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Welsh Affairs

Young offender institutions are part of the Prison Service; they are part of the prison estate. That is well recognised. Of course, we have split sites in many cases as well. I argue that there are other more appropriate interventions and that we should be looking at a wider range of residential settings: both secure closed settings and open settings. Prescoed was one such open setting. Because of the problem of overcrowding, that was turned into an open adult site, with all the attendant problems. I would have imagined that the hon. Gentleman had some sympathy in those circumstances. I turn to the issue of substance misuse. As we know, most crime is drug or alcohol-related. We need to improve and extend the detoxification and rehabilitation facilities and services available for substance misusers. We also need to start to treat misusers not just as criminals but as patients suffering a chronic and debilitating sickness known as addiction. If they break the law to fund a habit, a properly funded and publicly owned probation service should work with other agencies to implement a personal plan to avoid offending, including, where appropriate, the use of medication. In my view, that should include as a treatment option the prescription of diamorphine, or injectable pharmaceutical heroin, in standard doses for long-term addicts. A pilot is under way in three areas of England—London, the north-east and Brighton—and I understand that the preliminary results are encouraging. Clearly, we need to evaluate the pilot carefully, but if the results are positive we need to look at adding this as a treatment option for long-term heroin addicts. There have been extensive and large-scale studies in other countries—Canada, Germany, Spain, the Netherlands and Switzerland—so there is a body of research for us to draw upon. The German study showed, interestingly, that those prescribed diamorphine fared better in terms of their physical and mental health, and that an average of £8,500 was saved in terms of reduced crime. Two thirds of property crime is heroin-related, which is why the Home Office has decided to look at the pilot in this way. Medicalising the issue with heroin addiction—other drugs have to be dealt with differently—has another benefit; it changes the perception of the drug among young people. Instead of its being seen as something illegal and in some way therefore exciting, it would be seen as a loser’s drug, or as a medical problem that had to be dealt with. In Zurich, where they have had a 10-year pilot study of the medical prescription of heroin, there has been an 82 per cent. drop in new users, precisely for this reason. It is important that we stress that this should not be a free-for-all, nor is it legalisation; that is an entirely different debate. It should only be for people with long-term heroin dependency—a last resort for those who have tried and failed with all other forms of treatment, including oral methadone. It should be done only under very strict and stringent medical conditions in close collaboration with the police. As the hon. Member for Montgomeryshire (Lembit Öpik) said, this is not a new policy in the UK; it was known as the British model, and was the basic practice in dealing with heroin addicts from 1926 until 1968. Any GP still has the legal power to prescribe diamorphine or heroin to treat medical conditions, but must have a special licence to treat addicts with injectable heroin. There are currently three doctors in Wales who prescribe injectable heroin to addicts, so it is not an entirely new thing. The question is whether we have a systematic policy of looking at this matter, because the guidelines are unclear. To be fair, the Government, in their updated drugs strategy in 2002, promised to widen access to prescribed diamorphine for all those with a clinical need, and in May 2003 the national treatment agency for substance misuse said that prescription may be beneficial for some heroin misusers and gave a guarded endorsement of the practice. I think we lack a clear statement of policy that would give a lead to GPs, who may be receiving mixed messages at the moment about how this fits in with overall policy. If the evidence from the pilot is as encouraging as we understand, we could go forward and take a huge step towards breaking the power of heroin dealers and pushers on our streets. We could deprive organised crime of a core client base and make heroin trafficking unprofitable for the first time. We could free a new generation, and generations in the future, from addiction. I hope that we can build a cross-party consensus. Deprived areas have thousands of heroin addicts—coalfield communities have a 27 per cent. higher incidence of heroin addiction—and we owe it to those communities, and to the young people of the future as well, to think innovatively, to learn the lessons of the pilots and, if they are positive, to implement a new approach in our communities.