It is increasingly likely that many therapeutic services for drug
addicts and alcoholics could be scrapped because of a funding
crisis in primary care.
The warning comes from drug and alcohol groups that believe GPs
will decide against “opting-in” to provide medical and
rehabilitation services for substance misusers under a new
employment contract because primary care trusts won’t be able to
afford to fund them from next April (news, page 8, 14 August).
“It is a problem; the money isn’t there,” said Richard Phillips,
director of policy at Alcohol Concern.
Under the new GP contract, practices would be expected to have
knowledge of drug detoxification procedures, be able to provide
users with support and substitute prescribing, and train practice
staff. There are similar requirements for providing services to
But the British Medical Association is advising GPs not to provide
patients with services they do not get paid for.
Dr David Jenner, the professional executive committee lead for the
NHS Alliance, which represents PCTs, admitted that providing
substance misuse services was unlikely to be attractive to GPs,
especially if the funding was minimal.
“These are not popular services to provide: patients are
time-consuming, often have challenging behaviour and the money
“There is nothing in this contract that actually takes new money to
these services and it does not reward GPs through the quality and
outcomes framework,” he said.