Collective Voice responds to HM Treasury Consultation

Earlier this week, Collective Voice responded to a consultation run by HM Treasury on the forthcoming budget and spending review.

We highlighted how issues with alcohol and other drugs lie behind some of the key challenges that the UK Government and society face today, and how treatment and recovery services can be part of the solution.

Lots of this narrative will be familiar to people reading this blog, but we thought it was worth re-stating – particularly as context for these upcoming key decisions by HM Treasury. You can read our full submission here, but we’ve also summarised it in this blog post, which finishes with our five key asks related to funding. You can also read other sector responses from CGL, MEAM, and the Alcohol Health Alliance.

These aren’t our only asks of government, and they’re not necessarily our ‘top’ priorities, but they’re crucial to making sure that whatever investment our sector receives from the new Government, the processes help us really make a difference in people’s lives.

So here’s the case we put to the Treasury.

First, treatment for issues related to alcohol or other drugs is fundamental to delivering on the Government’s Missions and First Steps. It will help provide Safer Streets, build an NHS fit for the future, and kickstart economic growth.  And specifically on the First Steps it will help cut NHS waiting times and crack down on antisocial behaviour.

We know that a range of crimes are linked to use of alcohol or other drugs, and the health issues linked to substance use place pressure on health and social care services. In 2022-23, there were 262,094 hospital admissions where the main reason was directly attributable to alcohol, and this figure rises to 942,260 if we add in secondary diagnoses.

Most strikingly, there were 4,907 deaths related to drug poisoning registered across England and Wales in 2022, and this is a growing issue: the mortality rate for deaths related to drug poisoning has been getting worse since 2012.

But we know that treatment works in helping people turn their lives around. It can have a transformative impact for individuals, families and communities.

Unfortunately, as Dame Carol Black noted in her review in 2021, ‘funding cuts have left treatment and recovery services on their knees’. There were too few staff, working with caseloads at too high a level, and too many people – in what should be one of the most exciting and rewarding fields of work – had left, or felt it was harder to make a positive difference.

When the previous Government put funding into the sector, this was welcome, and has led to some key improvements, with an increase of 10% in the number of people accessing treatment.

We will lose these gains if the funding isn’t maintained, so that’s a key priority for us, but we also think that the way the funding is announced, distributed and monitored reduces its impact.

Currently, there are multiple time-limited grants, with detailed and overlapping reporting mechanisms, distributed to providers via local councils.

This approach, along with the timing of funding announcements, hasn’t given local authorities confidence in the Government’s long-term commitment, and so they’ve tended to put short-term arrangements in place, which don’t offer the same protection or security as standard contracts for staff or organisations as a whole. This means that providers have faced challenges in planning ahead and offering their staff security, and so there are fundamental issues in recruiting and retaining staff when compared with other sectors of health and social care.

The current arrangements also don’t seem to give a stable or sustainable approach for specialist services, such as residential treatment and inpatient detoxification.

We’re therefore asking the government to make it clear that they have a long-term commitment to treatment, so councils and other key decision-makers locally understand that treatment for people with substance use issues is an essential part of health and social care in the UK and will continue to be required in the future.

In our submission to the Treasury, we summed up our ask on funding through five key recommendations:

1. Spending plans should make and communicate a long-term commitment to providing treatment for substance use issues in the UK

2. Monitoring of funding and outcomes must be proportionate and appropriate

3. The Government should monitor budgets and impact across departmental boundaries, and support joined-up policymaking and service delivery across departments and organisations at a national and local level

4. Funding mechanisms should support the full range of evidence-based interventions to treat people with substance use issues

5. Funding models and oversight should support innovation in the treatment and recovery sector

We think these are straightforward and achievable requests, so we hope to see the budget not only maintaining or increasing the support for treatment, but also simplifying this system and making a long-term commitment to our sector, which can help the Government deliver on its Missions and key ambitions.