully the extent of the problem which these new provisions are designed to rectify. I recognise that a surcharge paid before entry to Britain is greatly preferable to charging people at the time of health treatment. If the surcharge were limited to short-term visitors and were the only charge, I would be inclined to support it. However, we know that the surcharge will apply much more widely than current provisions for visitors, and that migrants will continue to be charged as well for expensive treatments.
It is important to know what the threshold is for those charges for expensive treatments. If the threshold is in fact low, we could end up with a health surcharge and extensive charging for individual treatments. This would have equity implications for migrants and a significant cost implication for the NHS in administering the charging system. Most importantly, it would continue the unfortunate introduction of questions about affordability just when the person is going in for treatment. Personally, I am rather hostile to the very idea of introducing financial issues of affordability at the time of treatment, which is why I rather favour the surcharge idea. I hope that the Minister can clarify to what extent these charges will exist within the health setting.
A second question is whether charging longer-term migrants who are in employment and paying taxes and national insurance is regarded as reasonable by the Government. It would be helpful to know their rationale for this proposal. Have they undertaken an impact assessment of it on the willingness of overseas employees to come to this country and take up jobs here?
A related issue concerns British citizens who work overseas for some years and then return to this country many years later to take up employment here. It had not occurred to me that this Bill could conceivably affect them, but others have raised the question and it would be good to have the Minister’s reassurance that British citizens in this situation will not be affected.
In relation to primary care, can the Minister clarify whether access for migrants to initial GP and nurse consultations will include the prescriptions that would arise from many of these consultations, or will the prescriptions be charged in full to patients? The same question applies to community care. If a migrant with a mental health problem cannot access community care because they cannot afford it at the primary care level, have the Government assessed the risk of these provisions increasing the costs of secondary services that would, I believe, be provided free of charge in emergencies to migrants? They should be, but there is undoubtedly a relationship between providing good services in primary care and so reducing the impact on secondary care costs.
I put on record my strong support for my noble friends Lord Hannay and Lord Bilimoria and others who argue that foreign students should be exempt from the Bill. As others have said, higher education is an important export industry for this country. Yet foreign student numbers are falling fast, as others have pointed out. The Government plan to exempt halls of residence: if there is a rationale for that, then surely there is a rationale for exempting all student lodgings, for example. It seems that the Government are shooting themselves in the foot on that one.
On the more general issue of plans to use landlords as unpaid immigration officers, I share the concern of my noble friend Lord Best that landlords are likely to avoid by a very wide berth the possible hassle and fee, or fine, involved in unwittingly failing to spot an illegal migrant. This proposal could have a serious impact on the availability of private rented accommodation to all but the most obviously British of potential tenants.
The Government’s briefing indicates that the checks will be straightforward and quick for law-abiding landlords and tenants to comply with. Can the Minister clarify what is meant by “straightforward”? For example, if the landlord asked to see the prospective tenant’s passport, with a visa no doubt stamped inside, would that be sufficient to avoid future questions and investigations involving the landlord concerned? I hope that it would be.
The Minister referred to plans to protect vulnerable people. This is another area where I have to say that I am not convinced. Government briefing refers to “much simpler documentary requirements” for homeless and vulnerable people. The problem will surely be the absence of any documents in the possession of homeless people and of women fleeing domestic violence. I cannot imagine them having any bits of paper in their pocket in that situation.
Here we are assured that an e-mail Home Office service will provide the necessary information for some cases: if this has not been done within 48 hours the landlord can proceed and rent the property. For those with no documentary evidence we are told that there will be another option to obtain confirmation from the Home Office that the prospective tenant can rent a property, but no time limit is given for that process. Can the Minister explain the difference, again before Committee, because it really does not seem helpful? Some clarification at this early point could save the time of the House in Committee and I look forward to receiving the Minister’s information.
Anti-social Behaviour, Crime and Policing Bill
Baroness Meacher Excerpts(10 years, 5 months ago)
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Baroness Meacher (CB)
My Lords, in speaking to Amendment 56NA, I commend the noble Baroness, Lady Smith, and the noble Lord, Lord Rosser, for tabling it. We need government and, indeed, all political parties to get together to try to create a safer world for our young people while new psychoactive substances are so readily available to them. The amendment has merit on two grounds: first, it seeks to remove these substances from the shop window, as one might put it, which has to be helpful; and secondly, a feature of the amendment is that it focuses exclusively on suppliers and does not seek to criminalise the users of these substances. Those are two important points in favour of the amendment.
However, we need to be aware of some of the potential problems with the amendment. My only qualification for speaking today is that I chaired the APPG inquiry into new psychoactive substances, which received evidence from all the major governmental and non-governmental organisations involved in this field, as well as academics and those working on the front line, who really understand the implications of policies and perhaps their ineffectuality. As a result of that work, I have a number of concerns.
The first is the absence of proportionality or logic in the proposal. We have to accept, albeit reluctantly, that a sizeable proportion of young people will use drugs that may harm them. Our aim must surely be to reduce the incidence of addiction to any dangerous drug and, in particular, to reduce addiction to the most dangerous drugs, whether legal or illegal. We also need to reduce as far as possible the risk of a young person having a single dose of a substance that can cause death or serious injury.
Our drug policies must face reality. We will not stamp out drug use through bans and punishment. Our only hope is to create a rational system which makes abundantly clear to our young people those substances that are seriously dangerous, those that cause medium harm and those with short-term and relatively mild ill effects. We have not even begun to go down the road of proportionality in our drugs policy and, unfortunately, this amendment does not adopt this essential principle. Some other countries have done so, with impressive results, and even the US is beginning to take steps in a rational direction.
My comments on this amendment reflect my increasing conviction of the need for proportionality in our drug policies, combined with extensive information, education, treatment and psychological support for those who need it. Only with such an approach will we have a chance to achieve a safer drugs policy.
We need young people to respect the law. If the law is an ass, young people will get round it or simply ignore it. The amendment does not offer a proportionate response to these substances. There is also a lack of logic in the amendment, if I may put it that way; for example,
“a herbal substance with the appearance of cannabis”,
would be banned under this amendment. Why those particular herbal substances? They may in fact present a far lower risk and be far preferable for the health of young people than legal drugs such as tobacco and alcohol, and certainly the many other drugs that are available.
The Angelus Foundation, the organisation behind this amendment, argues in its briefing that the ban should apply only to synthetic psychoactive substances. It accepts that head shops have sold a number of substances that are non-addictive, do not cause significant social problems or are mild in their effects. It rightly says that such substances should not be caught by this amendment. But why should synthetic substances of similarly low risk and lack of social consequences be banned? Young people will very quickly realise the inconsistency in the situation.
Turning to a different issue, I find myself in agreement with the Home Office concern that the amendment completely bypasses the ACMD—the Advisory Council on the Misuse of Drugs. That august body of scientists should be at the heart of drug policy-making, assessing risks and actually making decisions—if I had my way —on the classes of different drugs. If we had scientists making these decisions, we would arrive at a more sensible set of policies.
Another and quite different concern is that if this amendment were passed it might be seen as a solution to the problem of NPS. Of course, a proportion of these young people will immediately go to the web if they cannot get what they want from the local head shop, and that proportion could be very close to 100%. Young people know all about the web—far more than I do—and it would not take them many minutes to realise that that is all they have to do to get what they want.
A very different question is whether the authors of the amendment explored the implications for research of this measure. Already, serious psychopharmacological researchers are having incredible difficulty obtaining the substances they need to undertake their research.
Also, have those supporting the amendment considered its cost implications? Trading standards representatives who gave evidence to our APPG on Drug Policy Reform made clear that if they are to take responsibility for policing head shops, they will need money to do it. That money has to cover the testing of those substances. It is no good their picking up a substance from a head shop if they have no idea what it is and no money to test it.
In conclusion, I applaud Angelus for its untiring work to try to reduce the access of young people to dangerous psychoactive substances. I welcome the attempt to reduce the risks to our young people of NPS. Whatever is agreed on the amendment, I hope that all political parties will work together to achieve improved policies to deal with the considerable risks presented to our young people by new psychoactive substances.
Baroness Hamwee
My Lords, I well understand the concern expressed by the noble Lord, Lord Rosser. For instance, I recognise what I can think of only as collusion between sellers and buyers of substances labelled bath salts, plant food, and so on. The noble Baroness says that this is her only qualification—come on, it is some qualification. We are very lucky to have her explain her point so clearly and, to my mind, so persuasively. As she says, trading standards authorities are as concerned as everybody else and struggling to find a way to deal with this. Has the noble Lord had comments on the proposal from the Trading Standards Institute?
Like the noble Baroness, the points that occurred to me, which I will not repeat but simply support, are: is this risk-based, is it evidence-based, will it bring the law into disrepute, does it recognise the psychology of the consumer? Chemists in China will stay ahead of the game and will use the internet. Of course we have to be smart, but we have to be smart differently, not try to beat them in the way that they are working.
Lord Taylor of Holbeach
I note the noble Lord’s point. I assure him that communication across government on this is very vigorous. I am sure he will agree that schools are not the only place where you can communicate with young people. We live in an age where there may be other less formal ways of conveying this message. I think the Government are right to see issues such as this also in those terms. I hope he will understand that our strategy is multifaceted; it is not just the single point that he made. The legal high trade is very resilient. It is inventive. There is no silver bullet for dealing with it. We need to ensure that whatever we are doing is equally resilient and effective.
The noble Lord, Lord Howarth may have been referring to a meeting of the Home Affairs Select Committee last week, at which my colleague Norman Baker, who is the Minister now responsible for drug policy, advised the committee that he is particularly keen that we look at all the options for tackling new psychoactive substances and learn from other countries in that regard—the noble Lord referred to New Zealand, for example—and that is what we are doing. However, even though this area is a cause for concern, caution needs to be exercised before we take any further steps. The possible unintended consequences need to be fully understood. That is why I think that the speeches of my noble friends Lady Hamwee and Lord Paddick, along with the excellent speeches from the noble Baroness, Lady Meacher, and the noble Lord, Lord Howarth, demonstrate that they are right to be concerned that the amendment and this new clause are deficient.
With this in mind, the move away from an evidence-based approach to drug harm that Amendment 56NA could imply is not one that the Government can take lightly; I think noble Lords were right to point that out. We are committed—as indeed we should all be committed—to ensuring that our legislative response continues to restrict the supply of harmful new psychoactive substances, both in our communities and online, by providing UK law enforcement with robust and practical powers to tackle this trade.
Baroness Meacher
The Minister said that the way forward is more enforcement. Is he aware of the view of the UK Border Agency, ACPO and others that the legal framework and the enforcement behind it is actually not fit for purpose to deal with the particular problem of “new psychoactive substances”, as they are called—although in fact they are often not new?
Lord Taylor of Holbeach
Enforcement is, of course, part of the issue. If we decide that we need to restrict the supply, we will need to have the methodologies of enforcement. However, I think that I have made it clear that having evidence and information is equally important to underpin any legislative background against which we are operating. There is much going on in this area and I make a commitment to keep noble Lords informed of developments. With that in mind, I hope that the noble Lord will be able to withdraw his amendment.
Drugs
Baroness Meacher Excerpts(10 years, 6 months ago)
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Baroness Meacher
That this House takes note of the report of the House of Commons Home Affairs Select Committee Drugs: Breaking the Cycle (HC 184, 9th Report, Session 2012–13) and the report of the All-Party Parliamentary Group for Drug Policy Reform, published in January.
Baroness Meacher (CB)
My Lords, I rise to propose that the House take note of the above two reports, the second of which is entitled Towards a Safer Drug Policy. Both raise serious concerns about the current legislative framework for drug policy in the UK. However, two other significant reports were issued at about the same time: the report of the Home Affairs, Health and Education Sub-Committee of our EU Committee and the BMA report, both weighty and well argued documents.
Why this flurry of reports on drug policy? I want to spend a few minutes describing the remarkable events of the past two years in the drug policy field globally. For 52 years since the single convention of 1961, the world’s drug policies have been driven by the UN conventions interpreted—and I emphasise “interpreted”—to mean that every use of illicit drugs must be treated as a crime and that every user of illicit drugs and every dealer must be treated as a criminal. The conventions were not drafted on the basis of evidence about how best to reduce addiction. No; they were drafted in response to a moral belief that taking drugs is wrong and that therefore everyone involved should be punished. No thought appears to have been given to the consequences of such a policy. Whatever our personal views about the morality of taking drugs—and people’s views differ—we all surely agree that good policy is that which reduces the level of drug addiction and harm to the individual and to others. Criminalising young people is contrary to that aim.
The Global Commission on Drug Policy deserves great credit. That august body, which includes former presidents, the former Secretary-General of the UN, Kofi Annan, and many other very senior people across the globe, was the first to call a halt to the obsession with punitive drugs policies. I quote from the first paragraph of its report:
“The global war on drugs has failed, with devastating consequences for individuals and societies around the world … fundamental reforms in national and global drug control policies are urgently needed”.
That comes from top global people.
In the two years since the publication of the global commission report, activity on drug policy reform has developed apace. Presidents of American states, including President Obama, initiated a one-year study of the implications of current drug policy for the Americas, including the impact on the central American states ravaged by drug trafficking, as well as the impact on the Andean countries involved in the growing of the coca leaf. At the general assembly of the Organization of American States in June this year, which two of us from the APPG were privileged to attend as guests of the President of Guatemala, the two reports of that study were debated. This process continues and further discussions are planned over the next 12 months in the search for reform. Uruguay has just passed a law to regulate the supply of cannabis—in other words, to disregard the requirement of the UN conventions that the possession, use, production and trade in cannabis must be treated as a criminal offence. This is the first country directly to contravene the UN conventions.
The Netherlands, of course, has for many years made cannabis available legally to users in its coffee shops. Interestingly, the Netherlands has virtually eliminated its heroin problem. It just looks at the relationship between those two, and we need to do the same. Spain has its own system of lawful or semi-lawful cannabis supply through cannabis-growing organisations. In the US, 20 states have now legalised cannabis for medical use—de facto legalisation of cannabis. Colorado and Washington have gone a step further and legalised cannabis for social use. The Department of Justice has agreed that it will not take any action with respect to those states; this is highly significant. President Obama’s drug tsar told me personally that these states will not get away with it, but President Obama appears to have a different view.
The importance of Uruguay, Colorado and Washington is that, for the first time in more than 50 years, evaluation of a regulated system has become possible. Many people believe that regulated herbal cannabis—and I emphasise “herbal”—properly labelled, with the THC level controlled, side effects and risks clearly shown, would be a great deal safer for young people than the illegal market that we have today. Regulation could, crucially, break the supply gateway to illegal skunk and other dangerous drugs. Young people who simply want a spliff would buy herbal cannabis from a lawful supplier and would not therefore have the need to approach a drug dealer, who will do their very best to sell them something far stronger—skunk, or worse. Now research can show whether such a policy really is safer than the illegal market. Can the Minister welcome that?
European countries are quietly moving away from criminalising addicts, providing heroin legally in a treatment setting, and establishing consumption rooms, where the police do not arrest people—the first step for many addicts in engaging with health and social services. In most European countries, the health department rather than the internal affairs department is the lead ministry, and drug addiction is accepted as a health problem rather than a crime. Can the Minister agree to look into the experiences of our European neighbours?
The EU has prepared a draft regulation of the European Parliament and the Council on new psychoactive substances. It was sent to me for comment, which I found interesting. It proposes that possession and use of NPS should be decriminalised. Does the Minister agree with the draft EU regulation?
This, then, is the context of the Home Affairs Select Committee and APPG reports and of today’s debate. The Select Committee visited Colombia, where the words “war on drugs” really mean what they say—and I was there to see it. Policies in the consumer countries supply billions of dollars to the drug barons to enable them to fight their Governments. The Select Committee concluded that there is now, more than ever, a case for a fundamental review of all UK drug policy in the international context; it calls for a royal commission on drug policy to report in 2015.
The Minister will no doubt point to the recent modest fall in traditional drug use, but it needs to be set against the explosion in the use of new psychoactive substances. But the Government also need to take note of a few other facts. Despite any recent modest fall in the use of cannabis—and it is, mainly, cannabis—the UK still has one of the highest levels of drug use in Europe. In 2011, it was one of only three countries in Europe where more than 30% of the population had taken cannabis. Are 30% of our population criminals? This is crazy. Despite our tough drug laws, England and Wales has the highest percentage in Europe of the population admitting to taking cocaine, at 9.6%, amphetamines, at 11.5%, and ecstasy, at 8.6%. The growth in the number of young adults who have ever used drugs has exploded under the Misuse of Drugs Act 1971 from 10% in the 1970s to 35% in 2009-10. There is a modest fall from 1996, but it is still a very serious problem. The cost to the Exchequer of drug-related harm is £15 billion.
The Select Committee also visited Portugal, where for 12 years the possession and use of all drugs has been decriminalised. Originally the policy was resisted by the right-wing parties; today all Portuguese political parties support that policy. I wonder why. The Select Committee believed the Portuguese model to merit significantly closer consideration by the UK. Does the Minister agree?
Our All-Party Parliamentary Group for Drug Policy Reform spent a year receiving written and oral evidence from witnesses in producing our report towards a safer drug policy. Our focus was legal highs—or new psychoactive substances, as they are generally called. But our witnesses repeatedly told us that it was not possible to consider legal highs in isolation. Most young people use a legal high as a direct response to the contamination of traditional drugs in the illicit drug market. If we sort out the illicit drug market we would go a long way towards eliminating so-called legal highs.
Legal highs, of course, present a very serious risk to young people. As one is found, the Chinese scientists set to work with their test tubes in their laboratories; they change the molecules and produce a new substance. Young people have no idea what that substance is, or what it contains. The UK is apparently the European hub for such drugs; I wonder why. They come here from China or India and are then distributed across Europe. Twice as many young people in this country have used legal highs as the average for the rest of Europe.
Witnesses from ACPO and the UK Border Agency who gave evidence to us were very clear that the current drug control systems are unable to deal with the web-based selling of these drugs from overseas; the system simply cannot do it. I have already referred to the EU regulation recommending decriminalising possession and use of these drugs—not only for one year, as this Government courageously introduced some time ago, but permanently.
On the supply side, we point to the New Zealand model, which places the responsibility on the supplier to show that their product is of limited harm. The supplier, not the state, has to do the research, which seems eminently sensible. The New Zealand policy is in its early stages, and I hope that the Government will be monitoring its effectiveness. The APPG report recommends an independent drug classification body, which would classify drugs according to the level of risk identified on a scientific basis, rather than on a political whim. All political parties find these issues impossible to deal with rationally. This is not a party political issue. The reality, though, is that young people know that our drug law is an ass and disregard it; that cannot be helpful. An independent body with responsibility for research, information and classification would help a lot. We could then more easily move gradually to more evidence-based policies. We should not do these things in a hurry but we are an awful long way from where we really need to be.
Of course, politicians will be responsible for the strategic direction of policy, and we have excellent examples of this model with the Monetary Policy Committee of the Bank of England, and with NICE in the National Health Service—difficult decisions delegated to independent bodies that can act rationally. We also want the lead department for drugs to be reviewed, and we share the views of the Home Affairs Select Committee and the other reports. The ideal would be to have a cross-party review of drug policy and cross-party policies emerging from that review. In the mean time, I hope that the Minister will recognise that this debate is a genuine attempt to respond to the plea of the current Secretary-General of the United Nations who, on 26 June, called for every member state to have an open review of drug policy and to consider all options. That is quite something from the Secretary-General of the United Nations. Can the Minister assure the House that the UK Government will join other Governments in Europe who are working with us on that review in response to the plea of the UN Secretary-General?
The Parliamentary Under-Secretary of State, Home Office (Lord Taylor of Holbeach) (Con)
My Lords, I am sure that I join all speakers in congratulating the noble Baroness, Lady Meacher, on securing this debate. I see her as a great asset to this House. The combination of expertise and experience, which I think we all expected, has produced an excellent debate, and I thank all noble Lords who have contributed to it.
As I doubt that I shall cover all the points raised, I hope that noble Lords will allow me to write to the noble Baroness, Lady Meacher, with a commentary on the debate and circulate it to all noble Lords who have spoken, as I think that that will do justice to the value of the contributions and the seriousness with which the Government also view this issue.
I also join in the welcome to my new noble friend Lady Manzoor and congratulate her on her maiden speech. We will all look forward to her contributions in the future, given the excellence of her speech today.
As the noble Lord, Lord Ramsbotham, pointed out, drugs ruin lives and cause misery to families and communities. For this reason, the Government have published the most ambitious drug strategy to date, Reducing Demand, Restricting Supply, Building Recovery: Supporting People to Live a Drug Free Life. That title is important; it sums up the strategy that we are seeking to pursue. Launched in 2010, it is highly ambitious in its aims and it balances activity across three strands: preventing drug use in our communities; supporting individuals in recovering from dependence; and cracking down on the illegal drugs trade.
This Government are committed to breaking the vicious cycle of drug and alcohol dependency. However, as many noble Lords have pointed out, there are no quick fixes. Simply focusing on reducing the harms caused by illicit drug use is not enough. This is why we are leading the way as one of only a few EU member states that have raised the level of ambition to take recovery beyond the treatment system and enable people to sustain their recovery. I hope that the noble Lord, Lord Hannay, is encouraged by that and by the role that we see ourselves playing in Europe.
While the strategy has recovery at its heart—helping individuals to be free from dependence on drugs and alcohol and to rebuild their lives—it balances this with a focus on education and support, which are needed alongside law enforcement. Since its publication, this Government have continued to focus on all three strands of the drug strategy to continue making a difference. We have removed unnecessary layers of bureaucracy, introduced streamlined processes and improved the accountability of decision-makers across a number of key areas. It is a policy in which all government departments work together. I assure the noble Baroness, Lady Hollins, and indeed all noble Lords, that the Home Office and the Department of Health have a shared approach to this issue.
Local communities are now at the heart of the public health agenda. We have scrapped expensive police authorities and introduced a single accountable person to make decisions on local crime, disorder and policing; we have established the National Crime Agency to lead the fight against serious, organised and complex crime; we have published the Transforming Rehabilitation plans to change the way we manage and rehabilitate offenders in the community; and new community budget areas will be able to combine resources from various local sources into a single pot with greater local control to improve services for local people.
There are some promising signs that our approach is working, with continuing positive trends in a number of key areas. Drug use is at its lowest since measurement began in 1996, with the use of any drug in the past year falling from 11.9% to 8.2% in 2012-13. In 1996, this figure was 11.1%.
Baroness Meacher
Does the Minister accept that that recent drop has mainly been in the use of cannabis and that it has been substantially offset by the explosion in the use of legal highs?
Lord Taylor of Holbeach
I do not want to sound complacent in giving these figures. I understand exactly what the noble Baroness is saying but the noble Baroness, Lady Greenfield, told us why it was very important to suppress the use of cannabis and how dangerous it can be as a drug. However, the figures show that there has been a considerable reduction in drug use. I think that we should acknowledge that and take some encouragement from it. We are going to need some encouragement because this is a difficult issue with which to deal.
I was going on to say that school pupils tell us that they are taking fewer drugs too. That is really important because these habits can be dealt with when people are young. In 2012, 12% of 11 to 15 year-olds reported having taken any drug in the past year, the latest in a downward trend from 20% in 2001.
The number of heroin and crack cocaine users—not just cannabis users—in England has fallen below 300,000 for the first time since records began in 2004-05, according to figures published by what was then the National Treatment Agency for Substance Misuse, now Public Health England, in March.
I agree with my noble friends Lady Miller and Lord Teverson and the noble Lord, Lord Ramsbotham, about targeting the supply side of this issue. To restrict the supply of drugs, the police, SOCA—now, the NCA—and other enforcement agencies are seizing significant quantities of drugs off the streets. In 2012-13, more than 109 tonnes of class A drugs were seized at home and abroad as a result of SOCA’s activity. The police and the UK Border Force made 216,296 drug seizures in England and Wales in 2011-12.
Local criminal justice partners across England and Wales managed the transfer of 88,000 class A drug-misusing offenders into treatment and recovery services in 2011-12 through the drug interventions programme, or DIP. The DIP is estimated to help to prevent around 680,000 crimes per year. This is the approach of intervening and not seeking to drive drug users into criminality. Moreover, well over 250 new psychoactive substances, also known as legal highs, have been banned to date. In June, we legislated to make 10 more legal highs temporary class drugs within a matter of days.
I agree with my noble friend Lady Manzoor that enabling addicts to recover is the right way forward. That is why we are supporting individuals in recovering from dependence. The strategy has maintained quick access to treatment, with average waiting times being only five days. Record numbers are recovering from dependence, with nearly 30,000 people successfully completing their treatment in 2011-12, up from 27,900 the previous year and almost three times the level seven years ago, at 11,200. Drug-related deaths in England have fallen over the past three years.
I should like to comment on the review and report of the noble Lord, Lord Patel of Bradford—and this applies, too, to the remarks of the noble Lord, Lord Ramsbotham. The Government are very grateful for the report in this important area. A number of recommendations from his report are being implemented as part of the Government’s health and justice reforms. I know that the Patel report proposed pooling all government drugs funds under a single, central governmental structure; this has been implemented, with the Department of Health funding all substance misuse work in prisons. I hope that that is carrying forward the noble Lord’s ideas, and the expertise that he brought to his report.
Given that we are making progress, the Government are not currently persuaded that there is a case for fundamentally rethinking the UK’s approach to drugs. However, we are not complacent and must continue, as we have been doing with today’s debate, to listen and learn from emerging trends, new evidence and international comparators. In particular, we are building on the commitment in the drug strategy to,
“review new evidence on what works in other countries and what we can learn from it”.
We are conducting a study on international comparators to learn more from the approach in other countries. We continue to develop our approach to evaluating the effectiveness and value for money of the drug strategy. This includes publishing an update on our approach to evaluation alongside the next annual review. The update will set out, at a high level, the approach to evaluation; it is not the evaluation itself.
I turn to some points raised in the debate. If I say that we are confident in our current approach to tackling drugs, it is not to be complacent. Drug usage has fallen to its lowest level since records began and people going into treatment today are far more likely to free themselves from dependency than ever before. However, as the noble Lords, Lord Birt and Lord Condon, pointed out, it is a very long haul. We are continually looking at new ways to reduce demand, restrict supply and promote recovery. The Government are undertaking an international study that will examine approaches in other countries, and we will seek to engage with the United Nations on this matter.
Given the complexity of the issue, the economic and social costs of class A drug use, and noting that the vast majority of this is attributed to crimes committed to fuel problem drug use, the Home Secretary will continue to be accountable for the overall drug strategy. However, as I have explained, all government departments work together on that strategy. Of course, there are other societal harms, including family breakdown, poverty, crime and anti-social behaviour. That is why drugs policy has to be a cross-government issue.
The Government are committed to an evidence-based approach. A number of noble Lords, including the noble Lord, Lord Howarth of Newport, and my noble friend Lord Taverne, hoped that we would pursue an evidence-based approach. Our approach is informed by the expert advice of the ACMD.
Baroness Meacher
My Lords, I rise, first, to thank the noble Baroness, Lady Manzoor, for using this debate for her maiden speech. It was charming of her to do so. I give special thanks to my two vice-chairs who are here today, the noble Lord, Lord Howarth, and my noble friend Lady Stern, not only for their valuable contributions today but for their ongoing work for the APPG which has made all the difference. I also thank Frank Warburton our research officer, without whom none of our reports would be produced at all.
I have to reply to just one point made by the noble Baroness, Lady Greenfield. The word “cannabis” applies to many different compounds; the whole point of regulation is to split the market for the low THC/high CBD relatively safe herbal cannabis from the illegal market for the much more dangerous high THC cannabis. That is the point. The scientists who gave evidence to our committee made that point very strongly.
It has been an extraordinarily rich, well informed and wide-ranging debate. I say a special thank you to the noble Lord, Lord Patel, for his challenge to all parties. I say thank you very much to all noble Lords who have spoken today.
Alcohol: Late Night Drinking
Baroness Meacher Excerpts(10 years, 6 months ago)
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Lord Taylor of Holbeach
I cannot give the noble Lord a quantitative answer. One of the measures under the anti-social behaviour Bill, which will arrive in this House shortly, will give the power—on the authority of a police inspector—to order the immediate closure of premises.
Baroness Meacher (CB)
My Lords, the Minister will be aware of the number of alcohol-related accidents that impact on A&E departments every week. Is he aware of the considerable evidence that alcohol is a far more dangerous substance than herbal cannabis which is, of course, an illegal substance in this country today? Does he believe that this is a logical policy?
Lord Taylor of Holbeach
I would not want to venture into a discussion with the noble Baroness, Lady Meacher, on the question of drugs. I believe that we have a debate on this tomorrow. Alcohol is clearly harmful if taken to excess and is responsible for considerable economic damage to the country as well as for health service costs.
Queen’s Speech
Baroness Meacher Excerpts(11 years ago)
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Baroness Meacher
My Lords, I do not intend to make a long speech today, but it is important to put on record the widespread concern that there was nothing in the Queen’s Speech yesterday on the drugs issue, probably one of the three most significant issues now facing the world. As we know, because of policies throughout the world, there is a market worth $350 billion a year in the hands of terrorists and criminal gangs.
We have a law in this country, the Misuse of Drugs Act, which goes back 42 years. In the past five months, we have had four well considered reports on drugs policy. Each of the reports has resulted from at least a year of hard work, inquiries, evidence taking, examination of research and so on. The reports come from the BMA, the Home Affairs Select Committee, the UK Drug Policy Commission and the All-Party Parliamentary Group on Drug Policy, which I have the privilege to chair.
The BMA, not surprisingly, makes absolutely clear that of course drug addiction is a health problem. If it is a health problem—and everyone now recognises that it is—surely our drug laws should reflect that. However, we have a law going back to 1971 which does not reflect that at all: it requires that drug use and possession must be regarded as criminal offences. All four reports implicitly or explicitly—all but the BMA explicitly—call for a review of our drug laws. Something needs to be done, for example, about the fact that it is the Home Secretary who leads on drugs policy. If drug addiction is a health problem—as I have said, everyone recognises that it is—what is the Home Secretary doing as the lead Minister? The Home Affairs Select Committee suggests a shared responsibility between the Home Secretary and the Health Secretary. The all-party parliamentary group would be content with that development—it is eminently sensible— although one might one day then go on to placing the whole issue with the Department of Health, as most European countries do. That is another issue but at least a shared role would be a start in the right direction.
Another issue which could be dealt with straightaway—there could have been something in the Queen’s Speech to achieve this—is the decriminalisation of possession and use of drugs. Again, if this is a health issue, what on earth are we doing criminalising our young people? By doing this we are really saying that a third of the young people in this country today are criminals, including, probably, many of our kids, grandchildren and goodness knows who else. Is this really sensible?
The Home Affairs Select Committee suggests that we need to pay more significant attention to the Portuguese laws. Portugal has, of course, decriminalised possession and use of drugs and diverts people straight into treatment. Whereas this policy was quite controversial when it was introduced about 10 to 12 years ago, now it has the support of the entire political elite, all political parties and the police service. The same applies in the Czech Republic where, again, drug use has been decriminalised.
I am delighted that the Minister, Jeremy Browne, is planning to visit a number of different countries to look at their drugs policies. They definitely have better drugs policies than we do. I am particularly delighted that he will visit Portugal. I hope that he will also visit Switzerland, the Czech Republic, Spain and, indeed, the Netherlands, which has a slightly odd policy. However, for all that, matters are not always absolutely perfect—the Spanish policy is not perfect—but we do and can learn from all these countries. As I say, I am very thrilled that the Minister will be going to them.
The all-partly parliamentary group is urging that he also goes to New Zealand because it is passing a law to deal with, as everyone else is trying to deal with, the problem of legal highs. If civil servants say that this is a waste of taxpayers’ money, I hope the ministerial team will say, “No, it is not. It will be a good use of taxpayers’ money if the Minister goes off to New Zealand”. I think it is possible that we need to go down that road.
I speak briefly today in the hope that Ministers will follow up Jeremy Browne’s visits with a review of the Misuse of Drugs Act 1971 and a change in the law. I want to draw the attention of the House to the fact that President Obama, no less, has changed the US stance on drug policy. Through his drugs tsar, Gil Kerlikowske, he has made it clear that the war on drugs is expensive and ineffective, that drug use needs to be looked at as a health problem, and there is a need to stop criminalising young people. For 50 years, the US has controlled western drug policy, so if it has been going in the wrong direction for all that time, let us follow it now that it has finally begun to move in the right direction.
Drugs policy has indeed been dominated by the US for 50 years through three UN conventions which require the criminalisation of the possession and use of drugs. These conventions and our 1971 Act were drafted when no one had any idea about what would actually work in this very difficult policy area. We know a great deal more today thanks mainly to the European countries that have pioneered far-sighted and, in the end, more effective policies.
I know the Government are considering how best to tackle legal highs and I applaud their efforts to come to terms with this difficult problem and move forward on it. I hope very much that the Minister can today give the House some assurance that, despite the silence on this issue in the Queen’s Speech, the Government are committed to improving the legal framework in this country at least to bring it into line with the best countries in Europe.
Crime and Courts Bill [HL]
Baroness Meacher Excerpts(11 years, 1 month ago)
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Baroness Meacher
My Lords, Amendment 6A relates to an amendment passed in this House to provide for an ombudsman service as a basic minimum of protection for victims of abuse by bailiff services. The lack of an independent regulatory system for bailiffs affects hundreds of thousands of our most vulnerable citizens, and we know that the recent and ongoing welfare benefits legislation will swell the numbers of such victims in the coming years. The purpose of bringing back this amendment to the House is to provide an opportunity for the Minister to explain the action taken since our debate. In December, the amendment had strong support from the Conservative Benches. The noble Lord, Lord Lucas, chair of the Enforcement Law Reform Group, said that he did not know one bailiff who would not support the amendment. The noble Lord, Lord Cormack, spoke eloquently about the importance of your Lordships’ House approving such a reform, but the Minister at the time could give no assurances.
Full ombudsman services are provided in health, housing, local government, financial services, legal services, telecommunications, prisons and other sectors, but we know that members of the public are probably more vulnerable to abuse of power by bailiffs than by almost any other cadre of workers. After all, bailiffs cone into our homes to seize our property. Little could be more offensive than that. Yet, in response to our amendment, the Government in the other place have rejected even this most minimal of protections for people who will inevitably include many mentally and physically disabled people who cannot fend for themselves.
I thank the Minister and his officials for a meeting last week when they explained many of the actions taken since our debate in December. I am grateful to the Minister for giving an assurance to this House—I think he gave this assurance—that every individual who is subject to abuse by a bailiff will have access to one or other ombudsman. It is a splintered system, not a complete system, but, if they can find their way through it, every victim will have access to the Local Government Ombudsman, the Parliamentary Ombudsman or the Legal Ombudsman. I hope the Minister will confirm that he said that. I should be grateful if he could make very clear that the Local Government Ombudsman will be able to deal with complaints about private bailiffs as well as in-house bailiffs. As the Minister made clear, the one area that is left out of this is companies. I have concerns about small businesses—perhaps one or two-person businesses—that may get into terrible debt trouble and have very unpleasant experiences. They will have no access to an ombudsman.
In his opening remarks, the Minister referred to training. I do not think he mentioned this, but I should be grateful if he could confirm that there will be a specific module on identifying vulnerability and vulnerable people. I should also be grateful if he could clarify that the training will not only include how to identify a vulnerable person but will be very clear about what the bailiff should do having identified a vulnerable person. It is no good identifying them if the bailiff proceeds to act inappropriately.
In December, I probed a lot about the length, breadth and depth of the training, and I am delighted to hear that there will be training of in the region of three months, including this rather important module. However, I should like to pursue the matter a little further. The Government’s response to the consultation referred to mandatory training. I should like an assurance from the Minister that there will be a set standard that a bailiff is required to meet. I am familiar with training in certain areas where the company simply has to tick a box to say that the bailiff has attended training. I am even familiar with security officers who will quite happily get someone else to complete the training for them and somehow or other the box gets ticked. We need an assurance that there will be a standard that bailiffs are required to meet. Will there be any independent verification of meeting those standards?
Finally, will the Minister say something about the work on information for victims that he mentioned at our meeting? We have a splintered and confusing system of ombudsmen for victims in different scenarios. It would be helpful to have on record the work going on with the CAB service, the web and so on to try to make sure that people know that they have access to an independent ombudsman. As the Minister said, the Government will reform the Tribunals, Courts and Enforcement Act 2007 to prevent the use of force against the person. Again, I should be grateful if the Minister could—perhaps he cannot—give some timeframe for that legislation.
In summary, the Government will introduce a certification process with no independent regulation of bailiffs and a rather incomplete and splintered form of ombudsman service. However, we can expect the quality of enforcement services to improve somewhat from a very low base. Of course, one cannot generalise, but we know that some very unpleasant things happen out there. There will be a staged process, to which the Minister referred, of implementation review. I hope the Minister can confirm that the results of those reviews will be made public and, at that stage, perhaps the Government will finally accept the crying need for independent regulation of bailiffs. I await the Minister’s response.
Baroness Meacher
I thank the Minister for his response and say that my amendment to the Motion is not moved.
Crime and Courts Bill [HL]
Baroness Meacher Excerpts(11 years, 5 months ago)
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Baroness Meacher
Baroness Meacher
I shall speak also to Amendment 118GA and shall not speak to Amendment 118G. I also wish to register my support for Amendment 118J, tabled by the noble Baroness, Lady Hamwee.
The aim of Amendment 118E is to clarify in law that Clause 29 is seeking to improve road safety and that whether a drug is controlled is irrelevant in this context. The Government aim to treat driving under the influence of drugs and alcohol on the same basis is to be applauded, but if it is irrelevant to road safety that alcohol is uncontrolled, why should it be relevant whether a stimulant or other drug is controlled? Surely the important point is whether the stimulant is affecting the driver’s safety behind the wheel.
I can illustrate the irrationality of the clause as it stands with an example. We know that when a controlled drug, such as ecstasy, is heavily contaminated, young people will switch to a similar, but uncontrolled drug, a powder, bought over the internet, probably from China. If there are two drivers, one driving dangerously because of the level of ecstasy in their body and the other driving dangerously because of the same level of the legal stimulant in their body, there is no difference in terms of traffic safety between the two drivers. Both are equally dangerous and surely should be charged, presumably for dangerous driving. I ask the Minister either to accept the amendment or to explain to the House why an intoxicated driver on a psychoactive substance, which the authorities simply have not yet had the time to ban—or perhaps they will never get around to it, as it takes them many years—should be treated more leniently than his friend on the same quantity of a controlled but no more intoxicating drug.
Earl Attlee
My Lords, as I understand it, the doctor’s instructions will trump the leaflet. If I am wrong on that I will write. Also, the leaflet normally refers to the doctor’s advice so the leaflet would give the trumping authority to the doctor.
The medical defence places what is known as an “evidential” burden on a person accused of committing the offence. This means that the accused person must simply put forward enough evidence to “raise an issue” regarding the defence that is worth consideration by the court, following which it is for the prosecution to prove beyond reasonable doubt that the defence cannot be relied on.
I know that the noble Baroness, Lady Smith, and my noble friend Lady Hamwee are concerned that a patient who inadvertently deviates slightly from the recommended dosage might be unable to rely on the medical defence. I want to reassure the House that the Government and the independent panel will take into account the normal therapeutic ranges for medication when considering what limits should be set for drugs. This will reduce the risk of patients who take medical drugs correctly being affected by this legislation. The panel will be well aware of the risks pointed out by my noble friend Lady Hamwee. I would also like to point out that in the terms of reference, term 6 is:
“To establish the likelihood of whether these concentrations would be exceeded through prescribed or otherwise legally obtained drugs (as distinct from illicit drugs)”.
A small minority of individuals taking long-term medication at elevated concentrations could be in excess of the specified limit for a particular drug, as was so well explained to the House by the noble Lord, Lord Walton of Detchant. In most cases such users would only come to notice if their driving is impaired—when they can be dealt with under the existing offence in Section 4 of the Road Traffic Act 1988—or for some other reason requiring police action. Another point to note is that the Code for Crown Prosecutors specifically states that prosecutors “should swiftly stop cases”, as I have already mentioned.
Furthermore, the Government expect that the courts will take a sensible approach to the operation of the new offence. For example, a defendant seeking to rely on the medical defence may be afforded more or less leeway depending on the facts of a particular case, such as the nature of the medical advice provided, including the wording of any leaflet accompanying the medicine.
Finally, in Amendment 118GA the noble Baroness, Lady Meacher, has also proposed that primary legislation should include requirements for testing to be reliable and for the Government to set limits that are linked to road safety. We do not consider it necessary to set these requirements in legislation. First, the preliminary testing devices currently being developed would undergo a rigorous type approval process before being used for enforcement purposes. This type approval process is so rigorous that it is taking some time to secure approval and I have raised this issue with my right honourable friend the Secretary of State because we need this equipment in operation. However, it is vital to the integrity of our system of justice that the courts can rely on the evidence of the new equipment. Furthermore, evidentially testing using blood or urine specimens is already carried out for the enforcement of the existing drink and drug-driving offences without any express requirement for the testing to be reliable.
Secondly, we are clear that the purpose of the new offence is to improve road safety, as I have already stressed, so careful consideration will be given to the advice received from the expert panel and to the responses to the public consultation before setting any specified limits and regulations. The regulations would then need to be specifically approved by Parliament using the affirmative procedure. The new offence is intended to enable more effective law enforcement and to improve road safety by deterring drug-impaired driving and bringing more drug-impaired drivers to justice. In light of the points I have raised I hope the noble Baroness, Lady Meacher, will agree to withdraw her amendment and that my noble friend Lady Hamwee and the noble Baroness, Lady Smith, will not press their amendments. I have been asked many detailed questions. Where I have not answered them I will write, and no doubt another place will look very carefully at these provisions.
Baroness Meacher
I thank the Minister for his response. I remain completely unconvinced that there is any logic at all in differentiating between controlled and uncontrolled drugs. I would submit that the North committee, to which the Minister referred, had no awareness of the incredible flood of new substances coming into this country. It is a vast number. There were 65 new substances this year, 49 last year and 41 the year before. That changes the entire environment within which we work and Ministers may come to regret the idea that this legislation should also fail to take account of those changes.
Earl Attlee
My Lords, we asked the expert panel to consider the drugs that we thought were causing a road safety problem but the last thing we said was that it should consider any other drugs that it thinks necessary.
Baroness Meacher
I know that noble Lords do not want me to take any more time because people need to move on. My only other small point is that the Minister referred to risk as being the main indicator of the need for action rather than impairment. I would suggest that the two are incredibly closely related. The importance of impairment is to avoid discrimination against certain groups and the stopping of drivers in particular communities when there may be no indication of an impairment of driving. It is those matters which we should be aware of. That said, at this stage anyway, I will withdraw the amendment although I may come back at Third Reading because we still await the outcome of the expert panel’s deliberations.