Government’s ‘payment-by-results’ drug treatment pilots questioned

Government’s ‘payment-by-results’ drug treatment pilots questioned Government’s ‘payment-by-results’ drug treatment pilots questioned

Government plans to pilot payment-by-results schemes to treat drug users will create “enormous practical challenges” and could waste public money, experts warned today. The UK Drug Policy Commission (UKDPC) said the proposed projects for drug users were “the most ambitious and complex” in Whitehall and “may not deliver the benefits expected”. “Public funds may be wasted and treatment denied to vulnerable people in need of care” unless the changes are introduced carefully based on evidence, the independent body said. Changes could also be brought in before their consequences are fully understood, the needs of each addict will vary and the problems will be compounded by the introduction of other radical health service reforms, budget cuts and the introduction of elected police commissioners, it said. In the Government’s white paper on drugs last December, six pilot schemes were announced which will be used to “incentivise recovery and drive success”, with the amount paid to those providing treatment for drug users dependent upon their success. The pilot schemes, to be set up this year, will cut bureaucracy and create a single system that would redirect funding “away from bureaucratic processing and into the recovery support that individuals need”, the Government said. But Alan Maynard, professor of health economics at York University and a UKDPC commissioner, warned “the devil will be in the detail”. “We support the principle of linking funding to the achievement of results,” he said. “But the devil will be in the detail about what results are realistically achievable and measurable and what the unintended consequences might be.” In considering the outcomes of four different areas – crime, employment, drug use and wellbeing – “there will be enormous practical challenges for those delivering services and for the management of the system”, the UKDPC said. Prof Maynard went on: “We urge caution in how it’s put into practice and the careful evaluation of the proposed pilot schemes is essential. “Recovery from drug problems can be hugely complex, with users often needing services in healthcare, housing, social services, skills training, and employment. “To get the system right takes a lot of work, and the changes will need to be introduced carefully, using the evidence from the pilots to shape the wider system.” A Department of Health spokesman said: “We welcome the UK Drug Policy Commission’s support for our approach of piloting payment by results for drug recovery and evaluating the pilots before they are rolled out more widely. “We also welcome the UK Drug Policy Commission’s support for the principle of linking funding to the achievement of results and grateful for the UKDPC’s involvement in the expert group which will oversee this work.”