Dear All,

 

Could not agree more, this for one not only confirms but intensifies my fears and anxieties regarding the commissioning of a USA Corporate Business to manage, devise, interpret, let alone 'SECURE' , the

coming National Census.

 

Relating to a question I asked for list members comments on,the following

 

will take you to the NTA (National Treatment Agency) 2007-2008> patients 'Treatment Outcome Survey Questionare'.

 

I find it deeply flawed & structured on the political 'belief' that all drug users/dependent users are actively engaged in crime, notably 'property crime'.

 

There is no recognition that a significant patient cohort enter treatment for health based reasons not via the 'criminal justice system' and related social systems of control and compulsion into 'treatment'.

 

I and many in this area find the convergance or more accurately the subordination of medical treatment, healthcare, public health issues, let alone factors such as social deprivation, economic disadvantages, marginalisation, housing, other health, factors to the interests of the 'crimminal justice' agenda to be a profoundley disturbing trend with precedents being set for other areas of health care and benefits.

 

To me, this questionnaire is designed in such a way as to elicit responses that confirm existing prejudice's, belief systems and to,confirm the epistemeological /'evidence' base for consolidating the existing direction of drug treatment policy, including coerced 'treatment', 'work' as the ultimate seal on 'recovery'- just as the gates over Auschwitz proclaimed "Work Makes Free"- if you buy that then you will buy anything, & the increasing crimminalisation of those who continue to use drugs.

 

In addition we are also seeing the emergence of a direct link between 'patient' response to 'treatment' & the provision of welfare & benefits. Albeit, for example, opioid dependence is defined by the W.H.O., UK Chief Medical Officer, even by the USA, as a 'chronic medical condition characterised by relapse' for which the provision of methadone maintenance treatment, life long if needs be, is & remains the 'Gold Standard' by which all other treatment/interventions are measured. Abstinence focused treatment policy is largely 'belief based', refuses to accept the scientific & clinical evidence base, despite a relapse rate with all the associated increased risk of Harm &/or Morbidity but is likely, indeed clearly, to form the basis for future treatment policy & practice under any Conservative Government. Sadly, all political parties play to popular predjudice at times such as this & a Labour Government remains the lesser of two evils.

 

All that can be predicted is pursuit of such policies have nothing to do with the well being of the drug user & the communities of which they are a marginalised and stigmatised part.

 

No other N.H.S. patient cohort would be treated in this manner, let alone be subjected to involuntary cessation of treatment, benefits, care, let alone be expected to allow the scrutiny of the minutiae of every minute of their waking and sleeping lives that patients entering treatment for drug dependence/use are.Let alone the additional measures of 'control' that are applied to patients entering treatment via the crimminal justice system. ( An alcoholic is subject to no such measures despite Alcohol being associated with social and community disruption, violence, crime, disease , death, etc.)

 

Another significant development has been the piloting of the 'responsibility' agenda in relation to health, health care, benefits, & treatment rights.

 

As made clear by Cameron this week & as piloted by Blairites in the Labour Party ( no longer the 'onward march of labour but the political organ of the 'mandarins & middle classes & vested interest groups- plebs no longer welcome) the provision of benefits & healthcare will be contingent on the individuals 'percieved' responsibility for their own condition.

 

It is easy to 'blame' drug users for being drug users & to contest 'why should you, having brought all this upon yourself through your own lifestyle choices, enjoy treatment, care & benefits" at the expense of 'proper society' , tax payers ( neglecting to recognise that any 'service user' in employment is unlikely to sing out loud about it for fear of losing job, career, professional status, etc.- I certainly funded my own dependence by sheer hard 'graft' & kept out of the system for as long as I possibly could & engaged solely for reasons of health, engaging vvia a health acarer run service in SE1 that placed me with a GP willing (unlike my own at the time) to provide methadone maintenance treatment until I could be placed with a specialist NHS clinic.

 

Previous attempts to engage in treatment led to me been shown the practice door on numerous occasions, obtain private treatment only to see my private Doctor being one to fall foul of the GMC, have their license suspended and leaving some 400+ patients such as myself without any care, support, medication, onward referral, basically thrown back onto street heroin, let alone exposure too HIV/AIDS or the 'still hitting home'

disease we now call Hep C.

 

At the time the dominant treatment philosophy was that the 'short, sharp, shock of involuntary methadone tapered withdrawal (lasting 6-12 weeks maximum with sub therapeutic doses, no offer of maintenance,& psuedo psycho-theraputic interventions such as 'group therapy', and other long discredited behaviourial/freudian/jungian based theraputic nonsense as it came into & went out of 'fashion'.

 

Still the case in the treatment of drug users & ME/CFS patients among an ever increasing patient cohort with .Cognitive Behavioural Therapy now being displaced by 'Motivational Therapies' as flavour of the moment.

 

So why ask for your comments? Let alone why I place great store by them?

 

Because 'statistical evidence' crimmological, sociological, pseudo clinical, and other wise manfactured/produced are deployed as foundations of past, present & future treatment policy.

 

Moreover, that the 'rights & RESPONSIBILTIE'S' agenda that both dominant political party's have embraced

has been pioneered and made 'manifest' in the field of drug treatment, policing, benefit provision & control & there increasing convergance has wider implications for the NHS, for social policies, the application of power, knowledge & control, leading, I fear, to increased oppression, surveillance,, repression & human 'rights' infringements.

 

In addition, this 'agenda' has already been applied to the obese, with Cameron asserting that the Obsese need to take responsibility for their condition, well I am obese as a result of ME/CFS imposed inactivity and disability which inhibits exercise & despite eating a miniscule diet i have put on 10 stone in weight due to a chronic condition aqquired through sheer over work, stress & suspected viral pathogen of unknown origin. Unless it turns out that I have had Hep C all these years that tests have failed to identify.

 

The present Labour government is likewise applying similar theologicaly based to the provision of benefits to the disabled and/or sick, which will see many of those afflicted with disabling health, mental health, & other conditions forced back into 'work' or the 'simulacrum of work' that investment in so called training courses

& compulsory attendance there-of 'simulates' (for statistical and media purposes) .

 

All I predict is greater harm, distress, poverty, and adverse conditions that as ever will afflict those most vulnerable to harm or likely to become 'revolting' according to the values we are expected to subscribe too for our 'recovery' to be complete.

 

what next, blame poverty on the POOR? Sad to relate Cameron & others have already made their position clear. Likewise the Scottish Theologians who currently run the 'Labour' party.

 

Again, statistical evidence is produced to support such belief based political practice and the social orders thereby created..

 

So I contest that 'Statistical Science' is a 'human Science' as indeed is all science; & can not be assigned (in Nietzsche's Terms) a 'vale' or evaluated  unless one takes into account the means, mode, epistemeological & economic conditions, let alone the 'dominant Zietgiest' prevalent at a given time and space.

 

Likewise statistical evidence both creates the 'subject & object' of study and the forces/ interrogative & investagative procedures employed in the manufacturing process.

 

So am I calling for a 'de constructive' contra 'statistical science' & means of production-perhaps- indeed yes? But I also harbour fears that the US Campus based embrace of Post structuralist theory ( notably within media, critical ,literary Studies and philosophy) marks it's duality or complexity of nature. I note this in that it can be understood as a co-opted unifying theology' of Globalisation and it's emergence into 'self' consciousness' yet simultaneously is able to serve as a tool and means to re-invigorate our 'engagement with Marx' & to re present radical challenge(s) to the current 'order of things' as well as a nomadic 'technis' that can be deployed to contest power relations as emergent under Globalisation.and our subjectification to a new (the king is dead long live the king) imperial order.

 

The US campus embrace of Derrida seems to miss or rather body swerve Derrida's long deferred engagement with Marx & his subsequent, late in life, self identification as a 'Marxist'.

 

Anyway, I am meandering way off topic and for the sake of your time, patience & sanity let alone my continued welcome on this list bring matters to a close.

 

So please have a look at this questionnaire, I would welcome any overt or 'off the record' commentary as I intend to pursue this issue further & am considering how best to make a critical challenge to the commissioning body as to the methodology and structure of this questionnaire (repeated every four months)

prior to launching a campaign among my service user peers to refuse or decline to respod to this information gathering exercise that, I fear, will only serve to further augment our control, policing, prohibition and disempowerment masquerading as empowering 'consultation'.

 

Best wishes: Alan J