|"Helping the practitioners ..."|
Currently (May 2013) I am:
Just wondering about the coincidence of the All-Party Parliamentary Group on drugs and the ACMD meetings this month both being on the same day.
Disappointed but not surprised to see that the government is back-tracking on its previous commitments to alcohol minimum unit pricing - this in spite of the compelling results of Tim Stockwell's Canadian research - and the introduction of plain packaging for cigarettes and other tobacco products. Given the presence of alcohol and tobacco industry representatives on Department of Health working parties, it's even less of a surprise - and perhaps a 'surprise' which was already 'spoilt' in 2010 when Andrew Lansely set up the 'consultative' bodies. It seems to me that this is a further example of commercial gain superseding public health interests - and in this respect it was significant that the public health minister, Anna Soubry *, appeared to be fighting a rear-guard action when the indications of a U-turn on these policies became apparent. I'm also interested in the argument that minimum unit pricing will affect the pockets and purses of 'responsible' alcohol users.By my calculations, using a 50 pence per unit minimum price, a 330 ml. bottle of lager (not super-strength) would cost a minimum of 82.5 pence; a bottle of wine £ 5.25; and a bottle of whisky £ 15.75. I asssume (aha!) that the majority of 'responsible' drinkers choose quality drinks. I can't see how that pricing would increase the costs of 'responsible drinking' - and it's certainly more than pub prices. Yet another excuse, it seems to me. And I wonder when we'll first hear public arguments along the lines of how much longer will the irresponsible use of illegal drugs be used as a brush to tar all users, including those who use responsibly...? * I am reliably informed that Anna Soubry often travels home after work by bus, continuing to discuss policy matters with colleagues while at the bus stop..
I'm also disappointed, but once again not surprised, to see the many claims by government and ministers that sexual behaviour and attitudes still need to be changed, with various references to domestic violence, objectification of women, trivialising of sex and sexual behaviour, 'consent' and, spectacularly, the current spate of revelations of on-going sexual abuse by public figures. In the face of this hand-wringing, Michael Gove's Department for Education (education for what...?) maintains a steadfast refusal to countenance PSHE becoming a statutory teaching requirement in schools, and the proposed national curriculum science outline reduces the content which can be seen as contributing to sex and relationships education. There seems to be a failure (deliberate?) of those currently with the power - and responsibility - to do so to act on the need, and to undermine PSHE in general, sex and relationships education in particular. This is a characteristic of government, not parliament, where debate and consensus are reaching high levels of quality and informedness. In spite of this, the relevant minister and ministry refuse to act. This is a situation where some in government are requiring or expecting the ends while at the same time not providing or even obstructing the means. It would appear that staff at the Home Office and the Department of Health are increasingly frusrtaed by the lack of response of their DfE counterparts in such cross-departmental topics, aggravated by DfE failure to attend relevant cross-departmental meetings.
Still thinking through, and thinking on, my February trip to South Africa, both the country and the work I was doing there - presenting a workshop on monitoring and evaluation to the staff of a community development programme - The Thoughtful Path - in Munsieville Township, on the outskirts of Johannesburg. Professionally, it was an extremely positive experience, with plenty of involvement, questioning and discussion. And the learning and making extra sense of the in-puts was being acted on from Day Two (of three...) of the workshop. Personally, it was fascinating to have a glimpse of, to me, a new country and set of contexts. And what an opportunity - to visit a second country in tranisiton, Russia being the first, and to be able to do so with local insights and a great sense of purpose.
February 2013: Pleased to see that the recommendations of the ACMD working group on khat include retaining its status as a substance not classified under the Misuse of Drugs Act...and interested to see if the Home Secretay accepts this recommendation. I attended one of the evidence gathering sessions of the working party and noted the range of views brought to the working party's attention; and that these were often contradictory. It seems to me that the Council's recommendations are sensible and pragmatic - and they make a welcome change from the succession of 'ban it' recommendations the Council has recently made with regard to new psychoactive substances and/or their precursors.
Increasingly puzzled and angered by the lack of progress in the Government's and the Department of Education's supposed consideration and review of PSHE. While many Ministers make statements and comments about the desirability of certain attitudes and aptitudes amongst young people - 'what' - there has been a consistent refusal to make the link with the 'how' - ways in which many of these attitudes and aptitudes can be supported and strengthened through work in schools. I and many colleagues have long wondered why this Government has not accepted or adopted the findings and recommendations of the 2009 Macdonald review of PSHE - and indeed whether they are even aware of its existence. The knowledge of PSHE and drug education demonstrated by a DfE spokesperson at a Mentor seminar late last year was depressingly poor, and their attitude casual and almost dismissive.
Absorbing the information and implications of the November 2 ClubDrug Clinic seminar at Chelsea and Westminster hospital; and yesterday's DrugScope Conference 'A question of balance.' Both detailed the selection of new substances and changes in 'drugs of choice' now emerging, which confirm the shift away from sedative to stimulant drug use amongst some drug using populations. Official responses are mixed: the ACMD seems to be concentrating on identifying and then banning both new psychoactive substances and legal highs when they are deemed illegal, whereas bodies like ClubDrug Clinic are working on a cross-disciplinary and cross-sector (statutory and voluntary) response to the emergence of new using patterns - and populations - and their needs. This includes providing an amalgam of drug and sexual health service, background and in-put, which is relevant and appealing to a very specific population. The responsiveness of the NHS, London Friend and Antidote seems to me to be a model of good practice. At the DrugScope conference it was heartening to hear Roger Howard of the UK Drug Policy Commission making the link from the drugs field to the established findings of social epidemiologists and others, including Richard Wilkinson, Kate Pickett and Michael Marmot, of the strong - causal? - links between income inequality within a country and the 'health' of that country and population - size of the prison population, prevalence of mental health problems, rates of inter-personal - including domestic and sexual - violence, levels of problematic substance use. Good to see the drugs field starting to make the connection, which has implications for how 'up-stream' policy responses need to be, even if a little belated...
And congratulations to Denmark's BrugerForening (Danish Drug Users Union) which celebrated its 19th. birthday on November 1. at an event attended by MPs and a Minister, amongst others, and whose BrugerVen (Users' Friend) award for 2012 went to Fixerlance, the NGO who pioneered the mobile consumption room in Copenhagen which has lead to Danish law permitting (since June 2012) the establishment of consumption rooms in Denmark. See my DrugLink articles for more...
March 2012: Saddened and disappointed by an exchange with a lecturer at the Institute of Education. I had been at a book launch - Stephen Ball's 'Global Education Inc.' - which described how much, globally, education (and other social policy) was in the hands of private (i.e profit-taking) organisations, dressed-up as 'philanthropic' or 'social enterprise' Foundations and Trusts. This is increasingly taking control of social policy away from governments and states and transforming them into clients and customers, 'buying' the policies and services being hawked by international organisations which, to me, seem to be a way of selling to national governments solutions to the social issues and needs which the same neo-liberal organisations have in large part been responsible for creating. Good business....one of the launch quotations was 'doing good by doing well' - i.e. providing solutions [to problems we have created or exacaberated] and making a profit from doing so. As if to demonstrate the power and prevalence of this thinking, I saw a former IoE lecturer after the launch, who told me that he was busy training schools who wanted to become centres of learning. When I expressed scepticism at the value of turning schools into teacher training institutions his response was that he was personally benefitting from it. Forget ethics and professionalism...
Digesting and reflecting on the the interviews and discussions from my five days in Copenhagen at the end of February. Thanks to the introductions and recommendations of Michael Jourdan **, I was able to set up five conversations and interviews with individuals and organisations active in the drugs policy field. The results were fascinating and informative, and all those I met were generous in their time and willingness to provide information and answer questions. The quotation I had found before my journey which provoked smiles and nods of assent - and of resignation - was that of the Norwegian criminologist Nils Christie: "The most dangerous use of drugs is the political." Now I have to distill my experiences and conclusions into 1500 words for an article to be published in DrugLink, probably in May. Yes, the furnishings and decor are as cool as the TV dramas suggest (The Killing and Borgen) - next time you're there have a look around Illums Bolighus... No, I didn't see Sarah Lund, in character or in real life. ** Michael Jourdan is the editor of the Danish journal Stof - it's about what it looks like - we met in 1999 (and have kept in touch since) when I was stopping off in Copenhagen on my way to Moscow for Project HOPE work and attended sessions of the Young People's sub-committee of Narkotika Råd - The Drugs Council - while it was still in existence. See DrugLink for more....!
February 2012: Taken aback by the extent of changes to education and health provision which the Conservative-led coalition has been introducing. I'm above all shocked at the thinly-disguised attacks on the public sector, especially education and health, and the accompanying dismissal and criticism of services and professionals, and their principles, skills and expertise. We were here before in the 1980s.... More specifically, I'm trying - not alone - to make sense of the responsibilities which free schools and academies will have for promoting and supporting young people's development - for implementing PSHE principles and programmes. And so far I am not encouraged or reassured.
The light relief for me will be a working trip to Denmark later this month to look at drugs policy, particularly around cannabis regulation and the provision of injecting rooms. These topics will be familiar to anyone who keeps up to date with postings on the Hungarian Civil Liberties Union's web-site. The arguments for both seem clear and well established - what I hope to discover more about is the extent to which a political consensus has been established and how far the necessary legislation has progressed. Watch out for my article in a summer issue of DrugLink. And for sub-titled TV fans, remember the references by the fictional Copenhagen politician Troels Hartmann in 'The Killing' to 'fixerums' - injecting rooms, mis-translated in the sub-titles as 'drug dens.' A case of fiction being very close to fact in this instance.
Surprised that it has taken me so long to return to this page to up-date it... My first thoughts this week (January 2011) reflect new colleagues and interests following my visit to the National Institute for Drug Prevention in Budapest in November. News this week suggests that the Hungarian government is reconsidering its approval of the previously established national drugs strategy, developed in co-operation with the EMCDDA and other international bodies using an evidence-based, scientific approach. This, it seems, is not to the liking of the new (2010) government. For both professional and personal reasons, I hope that this does not result in a retreat by a national government from evidence based drugs policy making: there's a worrying comparison to be drawn with governmental policy and attitudes in Russia. The strength and successes of evidence-based policies, including harm-reduction approaches, were well illustrated by Gerry Stimpson in November, when he gave the first Alison Chesney and Eddie Killoran Memorial Lecture at the London School of Hygiene and Tropical Medicine.
Along with many colleagues and organisations, I have been shocked by many of the public health and health promotion and education measures announced by the new UK government. Much of the progress and acceptance - and, crucially, funding - of PSHE and SRE which we were able to enjoy in the last years of the Labour governments has been called into question. Although the 'official' reason frequently given has been that there is no proof of the effectiveness and impact of those interventions and initiatives, it sems to me that it's not possible to make such judgements without having seen through and evaluated the interventions. This, then, says to me that the decisions have been made for ideological or whimsical reasons and not on any evidence-based judgement or assessment. It's especially strange given that so many of the interventions being questioned, closed down and un-funded have been those aimed at changing the situations from which Prime Minister Cameron made so much political capital in pre-election references to 'broken Britain.' Strange, then, that when in government existing work responding to some of the aspects of 'broken Britain' - for example, teenage pregnancy - are being closed down. There's a worrying parallel here with my Hungarian reference of the closing down of advisory and specialist bodies and organisations, using the camouflague of bureaucracy, resource saving, accountability and vested interests.
My own recent work has illustrated some of these tendencies. At the end of 2009 I had some direct personal experience of management styles and psychologies, both negative and positive. It was disappointing to reflect on the negative example, and to realise that for some managers (and Ministers?) it's the exercise of power that is the driver for their practice, not the quality or impact of the work for which they have a responsibility (why did you do that? because I can...) Like the closing down of advisory bodies by government, there's still in some quarters a conscious ignoring of evidence, experience and history. I've recently become interested in the concept and practice of work force development, seeing it initially as an interesting and effective way of adding to work-force skills and knowledge and changing professional cultures. My role as a tutor on the PSHE Certificate course for teachers for four years gave me some insights here, as did last year's involvement in the Liverpool John Moores University-led project to develop European Quality Standards for drug prevention. From these experiences, I've developed my view that work-force development needs to include those at the top of hierarchies - politicians and decision makers - as well as the practitioners who are those usually expected to take part in work force development and seen as being in need of it. Listening to an education Minister at Womankind Worldwide's November conference Freedom to Achieve reinforced my view - and, increasingly, experience - that those making the policy and strategy decisions, and the resultant demands on practitioners, often do not fully understand the issues they are responsible for. The Minister's committment to work combating violence against women and girls was clear and encouraging, his understanding limited and populist, poorly informed and simplistic.
The two relevant UK white papers for my area of work and interests - Healthy Lives Healthy People and The Importance of Teaching - both refer to PSHE and SRE, but with differing emphases. The DH white paper has more content about PSHE than the DfE, which suggests some differences of opinion and emphasis between the two Departments. It's noteworthy that the DfE white paper refers to consultations about SRE and gives a list of those to be included in any consultation - a list which omits young people. It's also intriguing that there appears to be no acknowledgement of the results of the reviews of PSHE, SRE and drug education which took place in 2009. This could give the impression that the present set of Ministers do not know of these reviews (unlikely) or that they are choosing to dismiss and disregard them because they were commissioned and carried out by a different government. So here's hoping that Chris Bryant MP's Ten-Minute Bill does get though parliament to make good some of the trade-offs in March - April 2010 which lost the clauses which would have made the provision of PSHE and SRE a statutory requirement for school and entitlement for pupils. I have on my shelves a book about UK attitudes to sex and relationships education called The Ostrich Position, which describes the current situation well. It was published in 1986...
November 2009: Seeing once again the conflict between knowledge and ideology being displayed by the sacking of David Nutt as Chair of the ACMD - not the first time I have referred to the ACMD here; and the instant, knee-jerk rejection by Government of the Robin Alexander report on primary education. So much for evidence-based practice - or am I being naive in believing that it ever meant anything...?
Pleased, nevertheless, to see that the recommendations that PSHE become a statutory part of the school curriculum have now been endorsed and acted on by governemnt - and noticing the back-lash from some organisations and voices which seem not to be aware of the real situations and needs of young people and want to deny them knowledge and opportunities to openly discuss sex and drugs. Duh. Perhaps deny and denial are the key words here.... So congratulations Ed Balls, you have got something right. As for the opposition voices: people like myself need to recognise that these views will always be present and that we need to be prepared to counter them, however tempting it is to wish that the debate might have moved on in the last twenty five years. My objection remains that such voices claim to speak for others and all when this is clearly not the case. I have been struck by recent meetings with parents in Tower Hamlets schools where individuals have expressed their opposition to sex and relationships education saying 'we' and have been challenged by others present, saying that the views being expressed are those of the individual concerned and do not represent everyone at the meeting.
I'm buzzing after my first (October) trip to Samara - at the evidence of good practice in schools and sexual health services, at the interest of professionals in developments in the UK, at the concern for scientific (i.e. evidence-based) programmes, at the willingness to listen and learn - in contrast to the suddenly changed climate in the London local authority I have been working with for some years - and the invitation to do some work with the social sciences department at the university. And at the high-level of skill and ability in translation and interpretation, which enabled some warm and in-depth interactive working during the seminar proceedings.
April 2009: Drawing breath after a busy nine months personally and professionally, and coming to terms with new hard and soft ware following a major IT failure in October 2008. Much has happened but some of it seems to be the same old same old...
The damage which can be caused by alcohol is being increasingly recognised and acknowledged, but the actions open to government, particularly around pricing, have been shied away from. Evidence based policy...?
The advice of the ACMD has again been dismissed by government, this time on the classification of ecstasy. The new characteristic of this dismissal was the public dressing-down by the Home Secretary of the ACMD Chair's legitimate and statistically justified observation comparing the fatalities associated with ecstasy use and those associated with horse-riding. Evidence based policy...?
The 'big' news in the education and schools sector is the decision announed last October that sex and relationships education and drug education will become statutory requirements in schools' teaching programmes - in September 2011.
I am maintaining my professional contacts with colleagues in Russia, and have began preparing for a locally-funded project in Samara local authority to plan and implement a programme of sex and relationships education in schools there. This promises to be an exciting and rewarding challenge. My first visit is arranged for September 2009.
I am enjoying the widening of perspectives and need for work discipline and good time-management presented by peer reviewing of articles and book reviewing. The worth-while books are expensive for a private practitioner - long live libraries.
Especially in the light of the 'credit crunch' and what I see as the failure of the Anglo-Saxon economic model, I am frustrated by the apparent lack of recognition by the Gordon Brown's of this world of the findings of the social edidemiologits, most recently in Wilkinson and Pickett's book 'The spirit level.' Once again, it would seem, ideology is trumping evidence, and in a particularly damaging and careless way.
interested to read the revived publicity being given to academies and what would appear to be misrepresentative and misinformed claims for their success by government - but no longer surprised to see evidence again being trumped by ideology and 'conviction.' This observation remains constant, in 2008 when first written and in 2009 when re-visited.
experiencing a sense of schadenfreude on reading of the growth in inequality under New Labour, a process I hasten to add that did not start in 1997 but has been an inevitable result of the macro-economic policies pursued by successive governments for the past thirty years. So much for the Anglo-Saxon models - of economic and cultural and social policies.
disappointed but not surprised that the Government has not accepted the ACMD's recommendation that cannabis remains a Class C substance. And struck by the Home Secretary's comments about the linkage between cannabis use and mental health - as if the ACMD had not taken this aspect of cannabis use into account in its evidence collection and decision making. So much for evidence based policy...
interested to note that in his twenty-minute presentation at the Drugs and Alcohol Today event in London on May 1 Vernon Coaker referred to drug use and to substance use but did not specifically mention alcohol. In reply to a comment from the floor he claimed that his brief did not specifiy alcohol - a somewhat faux-naif response in the light of his Home Office responsibilities, which include, we were told when he was introduced, 'drug and alcohol misuse.' Once again: so much for evidence based policy...
following the autumn and spring discussions on the reclassification (or not) of cannabis and the role of the ACMD with a mixture of interest, amusement, disbelief, puzzlement and disappointment - the latter at the lack of honesty and knowledge of some contributions. At least I'm getting value for money when I buy a newspaper ( I'm very old-tech - newspaper, buying ....) or switch on the TV
educationally, recognising from my experience, past and present, the numbers of reports and survey results which suggest that in the UK education is not, at present, a force for social change or advancement; and that educational achievement remains largely determined by an individual's class (i.e. socio-economic) origins and family background
aware of the growing ease with which alcohol can be obtained - also when most shops are shut. Home delivery services are becoming established, as they have been for some time in Spain. 'Availability' is the name of the game, it seems, for legal and illegal substances.
relishing a holiday (August 2007) conversation with Danish colleagues in a car park in Torshavn, the capital of the Faeroes, about drug and alcohol use and the Danish Center for Rusmiddelforskning based at Aarhus university. The car park was that of a car rental company, none of whose cars were locked, the conversation passed the time waiting for the office to be opened on a Sunday...
continuing to extend my understanding of the role of national income distribution as one cause of poor individual and social 'health' - with acknowledgements to Richard Wilkinson. This has been heightned by the August 2007 media stories about City bonuses and executive pay - disproportianately higher than in Germany, lower than in the US - and its ratio to average pay in those companies.
pleased to see that the July government teenage pregnancy stats., which include 2005 figures, indicate that the reduction in conceptions amongst under 17s resident in Tower Hamlets, where, with local authority colleagues,I am working with schools and parents on the provision of sex and relationships education for 5 to 16 year olds, has continued. Were I a politician I would claim that the Teenage Pregnancy Strategy is working. As a reflective practitioner, I am more cautious - but definitely encouraged.
enjoying the memories of a June break in Florence, where I realised that the UNICEF research centre which publishes the Innocenti reports is based in a former hospice for foundlings - hence the name.
interested to read the Lancet article (June 15) reporting on the high incidence of alcohol-related deaths in Izhevsk, Russia, a city which I visited in December 2006 and where the public health statistical over-view reported 'poisoning' as a major cause of death.
contributing to the end-of-Blair evaluation with a four-liner in the Guardian (May 14): 'Mr Blair believes "this is the greatest nation on earth." Did he read the UNICEF report "Child Poverty in Perspective" published earlier this year?'
continuing discussions with colleagues on the future of drug education following the publication of UK government and NGO reports which have questioned the role and impact of drug education as a prevention tool
working on a lower secondary school drug education project in S London, with the lesson piloting now completed. 'Back to the drawing board' for a final version of the lessons before materials are prepared and made available to schools and a training programme for staff intorduced.
revising an article comparing drug education and sex education - and seeking a publisher or editor
with colleagues from the Healthy Schools Team, planning for the next PSHE CPD programme in Tower Hamlets, using our experience from the first three years
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