Soapbox |
Marcus Roberts
Soapbox
DDN’s monthly column
offering a platform for
a range of diverse views.
22 |
drinkanddrugsnews
| April 2012
www.drinkanddrugsnews.com
ALL THAT IS SOLID
MELTS TO AIR
With turbulent change ahead
we should resist the urge to
start polarising the agenda,
says Marcus Roberts
DESCRIBING THE IMPACT OF CAPITALISM
in the 1848 Communist Manifesto, Karl
Marx and Friederich Engels observed that ‘all that is solid melts to air, all that is holy
is profaned’. This is a rather apt – if bombastic – prospectus for the change that will
hit drug and alcohol services in April 2013.
In 12 months time, the National Treatment Agency will have been absorbed into the
new public health service. The ‘ringfenced’ pooled treatment budget (PtB) may have
disappeared into a general public health pot. Local authorities will be managing the
next instalment of cuts anticipated for their 2013-14 budgets. Meanwhile primary care
trusts will have been replaced by clinical commissioning groups, health and wellbeing
boards will be emerging from their shadows, elected police and crime commissioners
will be in post, further welfare reforms will be implemented... and the list goes on.
What will the impact of all this change be in practice? Are we on the cusp of a
revolution for drug and alcohol services in England? Or is a lot of this likely to prove
more like surface turbulence with equilibrium quickly restored and more limited
impact on services addressing drug and alcohol problems?
The big fear is that local authorities will disinvest from drug and alcohol services
once they have more discretion over their budgets – particularly given a 14 per cent
cash terms fall in their overall budgets in the Spending Review period. There is no
getting away from the fact that the expansion of drug treatment in England has been
centrally driven – it is a product of the NTA, PtB and, indeed, of public service
agreements or PSAs. It also happened at a time when public spending was increasing.
Last time the responsibility for treatment lay with local authorities the picture
was not rosy. In 1998, New Labour’s first drug strategy declared that ‘the scope,
accessibility and effectiveness of available treatments are inconsistent between
localities and generally insufficient’, adding ‘there is considerable insecurity about
funding and disparity of provision’. Where local authorities now have more discretion
over budgets the warning signs are there – including cuts to young people’s services
and a drop in available housing support since the ring fence was removed from
Supporting People funding.
By April 2013 the new police and crime commissioners will also be allocating
budgets that currently help to fund drug and alcohol services, including the
Community Safety Fund and a significant chunk of Drug Intervention Programme
money. With the Community Safety Fund falling by 60 per cent from 2010-11 to 2012-
13, the director general of the crime and policing group at the Home Office wrote to
local authority chief executives in February 2011 to reassure them that ministers
intended that ‘other funding streams, including DIP grants, will be consolidated with
community safety funding for PCCs in 2013/14 and 2014/15 and thus provide them
with a significantly larger unringfenced budget overall’. The clear implication is that DIP
money could be used to plug the gaps in community safety funding.
So is it all doom and gloom then? Not at all. The government appears to recognise
the importance of drug and alcohol services and the vision of recovery-orientated
treatment set out in the 2010 Drug Strategy is to be applauded. Localism itself
creates real opportunities to work in a more collaborative way that responds to local
needs and priorities. The ‘ringfence’ around the pooled treatment budget has not
always been the sort of fence that you chat to the neighbours over, but sometimes
more like an electrified fence festooned with ‘keep out’ signs.
Behind the scenes a lot of thought is being given in government to how the drug and
alcohol spend can be protected after April 2013 (expect some combination of national
indicators, grant conditions and transparent monitoring and reporting). But even if these
protections are effective there is still a real risk of disinvestment from local sources,
which accounted for around 55 per cent of the drug treatment spend in 2008-09.
It might be rather facetiously concluded that the prevailing view in government is
that localismwill work out fine for drug and alcohol services so long as we don’t actually
do it. A more balanced conclusion is that we should resist the temptation to think in
terms of simple polarities – we do not need to choose between ‘centralism’ and
‘localism’ any more than we had to choose between ‘harm reduction’ and ‘abstinence’.
There is a middle way between ‘bureaucratic centralism’ and laissez-faire postcode
lotteryism, as there is between truculent oppositionism to reform and stoical mustn’t
grumblism. Strategically, we need to engage constructively with the recovery agenda
and the challenges and opportunities of a more localist response without compromising
the messages on the dangers of disinvestment, which are real and present.
Marcus Roberts is director of policy and membership at DrugScope