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with men as with women, are black people getting a fair shake, is the North East
performing as well as London? If you’re not asking yourself those questions then
you’re not really able to address what’s going on and improve it, and you’re letting
service users down. And unfortunately, in order to do that, you’ve got to do boring
stuff like keying in information, and it has to be collected in a consistent way.
James Brokenshire, when he was on the front bench in opposition, read out the
NDTMS definition for waiting times, I think it was, basically to take the piss out of
it, and all the Tory backbenchers were laughing their heads off. Well, five years in
they’re still using it.’
On that note, how much of a change did you see when the coalition
government came in?
‘Much less than anyone expected. There was a change in attitude – the NTA
immediately became the enemy within, because we weren’t ‘their’ NTA. The
important thing from our point of view was to hold on until PHE came in, because
it was ‘their’ Public Health England. So PHE, even though it continued the same
policy, was a good thing, whereas the NTA was a bad thing.
But this happens to all governments – all of sudden you’re in charge of stuff.
You’ve got a set of ideas you picked up from think tanks, you come into
government and instead of being able to make broad statements about you’ll do
this and do that, all of a sudden what you think and what you say actually matters
and you’ve got civil servants saying, “here’s the reasons why the other lot did these
things that you spent the last five years saying were stupid.” You start looking at
them and you go, “maybe it wasn’t so stupid after all – maybe there’s a reason for
that. We still think bits of it are bonkers or ideological, but other bits of it maybe
make more sense.”
So what you can do is say to them, “you want more people to recover – here’s
the sensible way to do that. You want that to happen at the same time as drug-
related deaths not going up, as keeping a lid on crime, here’s the bits of what the
other lot were doing that it makes sense to keep, and here’s the bits you could
sensibly change.”
We were able, with an awful lot of help from some very, very smart civil
servants in the Home Office and DH to get the key ministers to see that it was
actually in their departmental interest, and in the interest of the country as a
whole and of service users, to keep much more of the existing package than
anyone would have dreamt they were going to keep from the simplistic IDS/Centre
for Social Justice pre-election line. The other thing that helped was that IDS didn’t
play his cards very well within government and wasn’t able to persuade Andrew
Lansley and Theresa May to go down his route.’
How many of those achievements of the NTA under threat now,
do you think?
‘To an extent, everything’s under threat. NDTMS isn’t under threat instantly –the
solidity of it was exemplified I think
when Oliver Letwin agreed that it would
be used as the basis for the payment by
results pilot, so instead of being vilified
it was co-opted. How long PHE continue
to invest in it, and exactly where it goes,
is another matter.
But there are significant signs of
disinvestment from local authorities.
Some of that might be legitimate –
seeking better value – because
investment in the sector went up so
rapidly that it’s impossible to say that it’s
all been as well spent as it should, but
there are limits to how far you can
actually cut back. People will want to
readjust between drugs and alcohol,
people will want to spend on what I’ve
previously called “narrow public health” –
most of the benefits around drugs accrue
in terms of crime, welfare dependency etcetera, which historically have never been
very important to public health. Locating public health in local authorities should
make it easier to make that argument, but there is a sense in which that success
that you’ve acknowledged is largely invisible in the media and political circles.’
I was just about to come on to that.
‘So you’ve got Nick Clegg and his “failure in drug policy on an industrial scale”
stuff, and while that’s the default position – while the left think we’ve got a failed
war on drugs that will be solved by decriminalisation or legalisation, and the right
think we’ve got a wrong-headed harm reduction-led policy when we ought to have
abstinence – the only thing they can agree on is that we’re going to hell in a
handcart. Which is the opposite of the reality.
I gave a lecture to a group of criminology students recently and the only thing
they were interested in were the numbers I started off with, about the
improvements in the system, the decline in use and the crime reduction. They were
gobsmacked, they had no idea. They were saying, “What are your references for
this?” and I said, “It’s the ONS – this is what the official figures say.” People just
don’t know. It’s so locked into the media assumptions that it’s failed, and in a
sense it becomes a sort of proxy space for left and right to have an argument. I
think it’s even the case that because it’s working, because we’re not at the state of
crisis we were at in the ’80s with HIV or the ’90s with escalating crime, to an
extent that enables people to go back to their ideological corners and throw hand
grenades at each other. If there was a real problem they’d roll their sleeves up and
get it sorted.’
Do you think all that polarisation is starting to ease off at all?
‘I think the polarisation in the sector – the harm reduction/abstinence wars – has
calmed down. There’s still an appetite in bits of government to re-ask the question
about time-limited methadone, for example, which in my time they asked four times
and always got the same answer. They keep hoping they’ll finally find someone to
tell them what they want to hear, but the evidence remains the evidence.
What hasn’t calmed down is the ideological stuff about the legal status. But
what I think will change things dramatically is what’s happening in Colorado, funnily
enough. I think that will actually harden opinion against changing the law, because
now we’re starting to ask detailed questions about how does a market work and
how regulated can a market be. So rather than being theoretical these issues become
real. I think people are very dubious about where Colorado’s going to lead.’
With the involvement of big business and so on?
‘Absolutely. I don’t think there’s a space in between prohibition and marketisation
– that’s my gut instinct. You might be able to get there in Uruguay, when you’ve
got government control of supply – a political impossibility here – but not in a
22 |
drinkanddrugsnews
| November 2014
Profile |
Paul Hayes
www.drinkanddrugsnews.com
‘The left think we’ve got a failed
war on drugs that will be solved
by decriminalisation or
legislation, and the right think
we’ve got a wrong-headed harm
reduction-led policy – the only
thing they can agree on is that
we’re going to hell in a handcart.’