READY FOR ACTION
In February 2019 , then home secretary Sajid Javid appointed Professor Dame Carol Black to conduct an independent review of drugs . One year later , in the final weeks of a pre-COVID world , the first part of the review was published , focusing on drugs markets and the toxic combination of violence , poverty and exploitation that underpins supply and demand .
The review ’ s second part , aimed squarely at treatment , recovery and prevention , was originally scheduled for publication in autumn 2020 but – to the frustration of many ( including perhaps the author ) – has been pushed back by a combination of COVID-19 and congested government timetabling . However that long wait is now almost over . There can be little doubt that our field , and the people we serve , could be on the brink of the most significant opportunity for renewal in a generation .
We know this change cannot come soon enough . We are in the middle of an escalating drugrelated deaths crisis ; deaths from alcohol-specific causes have reached record highs and there are signs of concerning unmet need among young people using drugs . We must also add to this list the worrying health and social inequalities exacerbated by COVID-19 and their possible role as drivers of drug and alcohol use .
Over the last decade we have all faced profound structural
We must seize the opportunity to revolutionise the sector , says Oliver Standing
and operational challenges : political responsibility splintered across a number of government departments , insufficient funding and the need to stitch together ever more complex care pathways for highly stigmatised citizens . In the face of this challenging environment Collective Voice has worked – frequently in collaboration – to draw attention to the shocking human impact of significant funding cuts on the availability of treatment and recovery services .
Charities and social enterprises
‘ There can be little doubt that our field , and the people we serve , could be on the brink of the most significant opportunity for renewal in a generation .’
have been at the heart of the treatment and recovery world for decades , with expertise and experience that allows them to reach people in the community , residential rehab and detoxification units , and in prisons , supporting over 200,000 of this country ’ s most marginalised citizens every year . Substance use is not just a healthcare problem , rarely occurring in isolation from factors such as trauma and mental ill health , homelessness , joblessness or contact with the criminal justice system . The rich history of the voluntary sector in our field allows recovery communities and provider charities to fully recognise and flexibly respond to this complexity . But we also recognise that central political disinterest and disinvestment has left our capacity to do so significantly reduced .
In this context we await the review in real hope that Dame Carol has heard the calls made by Collective Voice and many others about the critical point the treatment system has reached . It is why the review must offer the vision of a brighter future of evidencebased and person-centred care for all . And it ’ s why we must now as a field focus on working together to use the review to make the case collectively for the political action necessary to deliver its ambitions . Together we can support more people into recovery and enable more families to heal – all while making savings for the public purse .
The human costs of inaction are real . We stand ready to work together with government and wider partners – local and national – to make the most of this vital opportunity , drawing on our individual and collective strengths to bring about the fundamental changes we all so desperately want to see .
Oliver Standing is director of Collective Voice
Dame Carol ’ s report is likely to make a number of wide-ranging recommendations , together representing a true ‘ system reset ’. Our top three priorities are :
1 . The review ’ s ambitions will only be realised with long-term , co-ordinated leadership within central government . This will require the meaningful input of multiple departments ( not just the Department of Health and Social Care and the Home Office ) with a formal commitment to crossgovernment working , a robust accountability mechanism and continuing ministerial interest .
2 . The new Office for Health Promotion , under the chief medical officer , will play a key role by contributing its specialist knowledge . It must have sufficient independence to ‘ speak truth to power ’ if the evidence on treatment and recovery does not align with the political will of the day .
3 . A robust , multi-year financial commitment will be required to meet the scale of the challenge . The recent one-year £ 80m funding injection has provided a life-raft of resource , but this increase must now be built on over the life span of the coming spending review to enable sustainable growth . erhui1979 / iStock
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