Ideas matter! All policy is underpinned by ideas and the quality of the ideas can make or break the policy. Three key ideas provide the effective foundations for current Australian illicit drugs policy – harm minimisation, substitution treatment and problem-based community-oriented policing. Harm minimisation acknowledges that while abstinence is the surest way to prevent harm, not everyone will choose this path. Therefore other strategies are necessary to assist illicit drug users, who range from occasional to chronic, to reduce negative personal and community consequences as far as possible.
The most significant success associated with this idea is the containment of the Australian HIV/AIDS epidemic among drug users through the provision of needle and syringe exchanges, condoms and peer education. Substitution treatment provided a break-through in therapy for illicit drug use. Substituting illicit drugs with a long-acting oral medication has provided the most effective treatment to date, especially for heroin users. It allows them to cease or greatly reduce illicit drug use, stop other crime, and stabilise and normalise their lives. Problem-based, community-oriented policing recognises that the police service is responsible not only for solving crime, but for preventing it. It calls for a style of policing that is much more engaged with the community, incorporating visible patrols, concerted actions at ‘hot spots’ and other strategies to reduce fear in the community. Each of these ideas came to prominence in the 1980s and they are periodically challenged by competing ideas focusing on zero tolerance, abstinence-only treatment and results-based policing. As society changes over time, new accommodations between competing ideas and ideologies must be found.
Two key aspects of illicit drugs policy are not currently guided by effective high-quality big ideas. For both prevention and corruption resulting from illicit drug profits, society is largely floundering, applying piece-meal strategies, often despite evidence of no or, even worse, counter-productive effects. An important element of DPMP is therefore to give consideration to key effective concepts that underpin policy, both in terms of providing critique and analysis of current and alternative ideas, and in helping to generate new high-quality notions. While there are many methods for creating and disseminating new ideas, these have not been systematically documented or analysed. In the feasibility phase of DPMP, we focussed on one method – Executive Sessions – because this specifically deals with big concepts, aims to be nonpartisan (and indeed thrives on the respectful interaction of different ideologies) and has a track record in producing transformative social change. As a matter of fact, problem-based community oriented policing is a product of the most successful Executive Session.
Executive Sessions were developed at the John F Kennedy School of Government at Harvard University. They involve bringing together a small number (20-25) of influential and innovative policy and practice leaders with about five intellectual leaders to discuss and develop new approaches to large unwieldy problems that are too big to tackle in other fora. The leaders generally meet twice a year over 3-4 years. Discussion papers are produced to assist the deliberations and to disseminate ideas and generate feedback from a broader constituency.
In all, seventeen Executive Sessions have been held to date. Of these, eight have covered criminal justice issues, the other nine have covered a broad range of topics. Three Executive Sessions are considered to have transformed policy and practice – the Executive Sessions on Policing, Medical Error and Patient Safety, and Domestic Preparedness. As outlined above, the Executive Session on Policing introduced problem-based community-oriented policing and revolutionised the way police departments operate in the USA, Australia, the UK and other countries. The Executive Session on Medical Error and Patient Safety helped move the focus away from individual mistakes to concentrate on systems failures and how they can be rectified. There was significant potentiation between the Executive Session and a concurrent US Institute of Medicine report on the same topic. The Executive Session on Domestic Preparedness was about half-way through its deliberations when the September 11 2001 attack on the New York World Trade Centre occurred. It was able to significantly influence the subsequent policy response to September 11. (One of the participants, a New York Fire Chief, was killed in the direct response.)
This Stage 1 project explored Executive Sessions in detail to examine the feasibility of conducting an Executive Session on the topic of illicit drugs and to explore more general lessons for evaluating and creating new policy ideas in the next phase of DPMP research.