Q
47Mr.
John Baron (Billericay) (Con): May I press you on
resources, Mr. Barnes—you are in demand at the
moment? Although I accept that the estimates are not precise, if the
Bill becomes law, you could have up to 100,000 additional addicts
seeking treatment. We have discussed the limitation on resources. As
the resources are presently constituted, can you give us your best
guess—I know this is a difficult question—as to how many
extra addicts could be
treated? Martin
Barnes: Oh, gosh. That is a very difficult question
to answer. Also, the situation varies, because some parts of the
country are being allocated additional resources within the pooled
treatment budget as an attempt to enable more people in the local area
to get into treatment. Some areas are seeing decreases in resources,
and projections for the next two to three years show that some areas
could see a reduction in pooled treatment funding of anything from 20
per cent. to 30 per cent. The issue of resources is therefore
increasingly localised. In terms of what the system currently can cope
with in respect of extra numbers, I could give you an opinion, but I
could not give you something concrete and say, “That is hard and
fast.”
Mr.
Baron: An opinion would be
welcome. Martin
Barnes: In respect of where we are with the treatment
system, it was right initially to focus on increasing capacity,
catching up on years of underinvestment and getting the work force in
place. Now, since this is and should be about improving effectiveness,
the resource pressure will inevitably increase, because you are trying
to get people in treatment linking up to the housing and training
providers, to get better access to primary health care, and to get in
place the advocacy and support networks that would help people’s
treatment and longer term outcomes. At the moment, the budget is being
frozen at a time while drug treatment providers—many of our
members—are trying to do more with fewer
resources. There
also an important issue in respect of supporting the work force. One of
our criticisms of the drug strategy is that there simply has not been
enough commitment, attention and resource put into ensuring that people
who work with problem drug users—not just in specialised
environments, but in more generic services as well—have the
knowledge, expertise and know-how to respond to the increasing
pressures and expectations on them. It is always easy for any charity
or group to say, “We need more money.” You hear that all
the time, but the world is not like that at the moment. There is
pressure on the treatment system to demonstrate effectiveness, but if
we are talking about significant increases in capacity, I do not
believe that the system can handle that and achieve the outcomes that
we want with the current resource
allocation.
Q
48Mr.
Baron: May I be a little unfair and return to my original
question? Can you give us your best guess? Are we talking about the
lower end—10,000 or 20,000? Accepting everything you say, and
that these figures are not precise, I would just like an indication of
whether you think that we do not stand a chance at all, or whether, if
we all pull together, there would be some chance of getting at least
halfway. Martin
Barnes: I might sound like I am trying to avoid your
question, but I am also thinking it through. The difficulty is that if
we are talking about 20,000 people, how will that work geographically?
Are there more people going into the system in some parts of the
country than in others? How does that match up with current treatment
provision? Also, what are the allocations likely to be over the next
two to three years? Flexibility is built into the allocations; they are
not cast in stone over the next two to three years. We are expecting
the treatment allocation for the next financial year to be announced
pretty soon—it was due last
week. My
honest answer would be, given that the treatment system has achieved
its target to more than double the number of people accessing
treatment, that going beyond the 200,000 on average accessing every
year would be extremely difficult without additional resources. In some
parts of the country, there is undoubtedly additional capacity, but the
situation is far from
uniform.
Q
49Mr.
Baron: Let me press you a little bit more. Taking a
slightly longer term perspective, if budgets were frozen, would there
be any additional resources that could be brought in from other areas
to help with regard to this possibly quite sudden uplift in treatment
need? Martin
Barnes: The pooled treatment budget is the primary
source of funding, but local authorities and local partners can also
allocate from within their own budgets. Part of the challenge in
respect of the drug strategy and investment in drug treatment is
ensuring that it is seen as a local priority. There is a reason why
the Government put a ring fence around the pooled treatment budget and
why they set up the NTA: if they had not done so, chances are that the
additional investment and spend on drug treatment, once this got down
to local decision makers, would probably have been allocated elsewhere.
That brings me back to the need for us still to make the case for why
investing in drug treatment is the right thing to do and to say that it
can be cost-effective. Unfortunately, that issue has become party
polarised. Local
partners have the capacity to put in additional resources. I think
that, from April, the Government and the NTA will be piloting new
initiatives that will try to free up the way that local partners,
including drug action teams, can allocate funding within their areas to
better address what are regarded as more local needs and priorities.
That might, depending on the evaluation, give us some lessons and
learning on how better to get people pooling resources and allocating
funding.
Q
50The
Chairman: There is very little time left. In 30
seconds, does either witness want to say anything to the Committee that
they had forgotten to share?
Martin
Barnes: I think that we have covered this in detail.
Obviously, we will be seeking to brief and put forward more precise and
detailed amendments with regard to particular concerns. It is not that
we have problems in any way with the commitment to provide additional
support, which can only be positive. However, from my
experience—both from consulting our members at DrugScope, from
CPAG, and from working as a benefits advisor—I know that there
can be distance between a policy objective and what Ministers want, and
what can actually happen at the front line on the ground, particularly
when resources are limited and DWP and Jobcentre offices are under
pressure, as they are at the moment. There can be a gap between the
policy intent and the outcome and impact on
individuals.
The
Chairman: I have to interrupt you. I thank you both very
much for the time that you have given to the Committee and for your
responses. 1
pm The
Chairman adjourned the Committee without Question put
(Standing Order No.
88). Adjourned
till this day at Four
o’clock.
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