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Baroness Massey of Darwen: My Lords, I am grateful to my noble friend Lady Gibson for securing and introducing this debate. She got in early with a punchy start and reminded us that we must all follow the progress of NOMS very carefully. I agree that a key issue is how any process of change is managed. Taking along collaboratively managers and staff in any system is essential.
I want to focus on the issue of drug treatment within NOMS as part of the Government's national drugs strategy. I have to declare an interest as chair of the National Treatment Agency for Substance Misuse, which was set up in 2001 to increase the numbers of people in treatment and to reduce waiting times. That we have done, and we are now concentrating on the quality of treatment following our recommendations set out in "models of care", which I shall refer to later. I shall also refer to two documents, the National Reducing Re-offending Delivery Plan, and the NOMS Strategy for the Management and Treatment of Problematic Drug Users within the Correctional Services.
Let me first give a brief background to drug use and offending and then post some issues that I think are important, including a couple of questions for the Minister. There are approximately 250,000 to 280,000 problematic drug users in the UK. There is, as we know, a strong link between drugs, crime and social exclusion. Many people commit crimes to fund their drug use and for many offenders mental health problems are associated with misuse. Drug treatment is not easy to deal with. There is no one solution and users frequently lapse. We need to be sure that any changes make things better.
The correctional services have a good opportunity to intervene and to treat drug and alcohol use as part of the offending behaviour. Until recently, such
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interventions have been haphazard and incomplete. There is still a long way to go, but at least we now have extra funding and government strategies to tackle these challenging issues. For example, funding for drug interventions in prisons and probation amounted to more than £152 million in 2004–05.
I was pleased to see that the National Reducing Re-offending Delivery Plan is owned by five government departments. That sends a signal that drug and alcohol misuse have to be tackled not just through punishment for crime or health intervention, but across other supportive measures, such as housing, education, employment and social care. Indeed, the first chapter of the delivery plan is all about partnerships and subsequent chapters discuss the various pathways to help and support. Chapter 7 discusses the drug and alcohol pathway. The NOMS drugs strategy and the government drug interventions programme should work closely together and through a forum consisting of relevant government departments and my agency, the National Treatment Agency for Substance Misuse.
At a local level, drug action teams lead the work by delivering interventions through the criminal justice integrated teams. The case management of drug-misusing offenders may begin before, and continue after, a period of treatment as part of supervision under NOMS. This encourages problematic drug users to access treatment and should provide continuity of support. The key issues are early intervention and the uptake of treatment. Once treatment is taken up, the key issues then are to retain people in treatment, so that they can fully benefit from it, and to build in community support. The proportion of people completing drug treatment and testing orders has risen from 28 per cent in 2003 to 36 per cent in 2004–05. Such orders are challenging and last from six months to three years. I hope that such progress will be maintained.
The integrated drug treatment system is due to be in place in prisons nationally by 2008 and should offer a wide range of treatment options, including stabilisation and maintenance prescribing for dependency, not just detoxification. All clinical services will be commissioned by primary care trusts by April 2006. Many of us have serious concerns about the quality of prison healthcare generally and it is something that we should be watchful about. We should welcome the options that will be available for drug-using prisoners. Sudden detoxification in prison can be disastrous, often resulting in a return to using or, worse, death from overdose.
I understand that there will be a unit or some other means of monitoring the drugs strategy within NOMS. The function of such a service will be to analyse information, set standards, liaise with stakeholders from the National Drugs Strategy, report to Ministers, sponsor innovation in drug programmes, commission evaluations and bid for resources to support the strategy. Again, I look forward to the detail of this; how it will work; and how these functions will be encompassed within the new arrangements.
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There are now also regional offender managers, referred to by my noble friend Lady Gibson, whose role includes ensuring that drug services available to offenders in their region comply with the National Treatment Agency's models of care so that good standards are set and offenders receive continuity of care when they move from custody to the community. A single offender manager will be responsible for each adult offender from beginning to end of sentence, developing with the offender a sentence plan and motivating the offender to complete the plan. I have a question about that shortly.
The needs of young people who offend and use drugs are different from those of adults. It is vital to use different approaches. Others have talked and I know others will talk about the needs of young people. The noble Lord, Lord Elton, has raised many concerns which I share, particularly those about the issue of prevention. Many of us feel deeply that appropriate alternatives to custody must be found. Certainly, young people who are drug using need creative alternatives to punishment. Their lives are frequently chaotic and strategies need to be put into place to address their complex needs. I am aware that the Youth Justice Board is taking this issue extremely seriously, and I hope that, within NOMS, these concerns will be addressed and not neglected.
I have a few final points and then a question. The concept of case management is fundamental to both NOMS and drug intervention programmes. Given that the same clients will often be involved with both services, it is crucial that key arrangements are agreed to manage individuals between both agencies. The introduction of Custody Plus next year will effectively mean that every drug user who receives a prison sentence will be released on licence and, given that the majority of these are likely to be referred to a drug intervention programme, it will become even more important to achieve a seamless working relationship. Is the Minister confident that such relationships and other inter-agency relationships will be developed effectively?
The role of regional offender managers in relation to the commissioning of drug services still seems unclear. NOMS has confirmed that it does not have any immediate plans to withdraw its contribution to the pooled treatment budget to fund the treatment element of drug rehabilitation requirements. As its commissioning role develops, it will be important to ensure that it is integrated into existing joint drug action team commissioning structures. If that does not happen, there is a danger that much of the work to integrate criminal justice based drug services with mainstream provision will be undermined. Does the Minister have any comments on the role of regional offender managers in this context?
I look forward, as chair of the National Treatment Agency, to working on improving drug treatment systems for offenders in conjunction with other agencies and government departments. It remains to be seen how NOMS will function. Many challenges lay ahead, not least those of partnership working and
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workforce morale. I know that the Minister is deeply concerned about these issues, and I look forward to her response.
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The Earl of Listowel: My Lords, I too thank the noble Baroness, Lady Gibson of Market Rasen, for calling this important and timely debate. I also thank my noble friend Lady Stern for providing us with a very helpful briefing yesterday afternoon.
My theme will be the need to balance the restructuring of the criminal justice system with the need to enthuse and engage those officers providing direct care to ex-offenders and those who immediately manage those officers. The Government have set an ambitious target for reducing re-offending and protecting the public. It is acknowledged that a solid relationship of trust and consistency with an interested adult is a key part of the rehabilitative process. Relationships of trust are vital to success. That has already been stated in the debate. Part of that is due to the sad histories of many of these offenders, their family backgrounds and the lack of trusting relationships.
Perhaps I may praise the Government, through the Minister, for all the important steps they have been taking to increase support for families and thereby address the roots of criminality. I think particularly of the children's trusts that the noble Lord, Lord Filkin, has been so involved with. Indeed, I very much welcome the Written Statement on Tuesday entitled "Anti-social Behaviour: Respect Action Plan". It stated:
"The cross-government drive to address problem families and support good parenting is at the heart of our strategy to build a code of respect for the 21st century".—[Official Report, 10/01/06; col. WS 4]
I very much welcome that Statement. I also pay tribute to the work that the noble Baroness, Lady Scotland, has done to protect children from the fall-out of domestic violence and on the special court which she has been involved in setting up.
There is widespread support for the principle of end-to-end case management. The question of private provision is more contested. In foster care there are private providers who provide a very good service and that has been acknowledged. In children's homes there are some catastrophic and appalling private providers, but there have also been good ones. It is a means of obtaining capital to provide more children's homes.
I will therefore listen with interest to the Minister's response to the concerns raised. I note particularly what the noble Baroness, Lady Gibson, said about the turnover rates in private prisons. Given what I said about the importance of trusting relationships, that rate of turnover worries me very much. It seems to make matters difficult to manage.
In principle, however, I would support what the Government were proposing if I had a sense that there was significant enthusiasm among those working directly in the field for that project. If I had the sense
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that the Government were carrying with them probation officers working in the field, I would be much less concerned about the matter.
Several of your Lordships were good enough to take part in a debate that I held in October last year on safeguarding children. In my mind, the most significant risk for children in this country arises from a lack of social workers and a continuing crisis in social work provision. There has been a revolution in the structure of services since the death of Victoria Climbié and I welcome many of the changes. I mentioned the children's trusts. I recently visited a pilot children's trust in Stevenage. The head teacher and childcare workers to whom I spoke were enthusiastic about the new opportunities of co-operation that arise from that children's trust. The social worker to whom I spoke could think only about the heavy burden of work that she was trying to manage and the new burden placed on her by the restructuring within the local authority. It caused me great concern to see her state of mind.
When we, at the centre, propose changes—perhaps particularly in the area of social care and associated areas—we need to think carefully about the implications of such changes for those working at the front line with vulnerable people. I remember the history of the Child and Family Court Advisory and Support Service—which was formed with the very laudable and sensible aim of restructuring the private and public law provision in the area, but which was, sadly, poorly thought through and managed. It was desperately sad to meet so many former social workers and guardians ad litem—people at the top of their profession—leaving prematurely because they had become so disillusioned with management. CAFCASS is now under new management and I understand that things are improving, but I am sure that the Minister will know better than I that children will have suffered because of their lack of timely access to guardians as a result of the badly managed change and restructuring.
The Government have taken important steps to improve the quality of experience of children who are taken into public care. I very much welcome that. Still, one in seven children in care has more than three placements in one year and the most problematic children have many more. The more difficult that children are to manage, the more placements they are likely to have. The more placements that they have, the more damaged they become. When young people leave care, it becomes more difficult to redress their past experience, which has left them marked. One should seize every occasion to give them the experience of a trusting, stable relationship with an adult who is interested in them and in their good. When those young people arrive in prison, one must make the most of that experience—and for other children who do not enter care but have experienced abuse or neglect or family breakdown.
Those relationships of trust and confidence with a particular person are so important in rehabilitating offenders and to the Government's achievement of their target of reducing the rate of offending. It is extremely important that the hearts and minds of those
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working at the front line should be won over by the Government, which would persuade me to give my support. I am concerned about a possible haemorrhaging of experienced probation officers, as we have seen in social work. There are new young social workers whose senior social workers are either so overstretched with their case load or have left for administration or other work that those green newcomers do not get the support that they need to be effective in their professional role and to sustain continued involvement in such a difficult environment. That may be one reason for some of the difficulties that we have now. I would be loath to see changes that led to such disillusionment in the professionals working in this area. What steps will the Government undertake to win over the hearts and minds of people working at the front line?
3.31 pm
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