Blog Entry: 2012-05-08 @ 13:36:49

Equality and access to opportunity are vital to the individual as well as the community. At Kaleidoscope we want the best people working for us, so to discriminate on the grounds of gender, race, religion or sexual orientation would mean we rule out large sections of the community who could do a good job for us. If you run a business you want the biggest pool of people to choose from, so you have an interest in a meritocracy. You do not want only people born into certain affluent families to be the only people able to do a job because everyone else did not have access to quality education. We do not want by default an apartheid system where only a very small part of our community is given the chance to succeed.

The broad political ideas of fairness and equality are vital but at the same time we also have to be honest about the world we live in if we are to deal with the many disadvantages people face.

In our society we often fail to look at the cause of a problem and simply deal with the symptoms. At the weekend the Daily Telegraph published an interesting article about the diagnosis of children who were labelled as having special needs. http://www.telegraph.co.uk/education/educationnews/9246067/Special-needs-used-as-a-cover-for-poor-parenting.html

It is very easy to label a child but often this is a means of avoiding what is happening in the family or the school they are getting support from. The diagnosis often leads to a medical solution, so attention deficit disorder is supported by a Ritalin prescription. In some cases this can be with deadly consequences http://www.ritalindeath.com/; for others it leads to a path of being dependent on either prescription drugs or their own choice of illegal drugs.

In failing to look at the underlying reasons for a problem we let the child down, we provide a reason for why they are not doing well as a medical one rather than one of poor parenting or poor educational support. In this way we are not being fair to the child and by denying opportunities to them are not being fair to society who well may be losing people with outstanding talent.

Gender politics are also an important issue. http://blogs.lse.ac.uk/politicsandpolicy/2011/09/01/online-gender-imbalance-political-exclusion/. In the article it is stated “The gender balance in UK politics is one of the most unbalanced in Europe, as only 22 per cent of candidates standing for Parliament in the last general election were female. New research by the Hansard Society on gender and digital politics has looked at the gender difference in online political discussion and debates, and here Andy Williamson examines the findings of the research, concluding that a more conversational, collaborative and less combative model of politics is really what is needed.

On Thursday I was delighted to see Debby Blakebrough winning her battle to become a County Councillor for Monmouthshire. As a Council 70% of councillors are men, so at least on gender issues alone she is making a difference.

Women in politics, as in the board rooms of our leading companies, are seriously under-represented. The reality therefore is we are missing out on a pool of talented people who could take our country forward, and in these tough economic times we cannot afford to do this.

In addiction terms however we are not equal. Men can eat and drink more because of a higher metabolic rate. Therefore when it comes to drugs such as alcohol women must be careful not to believe drinking at the rate as their male counterparts is a good idea.

In a Wired in to Recovery email sent on 6^th May the issue of women and alcohol is explored. In the article Dr Martin Phillips, a consultant gastroenterologist for Spire Norwich Hospital and the Norfolk and Norwich University Hospital, says that 15 years it was extremely rare to see young women with alcohol-related liver damage but it is now more common, and the youngest patient he has treated for the condition was just 19.

He said, “It’s a common misconception that women can ‘handle’ their alcohol intake just as well as men. That may date back to the ‘ladette’ culture we created in the 1990s. However, it’s simply not true: a woman’s liver cannot break down alcohol as quickly as a man’s – this is a biological fact.”

As we strive for greater equality we must not lose sight of difference. Sometimes that difference can be a disadvantage to the person. If we look at athletics men and women sprinters cannot directly compete because of physical difference. In the same way, in horse riding women are often at an advantage having a naturally lower body weight.

In society we do not want a mono culture where everybody tries to conform and be the same. We want to celebrate difference and nurture the talent that comes from that difference.

We may have manufactured pop but it is always more exciting to hear an artist who simply seems to come from another world.

Blog Entry: 2012-03-26 @ 10:12:22

I have often argued for minimum pricing for alcohol. Recently I was with a liver expert who spoke of the increase of liver disease amongst the population and especially younger people. On 22^nd March NHS research showed a 25% increase in liver disease over the past decade. The link with alcohol is clearly identified as the primary cause of this increased problem. The BBC website on the issue http://www.bbc.co.uk/news/health-17465403 states “figures published last December showed a 60% rise in alcoholic liver disease in young people over seven years”.

The argument against minimum pricing is that by itself it will not solve the issue for problem drinkers. The alcohol industry says the problem on our streets is caused by binge drinking which is a unique cultural issue in the UK. However many people drinking problematically are from relatively wealthy backgrounds and the unit pricing is not targeted on their wine and spirit drinking. In effect the argument is that this is a tax yet again on the poor who cannot afford higher priced products.

It is important not to claim that on its own minimum pricing can solve alcohol problems in the UK. I would argue for a significant reduction in advertising of alcohol products, that University Unions sponsoring drinking among young students should be reviewed and research regarding the new licensing laws needs to be put in place.

The evidence however is that minimum pricing does make a difference. Pre-loading of drinks before going out is common as people buy discounted drinks from supermarkets. These discounts that supermarkets promote can only come through higher prices on essential products such as food. The unit pricing does not impact pubs because their pricing would be higher than the minimum price set at 40p a unit.

The unit pricing should also mean that the drinks industry starts focusing on products with lower alcohol content. If we look at wine, beer and spirits there has been a tendency to increase the alcohol content, pricing should reverse this. So if you want a glass of wine, instead of 13% it may be commercially better to return to 11% with the drink still of a good standard in terms of flavour. The idea that beer in a supermarket is cheaper than pop clearly sends out the wrong message.

In many of our cities in Wales we see terrible scenes in our streets of drunkenness. In Swansea the “dentist’s chair” is advertised on a huge billboard. It is clearly an unhealthy position to link having a good time with drinking. David Cameron must therefore be right to say this issue must be tackled. The Independent quotes David Cameron “Binge drinking isn’t some fringe issue, it accounts for half of all alcohol consumed in this country. The crime and violence it causes drains resources in our hospitals, generates mayhem on our streets and spreads fear in our communities.  My message is simple. We can't go on like this. We have to tackle the scourge of violence caused by binge drinking. And we have to do it now.” http://www.independent.co.uk/news/uk/politics/new-minimum-alcohol-price-to-be-introduced-to-combat-binge-drinking-7582346.html

The minimum pricing proposal will not bring an end to alcoholism, although it may have an impact. What drives addiction is a desire to change one’s reality often chemically. It is my view that we cannot solve tackle alcoholism or drug misuse through government legislation but should address the key issues as to why people need to alter their reality.

The need for minimum pricing has been championed by the Welsh Government, so it is good the UK parliament has caught up. The need for this move cannot be underestimated as the conclusion of the lead Guardian article on 23^rd March demonstrates:

“Academics at the University of Sheffield, who have led research on the issue, estimate a minimum price of 45p a unit coupled with an off-trade discount ban already in place would reduce annual hospital admissions by 1,660 in the first year, rising to 6,630 a year after a decade, and cut the number of deaths by 60 in the first year, rising to 300 by year 10 of the policy” http://www.guardian.co.uk/society/2012/mar/23/coalition-minimum-alcohol-price-40p

Blog Entry: 2012-02-13 @ 15:09:11

The tragic death of Whitney Houston, so soon after that of Amy Winehouse leaves many people with the question ‘Why?’

Often people associate drug deaths with people in the inner city, with no money, few prospects and appalling family backgrounds. As with any stereotypes there are of course people who fit that narrow understanding. Yet the use of drugs and alcohol to the point of death is not reserved for a small group in our society. Damaging drug and alcohol use affects all sections of society and, this being the case, we have the challenge of understanding why.

One of the key debates to emerge is ‘what is the cause of problematic drug or alcohol use’? There are lots of theories although they tend to centre on the debate of whether it is a disease caused by some genetic flaw or whether it is linked to a person’s history, to their environment or to the way they were nurtured. This of course matters if we are trying to find ways of helping people rebuild lives and avoid tragic deaths such as Whitney’s.

The task for agencies such as Kaleidoscope is to use the best evidence available to support people in making changes in their lives. In treatment that means we keep an open mind as to what helps a person and we should not be fundamentalists in our approach. The simple reason for this is that there is no evidence that what we do brings guaranteed results; all we can show is that some methods seem to work better than others. There is little doubt Whitney had access to the best therapists, counsellors, treatments and rehabilitation centres that money could buy.

The government foolishly believes there is a cure for drug problems and is contracting agencies on a payment by results basis. The reality is that for some people we will not find the answers to their addictions. One reason is that the problems they face are much greater than the substances they sometimes take. Kaleidoscope has a hostel for people who struggle with mental health issues and in essence self medicate through drug and alcohol use. The task is to help people make changes, and often we do see significant improvements but we do not have all the skills to address the problems they struggle with. In the same way with drug taking and deprivation, we can try and signpost people to better job opportunities and housing but in the present economic situation it is very difficult for people who have a blank CV and left school with few qualifications.

The foolishness of a payment by results system is that there will be people who drug workers know may only make limited or no real changes to their lives. If there are financial incentives drug workers may pick people for treatment who benefit the agency by getting the results being promised to commissioners. The consequence of the payment by results system could be that the most vulnerable and those with difficult personal issues are forgotten in the treatment world.

Whitney Houston died, it would seem, from drug and alcohol related issues. She had many people who admired her voice, it would seem she had a supportive family and still a life of possibilities with a film due for release later this year. What we may never know was what her personal pain was and even more importantly how that inner hurt could have been healed. Sadly the truth is there are many less well known people with such hurt and we still have not found a way to help people either deal with the pain or, ideally, find recovery from it.

As a drug agency Kaleidoscope must continue to be committed to people coming to our centres and whenever possible give them a chance to leave chaotic drug use behind them; but for those who do not respond to our treatment system compassion and help personalised to their needs must still be given.

Blog Entry: 2012-02-02 @ 14:10:02

Birdsong is one of those novels that simply stays with you. It has two powerful elements, a passionate love and, through war, the hopelessness of life. The love the central character has for a young French married woman is in many ways the only thing that gives this young man something to hope for while he suffers in the trenches.

War, particularly the 1^st World War, is the most horrifying event in British history. People are forced to fight, often at gunpoint from their own side. A war managed by generals who only achieve high rank through birth and not any skill. A war that for the men and women involved had no real meaning.

It is often the case that those who lead us to the brink of a war have little feeling for those they ask to fight or for those who will be the victims of their orders. And in many ways we see victims of a senseless world in our work.

As I review Kaleidoscope’s history I sometimes see the dead from a war on drugs. The politicians continue to prosecute innocent people for self medication. The drug is blamed rather than the reasons for people taking the substance. The death of so many is because they suffered further pain through imprisonment, the secrecy of their problem led them to share equipment, the struggle for drugs led them to poor diets and further oblivion through alcohol.

We however are no longer pursuing a full scale war although it is apparent with people such as Ann Widdecombe that there are those who want to revive a war but with a lot more vigour. She wants young people to be criminalised for personal use of cannabis oblivious to the cost of that young person’s future.

The war in the UK causes significant problems in our inner cities and still leads people to be incarcerated. However it is the effect of this war overseas that is so painful to view. On Sunday the papers had pictures from Mexico showing a line of dead bodies, the latest victims in the war on drugs. Mexico is being torn apart by drugs and the country is in the grips of a civil war. Of course there are no easy solutions but let us not forget that illegal drugs fund criminal gangs with so much money they often have more power than governments. Looking at how we deal with drugs globally is not giving in to terrorism or thuggery. It is about looking for solutions where people can be human once more.

Birdsong is a powerful tale because we see war de-humanises people. Yet we also see the desire for people to love, and live a life where the simple aspects of life are treasured. It is not about big governments controlling us but treasuring those we most care for. When I look at the war of drugs I do see the destruction to people’s lives but the people we see often overcome being victims by being given respect and the chance to live a life where love and the simple things we often take for granted are possible.

Blog Entry: 2012-01-03 @ 14:47:37

The News on the first day back for many of us, January 3^rd is that the social care system is not working properly.  One of the key issues is how health and local authorities work together. One fears that the recent changes to health can only make the situation worst.

The big problem of health reforms is its abandonment of the principle of local authorities working seamlessly with health. To move GPs further back in the delivery of health care is a retrospective step both from a democratically accountable perspective but also understanding that health and social care are two sides of the same coin.

Alfriston is a unique service funded by Kingston local authority which I believe is key in the support of elderly people. The Centre provides a community hub, where people can access services such as a chiropodist, a hairdresser, balance classes, IT and it is a place to meet friends over lunch with a spot of entertainment. The classic criticism of such pieces of work is that it takes away people's independence and the use of a range of services where they can mix with other people of varying ages.

The theory of independence is one of the recent mantras of Government. Why, however, are we obsessed by it?  The answer in part is because we worry about creating dependency. Yet I think we are at our best when we are dependent on others.

Alfriston provides a range of services to many older people who are struggling at home because of health issues or are finding themselves isolated as their friends or partners have died and they do not have the regular routine of work. Creating a community place for the elderly means they can share with each other and out of that sense of community can plan for their own future. Many go on holiday either supported by the centre or through the friendships they make, they go to the theatre or on a day out to the country on the same basis. The centre works because it fosters that key sense of inter-dependence.

Experts in the field are now seeing the problem for the elderly is that of being lonely, isolated and at risk. The numbers of elderly grow but because of budget cuts to social care the threshold to getting support has risen. There is a need to think differently and what Alfriston Centre does is to create a cost effective service made so by those who can help others doing so but at the same time having their needs met by the social interaction.

In providing a centre for people you can set up advice services for debts, you can advise people as to their entitlements and you can see where abuse is happening. The centre is looking also to develop an outreach befriending services again primarily through volunteers but supporting the vulnerable. The centre today is in contact with over 700 people and each day is full to capacity. The centre allows people to leave hospitals earlier and delays the need for nursing homes. The real savings are remarkable for a service that costs the Local Authority approximately £60,000. Yet this service is unique because the responsibility for our clients does not meet the higher thresholds for access to care. The deterioration in a person’s mental health, or bed blocking is an NHS issue, but they do not fund centres such as Alfriston and so the rarity of such a provision.