The above are some of the conclusions reached in Document No. 3:12 (2004-2005) The Office of the Auditor General’s investigation of the management and supervision of measures aimed at substance abusers which was submitted to the Storting on 15 June 2005.
The purpose of the investigation was to shed light on the degree to which the Ministry ensures that the municipalities implement their supervisory initiatives aimed at substance abusers in line with the Storting’s decisions and intentions. As far as the municipalities’ supervision of substance abusers is concerned the investigation limited itself to those measures implemented in accordance with social welfare legislation.
Substance abusers have not been followed up
The Office of the Auditor General’s investigation has brought to light the fact that many substance abusers are not offered the supervisory care they have a right to from municipal social welfare services. In 43 per cent of the cases reviewed the social welfare services have spent a considerable amount of time assessing their drug-abusing clientele. In 25 per cent of the cases the social welfare services took a year or longer before identifying the existence of a drug related problem. Substance abusers are given access to the social welfare services to which they are legally entitled only to a limited degree; there is also a lack of accommodation specifically for substance abusers. Inadequate follow-up and contact between the social welfare services and their clients was identified with regard to those receiving treatment at rehabilitation institutions and those in the post-institutional follow-up phase.
The Office of the Auditor General’s investigation further indicates that the social welfare services spend a long time processing cases of compulsory treatment or rehabilitation involving the use of medication. Not all those applying for a course of rehabilitation involving the use of medication receive equal treatment at the hands of the social welfare services. Their procedures prior to submitting a case of compulsory treatment must be considered long in relation to the serious nature of the case itself. The social welfare services’ lengthy processing times for clients under assessment for compulsory treatment constitute a risk to the client’s life and health as well as to the children of pregnant substance abusers.
Inadequate routines for processing cases
The investigation also showed that several municipalities neither have adequate routines for processing cases nor satisfactory documentation in the case records or files maintained by their social welfare services. Such inadequacies in written routines within the social welfare services can result in differing practices between case officers in the same office and consequently lead to inefficiencies.
In light of the Office of the Auditor General’s assessment the Ministry ought to take the initiative in developing guidelines, tools and models for contributing towards greater systemisation and knowledge in the municipalities’ own working procedures. This should also contribute to substance abusers receiving improved follow-up treatment from their municipal social welfare services.
Response from the Ministry of Health and Care Services
The Ministry has stated that the report produced by the Office of the Auditor General represents an important basis for its ongoing work to improve conditions for substance abusers. In its response the Ministry points to the fact that a considerable amount of effort has been invested in improving both its work with substance abusers and their circumstances in recent years. It was pointed out that the offer of treatment involving the use of medication has been expanded considerably, that low-threshold health and social welfare services have been established, and that following recent reforms central government by way of the regional health boards had taken over responsibility for secondary health services from the county administrations including the responsibility of providing multi-disciplinary specialist services to substance abusers.
Delayed public announcement of documents compiled by or for the Office of the Auditor General pursuant to Document 3:12 (2004-2005) has been lifted, cf. the Governmental Audit Act, section 18, subsection 2.