Collective Voice responds to the Government’s consultation on the 2026 Autumn Budget

Our Chief Executive, Will Haydock, reflects on our submission to the Treasury’s consultation on the Budget, which will be published on 29 October.

You can download our full response here, but I thought it would be helpful to summarise some of the points we made.

This isn’t meant to cover everything we think or want to do as Collective Voice or a field, though I did try to cram in as many benefits and potential projects as I could.  The point was to try to make the case for the work we do, largely in financial and economic terms, and tie it to some key priorities that have already been set out by the new Government.  It would be a different response if we were writing to a different Government department, for example.

But I’d welcome thoughts on whether we’re saying the right things, in the right way.

Fundamentally, we started by noting that substance use issues are widespread and cause serious harm to individuals, families and wider society – but treatment works to reduce harm, improving and saving people’s lives.

We explicitly noted the links with some policy areas Andy Burnham has majored on in his first few weeks as Prime Minister, notably rough sleeping, youth employment and mental health, and the criminal justice crisis.  Perhaps we could have said more to link the work we do to the wider review of social care – the links there are certainly something I’m keen to explore.

Crucially, we emphasised that this is an urgent and growing problem, citing several authoritative organisations and individuals like the National Crime Agency (in both 2024 and 2026) and the Independent Monitoring Boards of prisons.

In terms of the next steps we recommended, I would group these into two.

First, there are recommendations that relate to the wider context in which our members work.

So as we’ve said before, we need an actual government strategy with clear priorities and outcome metrics to measure progress.  We’ll achieve more if all the relevant organisations and professionals know what they’re aiming for, and Government works to get all parts of them pulling together.

My fear with the lack of a strategy at the moment is that some key metrics have started to drop off (for example continuity of care between prison and the community) without that real push from Government, and we’ll soon see a spending review by the Government, and I’m not clear exactly how our sector will be judged.  It’s not so much moving the goalposts as keeping people blindfolded and then revealing after the game is over where the goal was.

We also need there to be the right resources to achieve any aims written into a strategy.  There’s no point setting out unrealistic or unachievable goals.  The investment also needs to be genuinely stable and understood as long-term, to drive improvements in commissioning and long-term planning such as workforce development and research.

And that resource shouldn’t just be seen as ‘health’ funding.  We know that problems around substance use – and therefore effective support – relate to all aspects of people’s lives.  And in Treasury / financial terms, the benefits accrue to different departments, not just health.  If someone’s offending is linked to their use of substances, and they get that under control, that’s probably more of a benefit to the Home Office and Ministry of Justice than it is to the Department of Health and Social Care.  And if we leave things to be just the responsibility of health, those benefits will always be underestimated, and our work won’t be prioritised.

This is why Dame Carol Black’s review recommended the creation of a cross-government ‘unit’ to oversee the creation and implementation of the drugs strategy.  This was created, but has lost staff and impetus over the past couple of years, and so we’re calling on Government to refresh and rejuvenate the unit.

Those are the ‘wider context’ points, but we also used our submission to highlight several specific policy areas and projects that we think should be prioritised.

First off, we addressed the prisons – and indeed wider criminal justice – crisis.  If we’re going to resolve this, specialist substance use support needs to be at the heart of the Government’s plans.  And if we’re to develop and expand our support provision for people in (or increasingly outside) prison, then we need to rebalance Ministry of Justice budgets so that alongside building and renewing prison places we’re funding rehabilitative support properly, including substance use treatment.

This ought to be uncontroversial, given that Government estimates suggest the current plan works out at between £500,000 per closed place in 2024-25 prices.   In addition, the annual cost of providing a place, once created, is estimated to be £56,618.  Treatment, including residential and detox, costs considerably less and promises much more.

The same logic applies to community supervision, where additional funding has been allocated to Probation in light of the changes to sentencing, but Probation won’t be able to deliver the full support package alone, so some of this investment has to flow through to other specialist services, including substance use treatment.

As well as funding rehabilitative work, we recommend that substance use treatment in prison is commissioned differently.  It should be seen as a dedicated service, with its own priority outcomes and contract management processes, overseen by a partnership of stakeholders including prison governors – rather than the current model of just being one small sub-contracted element of wider general healthcare contracts, with no outcome monitoring relevant to disorder or reoffending.

We’ve talked about this several times before in various inquiries and consultations, all of which – including Dame Carol, the Justice Committee and the National Audit Office – have agreed with us, but so far the Government has done nothing to change the current arrangements…

As well as specific work on homelessness and employment, there are a number of other projects we think could be prioritised at low or no cost by Government, which we highlight in the submission.  I don’t have the space to go into them all in detail here, but to provide some highlights, we suggest:

• Continued investment and support for the Addiction Healthcare Goals project
• The Department of Health and Social Care should create a specific programme to improve the treatment offer for currently under-served groups and monitor engagement and outcomes on an ongoing basis. The 2021 drugs strategy talked about this issue, but there has been insufficient focus from Government in practice.
• The licensing process for drug checking should be simplified, and the Government should provide national leadership to drive the establishment and maintenance of a network of accessible labs for analysis, and ensuring there is sufficient funding allocated to these facilities across the country. This is particularly urgent given the continued presence of synthetic drugs in the UK supply.
• We recommend that the Government ensures the legal framework and funding structures permit a range of models of enhanced harm reduction centres to be piloted across the UK.
• We’ve asked that the Department of Health and Social Care prioritises a focused programme to enable electronic prescribing for controlled drugs through community prescribing outside of GP systems. (Having been talking about this for at least a decade, I’m more hopeful than ever before – better late than never!)
• We recommend a full review of the data collected and processes required by NDTMS to ensure they reflect current challenges, practice and priorities. I’m hoping to be able to explain more about what we mean by this soon, as our new data and digital forum gets its teeth into the issue.
• Similarly, we ask for there to be more work to improve integration of datasets relevant to substance use at both the individual and aggregate level – though we ask that, given historic (and understandable) scepticism about sharing data about substance use, any work on data sharing is accompanied by clear and public communication by Government to explain what is happening and how it benefits

I think that’s more than enough for Government to be getting on with!  Hopefully some of this lands and we can see the real change we need to make support ever more accessible, more efficient and more effective.  Given the scale and urgency of the issues, with the record drug deaths, this couldn’t be more important.