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July 2013 |
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how they are obliged to work within a
legal and policy framework that is
often in direct conflict with funda-
mental medical ethics – not least the
commitment to ‘first, do no harm’.
I could continue ad infinitum with
quoting from the evidence but I ask you
to consider the above and give you the
chance to respond to this letter.
Thank you in anticipation.
Yours sincerely
Dr Chris Ford,
clinical director, IDHDP,
www.idhdp.com, Twitter: @idhdp
RESPONSE FROM
ANNA SOUBRY MP
Dear Chris Ford,
I am grateful for the opportunity to
continue our discussion on this key
issue. Of course, I agree there are
serious health issues concerning
drugs misuse
As a government, we set out our
position in the response to the report
on drugs by the Home Affairs Select
Committee.
Within the overall drug strategy the
Home Office leads on action to protect
society by stopping the supply of
drugs, and tackling the organised
crime that is associated with the drugs
trade. Crime is a major component of
the social and economic costs of class
A drug use. Current estimates suggest
that crime accounts for 90 per cent of
the total cost – and the UK’s response
relies on the crime fighting capabilities
coordinated by the Home Office.
Treatment forms a very important
part of our drugs strategy and the UK
has consistently sought to help
individuals who are dependent on
drugs by treatment rather than the
application of criminal sanctions.
Healthcare is the responsibility of the
four UK administrations’ health
departments. In England, the
Department of Health leads the
delivery of the drug strategy’s ambition
for more and more individuals each
year to achieve and sustain recovery.
This shared responsibility for
preventing and tackling the problems
caused by drugs is also reflected in the
structures at a local level. We have
introduced police and crime
commissioners, who will take
responsibility for local action to drive
down drug-related crime and anti-social
behaviour, and Public Health England,
which will support local authorities to
tackle drug and alcohol misuse as a
core part of their work, including
supporting recovery-orientated drug and
alcohol treatment services and delivery
of prevention and other health services.
GPs who help their patients to
tackle dependence are well placed to
play an important role in the new local
structures. With their understanding of
public health issues and through their
participation in clinical commissioning
groups, they can help ensure that the
planning and delivery of services are
joined up in a way which meets all the
support needs of people who are
dependent on drugs or alcohol.
Anna Soubry, MP
LESSONS IN LOCALISM
In your last issue you said doctors at
this year’s GPs’ conference were
concerned about how localism could
affect healthcare. While public health
minister Anna Soubry had faith in local
authorities, talking about the ‘robust
partnerships between stakeholders’,
delegates gave a ‘messy picture’ in
reality, with ‘massively reduced
commissioning teams in some areas’,
disintegration of shared care in other
areas and ‘conflicts of interest
everywhere’ (
DDN
, June, page 8). Then
in a recent
DDN Bitesize
, you asked
readers about what’s happening in our
area and what our experience has been.
I work in northern Alberta, Canada
as an addictions counsellor in a 60-bed
residential treatment centre. I began
work here in 1998 when we were under
the jurisdiction of the Alberta Alcohol
and Drug Abuse Commission and our
province-wide service had around 600
employees. The commission was
merged into Alberta Health Services in
2009. The purpose was good – to
integrate addiction and mental health
services with all other medical
services. Other regional boards and
local authorities were merged as well.
Since then we have belonged to a
single organisation that employs
90,000 workers to provide access to
quality health care services for 3.9m
people in Alberta.
As a frontline worker I didn’t notice a
lot of change at first. The most
immediate ones were that all staff in my
classification had to switch unions and
pension provider. Our hours of work
went from 7.25 hours a day to 7.75
hours per day. Then our software for
human resources and training changed.
I think that in the long run it is for
the best that we merged. I support the
idea of eliminating some of the
duplication of effort. We don’t really
need to reinvent the wheel and we can
all use the same policies on infection
control, use of computers, ethics, etc.
Many people want to go for substance
abuse treatment away from their home
community and that is simplified by a
single organisation. However we had a
province-wide addictions treatment
service since the ’50s.
Now, however, a new service is in
our building. Mental health workers run
groups on anxiety, relationship issues,
depression etc here. We can pop
down the hall and discuss with them
how they work with their clients. We’re
slowly learning from each other. I’m
willing to keep working at it.
In the next ten years I hope I see a
common database covering all of our
clients that we can access. Right now,
only our nurses can access the
medical database, and I have no
problem with that. However only
addiction staff province-wide can
access the database of the clients we
see. I can enter notes on that
database and anywhere in the
province where a client sees an
addictions counsellor who works for
Alberta Health Services; a staff
member can read notes from the
treatment the client got here.
Trish Wright, addictions counsellor,
Business and Industry Clinic,
Northern Addictions Centre, Alberta
OUT OF TOUCH
Mark Gilman's recent interview in
The
Guardian
(11 June), declaring 12
steps are best for addicts,
demonstrates how out of touch his
view of UK recovery movement is. I
found the article divisive and if his
beliefs are shared by PHE then that
saddens me. What happened to
choice and empowering people? Frog-
marching people to a meeting may be
OK in the US, but not in UK.
Carl Cundall, trustee,
SMART Recovery UK
VOLUNTEERS SPURNED
I live in East Yorkshire and run three
self-help groups. We have recently had
our funding for room hire withdrawn at
short notice for no obvious reason. We
find that some of the treatment
providers see voluntary groups as a
threat, and instead of working together,
block our attempts to reach out to
users who are desperate for help. We
only exist to help people, but find
obstacles put in our way. The provision
for alcohol abuse intervention in our
area is abysmal. Have other areas of
the country come across this?
Stephen Keane, leader,
East Riding Alcohol Support Group