‘We all knew each other, it was such a small sector,’ says Blenheim chief executive John Jolly of first entering the drugs field in the 1980s. ‘It would probably be overstating it to say there were 100 people working in the sector in London.’
As his organisation celebrates its 50th anniversary (DDN, February, page 8) he’s now been in the field for more than half that time himself, having become interested in drugs issues while working at a children’s home – ‘petrol sniffing was all the rage then,’ he says. His first job, however, was as a police officer.
‘I was very young – 19 – and what I discovered very early on was that the bit of the job I liked was the helping people bit, which is a large part of policing that goes unrecognised.’ He decided to train as a social worker, working at the London Borough of Newham for a couple of years, before going on to join Release. ‘I was working in the courts for social services when the Police and Criminal Evidence Act had just come in, and Newham was one of the pilot areas. So I went to Release as a drugs worker but I also knew as much about the Police and Criminal Evidence Act as anyone else there.’
He joined Release at the time when it was re-launching as a criminal justice and drugs policy organisation in addition to being a helpline provider. ‘During the four years I was there we focused on developing a new role as a leading policy organisation around drugs and the law, as well as campaigning and really getting to grips with some of the new drugs that were coming in, like ecstasy, which nobody had heard of very much until the mid-80s.’
So after almost three decades in the field what does he feel are the most significant changes he’s seen? ‘I’ll be honest, it’s the level of services – 25 to 30 years ago there were very few drug services up and down the country. When I started at Release you were only just starting to see the rollout of drugs agencies, so there are huge amounts of more resources and government investment. We really were on a shoestring back then.’
Does he feel that the results of that expansion are under threat now though? ‘I think that huge expansion actually carried some risks itself – It’s been a struggle to maintain a level of competence in the workforce, for example,’ he says. ‘But there are real risks now – for the whole of the public sector – and those are that there isn’t the money to pay for everything that the public sector needs to do. You don’t have to be a rocket scientist to realise there’s got to be disinvestment, and there’s going to be disinvestment in the substance misuse sector.
‘But there are some positives and some negatives,’ he adds. ‘We’ve done a very good job in tackling the problems of heroin addiction and addiction across the piece in the UK – if you’re not talking about alcohol. We’ve focused so much on tackling drugs that we’ve basically let alcohol get out of control. That’s the real problem we’re going to have over the next 10 or 20 years.’
The idea was that the disparity between drug and alcohol provision was something that Public Health England would be able to address. Is he not convinced? ‘Look, we have a real problem with Public Health England, and it’s in the title – “public health”,’ he states. ‘You have to look at the philosophy of public health, which is about the needs of whole populations – it doesn’t deal with the individual. So, from a public health point of view, I don’t care if a few people get ill and die – I worry about whether thousands are dying, and I’m much more interested in stopping the whole population dying before they’re 75 because they’re obese or drinking heavily. I’m not focused on the needs of somebody who’s alcohol-dependent or drugs-dependent – it’s much more important that I reduce the alcohol intake of the whole population.’
That this will have an impact on investment decisions is inevitable, he stresses. ‘I really characterise it as the needs of the many outweighing the needs of the few. The trouble the current drug and alcohol sector has is that we are set up to work with people with multiple needs – effectively the few – who are heavily dependent, with a whole range of multi-faceted needs that society has failed to respond to.’
So in that case does the treatment sector essentially not even belong in there? ‘I think we have a fundamental problem long-term,’ he says. ‘I’ve heard people voice this in government already, asking whether drugs and alcohol sit within a public health remit. Well it does in terms of reducing risk but in terms of treatment I don’t think it fits at all. My view is that the sooner it can move back to NHS England the better.’
Was getting rid of the NTA a serious mistake then? ‘I’ve always been a keen advocate of the NTA – not necessarily of what they did, but that we need a national treatment agency for drugs and alcohol. Getting rid of it has meant that we don’t have an advocate within government for what the Cabinet Office once described as a “wicked problem” – that is, it’s hugely important, it impacts on a whole range of crime, health and social agendas but isn’t top in any of them, which means it won’t get the investment. Health is not going to say, “This is where we need to put our investment” or criminal justice or local authorities, although it has a huge detrimental impact on all of their spending commitments.’
He’s expressed concerns in the past about the impact of poor and frequent commissioning, making a case for longer contracts (DDN, August 2013, page 20). ‘There are some examples of poor commissioning, but it’s more about changing the short-termism and increasing the commissioning capacity,’ he explains. ‘With the changes we’ve seen recently, for example, many areas just don’t have the capacity to commission drug services in any way that’s rational, sensible or joined-up. All I’m really saying is that what you can’t do is commission organisations like mine for a four-year contract and then every year say, “Actually, we didn’t really like what we commissioned – it’s not about what you’re delivering, but we want to do it differently so we’ll re-tender you and then 18 months down the line re-tender you again.” Tender something out, tender it for seven years, and have a conversation with your providers about how you’re going to change it.’
He’s also backed Nick Clegg’s call for a debate about drugs regulation. What made him decide to make that statement?
‘Well, because why wouldn’t you?’
No other major treatment organisations have. ‘I worded it very carefully so I wouldn’t be hounded from pillar to post, but in fact I’ve had not one complaint about it. It’s quite interesting – I’ve been working with politicians and every single advisor who’s gone in there has said exactly the same. When you’re sitting down with policy advisers in government departments, talking to ex-ministers, round the table with three or four ex-chief constables, we’re all saying the same thing. And that is, the Misuse of Drugs Act doesn’t work.
‘I actually think we need to regulate drugs, and we need to do it better,’ he explains. ‘The reality is we’re failing to regulate drugs at the moment and the Misuse of Drugs Act is an excuse for doing nothing. We don’t use it as much as we should and bits of it are problematic because they have a negative impact on particular ethnic minorities. It isn’t thought through and it isn’t rationally linked up – we’ve lost the plot in relation to alcohol and on legal highs we’re moving to a position of “if it moves, ban it”, pushing people towards ever-more dangerous substances. It’s a disaster waiting to happen. All I’m saying is we need to look at what we want to do, look at it rationally, and come up with a response for the 21st century. Because the Misuse of Drugs Act was written when we didn’t have a drugs problem in this country, really.’
As part of its anniversary, Blenheim is running 50 ‘recovery story’ case studies on its website over the course of the year (DDN, January, page 4), partly, he stresses, ‘to say, “Look, these people aren’t some sort of strange aliens who’ve used drugs and alcohol – they’re mothers, brothers, sisters, the bloke who’s delivering your newspaper and maybe the bloke who’s giving you shares advice. They’re human beings who have a problem and they’re no different from you, me or anybody else.” That’s a message we’ve been working really hard to give.’
Blenheim has grown to the point that it now helps more than 9,000 people a year. How does he see its future direction? ‘For us, it’s around quality,’ he says. ‘We’re going to continue to be a service provider and to work with people, and obviously we’d like to work with more, but it’s more important to us that we develop long-term relationships with the community and the service users we’re working with. We’re very clear that we’re not just a service provider – we’re a charity, we’re a campaigning organisation and we also provide services. For us it’s all about improving quality of life, campaigning for people who are stigmatised, developing new ways of moving people from dependency to autonomy and looking at how we embed what we do in local communities.
‘I would stress that it will be vital for organisations like Blenheim and the sector to really embed ourselves and be part of the communities in which we operate, rather than treatment providers that are dropped in from outside, and I think that’s one of the real risks with the commissioning culture. We’ve worked in some areas for 50 years and we’re part of that community, but those sort of long-term relationships are being threatened by the commissioning culture we currently have.’