Collective Voice welcomes the Health and Social Care Committee’s report of its Drug Policy session. This work shines a welcome light on a sector doing its best to meet the needs of those experiencing drug problems — and frequently a whole host of other associated life and social challenges.
“Witnesses were united in ascribing the falling standards of care to falling funding.”
“We call on the Government to direct significant investment into drug treatment services as a matter of urgency.”
The report rightly positions a serious lack of funding at the heart of many of the struggles in the drug treatment and recovery sector today. £85 million of public health funding has been lost in 2019/20 alone. Within that, drug treatment has seen a 27% reduction from 2015/16 to 18/19.
It is right to suggest funding is the chief reason for the gap between our world-class evidence base and the realities on the ground of a committed local workforce doing the best for its clients at a time of immense strain. Our ex-Chair Karen Biggs (Chief Executive of Phoenix Futures) gave evidence at the session to this effect.
Adequate, sustained funding is a necessary condition for the flourishing of the effective, evidence-based and person-centred treatment and recovery system we all want to see. More money would enable the system to support a greater number of citizens into treatment, meaningful activity and recovery.
Central oversight and scrutiny
The report suggests — as do many other commentators — that the needs of those with drug problems would be best served by the moving of drug policy ownership from the Home Office to the Department of Health and Social Care. It is absolutely right that drug dependence should be seen first as a health and social justice issue, and only second as a criminal justice one. We would welcome such a move, although the social, policy and political realities of the day mean that drug use is more than simply a problem of health.
Wherever the policy is owned, though, its success is contingent on an inter-department approach from central government which firmly grips drug treatment and recovery as the pressing issue it clearly is.
“We recommend that the Government conduct a review of the commissioning of drug treatment services to consider how they should be strengthened to enable them to co-ordinate and deliver the much-needed improvements to drug treatment services as effectively as possible.”
We welcome both the request that central government review the current funding and commissioning arrangements of drug treatment services and the suggestion of a central agency to strengthen this process.
The commissioning of treatment services is rightly identified as crucial. Local decision-makers and commissioners have not been shielded from the twin pressures of reform and funding reductions that have affected colleagues on the frontline. The vast majority continue to do an excellent and responsive job in very trying times.
Lastly, we would point to the excellent work done by the Advisory Council on the Misuse of Drugs’ Recovery Committee in 2017 which produced a fairly exhaustive report on this matter.
A healthy system
“There needs to be a radical upgrade in treatment and holistic care for those who are dependent on drugs and this should begin without delay.” Dr Sarah Wollaston MP, Chair of the Health and Social Care Committee
A healthy system is one populated by a skilled workforce of empathic practitioners effective in building the therapeutic alliance and dipping into the intervention toolbox to flexibly adapt to the needs and wishes of their clients. The report identifies a ‘crisis in the [clinical] drug treatment workforce’. Collective Voice believes workforce issues are not limited to medical staff but extend to all of those working hard to make a difference. Skilled and passionate people are feeling fed up after years of insecurity, anxiety and year-on-year cuts. They need stability and support and we welcome recognition of this.
The other quality of a health system is its ability to meet the people it supports ‘where they are’. An ambition for recovery and a dedication to harm reduction services are not mutually exclusive, rather essential characteristics of an effective and compassionate system. It is all of our jobs to support people to become well and give them hope. We are therefore supportive of any evidence-based harm reduction measures which achieve this — but would stress that they must exist within the context of the healthy system outlined above. The most effective harm reduction measures of all are national and local political leadership, sustained funding, effective local partnership and the delivery of high quality evidence-based treatment.