14 |
drinkanddrugsnews
| July/August 2016
Read the full stories and more:
‘This sector has a unique
talent for pessimism, which
is at odds with its strong
track record of helping
achieve positive change in
complicated lives.’
first person
Reasons to be cheeRful
Paul Hayes
is determinedly upbeat in the aftermath of Brexit
drug-related deaths – would require consistent,
committed political leadership over many years. This
is not going to happen.
So where does this leave us? In a much better
place than most of us think. This sector has a unique
talent for pessimism, which is at odds with its strong
track record of helping achieve positive change in
complicated lives. So the first thing we need to do is
reflect on our strengths and attributes.
England has a world-class treatment system
delivering rapid access to evidence-based
interventions for a higher proportion of our
population who need it than almost any equivalent
country. This has yielded major reductions in heroin
and crack addiction, very low levels of HIV infection,
and declining drug-related crime.
Despite static funding between 2008 - 13 and
reductions of around 25 per cent since, investment
in drug and alcohol treatment has still doubled
since 2001.
We have a wealth of intelligent skilled and
committed frontline staff. Over the past decade, the
ability of middle managers and senior leaders to
understand the environment in which they operate,
motivate staff to deliver, and provide a clear sense of
direction, has improved significantly.
The sector has learned how to draw on the
knowledge and experience of service users to enrich
the quality of delivery. This is now deeply embedded
and is key to current and future success.
There are key allies in Whitehall. The Home Office
continues to see treatment as one of its most
effective interventions to reduce crime. The chief
medical officers of the UK and NICE are stout
defenders of current evidence-based practice. NHS
leaders understand the role of alcohol and drug
treatment in diverting long-term cost pressures from
their hard-pressed services.
So how do we begin to deploy these resources?
Assuming there is no direct ideological challenge to the
evidence underpinning our success, the biggest threat
comes from a series of local decisions to de-prioritise
and disinvest by local authorities and their partners.
These will impact negatively on a population becoming
more vulnerable as it ages and also suffering from the
cumulative consequences of austerity.
This presents twin challenges to the sector. Firstly
we have to find a new narrative, as persuasive to local
authorities as previous harm reduction and crime led
narratives have been to central government. This
needs to be a shared endeavour across the sector,
service users and our allies in Whitehall.
Secondly we need to challenge ourselves to
become ever more innovative to protect and improve
outcomes in a climate of reducing budgets. Experience
suggests that this is more likely to be achieved by a
workforce that is optimistic, motivated and well led
then it is by managers and staff who are consistently
reminded of how powerless they are as they struggle
in the face of ‘the cuts’. However if working smarter is
genuinely to be more than rhetoric, we also need to
learn as a sector what genuinely can’t be achieved and
to walk away from contracts that are offered at a price
that cannot sustain outcomes.
Collective Voice is keen to work with the wider
sector to fashion this new narrative and gain better
understanding between all parties, but particularly
commissioners and providers, of the scope for
innovation and the point at which cash savings in
one part of the system create greater cost pressures
elsewhere. Our series of events in September for
service users, NHS and third sector providers,
commissioners, and young people’s services – which
will include officials from the Home Office,
Department of Health, PHE and local government –
will look at how we can best protect what has
already been achieved and respond to the new
challenges we face.
Paul Hayes is head of the Collective Voice project,
The country currently has no
government, no prime minister,
no opposition, no friends, and
may soon disintegrate – and
that’s ignoring the football!
As we pass through the most profound political
crisis since the war, what are the implications for the
alcohol and drug treatment sector?
Even in a situation of maximum uncertainty, two
assumptions seem reasonably robust: there will be
less money and declining political interest. The
referendum offered two visions of the economy post
Brexit – lower growth leading to lower tax revenues
feeding through into lower public expenditure, or a
Britain unleashed as a dynamic low tax, low spend,
low regulation economy. Neither of these suggests
imminent decisions to devote extra resources to
marginalised ‘undeserving’ populations.
Just as significant, the amount of national political
interest in our sector is likely to shrivel. For the
foreseeable future Westminster and Whitehall will be
obsessed with the mechanics of Brexit. The chances
of political time and energy being focused on
addressing alcohol and drug treatment are negligible.
Tactically this may have some short-term value.
There has been a lingering threat to evidence-based
treatment since 2010; the absence of political interest
may therefore be helpful in preventing renewed
ideological attacks. But solving the underlying causes
of dependence which are rooted in inequality, or
addressing the structural deficits in the system –
access to mental health services, jobs, houses; the
disconnect between prison and community services;
