08 February 2008
Novotel Hotel, Coventry
Justice Minister Lord Hunt has given a speech on the Interface between Coventry and Warwickshire Partnership Trust and criminal justice agencies.
[Check against delivery: this is the prepared text of the speech, and may differ from the delivered version.]
Parliamentary Under Secretary of State Lord Hunt of Kings Heath OBE:
Thank you for inviting me to speak today.
I hope that some of you may remember that I served as a minister - twice - in the Department of Health before my current role at the Ministry of Justice. It gives me particular pleasure, therefore, to see today that the local NHS Partnership Trust has invited key people from local criminal justice agencies to look at how health organisations are working locally with police, probation and court services.
This event today presents us with an excellent opportunity to help forge these links here in Coventry and Warwickshire, and I am delighted to be here. I want to learn more about what you have achieved so far and what you will achieve in the future.
Inter-Ministerial Group/Strategic Plan for Reducing Re-offending
I want to help set the scene for the day by talking about how we in government are working to drive forward the development of offender health services; and our associated aim to reduce re-offending and make our communities safer.
We often talk about joined-up government in Whitehall, and it is something that is not always so easy to achieve. But I am proud that for this agenda we have a truly coordinated approach across government, which brings together all the departments with a role in tackling re-offending.
David Hanson, my colleague at the Ministry of Justice, co-chairs the Inter-Ministerial Group on Reducing Re-offending (or IMG). This brings together ministers from all relevant departments, including Health, Communities, the Home Office, the Department for Innovation, Universities and Skills and the Ministry of Justice. It works to ensure cross-departmental commitment at ministerial level to the actions required to address issues for offenders and people at risk of offending.
The IMG acts as the catalyst to help my ministerial colleagues bring in their respective departments and to make the case that re-offending and prevention of re-offending is important. Not just within Whitehall, but also within local government, within business and with the community at large.
We are - as many of you will already know - currently consulting on the Strategic Plan for Reducing Re-offending. This consultation ends very shortly, on 18 February. Some of you I hope will have attended the regional consultation event in Birmingham last month.
This consultation builds on the progress made to date. There has been a great deal of good work in the recent past, but our re-offending rates still remain too high and we all know that this has a big impact on crime and local communities. I know that with the energy, the commitment, and the enthusiasm from partners here, which is mirrored throughout England and Wales, we really can make a difference.
And that is why this consultation is so important. We want to know what is working well at every level in England and Wales. We want to know how we can increase the role of the third sector in helping us shape and deliver solutions. I want to know how we can ensure we meet the diverse range of needs that offenders have, including the specific and different needs of women offenders.
Improving Health, Supporting Justice - the offender health and social care strategy
When I consider what the needs of offenders are, I always try to always bear in mind that offenders want the same things as everyone else - health care, a job, a family, and somewhere to live.
Of these issues, health is vitally important. With the high number of offenders with mental health problems, or difficulties with drugs, the contribution made by health professionals in addressing the needs of the offender population is absolutely crucial.
Equally, it is becoming increasingly clear that - due to the high prevalence of health and social care issues amongst this population - all partners need to be able to recognise major health problems in order to provide a gateway to a more appropriate agency.
Until March, we are consulting on Improving Health, Supporting Justice, the document which will form the basis of the Offender Health and Social Care Strategy this summer. I know that this Partnership Trust is working on its own response to this consultation. Indeed this event today has been organised as part of the response process - to help air and consider some of the issues.
There is a connection between health inequalities and re-offending. I have said that government needs to work in partnership. So, as we work in the Ministry of Justice to make the case, for example, that community sentences are a tough alternative to prison; I want colleagues in the Department of Health to recognise that measures such as these also represent an opportunity to address the underlying health and social care needs of offenders.
The Criminal Justice System can act as a gateway to health services for a part of the population that finds it hard to access appropriate mainstream health and social care services. It can present a particular opportunity to make a significant contribution to the health and well-being of an excluded proportion of our society.
Too often, these people have not previously engaged with health or social services and only access the services they need when their situations have led them to a crisis point. This is often far too late for any significant preventative health intervention to occur or to help prevent family breakdown. It must be cheaper and more effective for health and social services to intervene earlier, to improve and promote the health of vulnerable people whose situations might lead them to offend.
For example, if we consider offenders with a history of drug addiction - we know that the need to buy drugs is often the sole driver behind their criminal activity. If we can effectively treat these offenders - either in prison or in the community - we know that we can help take away a reason for them to offend again.
We are taking the steps to address this need. By April, 29 prisons will have introduced the Integrated Drug Treatment System (IDTS), and we will be extending this scheme to a further 20 prisons over the next 12 months. IDTS provides better clinical services, such as improved detoxification and drug maintenance programmes and greater continuity of care between the community and prisons, between prisons, and on release into the community, as well as helping offenders to address some of the deeper roots of their drug abuse.
Six years ago, this government made the decision to transfer prison health services to the NHS; and we have since backed up this transfer with significantly increased resources - investment has increased from £118 million a year in 2003 at the start of the transfer from the Prison Service, to around £200 million annually now. Health services have improved, as was recognised again last week by Anne Owers, the Chief Inspector of Prisons in her annual report.
Our aim remains to provide a range and quality of health services that is broadly equivalent to those available in the wider community.
These changes, these efforts to make prison health services part of the mainstream NHS, have meant that we no longer take people out of the health system when they are imprisoned. We have been able to improve the continuity of care of prisoners as they enter and leave prison because they are no longer have to leave and re-enter the NHS.
Our successes in prisons have shown us that prisons at their best, working with the NHS, can work as therapeutic environments, offering health improvements as part of the process of rehabilitation. All prisoners now get a health check. They can address their drug problems through clinical intervention, they can secure professional help with their mental health problems, they can get fit and they can receive help stopping smoking.
But we know that there is more that we can do to apply the lessons learned about health in prisons to the rest of the criminal justice system.
This is why we are consulting now on Improving Health, Supporting Justice - so that we can hear from professionals in the health and criminal justice fields about the improvements we can make to the services provided to this group of people, many of whom have complex needs which require partnership working.
Central to this is the need for us to work with local health and social care commissioners to ensure that the commissioning and delivery of health services takes full account of this group so that we can help reduce re-offending, better protect the public and develop safer communities.
Now we need to look at what kind of innovations we can introduce for offenders in the community - for example, the role probation can make in joining up services for offenders, as well as the contribution of the police and the courts.
Offender health strategy - some possible ideas
Let's look at some ideas in a little more detail.
The Police
With the Police Service we will look at the health services provided in police custody suites, to see if we can make closer links with the wider NHS. We will look at how we can help the police better recognise when they are dealing with people who may have mental health and drug problems - and help them to look to involve health and social care agencies more quickly.
One way we could do this could be to introduce a simple health screening tool to the police and the rest of the criminal justice system.
There could also be a role for Mental Health Trusts to help the police develop protocols and forge clearer and quicker links with mental health services.
With the police representing the first point of contact with the criminal justice system, it is vital that health and social services find ways to become more involved - to be available to make assessments of detainees, to place people in appropriate services if possible, and help the police use more of their time tackling crime.
The Courts
With the Court Service we will improve liaison with NHS mental health bodies, so that offenders who are suffering from mental illness can have their conditions fully considered by the courts before sentencing.
The Sainsbury Centre for Mental Health reported recently that not enough use is made of the mental health treatment element of community orders. They concluded that people are currently serving prison sentences who might possibly have been disposed in the community had the courts made fuller use of this sentencing option.
Because of this kind of problem, Jack Straw has asked Lord Bradley to review the way that the courts deal with mentally ill offenders - and more widely to look at diversion throughout the criminal justice system. I will speak on this in more detail shortly.
Probation
With the Probation Service we will work to improve the contact that offenders have with mainstream primary health services. We will examine new models of care - for example possible one-stop shops for probation and health care.
We will look to increase support for offenders in approved premises, and for those serving community sentences. We will bring a particular focus to prisoners who return to the community after short sentences.
We want to ensure that in future, everyone released from custody will have their health and social care support needs included as part of comprehensive resettlement arrangements. On their release into the community, no offender should find it difficult to access the services that can help them.
The changes to NOMS [National Offender Management Service] and the Prison Service we announced last week will bring prison and probation closer together, and I expect this to help the services we deliver to prisoners on release. At all stages, all the public services need to work closer together, to bridge gaps, and to help stop vulnerable people falling through the cracks.
Budgets
I said earlier that it is often cheaper to prevent offending, health and family breakdown than it is to provide health and social care interventions or to incarcerate an individual.
But, savings that occur through prevention in one area do not necessarily cause savings in other areas. Because of this, it might well be worthwhile to begin to think about the possibility of aligning budgets more closely. This could make it easier to develop new innovations - such as the one-stop shops.
Specific offender groups
Before I finish, I want to discuss the needs of three very important groups of offenders - women, young people, and those who are mentally ill.
Mental health
Offenders with mental illness and learning difficulties are particularly vulnerable. Mental health is a key part of the agenda for this event today - I note that most of the workshops this afternoon are concerned with either mental health or learning disability.
In prisons, we have already achieved a great deal in improving access to mental health services, and in starting to address the problems of mentally ill offenders.
We have introduced 102 mental health in-reach teams into prisons and, since 2006, all prisons have had access to their services. Since 2006/07, the Department of Health has invested £20 million each year on these teams. This year DH has also put in an extra £4 million for the further development of mental health services within local prison service establishments; with £1.5 million of this to develop Child and Adolescent Mental Health Services within the young people prison estate.
We have also improved the process by which prisoners who are severely mentally ill are transferred to appropriate hospital accommodation. This is helping us to transfer one third more prisoners than was the case in 2002 - numbers are up and waits are down.
For these transfers to hospital, we are currently running pilots to explore the possibility of significantly reducing the existing waiting standard of 12 weeks.
But we know that too many mentally ill people are finding themselves in prison, and that we must do more at earlier stages to prevent this from happening.
Therefore, at the same time as the wider consultation on offender health, Lord Bradley - who many of you will remember as Keith Bradley the former MP for Withington - is undertaking an independent review of the alternatives to prison for offenders who are mentally ill or who have learning difficulties or disabilities.
The Review will explore diversion at any point of the offender pathway, including diversion away from the criminal justice system itself, whilst continuing to safeguard the public.
Lord Bradley will be listening to the views and experiences of from service users, professional bodies, service providers and other interested groups over the next few weeks and months. This work will have the potential to shape and influence services in a highly significant way. I look forward, therefore, to reading the conclusions he reaches and the recommendations he makes.
Children and Young People
Children subject to the Criminal Justice system need to be seen as children first and offenders or at risk of offending second. Young people in this situation should receive age appropriate services, fitted to their needs and these services should be embedded into mainstream services for vulnerable children.
The final offender health strategy document will be published alongside a separate but associated strategy for children and young people.
Women
Baroness Corston's excellent report about Women with Particular Vulnerabilities in the Criminal Justice System has been very much at the forefront of my mind recently, with two debates in as many weeks in the House.
The profile of women offenders, and the reasons they offend, are significantly different from those of men. Consequently, it will be important to look at how health and social care services are delivered to women who come into contact with the Criminal Justice System.
A key strand of the offender health strategy will address the specific needs of women. It will incorporate responses to the recommendations made in Baroness Corston's Review.
Conclusion
So, to conclude. We are listening. We do want to hear your views. Let's move this agenda forward together; let's work together to make these strategies something that we all own; and let us all then work in partnership to support and deliver them. If we can take the opportunity to improve the health of offenders, wherever they are in the criminal justice system, we can then also make a real difference to our communities.