Tubby or not tubby: that is the question
The Patients’ Association was up in arms this week because the National Institute of Health and Clinical Excellence (NICE) gave the green light to offering material reward for compliance with drug addiction treatment - known as contingency management. NICE have come under fire from patient groups, including the Patients' Association, over decisions not to recommend the prescribing of certain drugs for breast cancer and Alzheimer’s. However, the Patients' Association expressed its dismay by attacking those with drug problems as having brought it on themselves, a product of their own lifestyle choices.
But imagine how much more angry they would be if NICE announced that there would be no more free treatment on the NHS for those whose health problems were brought about by alcohol, smoking and in particular obesity. A recent report by the Foods Standards Agency discovered that obesity was as likely to be found in middle-class families as those on low incomes. And a government-commissioned report leaked to the Observer (29th July) revealed government’s three-year target to reduce unhealthy eating was pie in the sky and that the NHS “will have to spend billions more pounds every year on treating patients with obesity-related illnesses”. Let he or she who is without sin cast the first doughnut.
DoH!
Question 34 in the government drug strategy consultation document asks, how can we improve the effectiveness of specialist drug treatment services…? Well, for starters how about not cutting £50m over three years from the pooled treatment budget as revealed in the Sunday Telegraph? (29th July).
Harry Shapiro
2 comments:
I think this post totally ignores the huge ethical concerns that contingency managemnt raises for the vast majority of professionals working in the drugs treatment field.
Financially rewarding clients to access treatment services will detract from the therapeutic processes offered and penalise those that refuse (on moral grounds) to toe this line.
Services that offer these financial rewards will no doubt tick the boxes of "new starts" and "retention in treatment" (get to 12 weeks and we'll give you fifty quid!), thus reducing drugs treatment's actual effectiveness in changing people's lives for the better even further into meaningless beurocracy.
I am astonished that rather than question this Druglink's attitude is to attack anyone that even questions this awful policy.
As the author of the blog, I entirely agree that there are significant questions to ask about the ethics of contingency management, especially if it just a means of ticking the right boxes.
The blog was simply to point out that if we start prioritising healthcare (however defined)on the basis of 'deserving' and 'undeserving', then we would have to cast the net very wide indeed.
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