West Midlands: devolution and drug treatment

07 March 2018

Marching wilfully with a sense of purpose into politically and legally sensitive territory is always likely to make headlines. And that is exactly what the West Midlands Police and Crime Commissioner got after publishing his drug policy proposals. The Commissioner’s choice of frontline interventions demonstrates a pragmatic and humane approach to keeping people safe and a willingness to follow the evidence. In the long term, though, it is two of his less eye-catching recommendations that may prove to be the most significant.

Firstly, we know that people dependent on drugs and alcohol end up in accident and emergency, hospital wards, courts, probation services and prisons when they would be far better off getting help for their dependence.  And so we welcome the Commissioner’s aim of diverting such people from the criminal justice system into treatment and boosting their chances of employment.

Secondly, funding for drug and alcohol treatment in any given area is scrappily split between several public bodies, so that the services it buys are also fragmented. For example, only thirty per cent of prisoners with an identified need for treatment find appropriate help on release.  It has taken the leadership of a high profile figure to attempt what we all know is needed: to get better results by joining up the various funding pots. (This also improves transparency and makes it easier for the Government’s new, cross-departmental Drug Strategy Board to hold public bodies to account.)

With devolution arrangements like that in the West Midlands now covering large chunks of England’s population, what better time to straighten out a decent-sized chunk of this messy, multi-layered funding jigsaw? If it can work in the West Midlands, maybe it can work in the in not-so-metropolitan devolution areas of Cornwall or Cambridgeshire & Peterborough. While localism sometimes works best at a micro level, such as putting a community building in the hands of a fantastic, local not-for-profit organisation, in the case of joining up multiple funding streams it works much better at the scale of upper tier authorities or devolution areas.

There is a potential spin-off benefit here. Right now, there is a risk that the successes of the drug treatment sector over the last twenty years will go into reverse, with the Government’s soundly-based Drug Strategy stalling before it ever gets started.  The glaring need is to stop funding draining away from drug and alcohol treatment services.  Yet removal of the ring-fence on the Public Health Grant in 2020 wipes out the last bit of protection for these. The Government knows that they will have to come up with something else or risk losing treatment as a stable pillar of the Drug Strategy.  So what to do? The obvious answer is to require the West Midlands – and other areas – to ring-fence treatment funding to stabilise expenditure at the current level. The Commissioner’s proposals make this easier to do and more productive.

And the Government could go further. Already, it intends to put funding for short term supported housing in the hands of upper tier councils, alongside that for substance misuse services. It is also reviewing how it will mandate the council-led public health functions in the run up to the ring-fence disappearing.  The underlying principles should include a new one requiring devolved areas and upper tier authorities to plan for and fund the “protection of vulnerable people”, with the regulations explicitly naming such overlapping needs as homelessness, substance misuse, offending and mental health.  This would support people with multiple needs, exactly those whom the Government aims to protect in its 2017 Drugs Strategy and new supported housing framework.

This type of mandating could pave the way for the proper integration and re-design of services to improve the life chances of such people, support and protect their families and communities, and save large amounts to the public purse.  On its own, it won’t be enough to stop public bodies diverting funding elsewhere, but with strong messaging or incentives and pressure from the likes of the Drug Strategy Board, this could have a significant effect.

Here, too, the West Midland Combined Authority – of which the Commissioner is a member – has form. Their second devolution deal includes a pilot scheme providing accommodation and intensive key working for rough-sleepers with multiple problems including substance abuse.  For the moment though, the spotlight is rightly on the Commissioner’s policy proposals. It is important that the Drug Strategy Board does what it can to facilitate them. Collective Voice members work extensively across this region and look forward to working with him.

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