When Tender is Tough

In line with the prevailing market forces underpinning the provision of health care in the UK, the specialist drug and alcohol service I have worked for over the past 16 years has been part of a competitive tendering process. The contract has been awarded to another organisation and the majority of staff are in the process of being transferred to the new employer as the service is excised from the current NHS Trust which has hosted it since its beginnings.

It has been a very stressful time for everyone because of the uncertainty, and this uncertainty remains for my colleagues who will be moving into what is effectively a black hole – there is no information about who will retain their jobs, whose will change, and who will be asked/forced to leave at the end of the consultation period.

I am fortunate not to be transferring to the new service, although this in itself raises very big questions about the relevance and future role of psychologists within the specialist field of substance misuse and addictions. This is not an isolated case. It has already happened  in other areas of the country and will continue to happen elsewhere – an unstoppable wave of politically- and economically – driven policies seemingly dissociated from both a sense of humanity for the people affected (staff and service users) and a deeper understanding of the complexities of substance misuse.

My role within the NHS Trust will change and I will not be working with drug and alcohol clients. As the realities of this dawn on me, I feel a lot of sadness. I have devoted a huge portion of my working life to the field of addictions and I am left wondering – in an illogical way – why this is not seen as important any more.

There is a sense of loss. My identity was as an addictions psychologist and this has been taken away from me. It is as though I am in a state of forced abstinence. I need to expect withdrawal symptoms and cravings to work in this area. There is hardly a day that passes without mention in the media of a drug or alcohol-related story – plenty of triggers for my cravings. Maybe later I could work with one or two clients with substance misuse problems – maybe I will be able to be a “social addictions therapist”, not take it to extremes. Or run an addictions group for a few weeks – a kind of therapeutic binge. The echoes all this has of the struggles faced by our clients may be wryly observed, but the feelings are no less real.

This has been an unusually personal post, but I am sure you will understand why.