What will happen when drug and alcohol services are at the mercy of local decision-makers, asks Marcus Roberts
There has been plenty of discussion about the implications of the results of the local election on 2 May for national politics, as a barometer of the performance of the national parties and their leaders. It is easy to forget that these elections are important outside of the ‘Westminster bubble’ too, because of their implications for local services. The elections of councillors in these upper-tier and unitary authorities will help to determine the composition of health and wellbeing boards and police and crime panels for example, local bodies that are making critical decisions about drug and alcohol services.
The enhanced role of local authorities also emerges as a theme for the Public Health England (PHE) statement Our priorities for 2013/14, published at the end of April (see page 4). While PHE is the ‘expert national public health agency’, in reality its influence will depend on its powers of persuasion and the quality of its ‘evidence-based professional, scientific and delivery expertise and advice’.
PHE will be important for the future of drug and alcohol services, having absorbed the former National Treatment Agency (NTA) in April. PHE includes ‘improve recovery rates from drug dependency’ among its priorities, and has inherited the personnel, expertise and infrastructure from the NTA to drive this forward – yet it remains to be seen what it can do, if anything, should some local authorities disinvest in drug services. The PHE ‘priorities’ document clearly states that ‘improvement in the public’s health has to be led from within communities, rather than directed centrally’ and that ‘PHE will not performance manage local authorities’.
A related question concerns the status of the Drug strategy 2010 and Alcohol strategy 2012 in a localist environment. For example, DrugScope argued that Department of Health guidance for health and wellbeing boards on local needs assessments and health and wellbeing strategies should include a list of key national documents to inform local plans. This recommendation was rejected when the guidance was published in March. So what weight will these national strategies carry with the people responsible for service design locally?
There has been a lot of debate about the likely impact of both the abolition of the NTA and philosophy of localism on drug and alcohol services, ranging from out and out doom-mongery to a ‘seen it all before’ nonchalance (‘plus ça change, plus c’est la même chose’, as the French have it), with most plumping for the ‘risks and opportunities’ mantra. We are now at the business end of the current policy cycle, so we will soon start to see what happens for real.
Marcus Roberts is director of policy and membership at DrugScope, the national membership organisation for the drugs field, www.drugscope.org.uk