Fourth Standing Committee on Delegated Legislation
Wednesday 21 July 1999
[Mr. Barry Jones in the Chair]
Local Government Finance (England) Special Grant Report (No. 48) on 1999-2000 Special Grant for Developing New Approaches to Commissioning Services for Drug Misusers (HC 513)
4.30 pm
The Minister for Public Health (Ms Tessa Jowell): I beg to move,
That the Committee has considered the Local Government Finance (England) Special Grant Report (No. 48) on 1999-2000 Special Grant for Developing New Approaches to Commissioning Services for Drug Misusers (HC 513).
The rather unusual procedure set out in the report should be put into the context of the Government's broad strategy for tackling drug misuse, especially among young children. I shall explain to the Committee why it is necessary to approve the spending of a relatively small amount of money in the specified manner.
Department of Health solicitors advise that under the special grant mechanism through which money for dealing with drug and alcohol misuse is channelled to local authorities, grants must be paid straight to voluntary organisations that will provide the required services. As the relatively small amounts of money allowed for in the report have been requested by the anti-drugs co-ordinator for examining and improving the way in which services for drugs misusers are commissioned by local authorities, such money will be held by the local authorities to which it is paid. We must consider the report in the context of that technical problem caused by the drafting of the current regulations.
Relatively small payments will be made to the six local authorities whose bids in response to requests for submissions of interest have been judged to be of high quality. As I hope that I have made clear, the UK anti-drugs co-ordinator regards the work funded by the payments as essential, as it covers issues such as differences in the commissioning of services and variable delays in different parts of the country in the referral of misusers for treatement.
I shall briefly set the report in the context of the Government's comprehensive drugs strategy. Hon. Members will be aware that the strategy has four key objectives—young people, communities, treatment and availability. Through the comprehensive spending review, an additional £217 million is being made available to support the drugs strategy during the next three years. Of that money, £50 million will go to health authorities and £20 million to local authorities, to enable them to meet the drugs strategy's commitment to increase the number of drug misusers in effective treatment.
The UK anti-drugs co-ordinator published his first annual report and national plan in May. The report estimates that there are as many as 100,000 to 200,000 problem drug misusers. That wide estimate shows the problem that we have in beginning to nail down more robust benchmarks for the number of people with whom we are concerned. The additional comprehensive spending review funding will increase service provision and begin to address one of the most chronic problems—the difficulty of getting drug misusers into effective treatment.
The annual report also identifies general imbalances in service provision, such as a lack of adequate after-care for misusers after treatment. Such a service is obviously essential to prevent drug misusers falling back into problematic drug misuse.
Returns from drug action teams around the country identify local shortfalls in the provision of appropriate services for particular groups most notably vulnerable young people and ethnic minorities. Current service commissioning does not always reflect underlying needs. Drug action teams provide a strategic overview, but their potential for joint working and planning has not yet been fully realised. With large amounts of CSR money available over the next three years, it is crucial that service commissioners work together to get the best value for the money available to them.
I turn briefly to the arrangements for the present financial year. Although the bulk of the £3 million available to local authorities in 1999-2000 through the CSR will go directly to provide new services through the drug and alcohol specific grant, officials agreed with the anti-drugs co-ordinator that a small proportion of that money should be used to develop new approaches to commissioning services for drug misusers. That should ensure that the new CSR money is used most effectively and that appropriate, flexible services are commissioned in line with local needs. As I have already stated, our legal advice is that the special grant report was the most suitable mechanism for paying local authorities to do that commissioning work.
A circular was issued to all local authorities on 1 February, inviting expressions of interest in both the drug and alcohol specific grant for providing services and the proposed special grant for commissioning development. The circular called for commissioning work totalling approximately £60,000 in each of the four social care regions, totalling no more than £240,000. That guidance stated that information gathered in these projects would be disseminated to other local authorities receiving CSR moneys in future years. So the idea is to learn lessons from the six authorities and disseminate them more widely. The social care regions subsequently received 20 expressions of interest in the commissioning development work, and asked six authorities which met pre-agreed selection criteria to work out more detailed proposals. Those proposals included a pan-London commissioning project to be overseen by Kensington and Chelsea housing and social services; a joint project between Portsmouth and Hampshire social services to address gaps in service provision; and proposals to encourage multi-agency commissioning in Peterborough, Liverpool and Salford.
I should add that in producing the report, the Audit Commission, the Local Government Association and the Department of the Environment, Transport and the Regions have been consulted. The Treasury has also approved this special grant report.
I am confident that the new approach is necessary, and will result in better working between local authorities and other agencies, such as health authorities and probation services. More broadly, the work to be funded by this grant, when disseminated more widely, will contribute towards the targets set out in the anti-drugs co-ordinator's annual report. Specifically, that means an increase in the number of misusers in effective programmes, a reduction in waiting times for assessment of need, and an increase in the number of funding decisions made within two weeks.
I have taken a little of the Committee's time to explain the background to the decision, its purpose and the way in which its success will be judged. I now commend the report to the Committee.
4.40 pm
Mrs. Caroline Spelman (Meriden): We are grateful to the right hon. Lady for taking the time to explain some of the background; she has certainly done a better job than the Library has of getting to the bottom of why the Government have approached the measure as they have. That will probably save us some time this afternoon, as I am sure that everyone present will be pleased to hear.
In trying to assess the importance of the report, we looked at it against the main objectives of the first annual report and national plan for the United Kingdom anti-drugs co-ordinator. It would be very difficult for us, in a spirit of constructive opposition, to oppose initiatives that are designed to tackle the very serious problem of drug abuse that afflicts this country. Being the country with the worst record in Europe of drug abuse is nothing to be proud of.
Despite that obvious problem, when we last debated the subject of drugs on 2 July—for the first time in this Parliament—the Minister for the Cabinet Office admitted that only a tiny percentage of drug misusers are in treatment. That compares very badly with best practice in other European countries, where up to half the drug misusers are in treatment. We understand the rationale for allocating public money towards more efficient commissioning mechanisms. None the less, I hope that the Minister will be able to clarify some points as we try to get beneath the surface of the document.
One of my concerns, based on what the Minister has said, is how quickly the information from the pilots will be disseminated to other local authorities. I have read carefully the history of the various approaches to tackling the drugs problem, and it seems to me that it takes a long time to evaluate and assess fresh initiatives and new approaches. The good results from new approaches rarely seem to be disseminated quickly enough for other authorities to benefit.
The targets that have already been set by the Department for a full assessment of its drugs strategy mean that no proper assessment will be completed before 2002. As a result, we shall be unable to assess whether the Government's strategy on drugs has been fully effective within the lifetime of this Parliament. I am particularly interested in how quickly the benefit of the new approaches on commissioning will be felt.
There is a general concern as to whether in principle it is wise to parcel up public money in this way and throw it at local authorities to pay for such initiatives, while existing approaches have not yet been properly assessed.
It appears from the description of the main features of the special grant in annexe B, that the new emphasis might be on those who are already, or are likely to become, dependent on drugs, and that commissioning will be in the area of prevention rather than cure. There are many good examples of new approaches to prevention, such as the Drug Abuse Resistance Education programme—DARE—with which I know the Minister is familiar. It would be useful, in the interests of saving public money, to draw some conclusions about commissioning from the DARE programme. There may already be lessons that can be disseminated from new approaches of that kind.
Also in annexe B, the targets of the special grant are more tightly defined in sub-paragraphs (i), (ii) and (iii). Closer examination reveals an emphasis on using the money to speed up the way in which things are done, rather than doing anything new. It is our belief that that is a priority correct?
What is meant in sub-paragraph (i) by the term ``problem drug misusers''? Surely all drug misuse is a problem. It is a subtle distinction between hard and soft drugs? I should welcome the Minister's clarification.
Annexe B goes on to enjoin local authorities carefully to analyse, manage and monitor the new approaches. Those activities are inherently quite expensive and labour-intensive, and involve qualified staff carrying out monitoring operations. If we are not careful, much of the £30,000 to be allocated—that is the suggested amount for Portsmouth, Hampshire and Liverpool—could be swallowed up in the back-room work of commissioning and monitoring the new approaches, unless those costs were part of the £6 million to be allocated over three years to help fund the major new research programme which will evaluate programmes of activity, as mentioned by the Minister for the Cabinet Office in the debate on 2 July.
Although we do not intend to oppose the report, it is worth placing on the record some of our worries about approaches to drug misuse. Local authorities have expressed concern to us that there is an emerging pattern of short-term initiatives, whereby parcels of money are doled our from the centre to local authorities. That money may kick-start initiatives, but they are not always sustained. Those who work on drugs problems complain bitterly about politicians' short-termism.
In my constituency, there is a project called Cascade which is operated by a national voluntary organisation. Initially, it had a three-year grant from the Home Office, but it must now rely for its continuation on a combination of trusts and foundations. Every year it also gets £28,000 from the health authority and £25,000 from the local authority, some of which is from the single regeneration budget. We have just heard that the local authority has failed in its bids for continued SRB funding on the ground that it is too affluent. That highlights the concern on the part of local authorities that there is a stop-start approach to the funding of new approaches in their work on various problems, not just drug and alcohol misuse.
I shall be interested to hear whether the Minister can give any guarantees that funding such as that which we are discussing today, which will be used for new approaches to tackle drug abuse, will be sustained to ensure that outcomes are effective and can be measured.
4.47 pm
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