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Criminal Justice and Immigration Bill

moved Amendment No. 11: 11: Schedule 1, page 124, line 39, after ““specified”” insert ““and designated by the Secretary of State on the advice of the President of the Royal College of Physicians as”” The noble Lord said: My Lords, at the end of a useful debate that we had something like two months ago at the beginning of Committee stage, I said that we would return to the question of facilities for the treatment of young people with a dependency on or a propensity to misuse alcohol. We all agree that it is right to have separate arrangements for this purpose. It is the first time that we have done so in legislation as far as I am aware, in spite of the fact that alcohol misuse leads to far more crime than drug misuse. We now have it in the Bill, for which we are grateful. We were addressing the question whether the arrangements in the Bill were proportionate to the problem and would enable the courts to apply the requirement with confidence that the necessary facilities actually existed. If they do not exist, or if they are seen to be ineffective, those young people who commit offences because of alcohol misuse will continue to be given custodial sentences to dry them out temporarily, without addressing the problem that causes them to commit the offences in the first place. Following that debate, the Minister wrote a helpful letter clarifying the powers of the court. Effectively, he said that with alcohol and other intoxicating substances, and with mental illness as well, the requirement is limited to attending the place where the treatment is to be delivered and does not extend to the actual treatment itself. That is because the requirements have to be subject to the Department of Health’s general guidance on consent and to the provisions of the convention on human rights. Compulsory treatment is not absolutely prohibited by Article 5 on the right to liberty or by Article 8 on respect for private life, both of which are subject to reservations, but the Government obviously take the view that, rather than taking the risk of litigation on these matters, they will make the orders and the treatments that depend on them ““voluntary””. I put that word in inverted commas, because presumably the YRO and the treatments to be offered to the defendant are as an alternative to a custodial sentence that would have been imposed if the person had not been prepared to accept the treatment requirement. In his letter of 4 March, the Minister said that in 2006-07 more than 25,000 young offenders were assessed by the youth offending teams and received early intervention and treatment for substance misuse voluntarily under DTTOs, now rechristened DRRs. He does not say how many of those cases related to alcohol or, of the ones that did relate to alcohol, how many were successful in terms of compliance. That is essential information that your Lordships ought to have if there is to be confidence in the YRO and the associated alcohol treatment requirement. I accept that the National Treatment Agency is the main repository of expertise in this matter. The Minister endorsed my comments on the report Review of the Effectiveness of Treatment for Alcohol Problems. Incidentally, the report emphasised the cost-effectiveness of brief interventions, which would be delivered at a much earlier stage than we are talking about here. I hope that there will be provision for brief interventions in the criminal justice system, too, as they have proved effective in the health system and are being piloted in a number of hospital accident and emergency departments. They follow the great success of the Paddington alcohol test, pioneered by Dr Robin Touquet, which has resulted in a reduction of something like 50 per cent in the number of young people coming back to A&E departments within two years following the treatment. The noble Lord said in the letter that the treatment services are indeed to be provided through the National Treatment Agency, which approves the deliverers of treatment, although it is a matter for the youth offending teams to make arrangements locally for access to the services by the young offenders who are their responsibility. Will the NTA provide guidance to local authorities and PCTs on the services that it will approve? If it does not, how can it ensure that best practice is achieved? What seems to be lacking, if I may say so, is any strategic mechanism through which the NTA can prescribe minimum standards or best practice, which it says is a must for all interventions to be effective. I was particularly concerned by the Minister’s comments in his letter that only a small number of young offenders who had failed previously to engage with YOT treatment services would need the further coercion and support that we are discussing and that, because those offenders would be clients of services that are already provided, no additional funding would be needed. Therefore, we are passing this provision in the knowledge that there is no money behind it. That is pathetic and short-sighted, given that as many as 1.1 million dependent drinkers may benefit from more intensive treatment given by specialist workers and given that we know that for every £1 spent on treatment £9.50 is saved in crime and health costs. Those figures come from NOMS. The failure to allocate more resources to the treatment of young offenders with alcohol problems, who are likely to cost far more than the average dependent drinker, is a grave omission. The 2006-07 British Crime Survey recorded 1,087,000 violent offences in which the offender was thought to be under the influence of alcohol; nearly half those were young people aged between 16 and 24. Last week my honourable friend the Member for Hornsey and Wood Green was told in an Answer that 14,500 people under the age of 18 were prosecuted in Greater London alone for drink-related offences in 2006—much the same figure as in the previous two years. That was the tip of the iceberg, because in 73 per cent of reported crimes the offender was not caught and half the cases where there is an arrest do not lead to prosecution. This and other evidence lead me to believe that we are putting insufficient effort into identifying young people whose offending behaviour is related to alcohol and into addressing the problems that they suffer when they come before the courts. I acknowledge that the crux of the problem, which is highlighted by the small number of people who have been subject to DTTOs, is that the overwhelming majority of young offenders with alcohol problems who come before the courts are not identified as needing treatment. This is not addressed by the treatment requirement, nor, I confess, by these amendments, but the expected frugal use of these powers by the courts is a sad reflection of the low priority that has always been given to alcohol, compared with other drugs, by the Government. I hope that this debate may do something to redress the imbalance. I beg to move.