Even if the treatment were available on the ground, the drug-using offenders who are its primary targets would not be reaching it in any numbers. In theory, there are new bridges feeding offenders into the treatment regime - the idea of using the criminal justice system as an outreach network is one of the core ideas of the drugs strategy. The government has spent UKP106m to build these bridges. In reality, they carry almost no traffic.
The first and most important bridge is arrest-referral: anybody who is arrested and who has a drug problem is interviewed by an arrest-referral worker who will offer them an appointment. The problem is that, according government research, 97% of those who are interviewed fail to make it into effective treatment: nearly half simply reject the approach; of those who accept an appointment, 78% never turn up; of those who do turn up, an estimated 45% drop out within a fortnight and 72% within six months. Home Office researchers found that in 12 months, 48,770 users were screened by arrest-referral workers; only 5,520 subsequently turned up for an appointment; only 1,545 in the whole country in all the 12 months continued to turn up for at least six months.
In Bristol last year, they screened 2,300 users on arrest; only 177 showed up for their first appointment. The reality is that, after three years of arrest-referral, the Bristol DAT has no evidence that even one user from arrest-referral has completed treatment. But, when the government wanted to tackle street crime last year, it sent down extra money which was earmarked for the hiring of yet more arrest-referral workers. The Home Office, sensing disaster, has reorganised the arrest-referral workers to introduce a new system of monitoring.
The second bridge from criminal justice into treatment is DTTOs - drug treatment and testing orders - which allow courts to order an offender to go for treatment. In February, the probation inspectorate reported that their operation was “extremely uneven” with “an unacceptably low level of achievement” which included “very disappointing” drug test results. Last year, only 6,186 orders were made nationwide; there were 5,419 proceedings against users for breaching them.
According to one Whitehall source: “Breach is the norm with DTTOs.” In Bristol, courts last year issued only 48 orders and Elliott reckons almost all of them are being breached by offenders who do not accept the treatment available and who are willing to take their chances if the court decides to punish them.
The government has come up with a remedy: regardless of the failure, Downing Street last year asked the Treasury to fund yet more DTTOs; the Treasury agreed to put up an extra UKP25m but only if the probation service agreed to increase their targets by 50%; probation had no chance of hitting the targets, but the Home Office accepted and rewrote the rules to produce a new DTTO which imposes only minimal requirements on offenders ( dubbed DTTO-lite by drug workers ).
The Home Office cannot be surprised by the failure of these bridges. They knew very well that both were fragile when they introduced them, because they tested them in pilots. Both of them produced alarmingly weak evidence of effectiveness. But the government pushed ahead with arrest-referral because, according to Whitehall sources, it was a way of channelling extra money to the police at a time when the chief constables were rebelling over their budgets.
In the case of DTTOs, the early pilot results were so bad that Home Office ministers, anxious that they might lose the money promised by the Treasury, simply rolled them out nationally before the final results came through and lied about the pilots.
The Department of Health and the Home Office are blaming each other for the failure of the schemes. The reality is that they have failed as a route to abstinence, because there is a limit to the number of addicts who will give up their drugs without wanting to; and they have failed as a route to maintenance, because of the lack of well-supported prescription, particularly of heroin.