Payment by results ‘pilots’ for drug and alcohol
recovery ‘went live’ on 2 April
– as
DDN
readers
will no doubt be aware if they are involved with
services in Bracknell Forest, Enfield in London, Kent,
Lincolnshire, Oxfordshire, Stockport, Wakefield or
Wigan. Others who may not be involved in the
eight pilot areas have their own reasons to be
concerned about payment by results (PbR).
Elsewhere some commissioners have develop-
ed their own schemes and the government has
encouraged others to join them. Other PbR initiatives are also impacting on the
drug and alcohol sector, including DWP’s ‘work programme’ and PbR in the
criminal justice system. PbR is emerging as the centrepiece of the coalition
government’s approach to public service reform.
Writing in the
Guardian
, Oliver Letwin, the cabinet office minister who has
led on PbR, explained that the basic principle was that ‘where vulnerable users
can’t exercise choice for themselves, the government should specify the result
it is seeking, and then pay the providers of the service if, but only if, they
achieve the result’.
Drug rehabilitation is particularly suitable for PbR, he claims, because ‘we
have been pouring billions into it over the years – with appallingly low rates of
successful recovery’, and, he believes, this situation can be turned around if
‘providers of drug rehabilitation are being paid their full fee only if they get
drug users properly off drugs’. The Audit Commission has recognised that ‘PbR
can provide sustained incentives for providers to improve outcomes, and to
find new ways of doing so. It can encourage new ideas, new forms of service
delivery and new entrants to service provision’.
Having been involved with the Department of Health’s co-design process
for the PbR pilots, I can testify to the thought and energy that civil servants and
local commissioners have given to addressing potential pitfalls and problems.
It should also be stressed that the PbR outcome framework is broader than
Oliver Letwin’s comments in the
Guardian
might suggest – there are two
further ‘domains’ alongside ‘free from drugs of dependence’ – ‘reducing
offending’ and ‘health and wellbeing’ (including cessation of injecting,
hepatitis B vaccination and access to housing). Nor does the first domain
simply pay out on ‘abstinence’.
But there remain significant grounds for caution and concern, particularly
as PbR is implemented in a rapidly changing and financially challenging
environment. The Audit Commission warns that ‘schemes that make a large
part of the payment dependent on performance are, for the most part,
untested and their overall effectiveness is not yet proven’. This echoes an
earlier UKDPC report, which concluded that ‘the approach being taken to
payment by results in recovery is going into uncharted territories and is
effectively a social experiment with a particularly vulnerable group’.
The government says that PbR has the ‘potential’ to improve the
performance of drug and alcohol services. It is now about actual delivery,
consequences (intended and unintended) and… results.
Marcus Roberts is director of policy and membership at DrugScope,
www.drugscope.org.uk. See page 12 for our feature on PbR pilots
Policy |
Legal
READER’S QUESTION:
My son and his friends get stopped and searched by police at
least a few times a week. The officers often say it’s because
they can smell cannabis on them, but they have never found
anything on my son. He feels like he’s being targeted and I’m
starting to think it might be because he is a young, black male
in an area where there is a lot of crime. Is there anything we
can do to stop this?
KIRSTIE SAYS:
Your son should make a complaint about the
frequency he is being stopped and searched, and
the fact that there do not actually appear to be
any grounds for this (based on the fact that no
drugs have ever been found on him). A complaint
can either be made to the inspector at the police
station where the officers are based, or to the
Independent Police Complaints Commission
(IPCC).
Many people are not comfortable making the complaint at the police
station because they worry about any investigation being independent.
However, even if the complaint is made to the IPCC, issues of this type are
often referred back to the relevant police station for local resolution. If the
decision at that level is unsatisfactory the IPCC can still be contacted.
Each time your son was stopped and searched he should have been given a
form confirming this, which will include details of the officers performing the
stop and search. This will be particularly important if it is the same officers
that stop your son each time, as this may support that he is being targeted by
them. There may be potential for an action against the police for harassment.
I understand that it must be frustrating for your son each time he is
stopped and searched unnecessarily, but he must try to remain calm. Any
hostility on his part may be misinterpreted by the police and lead to more
serious action being taken. It is important to cooperate with the officers at the
time and make any complaint about their actions after the event. Each time
your son is stopped he should make sure he records the officers’ names/badge
numbers and as much other information as he can to assist with the future
action he wants to take.
You do not mention if your son has been mistreated in any way, for instance
subjected to a strip search in a public place, but if this has occurred this should
form a separate complaint as well as part of the general one. It may also be
possible to take legal action against the police in this situation, and it will be
important to get details of any potential witnesses for this.
Email your legal questions to claire@cjwellings.com
We will pass them to Kirstie to answer in a future issue of DDN.
Release is conducting research into the disproportionate policing of drugs
offences. For more information on this issue call 0845 4500 215.
Release solicitor
Kirstie Douse
answers
your legal questions in her regular column
LEGAL LINE
CAN WE STOP THE
CONSTANT POINTLESS
POLICE SEARCHES?
What’s next for Payment by Results, asks
Marcus Roberts
in his first regular column
from DrugScope
POLICY SCOPE
UNCHARTED
TERRITORIES
May 2012 |
drinkanddrugsnews
| 11
www.drinkanddrugsnews.com