Opinion: The Health Secretary on Families – Progressive or Shifting Responsibility?

–  A series of blogs about families and substance use by our Policy and Research Assistant, Rebecca McColl

On the 8th of March, Health Secretary Sajid Javid “urged relatives to do what they can to persuade each other to lead healthier lives” during a speech on healthcare reform at the Royal College of Physicians in London (The Guardian). The Health Secretary said that families play a key role in helping their loved ones adopt better diets, stop smoking and stop taking drugs, which in turn would prevent future strain on the NHS by preventing an ageing population with several illnesses. Javid said of his own mother helping his father stop smoking:

“That kind of intervention is more powerful than most of us can imagine. Whether it’s stopping drug addiction or dealing with depression, there’s no more powerful motivating force than family.” (UK Government).

Although I would agree with Javid to an extent, yes families can play a key role in recovery and help their loved ones change their lifestyle, however, it feels as though the Health Secretary is somewhat shifting responsibility from the NHS (and the Government) and onto families. Javid said himself that “we need a shift from the state to individuals, families and communities.” His statement also fails to acknowledge that ‘motivation’ from family is not a singular solution to anything, and people still need support from various services (depending on their needs) and families should receive support in their own right too. The statement also simplifies the experiences of families, whose lives can often be chaotic and full of difficult decisions – if it was as simple as just asking your loved one to stop, Scottish Families wouldn’t exist!

Javid did go on to highlight the importance of personalisation in healthcare, saying, “We know that when healthcare is personalised – built around the person and their family – it works better” (UK Government). Javid does seem to be passionate about a Whole Family Approach, and vocal about the involvement of families in different areas of healthcare.

The speech prompted a response in ‘The Guardian’ by the anonymous writer ‘The Secret Drug Addict’ who wrote a piece titled ‘Note to Sajid Javid: the idea that my family could have weaned me off cocaine is ridiculous.’ They brought up various good points, saying sometimes, people who are dependent on drugs may not be surrounded by their families, may not have supportive families, and can sometimes be impossible to reason with when actively using substances. ‘The Secret Drug Addict’ then went on to discuss their own experiences with drug use and recovery, and how they now run a Twitter account (@ScrtDrugAddict) to help others (including family members).

However, ‘The Secret Drug Addict’ focuses on the potential negatives of families supporting a loved one using substances (citing a lack of understanding, doing things that aren’t helpful or constantly saving their loved one from the consequences of their own actions) and doesn’t acknowledge what Javid does – families can play an essential role in supporting their loved one – when they are given the tools and knowledge that is. There is strong evidence to suggest that when families are supported, this can drastically improve their relationship with their loved one and can sometimes allow for families to play an active and supportive role in their recovery. This does not mean the buck should start and end with families, however. Families can play an active role in supporting their loved one in whatever path they choose to take but should not be left with the responsibility for their welfare, which should ultimately lie with the NHS or other alcohol and drug service providers.

We need to find a middle ground – where families are empowered by programmes like CRAFT, SMART Families and Friends or other support systems. Where families are acknowledged and listened to, without bearing full responsibility for their loved one’s care. Yes, families can be essential to people engaging in recovery, but this doesn’t take away the need for drug and alcohol services or residential rehabilitation. Javid’s comments could be seen to perpetuate the guilt and stigma that families already experience (as well as passing guilt onto families for obesity and mental health too). Perhaps the Health Secretary would be better placed to use his passion for families to ensure family-inclusive healthcare, rather than shifting responsibility.

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