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The government must not let rehab go to the wall

    Yesterday morning I sat in on a ‘Concordat of Rehabs’ meeting. It depressed me. It was not because of the hardworking and honourable people who’d travelled on National Express coaches and at personal expense to get to it; nor because of the Concordat’s achievement of getting rehab back on the policy agenda. It depressed me because of the continuing story of inflexibility of the ‘powers that be’ and the roll call of ‘empty beds’ reported. From the start, the implementation of the Coalition’s drugs policy has fitted the existing straightjacket. Health officials from the top of the DoH downwards have called the shots in accordance with vested interests and processes (‘stakeholders’, ‘pathways’, ‘treatment journeys’ providing a convenient, but meaningless language of justification). Coalition ministers have deferred to the entrenched treatment establishment – one whose methodology to reduce harm has failed so spectacularly as Lord Fowler’s report on today’s aids epidemic witnesses.

    The Coalition has been outmanoeuvred at every turn, thwarted by departmental committees, outwitted by politically correct protocols and practices. The political cynics may ask what did I expect - that’s the way government works. But it patently can’t afford to. Drugs treatment is a classic example of public sector money churn feeding what Melanie Phillips has described as “the three decade liberal experiment which tore up every basic social value.”

    When you sit in the midst of such good, caring and dedicated people, as I did yesterday, and visit their centres (as I have done since I worked on Breakdown Britain) seeing their success with people abandoned to the social scrap heap, it is hard to see them sidelined and so totally undervalued.

    How many people would give their lives to help other people overcome destructive addiction? How many people have the wherewithal to commit to helping people like ‘Stuart’ back into sobriety, into life, new codes of conduct and purpose for living? (Stuart of ‘Stuart - a life backwards’, Harper Perennial, 2006, was a ‘homeless’ co morbid addict whose ‘welfare’ and CJ costs no one began to tot up before he stood on a railway line in front of a train. Neither his ‘biographer’, Alexander Masters, nor, as Masters expounded, the system – in this case Cambridge social and drugs services - had any idea of how to help him.)

    But this is exactly what these modest people of the Concordat have – and track records of success stories to boot, as Masters, had he set out to look for real help for Stuart, might have found out. They are the very people on whom David Cameron, his government and the country depends if his ‘Big Society’ is ever to come to fruition. Yet, rhetoric apart, he is letting their rehabs go to the wall while Britain burns, as literally it did during the riots.

    At Mount Carmel in south London, which hosted the meeting, 12 of its 18 beds lie empty and they are laying off skilled staff; at Pierpoint, in the north of England, of 43 beds 12 are empty; Bosence in Cornwell – 7 of its 14 beds are empty; just 24 of Bristol’s Western Counselling 52 beds are occupied ; Ark House – of 20 beds, 10 are empty; Walsingham House Bristol – of 15 beds , 7 are empty; TTP – 20% of beds are empty; Quinton House - of 26 beds, 13 are empty; Focus 12 – of 16 beds, 5 are empty. They are all voluntary sector/not for profit or small private abstinence based rehabs.

    Last June they wrote to the Telegraph on the back of my CPS report Breaking the Habit: why the state should stop dealing drugs and start doing rehab – to alert government to this crisis. An average of one rehab unit had closed each month in the two years before the election, they reported. Taxpayers were funding a methadone, wine and welfare culture to the tune of billions instead.

    These all-time low rehab referrals – just 3,914 last year – now look set to drop even further.

    Worse, this group of rehabs is no nearer to participating in the government’s drug’s recovery pilots (excluded by the NTA’s ‘pre-qualification’ questionnaire that ministers failed to disallow). Their continued efforts to educate the DoH, the NTA and local DAAT commissioners have fallen on stony ground, such is the ignorance about, and institutional antipathy to, abstinence based recovery.

    As CPS author Huseyin Djemil recently discovered, only ‘millionaires’ need apply for drug and alcohol 'treatment' contracts. Arbitrary tendering requirements favour 'preferred providers'.

    This means that rehabs will not get a bat in hell’s chance to show what they can do before they slip under. But the state funded super charities that are part of the problem, will continue to be advantaged.*

    Delegating and downloading ‘treatment’ budget responsibility to National Treatment Agency - the expensive quasi-quango that, quite extraordinarily, the Coalition has retained and has allowed to translate its policy intentions – has been disastrous. So too are the bureaucratic commissioning systems, the inadequate and unfair tendering processes, that count for accountability.

    But the buck stops with Ministers. They need to get onto the case. Fast.

    *like CRI (£56m in 2010, up from £17m in 2006; Turning Point (£69m in 2010, up from £15m in 2006), Addaction (£37m in 2010, up from £25m in 2006), Phoenix Futures (£22m in 2010, up from £14m in 2006)

    Kathy Gyngell has a first class honours degree in social anthropology from Cambridge and an Oxford M.Phil. in sociology. She has worked for the former ITV companies, LWT and TV-am as a producer and senior programme executive. A full time mother after the birth of her second son, she founded the voluntary organization Full Time Mothers.

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