Health and Social Care Bill

My Lords, I add my thanks to the noble Earl for his continued commitment to highlighting the needs of those suffering from addiction to prescribed drugs. It is one of the virtues of our House that it allows scope for noble Lords to highlight these issues in this kind of context. I am the first to recognise the pain and the plight of those whose lives have often been seriously damaged by such addiction, not to mention the damage done to families. There are clear national guidelines for the usage of and withdrawal from prescribed drugs such as benzodiazepines, and GPs, pharmacists and specialist prescribers have those guidelines, but we know that what the noble Earl said is correct. There is access to support and treatment services for addiction to medicines in most local areas but some local areas are woefully short of such services. My department has commissioned evidence-gathering reports looking at the problem of addiction to prescription and over-the-counter medicines. We published a report on that in May which found that support is provided from a variety of services across primary care, community care and the voluntary sector. However, it also found such patchiness of provision. I am sorry that the noble Earl said that he felt the Government showed little sign of supporting this group of patients or indeed taking the cause seriously. The national drugs strategy sets out an ambition to tackle all drugs of dependence, including dependence on prescription and over-the-counter medicines. My honourable friend the Minister for Public Health, Anne Milton, convened a round-table meeting of experts to discuss the future action required to prevent addiction to medicines and to improve support for people who develop problems. It included consideration of specific actions to support the commissioning services to respond to addiction to medicines, and a draft note of the actions agreed at the meeting has been published. We will be convening that round-table meeting in four to six months to review the progress against the action points. I hope that the noble Earl will accept that this is an indication not only of good faith on the part of the Government but of our appreciation that this is a problem that we have to tackle. We believe that local bodies, with their greater knowledge and understanding of local health needs, are best placed to assess the needs for services in general. That includes rehabilitation and support services. Under the arrangements set out in Healthy Lives, Healthy People, local public health bodies will be responsible for the commissioning of services in line with local need to support people recovering from dependence. This will provide local areas with an opportunity to better integrate the commissioning of drug and alcohol intervention and recovery services. Services will be contracted from a wide range of providers including the voluntary and community sectors. We think that local areas have a wealth of data at their disposal and the ability to consider this group of people within their local commissioning plans. The noble Earl, both implicitly and explicitly, cast doubt on the ability of local health bodies to tackle this problem. I have to concede that in many areas, or at least in some, the local structures have not been fit for purpose, but I highlight my belief that those local structures are being immensely strengthened by the arrangements that we are putting in place. Here I have in mind the health and well-being boards, which will be a local hub in which the health needs of an area and the priorities for healthcare can be defined and built in to the joint health and well-being strategies on which commissioning decisions should be based. The whole idea of that is that no group should fall through the cracks. If there is a need for a service, it should be identified through that process. We do think that the outcomes framework, which does not appear in this Bill but overarches everything that we are doing, will expose poor practice. It will expose those groups of the population that are not being well served, and the commissioners will be called to account for their actions or lack of actions. So I cannot promise jam tomorrow, but I do, I hope, hold out the prospect of significant improvement in this area. I would just emphasise to the noble Earl that, in the mean time, the Government are not going to take their foot off the accelerator. We do intend that his concerns should be addressed, and I hope that what I have said is of some help and comfort to him.