05 November 2009

Update on David Nutt, Formerly of the ACMD

It is a rough week to be an advising expert. David Nutt, chair of the UK Advisory Committee on the Misuse of Drugs (ACMD), was relieved of his duties earlier this week, as I mentioned here. Simon Jenkins at The Guardian has a valuable perspective:

Researching drug use is pointless since policy on the subject has nothing to do with evidence, only emotion. It has to do with fear of the unknown, the taboo of other people's escapist narcotics (or worse, those of one's children). Politicians could not care less what experts say – witness this week's smattering of support for Johnson. They care only for the rightwing press, whose editors suffer a similar taboo.

The test was how the Tories reacted to Nutt's sacking. Faced with a home secretary gasping for air, Cameron and his home affairs spokesman, Chris Grayling, rushed forward with oxygen. Parting company with half the cabinet and the weight of scientific opinion, Cameron had a bad attack of funk. He refused to defend Nutt, and asserted his conviction that ecstasy was as harmful as heroin and crack cocaine. This was the same Cameron who, as a backbench member of the home affairs select committee in 2001, had supported Nutt in taking the opposite view. He must know what he said this week was rubbish.

All these politicians accept in private that the law is in chronic need of reform. Yet should they dare murmur so, they seem terrified of being assailed by the Mail, the Sun and the Telegraph. They could handle the House of Commons. They could even carry their constituents. But the rightwing press holds them in thrall, perhaps because they feel powerless before its lash. Might their youthful indiscretions be discovered, or the antics of their children pursued?

Politicians can stand the pressure of corpses piling up in Helmand, but one corpse at a rave would be too much for their consciences. Whenever I have tackled Home Office ministers, from Jack Straw and Charles Clarke to recent, less distinguished holders of the office, the response is the same. Don't even think about it, they cry. We would be crucified by the press. Just say no to drugs reform.

The situation here is a bit more complicated than that of Clive Spash. My view is that the ACMD needs to be constituted as -- and here I'll slip into the jargon of The Honest Broker -- either a Science Arbiter or an Honest Broker of Policy Alternatives. If the former then the task of the committee would be to answer specific, fact-based questions posed by policy makers, like, is taking ectasy more or less dangerous than riding a horse? If the latter then the ACMD would present the pluses and minuses of a wide spectrum of policy options. In both cases the notion that advisors advise and decision makers decide would be preserved. If current policies don't allow either role to exist, then policies need to change.

Martin Rees gets this:
Scientific advisers are not there to rubber-stamp policies. Advice should reach ministers before decisions are taken; and when ministers want to reject it, they should discuss it first. Where government does reject scientific evidence, it must explain why openly.
Nature gets this about half-right when they call for independence:
The government, meanwhile, badly needs to restore its credibility on this issue. One good way to do that would be to follow Nutt's suggestion to turn the advisory council into an independent body reporting to parliament as a whole, not to any individual official. An independent, scientifically run drug-regulation system would also free politicians from having to politick over who is toughest on drugs, something that would spare them and scientists much unnecessary future trouble.
Greater independence from the home secretary makes good sense, but it is not sufficient. Greater attention needs to be paid to the actual work of the committee and its role in decision making. If it is to answer narrow technical questions then this needs to be made clear, and a process needs to be put into place to elicit questions from policy makers. I much prefer an "honest broker" approach that allows the committee to lay out a wide range of policy options for policy makers to consider. Independence helps in both cases, but an options committee would fill a very different role than a committee that arbitrates technical questions.

If issues about the provision of scientific advice are raised and debated because of this situation, a good outcome will result. However, it is hard to see anything other than a negative political outcome for Gordon Brown and UK Labor.

Finally, in the FT, Robert Shirmsley explains the real lesson here:

Prof David Nutt was ditched after asserting that riding horses was more dangerous than taking ecstasy.

The sacking provoked immediate uproar and howls about the sanctity of scientific advice (as if the entire discipline was not based on one scientist disproving the theories of his forerunners).

But why is no one focusing on the real menace? Killer equestrianism is obviously the new scourge of our society. Ten families lose loved ones each year due to horse-riding accidents and dozens more people sustain serious injury. Yet this is a pastime frequently pushed on to children. Indeed horse riders speak openly about grooming.

Given the tyranny of health and safety legislation it seems remarkable that more has not already been done to tackle the new menace of "equasy" or Horse.

Many of the warning signs about the equestrian community have long been obvious. Like so many other misfits they have set themselves apart wearing their own distinct uniform, including skin-tight trousers and polished boots, and often carrying threatening weapons such as whips.