My Lords, I thank all noble Lords who have spoken in this debate on the complexities of alcohol and substance misuse and mental health and the correlation with domestic abuse, from the point of
view of both the victim and—as my noble friend Lady Stroud said—the perpetrator. I thank the noble Baroness, Lady Finlay, for tabling these amendments and her work in chairing the Commission on Alcohol Harm.
I will start with the final comments of the noble Baroness, Lady Wilcox of Newport. She and I are cut from the same cloth in knowing the effectiveness with which multiagency work can help in all sorts of ways. The way that agencies communicate with each other can get to the heart of some of the problems in society.
I also acknowledge the contributions of the noble Baronesses, Lady Boycott, Lady Hayter, Lady Jenkin and Lady Jolly, and thank the noble Lords, Lord Brooke and Lord Ribeiro, for their expertise and their input into the Alcohol Health Alliance’s report for the Commission on Alcohol Harm, which was published last year. It highlights these complex relationships between alcohol, mental health and domestic abuse. I welcome the report; it makes for important reading.
As the noble Lord, Lord Marks of Henley-on-Thames, has illustrated, there is a frequent coexistence of domestic abuse, mental health problems and the misuse of drugs and alcohol, with complex interrelationships between them. The relationships are nuanced, and the noble Baroness, Lady Finlay, is right to identify this. It is also clear that there is no excuse for domestic abuse, and it is vital that people affected by domestic abuse get the healthcare they need.
I reassure noble Lords that we intend to reflect the importance of joining up domestic abuse, mental health and substance misuse services in the statutory guidance to be issued under Clause 73. We have a number of other, parallel measures to ensure that the join-up should be reflected in local health commissioning and the support that people receive. Noble Lords will know that local authorities, clinical commissioning groups and other partners produce an assessment of the local population needs, called the joint strategic needs assessment. This should include consideration of the needs of victims and survivors. The assessment informs a local area’s health and well-being strategy and the commissioning of services, including mental health and substance misuse services.
I will say something about local authority spending because noble Lords have referred to it. Local authority spending through the public health grant will be maintained in the next financial year. Local authorities can continue to invest in prevention and essential front-line services. This includes drug and alcohol treatment and recovery services. We are working on increasing access to substance misuse services, and we have appointed Professor Dame Carol Black to undertake an independent review of drugs to inform the Government’s work on what more can be done to tackle the harms that drugs cause.
I also draw noble Lords’ attention to ongoing work in the health system to create new integrated care systems where NHS organisations, in partnership with local councils, voluntary service partners and others, take collective responsibility for managing resources, delivering NHS care and improving the health of the population they serve. The development of a new integrated care system is a real opportunity to improve the join-up between different services and provide truly integrated care.
I turn to the specifics of the amendments. On Amendments 21 and 29, which relate to the role of the domestic abuse commissioner, the Bill already confers on the commissioner a wide remit in tackling domestic abuse. She has already started to provide public leadership on domestic abuse issues by raising awareness of key matters and monitoring and overseeing the delivery of services to ensure that they are as effective, evidence-based and safe as they can be.
The description of the role states that the commissioner must adopt a specific focus on the needs of victims from groups with particular needs, which could include mental ill-health or substance misuse. However, as an independent office holder, it will be for the commissioner to determine her priorities, which will be set out in a strategic plan developed following consultation with her advisory board, the Home Secretary and others.
As for Amendment 42, which relates to the composition of the advisory board, Clause 12 already provides that at least one member of the board must be a representative of the health care sector, and there is sufficient latitude for the commissioner to appoint other specialists as she sees fit.
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Amendments 94 and 104 relate to Part 4 and the new duty on tier 1 local authorities to provide support to domestic abuse victims and their children in safe accommodation. The Explanatory Notes make it clear that such support may include drug and alcohol advice and support. On the membership of domestic abuse local partnership boards, Clause 56 specifies the minimum membership; otherwise, the composition of the board is a matter for the relevant local authority and could well include a person with experience tackling substance misuse. However, we should leave that to the judgment of the relevant local authority. We are committed to taking wide-ranging action to improve understanding of domestic abuse across statutory agencies, through guidance, targeted resources and training for responding agencies.
In relation to Amendment 181, I can assure noble Lords that the statutory guidance that will be issued under Clause 73 will be an opportunity to focus on the complex relationship with substance misuse and mental ill-health as well.
A couple of noble Lords, including the noble Lord, Lord Brooke of Alverthorpe, and my noble friend Lady Stroud, referred to perpetrators. It is fair to say that addressing a perpetrator’s drug or alcohol use is unlikely, in and of itself, to reduce or solve the problem of domestic abuse. It is equally important that any alcohol or drugs treatment programme for perpetrators, as well as addressing the cause of the substance abuse, also addresses the complex dynamics that the noble Lord, Lord Brooke of Alverthorpe, outlined, and the power and control that underpin domestic abuse.
As we will come on to, Part 3 enables positive requirements, such as attendance at a drug or alcohol programme or a behavioural change programme, to be attached to a domestic abuse protection order. It will also be open to a court to require the subject of such an order to wear a sobriety tag. I know that the noble Lord, Lord Brooke of Alverthorpe, will be very pleased to hear that, as will my noble friend Lady Jenkin.
On funding, noble Lords will have seen the joint announcement last week from the Home Office and the Department of Health that we are investing an extra £80 million in drug treatment services, right across England, to give more support to offenders with drink and drug addictions, which can of course fuel crime.
The noble Baroness, Lady Finlay, and other noble Lords have, through these amendments, drawn attention to a very important issue in the arena of domestic abuse. I thank all noble Lords for raising it in this debate. I hope I have been able to persuade the noble Baroness of the existing provisions and ongoing work in healthcare, and that the Bill already provides the means for the domestic abuse commissioner and tier 1 local authorities, in the context of the new duty in Part 4, to address the links between substance misuse, mental health and domestic abuse. On that basis, I hope she will be happy to withdraw her amendment.