We are also here today to help launch the important new research carried out by Professor Tom Craig and his team on substance misuse as a cause and symptom of social exclusion.

This is the result of three years’ collaboration with London agencies working with rough sleepers. It has led to the development of an Assessment and Care Management Pack, which will be a useful tool available to social health care professionals across the country.

Helping someone to rebuild their life after drugs have nearly destroyed it requires all the pieces of the jigsaw to work together. And it is so good to see so many of those pieces represented here today.

All too often in life, we concentrate on dealing with a crisis as it happens. But preventing the crisis in the first place and providing help afterwards are of equal importance and demand equal attention.

That’s why I am so pleased that today’s conference focuses on rebuilding lives. Because that is what we must all be in the business of doing.

Rebuilding people’s lives is about more than just overcoming their addiction to drugs. It is based on respect for them as individuals. It is about doing everything we can to help them help themselves to become equal and active members of society.

For some this may be about a little bit of help at the right time. For others it may be a very long road to travel. Whatever someone’s individual circumstances, we mustn’t give up on helping them to become included, not excluded from, society.

The most visible victims of social exclusion are the people caught in a life of sleeping on the streets. The sad fact is that if these people aren’t addicted to drugs or alcohol or suffering from mental health problems before they end up on the streets, they almost certainly will be within a short space of time.

This is why ‘Coming in from the Cold’, the Government’s strategy on rough sleeping, is just as much about helping with someone’s heroin addiction or health problems as it is about making sure they have a roof over their head.

We have set the tough target of reducing the number of people sleeping rough by two-thirds by 2002. And we aim to achieve it.

To do so we must help the most vulnerable: those who are addicted to drugs and/or alcohol. If we don’t, we will continue to make to mistakes of the past over and over again, and the problem will persist.

But we’re not in the business of playing a numbers game. What motivates us is the need to make a real difference to the lives of the most vulnerable people – people who have been failed by previous initiatives.

Louise Casey, who heads the Rough Sleepers Initiative, often says to me that if she sees the same faces sleeping rough in two years’ time that she has seen for the last ten years, then we will have failed. I couldn’t agree more.

We know many things. People who sleep rough are more likely to: be poorly educated; have experienced some form of abuse; have been in prison; have lived in local authority care; have been in the armed services; or have mental health problems.

Unsurprisingly, they have a higher mortality rate from diseases and from suicide than the general population.

All of these factors can also lead people into problematic drug or alcohol use. An estimated 30% of all rough sleepers have problems with drug misuse. Two-thirds of under 25s (and half of those aged over 26) use illegal drugs on a regular basis.

We know that some rough sleepers and homeless agencies can encounter difficulties in getting access mainstream substance misuse services. There are often similar issues at stake:

• waiting lists
• rigid appointment-based treatment;
• problems of residency and registering with a GP
• problems with rough sleepers demonstrating motivation and presenting with multiple needs.

For example – there’s the case of the 17 year old drug-using rough sleeper in Victoria who had to ‘phone up twice a day to ‘prove’ that he was serious about coming off drugs, even though a detox bed was available. It took an outreach worker to negotiate this down to once a day, and he would then personally take the young man to a nearby ‘phone box.

I fully understand why it is important for someone to be motivated before going into drugs detox – these are precious resources. But we must also be realistic about people’s circumstances – especially if they are so vulnerable.

We know that treatment works. My role in the Cabinet Office, working with the UK Anti Drugs Unit, has taught me that.

And we are making progress. If we look at overall trends over the past decade or so it is quite encouraging to see that the marked year on year increases in the level of drug taking is beginning to level off.

We need to understand how effective the different services available are in dealing with people’s problems with drug use. So we are funding the National Treatment Outcome Research Study, which is looking at over 1000 drug misusers who have gone into treatment and will be measuring the effectiveness of different treatment options.

This is the largest study ever conducted in this country and I believe the final results, after the study is completed at the end of this year, will be of great value in giving us a picture of what types of treatment work best.

Already - and I don’t need to tell you this - the evidence is that across a variety of treatment services the results are positive.

Patients engaged in treatment show substantial improvements in reduced drug use compared to when they began.

We are the first Government to really put anti-drug treatment at the heart of a strategic approach. We have Keith Hellawell and Mike Trace to thank for all they have done in designing a 10-year strategy and focusing on the key priorities: treatment; prevention; cutting crime; and stifling the availability of drugs.

But we have to do more. With the expansion of new Arrest Referral Schemes and Drug Treatment and Testing Orders, we are going to need more treatment services available, including specific measures to help rough sleepers.

In London, where rough sleeping is so acute, there will be new services – dealing with the root cause – funded by the Govt and designed to help the most vulnerable rough sleepers.

Almost ½ million pounds from the UKADCU’s Seized Assets Fund will be transferred to the Rough Sleepers Unit to tackle drug misuse among rough sleepers in London. This means:

• New multi-disciplinary Contact and Assessment Teams, including specialist experts in substance misuse and mental health, will provide help directly to those sleeping rough on the streets. In addition, the Unit will be funding around 50 specialist workers to be ‘peppered’ throughout the homeless services, specifically to help those with multiple needs.

• A flexible prescribing service will be linked to hostels and nightshelters; and there will be increased drugs detoxification beds for chaotic poly-drug using rough sleepers.

These new schemes are in addition to the £7 million pounds worth of services that the RSU is spending to help rough sleepers with drug, alcohol and mental health problems across the country.

But this is not all we are doing. Very recently Jack Straw announced proposals for a National Treatment Agency. This is something we have been discussing with the Home Office and the Department of Health for some time as a way of giving central direction and focus to the resources given to drug treatment and avoiding money being lost in the system and not getting down to the front line where it’s needed.

The agencies involved in commissioning services will of course still have a crucial role to play in directing that money according to local need. While the principle has been agreed, there is an awful lot of detailed work still to do. We’ll be involving all the local agencies in making sure we’re not just putting another layer of bureaucracy over the bureaucracy that’s already there.

So there’s a lot of work to do. But we’re looking within the current spending review process - which covers the next three years - for a central, pooled budget for treatment services and having the National Treatment Agency there to administer that from next April.

We also recently held an advertising and recruitment campaign for 300 hundred new drug counsellors. So there will be the people available to deal with the pressures of increased demand and the problems faced by vulnerable rough sleepers.

Outreach work is so important. I visited a project in Brighton earlier this year called the Oasis Project. It’s specifically aimed at women and one of the key activities they undertake is outreach on the streets, as well as home visits and encouraging women to come to a drop-in centre.

There’s also a telephone helpline which makes it easier for people or get in touch and get support and advice – and a crèche.

It’s a project that like many others offers counselling and treatment services, dealing with a whole range of women some of whom have only just recognised the problems they have and others who are maintaining a drug free and stable life but still need that support.

I bet that many people in this room know how difficult it is to negotiate their way around the statutory agencies that help homeless drug users. To provide practical help with this and to promote good practice for those working with homeless people using illegal drugs, the RSU has funded a national Homelessness and Drugs Unit within Drugscope.

I know that one of the critical factors in tackling the problem of drugs misuse is motivating people addicted to drugs to help themselves. This reality has never appeared more stark to me than during a recent visit I made on behalf of the Rough Sleepers Unit to a nightshelter in Blackpool.

Here four out of the six young people I met were intravenous drug users. And they were not only addicted to drugs but also locked into a life cycle of rough sleeping, and offending. It is our job to help break the cycle.

This of course is not easy, as you all in this room are only too aware. The majority of the young people who stayed in the Cold Weather Shelter funded by the Government last winter were caught in a street lifestyle.

70 per cent of them had serious problems with crack and heroin. The means of income to fund these addictions involve begging, selling sex and shoplifting. Added to this are drug dealers who prey on vulnerable people, trapping them into a life of drugs.

One of the challenges for you is to show that there is a way out of that trap, even if those involved can not see it for themselves.

And we know it can be done. I’ve met for myself countless young people who have broken away from this damaging lifestyle and are now holding down jobs or are in college. This is why helping people rebuild their lives is as much a part of Coming in from the Cold as building more hostel beds or setting up new outreach teams.

It is the human touch that is crucial. Often that comes from dedicated counsellors and individuals, who identify and care for young people in need, who make them feel valued and loved.

This is why the Government is not just putting money into providing routes off the street but rebuilding lives away from it through jobs, education and training.

This is crucial if the revolving door between the streets and a home is to be stopped and former rough sleepers are to sustain more settled and less vulnerable lifestyle.

The Rough Sleepers Unit recently announced grants totalling nearly £2.4 million to fund projects around the country to do just this. The largest grant to be awarded was £400,000 to the Big Issue. This will be spilt equally between the Big Issue Foundation in the South and the Big Issue Trust in the North to help their vendors move away from homelessness and into education, training or employment.

Smaller grants have been awarded to grassroots schemes run by former rough sleepers including, in London, a new Groundswell project and the extension of a painting and decorating scheme run by the Thamesreach user group Huge Move.

In other parts of the country the funding will mean innovative projects including furniture restoration, social businesses, gardening, catering, driving, self build, befriending and volunteering, IT and lifeskills schemes. All are designed to give a better future for yesterday’s most socially excluded people.

We should never accept that anyone wants to live in the gutter or spend their life addicted to drugs.

And we should never underestimate what people can achieve with the right help at the right time.

The majority of the people we must help have had, at some point in their lives, friends, family, loves, hopes and aspirations. Our job must be to aim to help them get that again.

The challenge for us all is how, once we’ve helped someone out of an initial crisis, is to help them to start worrying about the same things that keep the rest of us awake at night – our job, our families, our friends.