What is it about your job that you feel would surprise the public?
Whether someone is struggling with heroin, crack, alcohol, self-harm or anxiety, what works in recovery is surprisingly similar: having structured conversations, making connections with other people and setting goals. This is because the problem is very rarely drugs or alcohol in the first place. They are a symptom rather than the cause; people are often using them as a self-medication for other stuff going on in their lives.
What’s been the biggest change you’ve seen since you started working in the NHS and social care?
The gap between what people expect and what health and social care services deliver is getting bigger. The latest data says that 32% of people access the internet only through smartphones – but many health services are still designed for people with laptops and desktops (or at times for pen and paper). That can be a huge barrier when forms are hard to fill in on a smartphone screen.
If you could make one change to the NHS and social care over the next 10 years, what would it be?
The single biggest, boldest and bravest thing that the government could do for people experiencing alcohol issues is to put a levy on the alcohol industry to pay for treatment. That’s a model that’s worked for banks – there’s a £100 million levy on banks that pays for debt advice. It would absolutely work for alcohol and it would also work for gambling – and it should be done today.
Change from the top
If you could give Matt Hancock one piece of advice, what would it be?
Digital transformation is really about changing how people work and what they do on a day-to-day basis – it’s not about technology.
What do you wish people at the top of the NHS understood?
The language that people use is really important. There’s a really good bit of guidance on the government’s website about looking for blood in your poo. The fact they use those words is really helpful, because people actually understand them. Asking people to look for ‘discolouration in your stool samples’ doesn’t work half as well.
Policy in practice
What policy have you seen successfully implemented, and why did it work?
A good one we’re involved in delivering is IAPT (Improving Access to Psychological Therapies). It makes relatively low-level psychological help more readily available to a lot more people early on. It still has a long way to go, but it has had a huge impact. It’s quite straightforward for NHS trusts and commissioners to get behind, it’s had significant political focus and has been backed by money.
What policy have you seen fail, or not be as successful as first intended?
Universal credit. Its design misunderstands how human beings behave in the real world. The assumption is you get paid monthly in one big lump sum and if you’re not used to managing money in that way, you can get into debt. In the drug and alcohol world, this leads to people getting into really dangerous and difficult situations. We’ve got to give people the ability to tailor their experience to what they actually need.
What policy and/or change in behaviour are you currently trying to implement, and how’s it going?
We are trying to make sure we only collect data that we are going to use. For lots of organisations like ours who work within a tight regulatory framework, it can be a challenge to balance what regulators and commissioners want reported and what is needed while you’re trying to help someone. That’s a really difficult balance to achieve.
Bonus question
The NHS is under pressure because...
People rightly want more. It’s always been the case, but we’re at a point now where people expect wi-fi on planes. That’s a wonderful thing about humanity – we are gloriously restless. And that is what will keep the NHS under pressure, but will also keep making it better.
Mike Dixon is the Chief Executive of Addaction, one of the UK’s leading drug, alcohol and mental health charities.
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