National Service Frameworks, introduced in 1998, are long-term strategies for addressing specific areas of health care. They identify the interventions that are recommended in particular areas and impose strategies for getting these interventions implemented to a consistent standard. There is an overall rolling programme of interventions for key areas such as coronary heart disease, cancer, diabetes and the care of older people. In addition there is an annual list of more specific priorities.

The operating framework for 2006/7, published in January 2006, sets out the government’s strategic vision for the NHS until 2009. It includes a section entitled ‘Priorities for 2006/7’, listing six areas for immediate attention: reducing health inequalities, reducing waiting times for cancer treatment, reducing waiting times for hospital treatment to a maximum of 18 weeks by 2008, reducing levels of MRSA, improving the patient appointment system and the choice of providers for hospital treatment, and improving sexual health and access to genito-urinary clinics.

Singling out drugs treatment in a comparable way would do much to make the point that it should be considered part, and a crucial part, of the mainstream health service. This commitment exists on paper: in the Department of Health’s own words, ‘Success will be the provision of drug treatment services as a core part of NHS business [italics added], with the necessary arrangements in place to sustain delivery at national, regional and local level.’ But the commitment has yet to be realized in practice.