Category Archives: Health Services

“The secret of health for both mind and body is not to mourn for the past, worry about the future, or anticipate troubles, but to live in the present moment wisely and earnestly.” – Buddha

Will we ever win the Drugs War?

CIA Map of International drug pipelines

International Drug Pipelines

President Richard Nixon is accredited with coining the phrase war on drugs back in 1971 however; is it really a war that can actually be won?

Since an oriental entrepreneur first realised the financial opportunities of supply & demand, and opened an Opium Den in London, our nation (who are not alone), has had a massive problem trying to combat the negative impacts of drugs.

Addictive drugs first faced widespread prohibition in the late 19th and early 20th centuries but the so-called ’war’ against the illegal drug trade is nothing new, it has been almost constant for centuries.

It all started with the Anglo-Chinese Wars (the First Opium War and Second Opium War), it progressed through the (continuing) issues in Central and South America and latterly, it still manifests itself in Afghanistan. Yet another ‘war’ that has claimed far too many lives during the military ‘policing’ efforts, irrespective of the additional terrorism context this time around.

Back in Victorian London, the media (and several popular British authors of the time) had a tendency towards the romanticism of many of the issues surrounding the illegal drug trade. They portrayed the City as an ‘opium-drenched pit of danger and mystery’ but mostly to boost the appeal of their publications. To be fair, London’s reputation as a centre of opium smoking at the time was mostly unjustified, but it did testify to the power of literary fiction over historical fact.

Much of the literary fiction of the past can also be seen in the media of today, especially (but not exclusively) when it comes to reporting on drugs and crime. To be fair to the media, much of the emotive and sensational headline methodology they use is actually based upon ‘official’ statistics. That and contrived PR campaigns issued by the government and police, both organisations who have a propensity for ‘cooking the books’ when it comes to producing crime figures (see here).

Media headlines and literature aside; there are (without doubt) far too many negative impacts upon our society which find their roots in drug taking and the illegal drug trade.

A report by the UK government‘s drug strategy unit (see here) stated that due to the price of highly addictive drugs like heroin and cocaine; drug use was responsible for the great majority of crime (little surprise there). It said; ”The cost of crime committed to support illegal cocaine and heroin habits amounts to £16 billion a year in the UK” (a shocking figure you must agree).

Note: despite the fact this amount is more than the entire annual UK Home Office budget it should be remembered; without some serious research into the figures and ‘claims’ (which I and many others rarely have time to do), I would suggest they’re only used as indicative.

Between 2011 and 2012, an estimated 8.9% of adults in used an illegal drug. For young people aged between 16 and 24, the figure was 19.3%…(HM Govt)

Whilst people continue to take drugs, and all despite government claims suggesting the figures are actually in decline, demand will always dictate supply. It will also always provide an opportunity for nations and individuals to see a lucrative business opportunity. Is prohibition therefore a viable and effective answer any more? 

The Transform Drug Policy Foundation (TDPF) say not… In their publicity leaflet ‘Illegal Drugs: The Problem is Prohibition; The Solution is Control and Regulation’ the TDPF seeks to draw public attention to the fact that drug prohibition itself is the major cause of drug-related harm to individuals, communities and nations. They call for this prohibition to be replaced by “effective, just and humane government control and regulation.”

To mark the 50th anniversary of the war on drugs, TDPF along with a range of supporter organisations, launched Count the Costs, a global initiative to raise awareness of the unintended negative impacts of current policies. As the mainly punitive enforcement model which has dominated the ‘war on drugs’ for the last fifty years appears to have mostly failed our society, perhaps it really is time for some fresh thinking?

The disastrous unintended consequences of the war on drugs are so obvious even the UN Office on Drugs and Crime – the agency which oversees the current system – has been forced to acknowledge they exist…(Counting The Cost)

The TDPF suggest there are seven distinct but overlapping areas of cost to our society, all arising from the methods we currently use in our battle against drugs (see here). Despite having a good understanding of many of those issues and the realities  involved here, including those rarely espoused by our government, even I was able to learn from the website.

The saddest part about all this is not the financial cost (although undoubtedly substantial), it is the immense cost in human life. The bodies of thousands being expended with impunity by the few for exceptional personal fortunes - yet another aspect of social decline due to the greed of mankind. (I see a pattern forming with this money thing!)

But to illustrate this issue in summary and provide an answer to the original question; can we ever win the war on drugs? There’s probably about as much chance of that as there is of Barack Obama beating the NRA into submission and turning the USA into a gun free society!

Booze Britain: The Alcohol #MUP Debate?

Booze BritainThere is no doubt about it, we have to call time on the Booze Britain Culture however; the arguments around how best to tackle the issue rumble on ad infinitum. I suspect that will still be the case for many more years to come…

I don’t think many right-minded people would disagree, the negatives of excessive drinking are having a profound impact on our society. Our NHS see the impacts, our police and other emergency services are in constant combat against it and ultimately, many members of our society are suffering from it. The health and anti-social behaviour issues are myriad.

Nevertheless, some of the figures being bandied about on all sides of the arguments are not always what they seem. Take for instance the £2.7 billion price tag impact for the NHS in 2012, claimed by David Cameron as fact but found to be questionable (see Full Fact).

When the Government published their Alcohol Strategy, they emphasised the drain of alcohol abuse on our society. Central to that argument was the “overall cost of alcohol-related harm” which they placed at a staggering £21 billion a year to the UK economy.

Was that right? Investigations into the claim found that “Neither the Home Office nor the Department of Health were able to explain properly where the figures were from, and there is no obvious single point of contact to verify the original calculations” (see Full Fact).

Political spin on statistics aside. in the blog Representing the Mambo a self-professed ‘leftie’ alluded to her support for the MUP policy. A policy that was being put forward in 2011/12, but now appears now to have been shelved by David Cameron.

Obviously there are class issues and base political calculation at play and any minimum price would affect working class people disproportionately, but the solution is obvious. Drink less. The left shouldn’t be encouraging heavy alcohol consumption and siding with the drinks companies and their socially destructive agenda…(Supporting the Mambo)

In March this year there was a political U-Turn on the previous rhetoric and David Cameron wobbled on his minimum price for alcohol pledge. Despite the recent adoption of a similar policy in Scotland last year, the legality of the process is having a difficult birth due to an objection from Europe about its legality.

What about the costs/benefits analysis surrounding Minimum Alcohol Pricing?

The Full Fact website responded to the very same question (see here) however; there is also a growing body of research and evidence which suggests, many of the claims made in the past are simply tosh. Despite all the rhetoric from politicians, who want to be seen as proactive about the Booze Britain issue, the proposals for Minimum Unit Pricing won’t actually achieve the desired results it sets out to do.

The Government wants to set higher prices for alcohol. We think this will punish the responsible majority. Why should responsible drinkers pay more? (www.whyshouldwepaymore.co.uk)

Despite the Why Should We Pay More campaign actually being ‘the voice’ of the Wine & Spirit Trade Association, who obviously have a vested commercial interest in the matter, there are also a number of valid reasons why Government-set higher prices aren’t likely to cure the Booze Britain problem (see here).

SABMiller, one of the largest brewing organisations in the world (another vested interest), have also released poll results from YouGov which show that, contrary to the Government’s claims of a boost to the industry, a 45p minimum price for alcohol will turn people away from pubs (Download YouGov report PDF -0.48Mb).

The Institute for Fiscal Studies have also examined the significance of a minimum unit price for alcohol, especially relating to on and off-licence sales and concluded; “ it is unlikely that a minimum price would have much direct impact for on-licence (pub) prices” (see here).

It’s a valid factor that could have influenced a decisions by the chief executives of 12 pub chains, nightclub groups and brewers; they recently wrote to The Daily Telegraph, urging the Prime Minister to “stick to his guns”, saying that the proposed (MUP) measure would “save lives and protect great British pubs” (see here).

Despite all the UK-wide calls for minimum pricing by many politicians, medical professionals, health campaigners and people from both inside and outside the industry, it appears the battle over alcohol pricing is set to continue for some time yet. With all the controversy and divided opinion, the minimum unit pricing policy could be dropped all together!

But what of my views and opinions?

Those who’ve been here before may already know some of the answer to that question, at least in part. With upwards of forty years ‘booze’ experience, firstly as a purveyor, secondly as an enforcer and latterly as a purveyor again but throughout, always a fan of the enjoyment obtained from sensible drinking, I think you could say I’m more than qualified to comment.

The first observation is; the ‘Booze Britain’ problems we face today are as a direct result of the changing attitudes now imbedded in our society over several generations. Getting off your head on alcohol is no longer the side-effect of having a good time, it is the sole intention of many who drink, in particular our younger citizens.

The second major impact on the issue is this; with the advent of and predominance of pub-chain conglomerates within the licensed trade, provision of alcoholic beverages has become a major commercial concern. It is no longer the ‘cottage industry’ it once was, the halcyon days when pubs were the hub of our communities and also, the actual home of the majority of licensees and their families. And all that before we even start to consider the impacts of loss-leader booze sales in our supermarkets.

The final negative impact is this; for several decades we have seen a decline in any realistic proactive enforcement of our licensing laws. Add to that a (mostly) ineffective reactive response to today’s anti-social behavior, resulting from the after effects of too much alcohol, and we have some serious problems. Issues which then have a profoundly negative impact upon crime statistics and our health services.

It’s unlikely there will be a sea-change in any of these factors overnight, despite what politicians may think or desire. Although MUP may seem a sensible measure at face value, it is a facile and inadequate solution. It is also unlikely to ever result in the aims it is designed to achieve.

The price of booze isn’t the problem here, or the route cause of the issues we face. It’s the predominant public perception of the rights and wrongs of getting off your head, that and a devil-may-care attitude to the impacts of the aftermath on others.

There is no singular ‘quick fix’ for the ‘Booze Britain’ problems we now face, MUP certainly isn’t the magic key. Any return to the erstwhile era of simply enjoying a night out, without all the negative impacts, is likely to take a generation or more to fix!

Emergency Services Call Handling: priority conflicts and poor investment

Emergency Services 2

Emergency Services

With all the advances in telecommunications and call centre technology, it’s suggested that we all get a far better service from our Emergency Services today but do we? Process is now supposedly based upon actual as opposed to perceived need. But who or what decides about the priority of the initial request for service?

Many senior managers within our emergency services say; incident grading and medical triage, now usually at point of contact (i.e. via telephone) is the way forward. It’s considered the best way in which to manage our expensive and limited public resources effectively.

Two-tier priority system to be introduced - Calls to the emergency services requesting an ambulance are to be prioritised for the first time in an attempt to save lives, it was announced yesterday…(independent.co.uk)

But often the priorities in call-handling process has more to do with cost than it has to do with saving lives, or even the quality of service delivery; today cold hard cash is the driver, that and the self-promotion of those responsible for the management of the process.

Obviously cost implications are always important, now more so than ever before however; is it right to penny pinch at the front end of our emergency services whilst gallons of cash still disappears down the plughole of incompetent administration and bureaucracy on a daily basis?

The modern-day prevailing analogy, ”you can train a monkey to answer a phone” is used too often and is actually flawed, in so many ways. It’s not working and the correct balance of human and technical resources are out of kilter with each other. In addition to that variable, too little consideration is being given to the recruitment process, correct levels of training and subsequent retention of suitably motivated and skilled individuals to perform the call-handling task.

Hundreds of thousands of phone calls to the new police non-emergency 101 number are going unanswered, figures from forces in England and Wales suggest…(bbc.co.uk)

Having devoted a large part of the latter years of my police career to the command and control aspect of policing, I’m well versed in the call handling process, the incident logging systems and the technicalities of computer aided dispatch within the emergency services. Much of the so-called ‘news’ on the subject is generally seen by the media as just another police/government bashing opportunity. The chance to make another story of ‘concern’ under yet another emotive and/or shocking headline.

While the government insists that crime is falling, despite the significant cuts to the police service, the high volume of unanswered calls suggests that many offences may be going unrecorded…(Steve White – Police Federation)

The impact upon the quality of service currently delivered is hardly considered in reality. Despite the much hailed removal of government performance targets in policing, the service we get from our police (and other emergency services) is more about figures and percentages, rather than people. And don’t forget, when it transpires the organisation is lacking in some way, that factor is usually disguised with some cleverly manipulated statistics or PR hype.

Staff numbers have been (and are still being) cut at alarming rates, despite increases in workload and public demand. Individual knowledge, experience and skills have been hemorrhaging through the arteries of redundancy for some time now and training is either poor or almost non-existent in many areas.

We’re at the point whereby our emergency services rely almost solely upon the technical aspects of the call handling process and fail to devote sufficient time and effort into the human resources variable. Simply providing call-handlers with scripts to work from, along with masses of database information and instructions to query, may help hit call answering targets however; it doesn’t actually bode well for ‘efficient’ call-handling in the future and it certainly doesn’t have much impact on the service delivered after the call answering target has been achieved..

We should all be mindful that the vast majority of police call handling centres are actually achieving the targets they have been set; 96% of all calls to 101 answered within target (eg 30 secs). That ain’t bad going under anyones standards. 

But today, mostly due to national austerity measures, many public sector processes are now all about doing things on the cheap. Yes the cost is and always has been important factor but quality of a product and good service doesn’t usually come cheap!

What we all need to decide is; are we happy to allow our emergency services (mostly because of political interference, self-interested management and past waste) to continue delivering lower levels of inferior service?

Given our financial investment, via our personal taxes for those services, I would like to think not. I know I expect better, don’t you?

Follow

Get every new post delivered to your Inbox.

Join 784 other followers