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I’ve been afforded a window into a few recovery providers practices via discussions with some workers I’ve come to know through my own recovery. The running theme seems to be a focus on service user retention at any cost, which often can be invariably at the cost of the service user.
This seems to be driven by the tender for contracts (to provide services) system, where providers bid for the said contract at regular intervals.
Now competition should ensure better quality services but the criteria for winning the contracts seems to be focused on finances (how cheap they can provide a service) and not on quality. To prove your worth as a provider, numbers accessing your service seems to count first and foremost.
Obviously prescribing services such as the CDT have historically held the reigns of power and have done so well. With an almost automatic right to receive the contract to provide services,they have become a complacent, lazy service. Regurgitating methadone prescriptions with surprising inefficiency.
Yet now we’re recovery focused and this emphasis changes things or does it? For services are still working against each other, and are protecting their interests at all costs (usually at the cost of the service user)
The fact is that, in our vulnerability as service users, we ignorantly accept the poor quality of service provided (particularly via the CDT) due to the acceptance of our worthlessness (an opinion often reinforced by the said service provider).
But there’s a saying about the worm turning and service users are beginning to realise that there is a duty of care. That they deserve respect and quality of service. It would serve service providers well to remember that without the service users they would have no job.
There are good workers out there, and I’m not making a personal attack on workers per se. I’m making the point that the service providers that they work for are restricting their effectiveness due to their focus on client retention and it appears that the service providers have little consideration for their clients welfare.
A good point very well made Tony. Having received treatment for various things in the last 42 years, as have most of us, I can honestly say that treatment centres are amongst the most depressing and badly maintained spaces I have ever been in.
This lack of care of the environment seems to reflect a lack of care for the user. We often joke that all that is needed is a sign that says ‘Abandon hope all ye who enter here’.
In Streatham, where I used to live, there is a building that used to make us laugh when we walked past it. In true Victorian style its name was carved on the outside – ‘Hospital for the Incurables’. Perhaps things haven’t changed that much!
This is why I always ask people to ask themselves – would you use the services you commission or you provide? If the answer is no what are you going to do about it?
Pucker blog to digest across the country, at one time providers down my way was paid by the local govermant using block contracts, this meant individuals were allocated a service deemed suitable to meet their needs.
In time there was a general agreement across the political parties that this system was failing to meet every ones needs or desires and there was a need to find another way.
One suggestion was a personalised social care system that would be tailored to meet individual requiremnts. This idea complimented the national agenda for recovery oriented care and reducing social exclusion.
Down my way this is slowly yet surley being put into place with the NHS Parnership Trust.With new service users being assessed and pucker care plans being put into place. This is both with CMHT,s and DAT,s.
Yet has only just been implemented and they are learning the pit falls that are coming up for individuals, however it is positive that it has been implemented. A postive move forward in the right direction for providing the approperiate service and support for us service users.
Pucker for you to blog and the issues.
Tony,
I 100% agree with you. I’d like to say a lot more than that about services competing against each-other but think that it is probably best not to in such a public arena.
Suffice to say that I have seen evidence of service users, recoverees and volunteers suffering from being the “piggies in the middle”. With different services wanting to claim “ownership”, rather than promoting choice & partnership working.
I’ve probably said too much already, so I’ll leave it there
Matt
Important points all round and something that I would love to have answers too! Mark’s question is an important one to be asked consistently. I guess a lot of this comes from the system of competition and number games. We were talking about this this week – what is a ‘success’? And what about measuring the numbers of people who no longer need to access services because thir recovery is supported in the community?
