Published: 02/09/2004, Volume II4, No. 5921 Page 21

Brand recognition and development have become the new goal of service providers hoping to land new contracts.This is bad, says Trevor McCarthy

The commissioning of alcohol services is both a disorganised, uncoordinated shambles and an example of genuine cooperative local partnerships in action. The National Alcohol Harm Reduction Strategy for England may make things better or, just as easily, make them worse. Alcohol professionals gave the strategy a mixed reaction: some bemoaning the lack of new money, others cautiously optimistic.

Alcohol services are a hotch-potch: in every case a product of local decisions, vision and whim. In some places health is the main funder, in others, the local authority. Some services have expanded in recent years, often by moving into the drugs field, with its avalanche of funding; others have experienced cuts.

Nobody defends the current picture although it does have one key strength: every alcohol service in the country is an example of true partnership. With the strategy gathering momentum, alcohol commissioners should pause for thought. New investment will come. There is a real risk it will be squandered.

In the drugs field, as investment increased, relationships between commissioners and providers became increasingly distant. The burden of bureaucracy meant that smaller agencies were no longer viable. Amicable relationships between commissioners and services collapsed.

Suspicion and aggression poisoned those relationships. The managerialism virus bred caricature commissioners spouting management jargon they had just learnt and not quite understood. Conditions were set for McDonald- style drug services - in his book The McDonaldization of Society, George Ritzer argued that in such systems quantity equals quality.

A few drug service providers infected themselves with the managerialism virus. They learned the language and talked the talk more fluently than the commissioners. They tendered promiscuously, bamboozling local purchasers.

The outcome: a few large national drug agencies with several staff devoted to tendering and bidding. They are brands with brand loyalty - loyalty to themselves and to developing their brand.

However, there are rumblings across the country that these big services are very good at what they do, but what they do is not very good. Practitioners know this; at conferences and forums they meet and share horror stories. Ironically, commissioners do not know, precisely because they have no forums where they can meet.

The big brands are already positioning themselves to tender for new alcohol contracts. Alcohol commissioners should mistrust seductive overtures from national brands. What added value do they bring? Could it compensate for losing genuine local presence, local relationships and understanding? Make tendering transparent: convoluted processes will exclude smaller agencies who focus on service delivery, not brand development.

The real danger is of losing existing genuine alcohol partnerships through importing businesslike agencies. They are relentlessly competitive and continual competition militates against true partnership. What do you want to pay for in your area: locally focused alcohol treatment services or a designer label? Your drinkers are already labelled. Invest with care.

Trevor McCarthy is coordinator of the Community Alcohol Service for Coventry and a trustee of Alcohol Concern.