Collective Voice

Recently a new drug and alcohol policy group has been making a stir in England. Called “Collective Voice” this group have a stated aim of “ensuring that the voices of the drug and alcohol treatment sector and those who use our services are represented effectively”.

All well and good. Since the demise of DrugScope many people have been concerned about the lack of a voice to represent the interests of those affected by drugs and alcohol.

The group comprises 8 of the largest organisations providing drug and alcohol treatment services in England. So that’s CRI, Addaction, Cranstoun, Swanswell, Turning Point, Blenheim CDP, Lifeline Project, Phoenix Futures.

As a group of organisations they have a combined turnover of £380 million - and an impressive record of growth. They are the dominant voices in the sector. And what are their concerns? Well they are pretty unambiguous about that. There is one thing at the top of their list.

Money.

The “Collective Voice” tell us that investment in drug and alcohol services is under threat and that they want to “promote and defend the interests of those who need our services”. Its an exciting initiative. The appointment of Paul Hayes to lead the work is a signal that they are serious about engaging with government. The financial investment they have made and the work they have undertaken to get this far demonstrates their commitment to doing something. They have pooled a small amount of resources to undertake preparatory work for a new intermediary body for the drug and alcohol sector and also to lobby government and local authorities to preserve investment.

This focus on disinvestment may seem strange to those who see issues like the lack of access to harm reduction services, the squeezing out of small providers by the large charities, the increase in drug related deaths and the very poor outcomes being delivered in many areas through the further spread of approaches that have no evidence base - or worse are contrary to the evidence base we have - as of as great or greater concern. That is not to say that disinvestment isn’t a concern - rather that there may be issues of greater concern for any new organisation seeking to provide a voice for people who use services.

For this group however, who expanded their services significantly during the period Paul Hayes presided over treatment investment from the NTA, disinvestment is the critical issue. And you may well say they are funding this, it is their right to prioritise these issues.

Clearly however there are questions to ask.

Will these organisations stand up for evidence based interventions? Will they challenge political decisions that promote punitive and damaging interventions (like benefit sanctions for those refusing treatment) and the rewriting of the evidence base to meet political objectives?

Can these organisations support the drug and alcohol treatment workforce to deliver services ethically and in the interests of service users when commissioners and government push for non-evidence based unethical approaches to treatment like involuntary detoxification, rationed harm reduction and mandatory mechanical recovery?

Are these organisations - who because of their size, market positioning and infrastructure have a naturally assertive approach to growth - capable of looking beyond their own economic interests and supporting the smaller voluntary sector organisations and social enterprises who have struggled most to survive in our unnecessarily aggressive commissioning culture? A charity CEO is bound to act in the interests of the charity they run. Month after month, the larger charities in our sector - the ones who have set up Collective Voice - effectively put the smaller ones out of business as they implement their board approved growth strategies.

Are these organisations able to see beyond investment in the services they provide and build alliances with those addressing the wider cuts in welfare, housing support and real employment that cause so much damage to the individuals who could benefit from their services?

At the moment the Collective Voice represents the most economically successful organisations in the drug treatment industry. When measured by turnover, numbers of service users and geographic scope they are undoubtedly the leaders in the sector. Is it possible for such an elite group - invested as they necessarily are in the success of government strategy - to act independently in the interests of service users? Can we assume that there is an inevitable co-terminosity in the interests of these major charities and those of the most vulnerable in society?

Some of those involved have already worked alongside others in the field to campaign for really important stuff - like the expansion of overdose prevention campaigns. Others have been notably silent on issues such as the unprecedented rise in drug related deaths. Some have worked alongside Iain Duncan Smith and his think tank The Centre for Social Justice in developing policies and approaches that are influencing government drug policy today.

They are asking for people to join them - to become involved. I am sure many people will. They are, at the moment at least, the only game in town for those hoping that in discussions that affect those experiencing problems with drugs and alcohol in England a voice other than that of Iain Duncan Smith and his chums will be heard in Whitehall.

It may well be that we do need a body to replace Drugscope - or to provide similar services particularly in terms of information. I am however pretty certain that what we don’t need is a trade body for the powerful organisations who already dominate the treatment sector.

Personally I have a natural suspicion of consensus built on economic expediency - and of the ability of those whose positions require them only to act in the interests of their own organisations to deliver a genuinely independent voice. The potential for the Collective Voice to operate effectively in the interests of large service providers is unquestionable.

Whether they can - as they say they want to - promote and defend the interests of the vulnerable individuals who need access to effective and evidence based drug and alcohol treatment remains to be seen.