Today I have met three leading members of the Addaction team in Liverpool. For those of you who don’t know Addaction they are probably our biggest national charity dealing with drugs addiction with a turnover of £40,000,000+ and about 1,200 staff. They have worked in the field for about 20 years and set very high standards of care for the people they assist.
I was stimulated to meet them by attending a presentation at the home of Dr Oelbaum, one of my constituents, who works part time for them and part time as a GP. The presentation made me realise how much I don’t know about drugs problems; the hour I spent today reinforced that lack of knowledge!
Of course I know that drugs are a major problem. Not only do they wreck lives but they damage communities. Drug users need a lot of cash. Most acquire it by burglary, shop lifting, prostitution and other illegal means. They cause hundreds of pounds worth of damage and much uncountable distress for each break in. I was surprised to learn that in Liverpool there are at least 3,000 people whose lives are severely curtailed by drug use. I was not so surprised to learn the number, although unquantified, is much larger for alcohol abuse.
But I didn’t really understand the ‘drugs continuum’. I thought that people either took drugs or didn’t. For many there is a middle way using things like methadone to control cravings. Thus they can function well and still make a contribution to employment, family and community life. This is an important lesson for all policy makers – not to see things in black and white. Giving up an addiction is not easy and some never make it but the right help at the right time means that they minimise harm to themselves and others by minimising their intake. This is as true of lung cancer and smoking; over eating and obesity as it is of drugs.
Addaction set me three challenges today which I hope to respond to in detail as I think things through more clearly using the information they have given me:
- Ensure that drugs are still clearly seen as a major problem. In the last few years much of the support that would have gone to drugs agencies ahs moved to the new drug of choice alcohol. Yes there are more people with alcohol problems than ever before but the problems caused by drug abusers should not be minimised.
- This may sound counterintuitive to the first but treat Drugs and alcohols together as “Substance Abuse”. Many people suffer from both and Addaction does alcohol stuff because they cannot reasonably say “we are only dealing with your drug problem – go along the road with your alcohol problem.” Chaotic people just cannot work like that. Dealing with them together would actually save money by merging organisations and improving practice
- There are real dangers with the performance related pay approach advocated by this government and the last. We have seen the appalling nature of this in the emerging A4E scandal with someone making £8.6 million a year from the unemployed. Payment for results can be good if you measure the right things – especially outcomes and not outputs. But it also encourages cherry picking of the people with the least problems and ‘body grabbing’ as organisation s see each client as cash on legs and tries to keep them within their organisation irrespective of whether they are the best organisation for the individual.
In a wider sense the meeting with Addaction also reaffirmed my faith in the 3rd sector. I don’t think that the 3rd sector ever could or should replace a strong, well managed public sector. I do however think that well run organisations like Addaction can play a big part in the development of community led solutions and can be more fleet of foot and responsive to change than the large organs of state.
So well done Addaction. Thanks for all the work that you do for us here in Liverpool and I look forward to working with you for a long time to come.