CAMERON’S DRUG STRATEGY IS NOBBLED AT STARTING GATE
With the Coalition’s first Drug Strategy – Reducing demand, restricting supply, building recovery: supporting people to live a drug-free life – not even a month old, the Department of Health/National Treatment Agency for Substance Misuse rushed to incapacitate prime minister David Cameron’s vision of “Supporting people to live a drug-free life”, indicated in the strategy’s title and which “is at the heart of our recovery ambition”.
Organisations with a track record of getting people drug free have been excluded from recent contracts and from participating in Payment-by-Results pilots which were intended to be templates for the country’s recovery from drugs and all their attendant problems. It is akin to Ascot being run by mules, with race horses disqualified from entry and race dates kept secret from all but a cabal of mule owners.
“Insanity,” Albert Einstein said, “is doing the same thing over and over again and expecting a different result.” Despite the government announcement that the NTA would be abolished – perhaps influenced by the facts that drug deaths rose under its regime, and only 2% of people presenting for treatment were referred to drug-free providers – it was put in charge of the PbR application process.
What happened next was that, instead of its usual expensive taxpayer-funded media hype, the NTA quietly posted the details onto its website. It did so only a few days before Christmas, with a deadline of 20 January when public-sector potential partners did not return to work before 4 January, so there was effectively only about a fortnight to bring together a diverse group of partners for this template for the future… less for providers not made aware of the web page’s existence; it is not even flagged up on the NTA home page.
For the NTA did not inform the residential/quasiresidential/ daycare providers with a track record of getting people into full recovery. Instead, it wrote to the public sector, seeking “innovative” rather than proven delivery by organisations with literally thousands of years’ experience between them. Addiction Today’s queries to all the country’s providers of full recovery elicited that only one had been informed by the NTA (by the exceptional Mark Gilman). Only one had been informed by its local public-sector ‘fund holder’, a moot point as the fund holder “was not interested” in applying.
And here’s another way that Cameron’s recovery runners have been nobbled: even where they were informed (by us and DSDaily), they have been disqualified from entry. The criteria in the “invitation to tender” Pre-Qualification Questionnaire were worded in such a way that only fund holders (of pooled treatment budget, IDTS, Carats, Dip, PCT mainstream budget, local authority community care budget) could qualify. Needless to say, providers of full recovery were not consulted on drafting the invitation. Nor, it seems, will they be part of the co-design scheduled to start in April of the Payment-by-Result pathfinders.
“It is palpably absurd that all the richest reserves of knowledge re the delivery of recovery-oriented treatment are completely ignored,” summed up Nick Barton, CEO of Action on Addiction.
“To not run PbR pilots with services which have been providing for a long time the kind of results which the government wishes to see more widespread, makes poor sense. It is a half measure and does not underpin the vision of the Drug Strategy 2010, inasmuch as we are haunted again by the same old failure,” added Carl Edwards, director of ParkView Projects.
COMMENTS FROM PROVIDERS WITH A TRACK RECORD OF FULL RECOVERY
“We have spoken at length to the local DAT about their plans for a pilot project. We provided them with information that clearly demonstrated our ability to provide most of the services they say they would like to offer to clients. However, they have chosen not to include us in their plans.” Jan De Vera Davey, director, Open Minds
“I find it very hard to understand that when the Government wants to focus on recovery, the Department of Heath / NTA bring out a pilot for payment by results that excludes nearly all the smaller organisations with the most experience and proven success of delivering recovery. This will lead to a ‘Ratner’ style treatment field with cheap, poor quality treatment and more people suffering.” Brian Dudley, CEO, Broadway Lodge and board member of EATA
“If I hadn’t been informed by you, I wouldn’t even know it was happening. I got in touch with DH who told me to contact NTA. I phoned NTA south west, they said talk to the DAT, then nothing.” Brendan Georgeson, treatment coordinator, Walsingham House.
“Didn’t realise they were going for pilots until you contacted us. Typical really, we are never informed about anything by either our local CSDAT or the NTA. We are never informed about capital monies available or anything that may prove beneficial to our service.” Amanda Lea, director, Western Counselling
“We have never been contacted by the NTA about a pbr pilot. In fact, we do not get contacted by the NTA for anything!! We have several issues about PbR. It will perpetuate the continued falsification of outcomes to demonstrate ‘success’ which has been happening for years. It thus opens the door further to fraud and corruption.” Paul Spanjar and Steve Spiegel, CEO, Providence Projects
“We have not been approached by anybody. But I am disturbed about PBR as they don’t even seem to agree on what a result is yet. I am particularly worried about the fact that someone been placed on to a methadone script could now be considered a positive result. I have also heard one government spokesperson describe a possible result as being full employment for a year. On that criterion, very few of us will get paid, whatever field we work in.” Chip Somers, CEO, Focus 12 and board member of EATA
“The principal (perhaps only) result for anyone suffering from dependency must be the end of that dependency. The acquisition of social capital (education, employment, housing etc.) will contribute to ending dependency but they are not measures of it. What could be measured are indicators as to what degree there has been a reduction in substance misusing lifestyle.” Nick Barton, CEO of Action on Addiction
“We have not been approached or asked to participate by the NTA or local fund-holder to participate in the PbR pilots, even though the Ley Community has 40 years’ experience in residential rehabilitation. At a briefing event at the House of Commons before Christmas, NTA CEO Paul Hayes talked about the pilot PbR schemes and made it clear this would be an opportunity for providers to apply. But when I downloaded the invitation to participate, I was astonished to see it is a partnership system approach! The timing of the invitation was ridiculous together with the tight turnaround. I rang the two named contacts on the document only to be told they had finished for Christmas and would not be back until 4th Jan – when I asked if anyone else could help I was told no not really. If the Coalition Government is committed to recovery then why is the DoH/NTA excluding small providers? At the end of the day, the people who suffer are our beneficiaries, those most in need of recovery who will struggle with yet another complex navigation around a system.” Wendy Dawson, CEO, Ley Community and board member of EATA