Sector welcomes Black’s ‘gamechanger’

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‘Thoughtful’, ‘thorough’ and ‘a gamechanger’ were reactions of the Drugs, Alcohol and Justice Cross-Party Parliamentary Group to part two of Dame Carol Black’s Independent review of drugs. ‘It presents a unique opportunity that we must attempt to seize,’ said co-chair Lord Ramsbotham.

Mike Trace, CEO of Forward Trust
‘Spend to save [had] proven to be a good investment’ – Mike Trace, CEO of Forward Trust
‘The government must either invest or keep paying the consequences, including the financial consequences,’ said Dame Carol. The review was about ‘whole system change’, she emphasised, ‘not an easy thing to do and it can’t be done without investment.’

Taking the online meeting through the report’s key proposals, she highlighted the need for effective local partnership working (which had become ‘very fragmented in a very unhelpful way’), and action to restore a ‘demoralised and diminished workforce’, which acknowledged the value of peer support. Peer support could not be exploited as cheap labour, she emphasised, and ‘the passionate and committed people providing it need training and support’.

The Central Drugs Unit – to which six department of government would contribute, with the input of other departments at different times – would ensure that key issues were addressed. Employment, housing, and addressing mental health and physical care together were vital elements of whole system change, which Dame Carol stressed was absolutely essential. ‘You can’t pull off one or two of the recommendations. There has to be whole system change,’ she said.

With ‘problems wherever we look’, from staff shortages to ‘a huge increase in unmet need’ particularly among young people, we needed to move to a different model of commissioning – from the ‘horrid, competitive’ three-year contracts that demoralised staff and failed service users, to a more collaborative approach with ‘the individual at the centre’. Opportunities were being lost – employment support trials by DWP had been successful at getting people back into work, but it was ‘very sad the number of people who want to make changes in their lives but don’t have the support’.

Action was needed to redress the ‘very poor state of residential rehab and detoxification’ and drug and alcohol problems and mental health needed to be addressed together, as ‘dealing with one before the other is silly. You wouldn’t delay someone’s cancer treatment while you focused on another issue,’ she said.

‘Proper needs assessment needs to be done as different areas require different things, then specialist commissioning to deliver against this needs assessment,’ said Dame Carol. The sector needed to ‘start to get to grips with what is the real problem and commission in an intelligent way’.

Drug treatment representatives
Read more, news, analysis and reaction to Dame Carol Black’s report

Participants agreed it was an excellent report. ‘So, what happens next?’ said Mike Trace of the APPG For Drug Policy Reform. Urging parliamentarians on the call to make this their agenda, he said that the last 20 years had proved again and again that ‘spend to save [had] proven to be a good investment’. The new Central Drugs Unit – such as was disbanded 20 years ago along with his own participation – was the best way of doing this, but the staffing and culture of the unit would be ‘essential’ to its success. ‘It could be a wonderful thing or just another committee,’ he said. ‘It needs to be outward looking and work with the field and the people affected.’

Steve Rolles of Transform was among those to question why prisons had been left out of the remit, calling it ‘odd and a shame’. There were also concerns as to why the Central Drugs Unit was based in the Home Office, where some felt that health would come secondary to the view that ‘drug users are bad’.

The remit of the review had also not included alcohol, but Dame Carol hoped that it would benefit people with alcohol problems as well as those with drug problems, ‘as we know so many people have both’.

Treatment providers thanked Dame Carol for the report and the opportunity to engage. Yasmin Batliwala of WDP welcomed the ‘holistic approach and the case for investment’ and wanted to know more about how we could move from competition to collaboration, which prompted Dame Carol’s comments on changes to commissioning, as ‘the way money is given could encourage collaboration’.

Karen Tyrell from Humankind thanked her for ensuring the voices of service users came through and asked, ‘what advice would you give to service providers to see these recommendations come to life?’ 

‘A proper needs assessment needs to be done as different areas require different things – then specialist commissioning to deliver against the needs assessment,’ responded Dame Carol. We needed to get to grips with what the real problems were and ‘commission in an intelligent way’.

Felicity Simpkin from With You asked Dame Carol to confirm whether the proposed £190m was on top of the £80m allocated this year, which she did. 

‘Being able to use that money well is difficult when you have a depleted workforce and fragmented commissioning,’ Dame Carol added. ‘We need to show that the money invested gives us a return and will have to fight very hard in the spending review as there are a lot of competing requests on the budget.’