Mrs Cheryl Gillan (Shadow Minister, Home Affairs; Chesham & Amersham, Conservative)

Clause 15 deals with disclosure of information about the assessments. I have only a brief point to make, but clarification from the Minister would certainly help me, if not the rest of the Committee.

Subsection (1) states:

''An initial assessor may disclose information obtained as a result of an initial assessment to any of the following—

(a) a person who is involved in the conduct of the assessment;

(b) a person who is or may be involved in the conduct of any follow-up assessment.''

That is a specific restriction on who can have information that has been adduced from the initial assessment. Clause 17(4), however, reads:

''An initial assessor may disclose information relating to an initial assessment for the purpose of enabling a court considering an application for bail by the person concerned to determine whether subsection (2) or (3) applies.''

What is the definition of being

''involved in the conduct of the assessment'',

and to whom will it apply? Is it the police officer who took the client into custody? Is it any replacement officer who has taken over on the case, because police officers move around and their involvement is not always continuous? What about the probation officer, who will need information on the assessment to move the individual forward? We are talking about individuals who often have complex roles and are subject to intervention from various bodies. What about a prison officer or governor, who will be involved in the interim between the first assessment and any follow-up assessment if the due process of law has kicked in and the individual concerned has been put into a custodial situation, either as a result of   sentencing or because they are on remand? What about a doctor or other medical staff involved in the emergency treatment of that individual?

I am sorry to throw up a range of examples, but I suggest that the issue is important if there is intended to be a restriction, qualified only by clause 17(4), on the people who can receive information from the initial assessment. Again, the Bill is narrowing down a provision, which will mean that the individual is prevented from receiving the wider help that is envisaged elsewhere in the Bill.

Mr John Mann (Bassetlaw, Labour)

I always get a little nervous when I hear the term ''multi-agency''. In my experience it often means ''multi-excuse''—everyone is responsible, so no one takes responsibility, which was certainly the situation in Bassetlaw until two years ago.

I want to ask a question in relation to a constituent of mine, whom I shall refer to as Ms X. She does not live in the Bassetlaw side of my constituency, where the GPs do treatment, but lives in the Mansfield side. Ms X receives a script via a drugs worker but gets anti-depressants quite separately, from her GP. Having checked the records, I know that most drug addicts in my area are registered with a GP but have bad attendance records while they are addicts. Indeed, during those periods they rarely visit their GPs or dentists at all, even though they are registered. Ms X is registered and has to receive anti-depressants from her GP.

Currently, if Ms X were arrested, as she might have been on many occasions, assessed post-arrest and put into treatment, her GP would not be entitled to receive information of that assessment. If the clause were considered further in the light of our discussions, we would have a golden opportunity to overcome the data protection issues that stop the police from providing vital information to GPs.

Nottinghamshire is, I think, the only place in the country with drug testing on arrest in all custody suites. It is to Nottinghamshire police's credit that they have attracted the funding for the system and had the wherewithal to put it in place. The police say that testing on arrest is incredibly valuable, and having looked at the detailed results, I agree with them. For the GP or indeed anyone else involved in the treatment, that information would also be incredibly valuable, as they would know whether an individual in their health custody had tested positive for drugs in an assessment on arrest or had admitted to the use of illegal and health-harming drugs.

In addition, if there are significant programmes using methadone or buprenorphine, the issue of diversion can be addressed. Someone writing a prescription for buprenorphine or methadone would want to know, for two reasons, whether their patient was selling it illicitly. First, that would obviously be an illegal sale, but secondly, there would be ramifications for the health of the individual, because someone who sells on is not using their dosage or are taking the wrong dosage. In making out a prescription precision is vital; methadone is probably the most obvious example, but the same would be true of buprenorphine. Similarly, if a patient were receiving   what should be prescription drugs illicitly, that information would be useful for continuing health assessment.

At the moment, it is not possible to work in that way. The information is in the custody suite at Worksop and other police stations. Under the arrangement in question, a significant new pool of information about people's health would be available. Nottinghamshire police certainly feel that they do not have power to provide the information to the health service, although the health service could do with it for the purpose of effective treatment.

It seems from Home Office research that has never been questioned that the majority of class A drug addicts are liable to involvement in acquisitive crimes with an impact on the rest of the community, as well as in buying illicitly. Therefore, even if it benefits only a small minority, in relation to health issues connected to diversion or failure of substitution treatment admitted in assessment—in other words if someone is on a programme but has been arrested and found to be in possession of heroin or crack or to have it in the bloodstream—the information should be given to the health service.

In relation to the follow-up assessment and what happens after it, the point is not an esoteric one; it is vital, because there are those who argue that buprenorphine and methadone are bad forms of treatment, because of diversion. Some of those who use that argument are, as I know from my experience, involved in the assessment process and, as I understand it, will continue to be involved. Without accurate data on diversion they are making a guess, but in Nottinghamshire accurate information about those who have gone through the custody suite is available, although not to the health practitioners to whom it should be available.

I should be interested to know whether the Minister feels, in relation to disclosure of information, whether what I suggest would be permissible under the law anyway, or if not whether the creation of such a power of disclosure to a third party—an appropriate competent health professional—would be worthy of consideration later in the progress of the Bill.

Ms Caroline Flint (Parliamentary Under-Secretary (reducing organised and international crime, anti drugs co-ordination and international and European issues), Home Office; Don Valley, Labour)

Clause 15 provides that information obtained as a result of the initial assessment or follow-up assessment may not be disclosed without the individual's written consent, save for information sharing purposes between those persons involved in the conduct of an initial or follow-up assessment.

That does not affect the initial assessor's ability under clause 17 to disclose information about the initial assessment for the purpose of determination by the court, but it is about making sure that information sharing should happen through different protocols. Those information sharing protocols would have to apply and be implemented within the established legal framework.

The legislation provides that the information obtained as a result of the initial and follow-up assessments may be disclosed to a third party only with   the individual's express written consent, except in a case in which information sharing might be necessary. It might be necessary to share that information with a number of people for a number of reasons. Let us not forget that the assessor is not prescribing; the assessment process is a means of identifying whom people need to see in order to take follow-up action. Let us also remember that GPs can disclose medical information only with the consent of the patient.

We could turn the arguments of my hon. Friend the Member for Bassetlaw around and say that those involved with drug addicts and working in drug intervention programmes should have an automatic right to see the records of individual patients in a GP's practice. He might agree with that, but there are disclosure issues in the example that he gave. He mentioned Ms X, who is receiving both treatment for drug addiction from drug treatment agencies and anti-depressants from her GP. I hope that if she has visited him as a constituent, he has advised her that that information is worth sharing. My experience—I do not say that it is foolproof—is that the drug users whom I have met have given permission for people to contact different organisations and groups.

Let me give an example from another field, prostitution. A number of the mobile outreach units that work in areas in which prostitutes operate engage with those involved, who are mainly women, about their drug taking. The mobile units have clean needles to exchange, but they also have information about where people can go if they want to talk and to get assistance with their drug problem. I know that those working on such projects ask the women whether they are prepared to sign waivers so that they can follow up and find out what has happened. That works very well.

I do not feel that what my hon. Friend has said is necessarily pertinent to this clause, but I shall think about it. It is not an easy situation. Currently, GPs are not obliged to provide medical information without the consent of the patient. If we were to opt for a different route, we would have to be mindful that it could be a two-way street.

Mr John Mann (Bassetlaw, Labour)

The issue has been discussed by my primary care trust and by the drugs intervention police unit. I shall discuss it further with them tomorrow morning. The health services would be keen to have that information, but they are nervous about the legal implications of getting it. However, if it were or could be provided by law, they would want to get it precisely because of the issue of diversion. The police are not interested in the individual records of patients; they are interested in trends, and I agree with them. What is important to them is to know the kinds of treatment being given—the modalities—and the overall consequences.

For example, if 300 people are on a certain dosage of methadone, it is worth the police's while to know and understand that. If those people are all using Subatex tablets, the police should know that. If they are all on   detox programmes or a combination of treatments, the police should know, because then they will know what to look for when it comes to diversion issues. If anyone were admitting to buying naltrexone in my area, where there are no prescribers of naltrexone, that would clearly be an issue for the police when they investigated supply coming in from elsewhere. I welcome the Minister's offer to consider that further.

Ms Caroline Flint (Parliamentary Under-Secretary (reducing organised and international crime, anti drugs co-ordination and international and European issues), Home Office; Don Valley, Labour)

Obviously, police intelligence is important. We share statistics about the results of tests for heroin and crack cocaine with the police; we do not link them to individual people, but gain such intelligence in a more global way to indicate the number of people coming through who are using different drugs.

We have already discussed which drugs we test for and why. To move a step further needs consideration, as issues of people's rights to privacy need to be addressed. I take my hon. Friend's point that it is important that we have a sense of what is happening in drug markets in our communities, but more thought is needed on this issue. He is talking not about test results, but about sharing information about people's health and how they are using drugs or substitutes.

In trying to ensure that we clearly track people's progress, particularly if they are dealing with different agencies, we are looking at information sharing protocols that could be established to make sure that the relevant people, who may include GPs, can be part and parcel of the process. My hon. Friend will be aware that when people engage with one person in the system, we often do not get a complete package of understanding about their needs. I agree that we need to ensure that we do not lose people in the system. Where appropriate, information sharing should be encouraged for the benefit of the individual and for an effective programme. I shall think about what he said, and see whether any other issues can be addressed.

Question put and agreed to.

Clause 15 ordered to stand part of the Bill.