A Moment of Madness

Here I am, after another break wondering what one earth is going on. The drug treatment world went mad a couple of weeks ago. This is what happened.

Mark Easton, BBC News Home Affairs editor had been investigating drug treatment services in the UK for Radio 4's today programme - a flagship news-agenda setting show. This was probably because the consultation period on the next government drugs strategy is coming to end and everyone is setting out their stalls. Quite reasonably he asked if we are getting value for the millions being poured in to the treatment (and indeed the enforcement) fields. He interviewed the CEO of the National Treatment Agency (NTA) and skewered him. Firstly he wanted to know if it was ethical to 'reward' drug users for clean urines by giving them drugs and money. Apparently this is a model being used in the States and considered for trialling over here. Cue CEO spluttering and coughing and weaseling around. Then Easton asked if he had read one of his own agency's reports - he had not. Now please remember everyone, this (the CEO) is a man who is quoted in print (Drink and Drug News Feb 2007) as saying that if drugs services were failing the NTA 'would send the boys round'. Nice.

So the picture Easton painted was of an out of touch Chief Executive of a National Treatment Agency, responsible for spending a LOT of public money which didn't seem to be getting results - lots of patients get signed up for treatment at clinics but then never attend appointments and aren't discharged so appear as 'still in treatment' on the stats. Not only that, it was considering bringing in a 'reward' system for users who complied with treatment which appears to use drugs (upping of prescribed drugs for example) as reward for good behaviour) and this is someone who issues threats in print. Hardly an ethical lead one ponders.

Well I and a lot of others can recognise the picture Easton paints. CEO's set the tone for an organisation and true to the NTA CEO's style his 'boys' - there are girls too, are agressive, bullying and contemptuous of treatment services. Often meetings are opened by NTA staff with quite naked threats to funding and assumptions are made about treatment services based on poor quality or out-of-date data. Resistance is futile. Arbitrary targets are set based on little evidence and the threats force services to adopt dubious ways of massaging their data for a quick win instead of getting patiently on with a long job caring for troubled and chaotic people.

Time for a shake up at the NTA dontcha think? Let's get the new drugs strategy underway with a radical review of the NTA and its fitness for purpose. I think it's time for a blog entitled 'NTA Watch'.