THE paper on Glasgow’s proposed safer drug injecting facility, which goes to the city’s social care integration joint board this week, delivers more questions than answers.
Intended as a business case for the project, it suggests millions of pounds could be saved by the health service if it prevents the transmission of HIV and other blood-borne viruses, or can reduce the demands on A&E departments from those who would otherwise inject, in public, in the city centre.
But the paper, by Susanne Miller, Glasgow’s chief social work officer, does not say how much the pilot will cost and cannot estimate how much will be saved. It is all but impossible to do so – avoiding overdoses and A&E visits will save money, but how much will be saved to social services? The report itself admits there may be increased demand, as a goal of the project is to get people who are not normally in touch with social services provided with health care and support.
Stopping the spread of HIV can save significant sums – the report says the 78 people infected in an outbreak in Glasgow two years ago will cost the NHS an estimated £28 million in lifetime treatment costs. But the report can’t easily show that the injecting room will prevent further spread of HIV, especially as it won’t help those who use drugs outside of the city centre.
Nevertheless, the source of the outbreak is believed to have been a new arrival who joined the estimated 400-500 people who regularly use drugs in the city centre, and it spread largely within that group.
Despite the gaps in information, there is strong support for the proposal among charities and health staff working with drug users on the front line. The evidence for such facilities is clear from the experience of 90 projects in 61 cities around the world.
The real question is about how this project will be paid for. Budgets for drug services have been cut aggressively. The savings implied in the business case for this plan are nearly all to the health service. Health and social care integration is founded on transferring resources from acute care to preventive and community-based responses. Will the savings from the drug-injecting service be redirected to help it pay for itself?
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