Q: WHEN IS £54MILLION NOT £54MILLION?
A: When the NTA recycles a two-year old press release with an unusual juxtaposition of words and figure.
Read related blog here.
“The places in 42 residential treatment and supported housing centres throughout England will work with addicts to help them to overcome their drug dependency and support them in leading drug-free lifestyles.”
Readers taking these words at face value would be forgiven for thinking that £54million funding had been given to abstinence-based residential treatment centres. It is unlikely they would interpret the figures as a maximum 142 rehab beds with funding of perhaps £4.5million – at most £17million.
Readers would also be forgiven for thinking that this is a new initiative. Also wrong.
In October, before the latest release was issued, I requested a breakdown of the £54million originally publicised in 2006, then again in May 2007. NTA communications manager Jon Hibbs replied that the breakdown was provisionally allocated as follows:
· 14 residential rehabilitation schemes, £17million (142 beds)
· 9 NHS inpatient detox schemes, £16million (132 beds)
· 16 supported housing schemes, £13million (185 beds);
· 1 prison development, £8million (128 beds).
NHS detox, supported housing and prison are not necessarily part of a drug-free continuum, and significant funding went to their refurbishment and remodelling rather than new places, so more transparency is needed to understand how the tier-4 funds were allocated. Also, the vast bulk was not allocated to organisations with a proven history of abstinence-based care. But make your their own assessment by clicking here; or try to extract a picture from the Department of Health announcement (click here).
In an earlier communication to Addiction Today editor Deirdre Boyd, Hibbs wrote that: “I fully accept that as an arm of government the NTA is often going to take the role of the whipping boy in debates within the drug treatment field, but it is in all our interests that this is done on the basis of facts and figures about what the NTA is doing rather than perceptions and misconceptions”.
I hope that this breakdown of figures supports him in doing that.
FACING THE REAL ISSUE.
Even if £17million or £54million had been awarded to abstinence-based treatment, referrals to such treatment are so low – 2% of patients – that 15 residential rehabs have closed in just over a year. The remainder have empty beds. Some have made staff redundant. Some fear closure. And this is in the face of patients pleading to be admitted.
The NTA must address this referral crisis or let others take the lead. There is a role for both abstinence and harm reduction: the driver must be the patient’s recovery and not “how do we keep ourselves in jobs and the patients dependent on us as well as the drug”. Only when good practice starts to become established will distracting arguments about abstinence “versus” harm reduction abate, as practitioners become true colleagues and partners across integrated care plans.
THE SCOTTISH WISDOM.
When the Scottish government wanted to set up a range of abstinence projects in Scotland – of which the Leap project is one – it bypassed local Drug Action Teams and invited bids specifically for abstinence projects. The received message was that DATs would spend additional money doing the same things they had been doing all along (overprescribing), abstinence services had to be commissioned directly.
This is the opposite of what has happened in England. If the tier-4 capital funding is to be filtered through the very organisations which failed to support residential treatment and abstinence in the past, then the money could disappear into the black hole of local finance.
When Keith Hellawell was UK drug czar, he concluded that the hardest task he faced was finding out where the money was going. Perhaps the NTA, Department of Health, PCTs and LAs will prove him and us wrong, and they will provide full and transparent accountability for the funds, so it is clear to understand where it is being disposed.