If drug users cannot be dissuaded from taking drugs, is it better to help ensure their drug-taking is as safe as possible? This is the harm-minimisation approach that Glasgow City Council is taking with its proposal to open a facility for heroin users. This safer drug consumption facility, sometimes referred to in the press as a “fixing room” would provide clean needles, safe spaces and medical supervision alongside advice, treatment referral and a number of other facilities. In some cases, where current treatments were unsuccessful, users may be offered medical-grade heroin, diamorphine.
This not uncontroversial idea is aimed at a small but vulnerable group of drug users who inject drugs in public places. Street use causes problems for the wider community, such as discarded needles, but also poses great risks to users, who face increased risk of infection, blood-borne viruses or overdose. Glasgow council’s proposal arrives following a significant increase in HIV infections and drug-related deaths among addicts.
All are supervised by trained staff and have a number of rules and regulations about who can access them and what behaviour and practices are allowed. Often these are set up near to known drug markets, so drug users can take their recently purchased drugs in a clean, safe environment – rather than injecting in alleys, parks, stairwells or public toilets.
While there is often public opposition to drug consumption rooms, studies that have evaluated their use in other countries conclude that they are cost effective, often reach the most vulnerable drug users and lead to less public nuisance. Initial public resistance towards them was found to fall once they had opened.
For drug consumption rooms to be successful, a key group of people that must be persuaded are the drug users themselves. We conducted a study of attitudes towards safer consumption facilities among current or former injecting drug users, mainly heroin users. We found they were largely in favour and would make use of them if one were to open nearby. They were also willing to abide by the rules that using such a facility would require – such as no drug sharing.
While the respondents gave various reasons for public injecting, the majority who had injected in public places in the previous month did so out of necessity – despite only around a third being homeless – and would rather have an alternative. Some felt injecting in public was degrading, while others did not wish to be seen by children.
One aspect that drug users were not in favour of, however, were rules forbidding injecting in the neck or groin – rules common to these sorts of facilities in other countries.
Those users with a long history of injecting and who use public places are at high risk of death from overdose – and it is these high-risk users that are being targeted, as they stand to benefit most from the facilities provided by drug consumption rooms.
So studies have shown that safe consumption facilities can succeed in reaching long-term drug users who have had no previous contact with treatment services, and can be effective in getting some users of the facility into treatment programmes. A centre such as the one proposed in Glasgow, which still requires legal approval, would need to be monitored – and should be only one part of a strategy to address problem drug taking. But if it reduces the harms of public injecting, reduces HIV infection rates, overdoses and deaths among some of society’s most vulnerable people, then it may be that the time has come to trial a different approach.
Georgia Butler does not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and has disclosed no relevant affiliations beyond the academic appointment above.
When the much anticipated Uber judgment on the self-employed status of two drivers came in, the victory was described by their union, the GMB, as “monumental”. Respected commentators including the lawyers, Leigh Day, and the Guardian newspaper described the judgement as “historic” and “a landmark”.
There is no doubt that the judgement delivered by the London Central Employment Tribunal on October 28 was an advance in the campaign to provide workers’ rights to the hundreds of thousands that are wrongly classified by their de facto employers as “independent contractors” or “self-employed”. But this is no triumph. It is only a small victory in one battle that is part of a much larger and more protracted war. There are five principal reasons for this.
First, Uber will appeal to the Employment Appeal Tribunal, and if unsuccessful there, go to the Court of Appeal and maybe all the way to the Supreme Court. As its business model and, thus, profits, are fundamentally based upon using what the Employment Tribunal regarded as a “bogus” form of self-employment, it will expend a huge amount of energy and resources to overturn the ruling.
There is a second, more quintessential reason. The nature of the Employment Tribunal decisions means that if many more Uber drivers wish to be availed of workers’ rights – minimum wage, sick pay, holidays, pension enrolment and so on – then they will have to take Employment Tribunal cases as well. Therefore, it was wrong for various commentators such as lawyers and personnel professionals to imply that the rest of Uber’s 40,000 drivers in Britain will be now suddenly be entitled to workers’ rights.
Sure, the Tribunal’s finding does intimate that idea but it is no more than that. The ruling is not binding upon how Uber treats its other drivers – something Uber itself is clearly aware of. The other drivers were not joint plaintiffs in the case. The only way the GMB union can make Uber cave in on all of its drivers is not only to take many, many more ultimately successful cases (as it seem intent upon doing), but also to use various non-legal avenues to pressurise Uber into changing its ways.
Organising consumer boycotts, investor strikes, industrial action of the Deliveroo sort are all viable options. This would be most effective if deployed, along with the legal means, against Uber in a form of pincer movement.
Another important tool available to the GMB at the moment is to use the statements of the prime minister, Theresa May, concerning an economy that “works for all”. If it can get other Employment Tribunals to see which way the political wind is now blowing, this will increase its chances of success.
One case at a time
A third reason to avoid jubilation is that even a final victory after appeal in the Uber case would not automatically mean success for the host of other self-employed workers bringing similar claims against the likes of Addison Lee, Excel, City Sprint and eCourier and backed by their GMB and IWGB unions – or any others that might come in the future elsewhere. This is because each is treated in law as an individual case. Even where there are class actions of multiple plaintiffs in a coordinated series of cases, the judgements only apply in law to them.
So the plaintiffs’ cases against Addison Lee, Excel, City Sprint and eCourier will have to pass the same stringent tests that were applied in the Uber case and show that in different settings that their work – and the organisation of it – was effectively controlled in a conventional managerial method. Moreover, cases take time. The process of gaining the Uber ruling started in the summer of 2015.
Fourth, even if those other cases are successful, Employment Tribunal rulings are no substitute for a legislative solution. Ultimately, case law precedents can be undermined, overturned and superseded by other case law precedents. Legislation – along with robust enforcement – is the only way to outlaw the bogus use of self-employment. Anything else means that the war to do so means fighting on a piecemeal, incomplete basis.
Fifth, and crucially, employers will undoubtedly find new ways to introduce and embed self-employment. We have seen it already in the construction industry. New rules in 2014 sought to stop employment agencies falsely providing workers on a self-employed basis, but all that happened was that workers were shifted over to so-called “umbrella” companies where workers can be employed legally on a temporary basis and many on zero hours contracts. The practice is now spreading elsewhere. As employers have both the means and the motivation, they will develop new methods to get around any legal challenges. Again, this flags up the need for legislation to provide a blanket ban on bogus self-employment.
The two Uber plaintiffs, James Farrar and Yaseen Aslam, along with their union, the GMB, are to be congratulated on pushing open the door to the legal possibility that self-employed workers might gain worker rights. But it will take much more than this to turn the possibility into a probability, let alone an actuality. Political and legislative change is needed to make sure that their victory is neither Pyrrhic nor temporary. Unless that happens, the Uber ruling will not even be the end of the beginning for bogus self-employment.
Gregor Gall is the editor of Scottish Left Review and the director of the Jimmy Reid Foundation.
The PM was interviewed on the Andrew Marr show this morning. We’ve factchecked some of the claims about housing, tax, welfare, and jobs. “[In] 2011, you relaunched the Right to Buy and for every house that was sold you have replaced one in ten”—Andrew Marr This is about right. Between April 2012 and December 2014, 26,000 […]