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Juice, booze and the need for quality care

December 4, 2008

column-picture1I don’t know about you, but I often wonder why there is so much talk about the price of alcohol and no comment whatever on the price of soft drinks…

The Pre-Budget Report heralded, among other things, increases in duty on alcohol and tobacco. We see in the press – both local and national – report after report about the problems of Happy Hours, and the anti-social behaviour caused by people that have drunk to excess.

And yet no one says a dickiebird about it costing the earth to buy a fruit juice or a pint of nasty, hose-poured lemonade.

I’m not saying cheap juice is the solution to this difficult social problem in the UK, but that soft drinks are so unbelievably expensive can’t help matters.

I have written before in this column about the effects of alcohol on mental health and the way in which substance misuse and poor mental health can go hand in hand.

As a social worker in our local crisis resolution and home treatment team, I and colleagues meet people with such problems most days.

What is concerning a number of us at present, is the gaps in service provision for people with addictions problems, and the lack of capacity of adult mental health services to offer specialist support for people with dual diagnosis (addictions and mental illness).

I have written before about a colleague’s vision for increased support for homeless people with alcohol and drugs issues, and the need for wet hostel facilities with rehab and move-on parts to the service.

The importance of this was confirmed for me through my contact with Hastings Trust staff at the recent ‘Let’s do business’ event.

Homelessness, in their view, remains a key local issue.

There also needs to be increased capacity for daily detox and aftercare treatment via a service, and a model of care, that prioritises social problems alongside the medical need for detoxification.

As a starting point for this crucial debate, Cllr David Rogers, the (Lib Dem) leader of the Opposition on East Sussex County Council has put in, on my behalf, a number of questions via the Health Overview and Scrutiny Committee, so that we can establish exactly what monies are being spent locally in order to combat these problems, and what services are resulting.

Local accountability and the ability to shape services to local need is what is sadly lacking in much of the NHS. This is why the Lib Dems have proposed directly elected Local Health Boards.

The target and tick-box culture is driving front-line workers mad. The fines that are being introduced alongside these targets are completely counter-intuitive in respect of service improvement.

We need to get back to prioritising the quality and experience of care for the people that need the support of health and social care practitioners.

We need to be providing services that have been devised around the fostering of useful models of practice, rather than ever-decreasing annual budgets.

Because the reality is that poverty and substance misuse also go hand in hand. And our constituency has some of the poorest areas in the South East of England.

Substance misuse affects not only the immediate individuals and their families, it has implications in respect of community safety, health budgets, regeneration. The list goes on.

We need to get smart, we need to think again, and we must begin to invest to save.

[What do you think about local substance misuse services?  Please use the form to send in your comments]

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