Imran Khan is the Director of the Campaign for Science and Engineering.
The media has reported that the government has put forward proposals to downgrade the importance of scientific advice in the formulation of drugs policy.
The moves have come via the Police Reform and Social Responsibility Bill (‘Police Reform Bill’), published last week. Two clauses of the Bill relate to the work of the independent Advisory Council on the Misuse of Drugs (ACMD).
The ACMD was established almost 40 years ago under the Misuse of Drugs Act 1971, it brings together a range of independent experts who advise the Government on drugs policy. Their reports are based on how you go about minimising the harm that drugs may cause. They take into account everything from addiction and crime to public and personal health. Ministers aren’t bound by this advice – they can take it or leave it.
Importantly, the 1971 Act specified that the experts appointed by the Government had to include a medical doctor, a veterinarian, a dentist, a pharmacologist, a representative of the pharma industry, and a chemist.
This may be about to change. The Police Reform Bill quietly sets out in clause 150:
“In Schedule 1 to the Misuse of Drugs Act 1971 (constitution of the ACMD), in paragraph 1-
(a) in sub-paragraph (1), omit the words after “appropriate”, and
(b) omit sub-paragraph (2).”
If enacted, this would change the legislation to say that “The ACMD […] shall be appointed by the Home Secretary after consultation with such organisations as he considers appropriate”, doing away with the requirements for specific professions. It would give Theresa May the freedom to have a committee which lacked, for instance, a medical doctor.
Home Office Minister James Brokenshire claims that the changes “will allow us greater flexibility in the expertise we are able to draw on”, rather than move away from having expertise. But the Home Office already has that flexibility – only six posts on the committee are defined, with the rest left to the government’s discretion. It’s difficult to imagine a situation in which you would not wish to have, for instance, a doctor on this committee, so the Government’s objectives are unclear at best.
Clause 149 of the Bill also sets out new powers for the Home Secretary to speedily ban any substance for up to one year. This is probably a response to the mephedrone “legal high” crisis that concerned politicians earlier in the year. The new legislation would allow the Home Office to put a temporary ban in place if
“it appears to the Secretary of State that—
(a) the substance or product is a drug that is being, or is likely to be, misused, and
(b) that misuse is having, or is capable of having, harmful effects”
There may well be a need for a mechanism which allows ministers to rapidly deal with harmful substances, but one would hope that some thought would be given perhaps to at least consulting the ACMD, given that the Government has a ready-made body of experts on drug policy.
The government should be wary of rushing headlong into these changes because the status of the ACMD is something of a raw nerve for the scientific community. It is not so long ago that a third of the committee resigned when the previous Home Secretary, Alan Johnson, decided to sack the committee’s chair, Prof David Nutt. Nutt is Chair in Neuropsychopharmacology at Imperial College, and a past President of the European College of Neuropsychopharmacology. In his academic capacity he had published findings which appeared to contradict the Government’s drug policy.
But there is a bit more background to this story.
Recent History of the ACMD
In 2007, Cannabis was a Class C drug. The Government – reacting to concern about mega-strong skunk’s potential to cause schizophrenia – asked the ACMD to review the classification. A year later, after a thorough investigation, the ACMD wrote back. They told the Home office that, based on the research, Cannabis should stay in Class C.
Home Secretary Jacqui Smith – as it was her right to do – rejected this advice, and announced that the drug was to be reclassified as a Class B substance. As well as scientific advice, politicians will consider public opinion, media and political pressure, party politics, manifesto commitments, and perhaps even personal opinion. But there was significant concern from scientists at the time, including the former Government Chief Scientist Lord May.
In February 2009, the ACMD released its report on Ecstasy, recommending that it be downgraded from Class A to Class B. Jacqui Smith again decided not to concur with this expert advice, with the Home Office announcing that it “will not send a signal to young people and the public in general that we take ecstasy less seriously“.
ACMD Chair David Nutt later, in his capacity as an academic, wrote a paper which compared the harms of taking ecstasy to the harm suffered by victims of horse-riding accidents, in an apparent attempt to provide a perspective on relative risk. It appeared in the Journal of Psychopharmacology. As a result, the Home Secretary criticised Nutt in the House of Commons and asked him to apologise. Many felt was this was unfair, given that it was Nutt’s job as a scientist to set out the facts as best he saw them, and he wasn’t publishing the paper in his ACMD role.
Months later, Nutt – again, in his personal capacity – gave a lecture entitled “Estimating drug harms: a risky business?” In this lecture he, amongst other things, set out research seeming to show that cannabis was less harmful than alcohol – a claim which was picked up by the media.
The media coverage prompted the new Home Secretary, Alan Johnson, to claim he had “lost confidence” in Nutt, and dismissed him, despite it never being clear that Nutt had broken any guidelines or codes of practice.
Independence of Scientific Advice
CaSE worked with Sense About Science and a range of scientists to draft the new Principles for the Treatment of Independent Scientific Advice which highlighted the academic freedom of scientific advisers, in an attempt to ensure there could not be a repeat occurrence of Nutt’s dismissal. The Principles were sent to Downing St by the then President of the Royal Society, Lord Martin Rees, and a slightly watered-down version of the Principles was eventually incorporated into the Ministerial Code.
That brings us almost up to date. The other wrinkle is that there is an outstanding issue over the independence of scientific advice to government. In October, the coalition set out a list of ‘quangos’ (formally, non-departmental public bodies, or NDPBs), which were being scrapped or reformed. Unfortunately, some of these NDPBs include Scientific Advisory Committees. The ACMD is unaffected, but many of its sister bodies could be at risk. CaSE has provided evidence to the House of Commons setting out the possible implications for the independence of scientific advice.
While the Home Office may genuinely feel that the ACMD needs to be reformed and brought up to date, not only good practice but history demands that any such reform must be done sensitively and with care. Unilaterally removing requirements for expertise is not the way to go about it. It gives the impression of a lack of respect for the independence and importance of expert scientific advice, which we hope is not the reality.
The Police Reform and Social Responsibility Bill gets its first debate in the House of Commons on the 13th of December, the start of a long process during which it will pass through both Houses of Parliament. We anticipate a lot of debate on this issue, the first real test of the coalition’s commitment to evidence-based policy.