The Vision Project

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A PERFECT STORM. Sadly, since 2010, England has systematically disinvested in harm reduction. The political firestorm debate of 2008 saw the abstinence model of intervention win out over harm reduction. The Government’s new drug policy in 2010 saw a political shift away from harm reduction. This occurred at the same time as a move in the commissioning responsibility for drug services from the then primary care trusts to local authorities, just as the authorities ran out of money. The ring-fencing of funding for HIV, which supported drug services disappeared and harm reduction had to start competing for funding against a range of other worthy causes within public health. There is no doubt that many people have benefitted beyond their hopes from the opportunities delivered by the recovery model, but many people who use drugs are so much worse off. In the UK we are experiencing an increase in homelessness and drug related deaths which are greater than they have ever been. We have now also had the first major outbreak of HIV in our history, a fact which outside of Scotland hardly anyone knows or talks about. Many harm reduction services who traditionally provided a front door into treatment services and no less importantly a safety net for people who couldn’t manage the treatment options on offer, now provide little more than the distribution of injecting equipment. The systematic disinvestment in harm reduction in England has left many people alone, isolated and vulnerable, without skilled harm reduction workers to do what they always have. Engage, support and save lives. A recent exchange on social media described a triage discussion with a new client registering at a needle and syringe programme provided by a large national charity. This is a quote from the discussion; ‘whilst going through the triage paperwork to register he was asked his preference regarding administration of substances. He told the worker he was an IV user. The worker didn’t know what that was, so he expanded saying he was an intravenous user. The worker still didn’t know what that meant.’ Does this represent what happens in most drug services? Of course not, but it does happen and it absolutely should not. So many drug services now have staff covering the needle and syringe programme who do not have the required knowledge, skills or even in some cases the appropriate attitudes to engage with some of the most marginalised and vulnerable people in our society. In this environment, good quality harm reduction cannot happen and we have little hope of reducing or ending the harms and social isolation of drug users, until there is enough political will to develop a drug policy which truly reflects the value of human life. Naloxone (the opioid overdose reversal drug) is not the answer to saving the lives of people who use drugs, harm reduction is, of which naloxone is one important component. We must celebrate the commitment and compassion of those who work in our field and properly educate, train, mentor and support them. This doesn’t have to cost the earth, it’s not a financial issue, it’s a cultural one. In a world increasingly dominated by pharmacy provision of syringes, we appear to have forgotten how to like and respect people who use drugs. If we lack positive enthusiasm and optimism, what right do we have to expect this in others? Services must properly support our amazing colleagues to once again create the culture of acceptance and engagement, save more lives and improve the health of people who inject drugs. We need to reimagine how harm reduction can work in this austere climate and, yes, maybe this also means we need to rediscover a new style of activism to once again make a difference by keeping people who inject drugs alive and well. We must also engage with our communities in a way that encourages them to reframe their understanding of drugs and the people who use them. We have to challenge attitudes and break down the barriers which prevent society from feeling compassion, understanding and acceptance for people who make life choices that can carry risk. We accept people who make life choices that lead to heart disease, diabetes, respiratory disease and cancer, yet condemn people who inject drugs for ‘wasting precious health resources’ because of their life choices. This health inequality is perverse and is perpetuated by a political policy which continues to classify people who inject drugs as criminals, fails to support harm reduction and does nothing to challenge society’s perpetual exclusion of people with genuine health needs. In the absence of any political will to address this, our only hope is that the field can become activists once more and bring about the change we need. We did it before; we can do it again. 20 THE VISION PROJECT
CONSERVATIVE SOLUTIONS TO THE HOUSING CRISIS WRITTEN BY JACOB REES MOGG Jacob has been the MP for North East Somerset since 2010 and is the current Leader of the House of Commons and Lord President of the Council. It is an honour to be asked to write an article for DHI’s 20th anniversary. Its vision, to “end social exclusion by ensuring that everyone has their basic needs met and is able to thrive by contributing to the richness and wellbeing of their community” is laudable... Housing is an issue which I have long felt has not been given enough prominence and is particularly relevant to the debate on social exclusion. There are few things more socially excluding than being homeless. Currently in the UK we have a housing shortage. This affects a wide range of people in society but principally the young and the less well-off. Owning their own home is a distant dream for many but this should not be the case. On the contrary, it should be the norm, something that everyone can aspire to and achieve. There are so many advantages, security, sustainability and social benefits and there are also significant financial advantages. A study last year found that owning a home is cheaper than renting in every part of the UK. Unfortunately, the major hurdle of saving enough money for a deposit stands in the way. So how have we got to this situation where there are, quite simply, not enough houses to go round? On 3rd October 1980 the Conservative Government, under Prime Minister Margaret Thatcher, introduced the policy of ‘Right to Buy’, which, subject to certain conditions, allowed people living in council houses to purchase them at discount rates. This was an excellent policy. Enabling people to have the ability to improve their situation is at the heart of Conservatism. However, this policy turned social housing into private housing. This loss of social housing should have been fixed by building more. This is something that successive governments, Conservative, Labour and the Conservative / Lib Dem coalition, have failed to do. In addition, several new countries joined the EU, meaning that anyone from those countries could come to live in the UK. The result was that immigration jumped from an average of 30,000 per year to 300,000 per year. Now let us be clear. Immigrants provide an undoubted benefit to our country and to our economy. However, anyone coming to this country naturally needs somewhere to live. This means you need to build enough houses to accommodate the increase in population. This is something that, again, successive governments have failed to do. The current Government is finally addressing the problem. There is now significantly more house building taking place but it will be some time before we get close to resolving the issue. We need to keep building houses and we must not stop. It is worth noting at this point, that any house building helps everyone affected by the housing crisis. If a four-bedroom home is built, it is likely that the family who buys it will be upgrading from a three-bedroom home. This house will then be freed up for people upgrading from a two-bedroom home and so on. Nevertheless, it is important that a range of properties, including social housing, are provided when new housing is built. My preference is for houses with gardens. Studies have repeatedly shown that this is where people want to live. Most people do not want to live in tower blocks. The other vital point is that house building must be accompanied by the necessary infrastructure – new schools, shops, surgeries and roads. Two things then happened in the early 2000s. The Labour Government relaxed the immigration rules, making it much easier for people from outside the European Union to come here to live.
Page 1: THE VISION PROJECT
Page 5 and 6: CONTENTS FOREWORD pg 5 FROM RAT PAR
Page 7 and 8: FOREWORD WRITTEN BY ROSIE PHILLIPS
Page 9 and 10: “But this isn’t about houses -
Page 11 and 12: It means free and easily accessible
Page 13 and 14: “While there is no silver bullet,
Page 15 and 16: “WE WILL NEED SOCIETY, AND IN PAR
Page 17 and 18: HOW WE CAN END HOMELESSNESS WRITTEN
Page 19: WHERE HAVE ALL THE ACTIVISTS GONE?
Page 23 and 24: DHI couldn’t change the situation
Page 25 and 26: In an era of austerity, budgetary c
Page 27 and 28: VCS organisations and social activi
Page 29 and 30: How do we reduce the pressure on yo
Page 32 and 33: A VISION FOR PRIVATE RENTED HOUSING
Page 35 and 36: NO ONE LEFT BEHIND TACKLING SOCIAL
Page 38 and 39: TAKING BACK CONTROL? WRITTEN BY JEF
Page 40 and 41: BUILDING BRISTOL AS AN INCLUSIVE CI
Page 42 and 43: It was only by engaging with DHI th
Page 44 and 45: Social policy and the substance mis
Page 46 and 47: Often, low pay is synonymous with j
Page 48 and 49: Again, they are all sold without an
Page 50 and 51: HOW SHOULD WE BE HOUSING PEOPLE IN
Page 52 and 53: HOW DO WE STOP TODAY’S YOUTH FROM
Page 54 and 55: LOOKING TO THE FUTURE WRITTEN BY ST
Page 56: CRIMINAL JUSTICE AND SOCIAL EXCLUSI
Page 60: Developing Health & Independence 15

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