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Standing Committee on Indigenous Affairs
15/05/2014
Harmful use of alcohol in Aboriginal and Torres Strait Islander communities

GRAY, Prof. Dennis, Member, National Indigenous Drug and Alcohol Committee

WILSON, Mr Scott, Deputy Chair, National Indigenous Drug and Alcohol Committee

Committee met at 11:49

CHAIR ( Dr Stone ): I declare the meeting open and acknowledge country. I declare this public hearing of the House of Representatives Standing Committee on Aboriginal and Torres Strait Islander Affairs inquiry into the harmful use of alcohol in Indigenous communities. I would like to acknowledge the Ngunnawal and Ngambri people, the traditional custodians of the Canberra area and we pay our respects to the elders past and present, and to all Australia's Indigenous peoples.

We want you to note that these meetings are formal proceedings of parliament. Everything said should be factual and honest, and it can be considered a serious matter to attempt to mislead the committee. This hearing is open to the public and we welcome you. Would one of you like to make a brief introductory statement before we go to questions?

Mr Wilson : Thanks a lot for inviting us along to the inquiry. In case you do not know, the National Indigenous Drug and Alcohol Committee—we were just talking about it over a coffee before—is in its 10th year of operation this year. We are made up representatives from around the country—Aboriginal folk and some non-Aboriginal colleagues such as Dennis. We are a subcommittee of the Australian National Council of Drugs, and we provide advice on Indigenous drug and alcohol issues through our chair, Professor Ted Wilkes—who unfortunately could not be here today and who is also a member of the Australian National Council of Drugs—to government ministers and on up to the Prime Minister.

As you probably noticed, in our letter that we submitted to the inquiry, we have been involved in a whole range of different issues over that 10 years. One of the things that we did not put in there that you might be interested in receiving a copy of later is that we are just in the process of finalising an Aboriginal and Torres Strait Islander AOD treatment paper that we will be launching probably at the NIDAC conference which we hold every couple of years. This year it will be down in Melbourne. Those are some of the things that we want to raise.

Some of the things that we will probably be focusing on or would like to focus on in the inquiry today are around not just CDR and the terms of reference but other things such as ongoing care for Aboriginal and Torres Strait Islander folk and the issue that came up perhaps in the budget. If we want to have success for Aboriginal folk, it is about addressing alcohol and other drug issues. If you do not address those sorts of things, outcomes around education, employment and community safety issues are obviously impacted quite heavily.

CHAIR: Thank you very much. Everyone has a summary of your submission in front of them on page 27. I notice you mention FASD. You support it being declared a disability and you will know that that is one of the terms of reference that we are particularly looking at and the prevalence and cost of FASD, particularly diversion programs for them. In you inquiries and your work, have you seen any examples of programs to support children who are born with those disabilities related to alcohol consumption or programs to help women who are drinking while they are pregnant? Beyond that statement, you would of course understand, but have you got any other evidence that you have been able to get?

Mr Wilson : I attended the first world conference into fetal alcohol spectrum disorder in Canada, probably 10 years ago now, and clearly in places like Canada they do have a whole range of different programs that are targeted at not just communities but the individuals who are impacted. When I was there we did meet with a Supreme Court judge who could get all the various agencies to do things around fetal alcohol for the individual client; otherwise they end up in breach of court and things like that. There was a whole range of programs and policies that I witnessed in that period. Only eight Australians besides myself were there, including Professor Elizabeth Elliott, Sue Miers and Carol Vowles.

The only other program I have noticed since being back in Australia that is a bit effective is the Lililwan project. If you look at their DVD called Tristan's Story. If every community had all of the add-ons that community had—speech pathologists, occupational therapists and all of that—they might have a positive outcome, but as you probably know most remote communities don't have access to a major university like the George Institute at Sydney Uni. Our organisation runs fetal alcohol awareness programs too.

CHAIR: Could you provide us with that material?

Mr Wilson : Yes. It is quite clear that once you explain it to Aboriginal folk they will tell you straight away that family members display similar sorts of issues. They clearly have fetal alcohol in their minds. The problem, as you probably know, is that there isn't an agreed diagnostic tool. You can almost chart these kids' course: it will be behaviour management classes, eventually juvenile justice and down the track adult prison.

Prof. Gray : I have not done work directly on fetal alcohol spectrum disorder myself, but I have done evaluations of treatment programs. There are a lot of people who are cognitively impaired from FASD but also from acquired deficiencies through alcohol related violence or motor vehicle accidents, and there are no services for them. In many residential treatment services people are more or less parked there because there is nowhere else to put them. They do not respond well to treatment and they do need disability services.

Mr SNOWDON: I am guessing that your treatment paper, which you will launch in Melbourne, traverses some of this information.

Mr Wilson : It does.

Mr SNOWDON: Could you give us an outline of what is in it? I know you don't want to publish it in advance.

CHAIR: Perhaps you can give us your key findings, which you have already started to summarise.

Mr Wilson : It is basically a summary of what we know does work and, without being presumptuous, I would say members of this committee do as well. This is not a new area nor is alcohol related violence. We do know what works and our treatment paper goes into a whole range of different interventions that could be put in place or are already in place. It basically looks at principles that could guide not just Aboriginal services but also the non-government sector support groups like church groups, the Salvos which tend to be coming into the Aboriginal AAD space more and more. It is to make sure that there are principles around the treatment we would expect those organisations to adopt.

Prof. Gray : Paralleling that, my research group is doing a paper on Aboriginal treatment services as part of a wider review of the treatment sector that is being done by the Commonwealth's Department of Health at the moment. Again, I think the message is much the same. There are lots of things that we know work, but the key is to actually get out there and do them.

But I think there are a couple of big gaps. One that Scott mentioned before came up about five or six years ago when we did a review of the Aboriginal treatment sector, and that is the lack of ongoing care for people who come out of treatment. One of our colleagues is a member of the Australian College of Physicians and he is preparing some work on this at the moment. As he says, the three months that someone is in residential treatment is the easy part; the hard part is the two years when they come out. That is when they need support and generally there are not those kinds of support services there. I think that one of the tendencies is for medical and counselling people to focus particularly on their aspect of it. But the support needs to be much broader. They need to be plugged into housing and various kinds of supportive employment and family support and those sorts of things. We put a lot of money into residential treatment but we waste that investment when we do not follow up on it.

Mr SNOWDON: I will just follow up on that question in terms of residential treatment. I have had a concern for a long time about the effectiveness of residential rehabilitation services. I think there are huge question marks depending on the length of time people spend in the residential facility, how it is run, what services they have attached to it and those sorts of things. Do you have a definition, or in your paper have you defined what best practice might be in terms of residential rehab services?

Prof. Gray : Not specifically at this stage. That is still a work in progress. I think there is clearly a range of treatment practices—cognitive behavioural therapy and those sorts of things—which need to be part of the program. I think the advantage of residential treatment services is that they get some people out of environments where there is a constant flow of grog. For example, in Alice Springs people come from the town camps and go to the residential unit there and then they go back to a situation where there is no support. We need to be providing that support, and Aboriginal organisations will be the first to admit it.

There is some variation in the quality of services that are provided. In general terms we know what best practice is and we need to be putting in place quality assurance programs. There are a couple of things there. As I said, we know what works. What we need is a workforce that is trained to do that and then we need quality assurance programs in place to ensure that those programs are properly delivered.

Mr VAN MANEN: You said in your opening remarks that the organisation has been going for about 10 years or so. In that 10-year period, have you seen an improvement in the instances—and by that I mean fewer instances—of alcohol-related issues in the Indigenous community, or is the situation getting worse or is it about the same? And is the work you are doing currently fairly recent work? Why hasn't that work been done in the past to assess the effectiveness of various programs et cetera?

Mr Wilson : At the end of the day, yes, there has been some improvement in some areas. For instance, take petrol sniffing. It used to be on the front page quite often. When the government at the time introduced Opal fuel, for example, especially in the Pit Lands and in the footprint of where Opal is, petrol sniffing to a certain extent died almost immediately. We still have Aboriginal communities outside that footprint that sporadically have petrol-sniffing issues. As long as groups like us are aware of them, then we have a mobile team that can go to those communities and try to stamp it out quickly, because if you do not do it straightaway then before you know it, it takes over.

In terms of some of the other substances, you have probably seen in the paper things like: 'Our issue is not just an alcohol-specific issue'. I was in Port Augusta just recently, for example, and people were telling me that a lot of younger folk are now starting to get into the cycle of crystal meth use and stuff like that. You cannot just say, okay, let us just sort something out here and then the whole issue of substance misuse disappears, because new substances appear. On the weekend there were overdose deaths, for example, in Murray Bridge from miaow miaow, which is the name they give to bath salts that you can import legally. Then people obviously inject that.

By having people on our committee from around the country we are kept pretty well up to date on the traditional issues and also some of the emerging issues that the committee might need to have a little bit more of a focus on. At the NIDAC conference, for example, we have a whole session on crystal meth. A lot of folks just do not know how to deal with people who have crystal meth problems, so we are focusing on those issues as well.

Prof. Gray : There have been evaluations of various interventions. In some ways, things have got worse. But without these programs they could have been much worse. For example, in the submission that our institute made separately to the inquiry we looked at the impact of the introduction of a liquor supply plan in Alice Springs. Basically it was an indirect price control measure where the cheapest forms of grog—cask wine and fortified wine—were taken off the market. It showed a fairly dramatic reduction in consumption. Then we looked at hospital admissions for wholly and partially related alcohol conditions. When we modelled the trend before the introduction of those restrictions and applied it subsequently, we expected that trend to keep going upwards. But what in fact happened was that, although there was an increase, it was nowhere near as great as predicted if the previous regime were kept in place. I think we can show that for a number of smaller interventions, but no-one has done it on a national scale.

Mr RAMSEY: I have a couple of questions. Scott, you are on the Aboriginal Drug and Alcohol Council and are involved with the rehab centre at Port Augusta. Is there a direct link between your bodies?

Mr Wilson : I am employed by ADAC. Because of my expertise on the ANCD and NIDAC—

Mr RAMSEY: I was just wondering. That is fine. The question I really have is about this conundrum: do we restrict or do we educate when we are dealing with drug and alcohol issues? You would be well aware that there have been what I would call draconian alcohol restrictions introduced in Coober Pedy in the last six or eight months. This has had a dramatic effect at least on the streets of Coober Pedy. You could say that it has shifted somewhere else, but we are not too sure whether it has shifted. That has certainly increased the quality of life for most people who live in Coober Pedy. But I am wondering about the strength of those restrictions. Yes, you can restrict everybody from buying more than one bottle a day. But inherent in those restrictions is an absolute ban on people who come from the APY Lands. That is what the leadership of the APY want, and I fully support it. But how long will it be before someone takes that to court and blows it all to bits? How robust are those restrictions when you ban people by address?

Mr Wilson : As you probably know, there is a dry zone committee or conference happening today in Port Augusta which includes all of the different Aboriginal and non-Aboriginal communities from across the state to talk about these sorts of issues. We asked the Aboriginal Legal Rights Movement at the time whether it was discrimination to exclude people based on postcode or address. They said no. That surprised me.

Mr RAMSEY: I reckon it is a human rights thing. I do not want it to collapse, but I would like to know what threats are there.

Mr Wilson : There is that. But if you look at some of the other places, such as Norseman, for example, which is just over the border in WA—it is not predominantly an Aboriginal community; they make up about 10 or 20 per cent—they collectively came together, recognising that some of the products being sold were creating most of the harm. So the Aboriginal and non-Aboriginal community then went to the publicans and said, 'Would you voluntarily ban these products?' This is going back quite a few years now and it is still going as a voluntary issue.

Mr RAMSEY: But that is a little different to banning someone by address.

Mr Wilson : It is.

Prof. Gray : There was a case in the Northern Territory, the Curtin Springs roadhouse, where the Pitjantjatjara people applied for such a ban. They went to the Race Discrimination Commissioner and got an exemption under the Racial Discrimination Act which made that ban legal.

Mr SNOWDON: I would like to follow up on the question about supply and demand. You have done a lot of work in this space. Have you looked at the restrictions that happened in the Northern Territory with the banned drinkers register, how that impacted upon consumption and behaviour and how things might have changed subsequently as a result of the lifting of the banned drinkers register?

Prof. Gray : We have not looked at that in detail, but the People's Alcohol Action Coalition in Alice Springs got access to the hospital emergency department presentations data for the period prior to and subsequent to the introduction of the banned drinkers register. What happened was that in the 14 months prior to the introduction there was a slowly increasing rate of hospital emergency department presentations. When the banned drinkers register was introduced, that rate continued to climb at a higher rate than would have been expected. But even the critics of the register did not claim that it had adverse effects. When the banned drinkers register was removed there was a dramatic increase in emergency department presentations, which is a prima facie case that the register was having some effect. There needs to be more work done on that, but it looks as though that register was effective.

Mr SNOWDON: Can you explain to the committee how the banned drinkers register worked? I could explain it, but it would be better if you did.

CHAIR: We had a lot of evidence about that in the Northern Territory.

Prof. Gray : Basically what happened was, if people were apprehended for alcohol related offences—I think it was three offences within a certain period of time—they were banned from purchasing alcohol for a period of three months. They had a photo ID system which had previously been put in place in the Northern Territory, so there was a way of checking.

Of course, in a way it is like all these kinds of restrictions: whenever you introduce restrictions, there are going to be some people who attempt to circumvent them. The question is not whether people are circumventing those restrictions but to what extent they are circumventing them. For a whole range of restrictions, we have seen that people circumvent them, but the procedures people use to circumvent them have nowhere near the impact that the original restriction had. I think that appears to be the case with the banned drinkers register.

Ms PRICE: What are your observations or what are your views on the prevalence in these communities of black market alcohol? I know that in one particular community in Western Australia you can ban people from drinking and have restrictions, but there is always a way to get around it. I am interested in your views on that.

Prof. Gray : I think I have answered that already. There will always be people who get around it. Sure, there will be people bringing grog in, or people will make home-brew or those sorts of things, but they cannot produce it or transport it in such quantities as before the bans were put in place.

For example, a number of years ago we looked at restrictions in Tennant Creek. The main ones were no takeaways on Thursdays and bans on sales of cask wine. A number of people said, 'People are getting around this by purchasing alcohol from sporting clubs,' which were not subject to the restrictions, or they were going to Threeways Roadhouse down the road and buying it from there. So what we were able to do was get access to the liquor sales from those places. Sure, there were slight increases in sales from sporting clubs and the roadhouse, but again they nowhere near offset the ban that was the result of the liquor licensing commission's decision.

Mr PERRETT: Back to some earlier evidence particularly about compulsory treatment, is there any data on the efficacy when it is compulsory, as in not a willing person? When we were in Tennant Creek and in Alice Springs we heard some off-the-cuff comments about how difficult it is when someone is dragged screaming to the dry—

Prof. Gray : There are a couple of reports, one of which was done by the ANCD. It showed that compulsory treatments are not more effective than voluntary treatment.

Mr PERRETT: But not less effective?

Prof. Gray : Not less effective.

Mr PERRETT: But not more effective.

Prof. Gray : There are other issues.

Mr PERRETT: The legislation would get more people into the stream, obviously.

Prof. Gray : There are lots of people in communities who actually want to give up grog. When you introduce the mandatory regimes, you keep people who are more motivated out of positions. In Alice Springs, for example, they put a lot of money into mandatory treatment, and what has happened at CAAAPU is they now have two streams of treatment. The government is so keen to make mandatory treatment work that they are putting more resources into the mandatory treatment than they are into the regular program. The organisation is trying to balance that out to the extent that it can. There is the same problem: there has been no allowance made for what happens when those people come out.

Mr PERRETT: Leaving that aside, in terms of job, family, environment and all those things—that being equal—you are saying that there is not a lot of difference between compulsory treatment and voluntary treatment. That is, someone arriving at the program voluntarily or dropped there by police.

Prof. Gray : In terms of the outcome. The people who go in mandatorily need more work. You have spent more time with those people to get them to the endpoint—more resources.

Mr VAN MANEN: This probably on a different tack. Our trip to Alice Springs brings this to mind. Have you noticed a difference with alcohol and other drug related issues in the Indigenous community based on the economic and housing situation for Indigenous people? The reason I use Alice Springs as an example is that, if you have a lot of Indigenous people living in town, as we all normally do, you could also have those living in town camps. It is the same at Tennant Creek. You have people living in town and also in the communities. Is there a difference in the issues to do with alcohol and substance abuse, depending on their residential and economic circumstances?

Mr Wilson : Yes, I think so. At the end of the day, if you have 10-plus people, which is not uncommon, living in a house, it gives you a bit more economic buying power, to buy collectively, not just alcohol but other substances. It is not just Alice Springs and places like that; all you have to do is go to the parklands around Adelaide. Once they declared the CBD a dry zone, it just forced all the folk into the parklands. There is upwards of 100 Aboriginal and non-Aboriginal people in the parklands every day. You can go there and people will be drinking and at some stage during the day other folk will come in to sell other substances to people who are already, let's say, pretty inebriated. What you tend to find is that people who might come from traditional communities might pick up some of those habits in town and then, when they go back to their communities, they have other issues. So it is about economics. Substances or alcohol are relatively cheap, if you ask me, in a lot of those small rural communities. Drugs are pretty pervasive. I could probably go anywhere in Australia and get any sort of substances you wanted.

Prof. Gray : There are a couple of older studies which look at alcohol consumption coming out of work from the national household surveys. They show that Aboriginal people who are on higher incomes are less likely to drink excessively than those on low incomes. There is a paper by a guy named David Thomas, who has worked in the Northern Territory. I think he is now based in Melbourne. He has looked at social determinants of smoking and found similar things. So employment and higher incomes are protective against smoking, which is a major issue.

Mr VAN MANEN: That probably applies to the broader community, as well.

Prof. Gray : That is right.

Mr VAN MANEN: We are spending an enormous amount of time and money on treating the results of people being in a low socio-economic situation. What are we doing to try and lift them out of that low socio-economic situation so that those health and other consequences start to dissipate? Have you done any work on that or had a look at that?

Prof. Gray : I have not, specifically.

Mr Wilson : At the end of the day, you are right, if you do not address the social determinants of health such as housing, poverty, unemployment and a whole range of things, then people are going to get more entrenched in the cycle of substance abuse.

I am an Aboriginal person. We tend to have family issues where, if I was unemployed, I would have no problem surviving within the family structure. It is part and parcel, I suppose, of the lifestyle. It is fortunate that I do have a job. I am originally from the Northern Territory so a lot of my family members are unemployed, on the banned drinkers register or have a whole range of issues.

But things tend to be just one-off. You might get funded to do X, Y, Z and then the funding ceases or the program comes to an end. I know governments do not like it but, at the end of the day things needs to be long-term and sustainable.

That brings us back to Warren's issue about the treatment side of things. If I was a client at Odyssey House in Victoria they would accept that I am a client for a long period of time. It would be no different if I had diabetes or a heart condition—it would become a long-time issue to manage. Once I had finished my treatment there and transitioned into a half-way place I would then have support to get myself into a job and a whole range of things. There would be living-skills programs and stuff like that. It does take a lot of time but you can have good results.

I was one of those folk. I was in and out of—they did not have a juvenile detention centre when I was a kid—an adult jail. But I now have a masters in Indigenous health—so we can turn around—but that was because I had people beside me who were prepared to put time and effort in.

For most Aboriginal folk who get into a problem it is almost considered normal—'What problem do I have?'—because everyone else is doing exactly the same. They are either drinking or taking elicit drugs, so it becomes normalised. So you just think that you are living a normal life. To step out of that is, in some cases for some folk, very difficult. Sorry if that—

CHAIR: No, that is very useful.

Mr NEUMANN: The Australian Institute of Health and Welfare put out a report recently about incarceration of Indigenous juveniles—10- to 17-year-olds. There has been a massive increase in community orders as well as detention and incarceration. You mentioned in a final bullet point, better treatment and support within the criminal justice system and you mentioned diversionary programs. What works in those diversionary programs? Where is it working and where is it not working?

Mr Wilson : You could look at the diversionary programs, as I said, which are not just one-off counselling sessions, which tends to happen under the Police Drug Diversion Initiative. Let us say that I am the person: as long as I appear once, I tick off the box and that is the end of my diversionary strategy, so I do not go through to the criminal justice system. In places like Canada, they will follow that client right down to the final detail to make sure that they have proper housing, proper support, and things like that. You also have to remember that, if you are in a behaviour management class, if you are a primary school kid and you have already started mucking around because you might have fetal alcohol type issues, teachers do not have enough time to focus on that one kid who is mucking around, because they have 30-odd kids. What happens is that you fall through the crack.

Diversionary programs that have and do work—you funded them in the budget—are programs such as the Clontarf Foundation. There are a range of others out there like Red Dust program, which I know works in the town camps in Alice Springs. It employs a bit of a different model. There are some programs out there that do have runs on the board in terms of having success down the track. It comes down to the issue, again, of them being long term. You need to turn people around. It is not just that individual, you probably have to bring the whole family, if not the whole community, with you when you are trying to turn them around. If one kid has success then, before you know it, they might ostracised by the rest—'you think you are better than us'—or whatever. It is better if you can do community-type programs. In terms of Opal fuel, in some of those communities that were really basket cases not that long ago, you can go to places in the pit lands and surrounds and they are actually having some really good outcomes in terms of kids going right through to high school and stuff like that.

Mr NEUMANN: This committee previously looked at the youth courts in New Zealand, the Maori courts, and the wraparound services there. We have had Koori courts and Maori courts in other states. There is a Maori court in my state of Queensland with programs in relation to those sorts of things associated with them. Are they good models for us to adopt in Australia or resuscitate into the states of New South Wales and Queensland.

Mr Wilson : They could be. We have the Nunga Court in Adelaide, which similar to the Maori court, but unfortunately there is no other program. So, you go to court and you have already pleaded guilty because it is a sentencing court. The Magistrate, although he might want to divert you to other places, unfortunately does not have that add-on, so he does not have anywhere to divert that client to get the sort of support that the Maoris or some of the other courts have. Unfortunately because the courts and, as you know, the prison systems are state issues, it is difficult trying to get the state government to accept that there is other work that they need to do.

We did get funded quite a few years ago with a prison program where we worked with prisoners and had it evaluated. It was actually a fairly good program, but once the federal government funding ran out, that was the end of the program. We tend to start things. If it is federally funded we start things. The federal funding runs out and the state government looks elsewhere because their whole philosophy is pack 'em, stack 'em and rack 'em, as Premier Rann said a couple of years ago. As you probably known, even with the tough on violence legislation that is happening around the country there has been an increase. Just in New South Wales alone, for example, there are well over 900 more prisoners who are now in jail and perhaps would not have been there before that time.

In saying all that we have been heavily involved in justice reinvestment. They are doing a trial in Bourke in western New South Wales. From what I understand about justice reinvestment, information coming from places like Texas, they have seen a decline in prisons being closed and new ones opening. They have actually had a far better outcome. My understanding with the trial in Bourke is that they are actually looking at juvenile justice and seeing whether they can turn those kids around. As you probably know from the report that we did, and which Warren launched when he was the minister, for every non-violent offender who is diverted and who might be there for an alcohol-related or drug-related issue, a state government can save up to $200,000 per offender per year. That, at the end of the day, would probably fund your treatment centres.

Prof. Gray : Can I pick up on the point about incarceration. Before, we talked about the need for ongoing care for people coming out of residential treatment programs. But there is the same need for those people coming out of jail. So many people are in jail because of drug- or alcohol-related offences. They may or may not get some sort of treatment or some sort of program in jail, but when they come out they have got exactly the same sorts of needs as people coming out of residential treatment, and all too often it is lacking.

CHAIR: We are going to round up pretty soon, but I want to ask one last question.

Mr SNOWDON: Can I have one after that?

CHAIR: Sure. But we will all be brief. We have not talked much about the responsibilities or roles of the alcohol industry itself. Obviously, it is a very big business that is making lots of money. We know about the social determinants of people abusing alcohol or drugs and the consequences of that, but, beside the social determinants, to what extent do you think the advertising the alcohol industry does, and the relationship it has with sport and sponsorship, makes a difference? Some of these communities that we talking about are very remote, but they still have access to television and other images that metropolitan people see—and I am thinking about metropolitan Indigenous communities as well. Do you think it would make much difference, in terms of the rates of high-risk drinking in Indigenous communities, if, for example, television was banned from showing any alcohol advertising during normal children's viewing time? It is associated with live sport broadcasting. Do you think that the sponsorship of sport by alcohol companies would make a difference for Indigenous communities, given that they have got so many social determinants of alcohol and drug use?

Mr Wilson : I think it would. For example, the last time I was in Alice Springs there must have just been the V8 Supercars in Darwin, and Jim Beam is clearly one of the major sponsors. I went to the Alice Springs casino and Jim Beam stuff was plastered all over. They had the major promotions. Even when the South Australian government, for example, produced huge posters targeted at people from the 'Pit Lands' about the restrictions in Coober Pedy, they had it in English and, then, when it was translated into Pitjantjatjara, the only words that they did not translate into Pitjantjatjara and appeared in English were 'Jim Beam'. And I thought, 'Okay, well, Aboriginal folk do not have a Pitjantjatjara word for whisky.' Clearly, Jim Beam is predominantly there. I thought that for the Jim Beam company it was positive advertising.

Prof. Gray : I think the other way to look at it, too, is from the other side. If this stuff did not work then they would not be doing it. It is economics 100. If you want to maximise your profits, you externalise the costs. As Australian citizens, we are picking up the costs.

CHAIR: Indeed. You mentioned the price controls. You have obviously looked at the tax scenario. It is interesting that we now have both the beer and the spirits companies talking about volumetric—

Mr Wilson : Volumetric has been spoken about for a long time, since I have been involved in this area. Perhaps if the wine industry, which produces some of the products that people use to excess, had a volumetric tax, some of that overconsumption might actually decrease because obviously the price would increase as well.

Prof. Gray : Actually, there is a difference within the wine industry, too, because for some of the premium producers it is in their interests for the volumetric tax to be introduced because, at the moment, they are paying on the cost of production. At the time the GST was introduced, we worked with independent winemakers and they were all for it. So the wine industry is not united on this. It is the large-scale producers who, as some of you know, control marginal seats in South Australia. They are very influential.

Mr SNOWDON: What about the merits, or otherwise, of the floor price as opposed to a volumetric tax or a floor price with a volumetric tax?

Prof. Gray : To me, the volumetric tax has lots of appeal because it can be applied nationwide by the federal government. It also has the appeal of taxing beverages with differential alcohol contents at differential rates, so it is a much more efficient way to do it, I think. We know that minimum prices work in Alice Springs, for example. As I said, taking cask wine and cask fortified wine off the market is an indirect price control measure, and you actually up the price. It works. It is being tried in other places. Personally, I do not think it is as effective a mechanism as the volumetric tax. I suppose, whether you introduce it as well as a volumetric tax is dependent on the level of tax you set. You could virtually set a minimum price through the tiered taxation system. To me, you are adding an extra complication by bringing in the minimum price as well as the volumetric tax. But, in the absence of movement on the volumetric tax, I think a minimum price is an option, and it is something that state and territory governments could introduce, for example.

Mr Wilson : Clearly, the biggest winners in those sorts of scenarios are your retailers, such as Coles and Woolies. If you look at the UK and the New Zealand data, they make big bucks through the minimum price. I agree with Dennis, but at the end of the day some of us have been out there pushing for a volumetric tax for a long, long time, in particular with the wine industry.

But, in closing, some things that we think the inquiry could look at or could include, which would not take that much to do are, for example, the reintroduction of the wholesale sales data. I think it was the member down there who was asking, 'Do you know whether these things work?' Without actually knowing, in given communities or given locations, how much is being consumed, if you have an intervention, you do not know whether it is effective. So, clearly, if you were collecting the wholesale sales data, you could then use that to say, 'Okay, this intervention that we had going in Alice or wherever was effective, because you can clearly see there was a drop in consumption overnight,' for example. There are things like that that the committee could perhaps recommend—which obviously is not hugely costly.

There is also the issue about ongoing care; it used to be called after-care. Those sorts of things are obviously a little bit more expensive, but most rehabs and that do not get funded—I am talking about the Indigenous side. We get funded for the cost of running the rehab and having clients there, but once they leave that is the end of it; we do not get funded for that after-care. That needs to be re-looked at, so that you are part of that person's life. I think, at the end of the day, if you had things like that in place, you would have a far better outcome for the individual and, ultimately, for that community, because they would see members coming back. Relapse is part of it, but in ongoing care you recognise that and you treat the person when they have a relapse. Then more and more family members and other community members might actually go down that track of seeking help.

Prof. Gray : Can I make just two quick points?

CHAIR: Sure.

Prof. Gray : Scott's point about sales data is really important, and we have actually used it to show the effectiveness of interventions in both the Northern Territory and Western Australia. I think that is an important point. In terms of treatment, one of the approaches we are taking in our review for the Department of Health and as the larger study is doing is that approaches to treatment need to be person centred. What does Joe Blow on the ground need in terms of services? The services need to be targeted to the person. It should not be the person trying to fit in with government silos or NGO silos or whatever—

Mr SNOWDON: An individual case management approach.

Prof. Gray : Yes.

CHAIR: Person-centric rather than a one-stop shop.

Prof. Gray : Yes, but also recognising, though, that those people are embedded in families and communities.

CHAIR: And the culture, as you referred to before, Mr Scott, is one where you share. It is communalism, so if one person appears to have got on the wagon then that is a problem; the others say, 'What are you trying to prove, what's the problem?'

Mr Wilson : Yes.

CHAIR: We thank you very much for your contribution. I think we are all good now? As you know, we all have to come and go in this place; do not feel concerned that we are fewer than when we began!

Before I close the public hearing, I call upon one of our members of the committee to move that the committee authorise the publication of the evidence given before it at this public hearing today, including publication on the parliamentary electronic database of the proof transcript. There being no objection, it is so resolved.

Resolved that these proceedings be published.

CHAIR: I now declare this meeting closed, and I do thank you very much for your contribution. You will be getting a transcript, which you need to check to be pleased that we have it all accurately and as you said. You have also referred to a number of other studies that you have been engaged with, including with the Department of Health. We would be very keen to follow that up and make sure we use that data and that we do not re-inventing wheels.

You also referred to the Port Augusta two-day dry zone conference. We would like to follow that up as well and make sure good use of any useful information. You also mentioned a particular program, the Red Dust Role Models in Alice Springs; I do not think we have encountered that one.

Mr Wilson : With Clontarf, it tends to be more football and that—

CHAIR: Boys, yes.

Mr Wilson : The Red Dust involves people like Allan Border and a range of other individuals.

CHAIR: I see. And the girls?

Mr Wilson : And women. It is not just—

CHAIR: Footy and boys.

Mr Wilson : Footy for the boys and netball for the girls. It is a whole range. My understanding is that they do have some success in some of those areas.

Mr SNOWDON: Nova Peris has been involved in that.

CHAIR: Right. And also, the Justice Reinvestment in Bourke trial—we need to tune into that as well.

Mr SNOWDON: Can we get whatever outcomes might come out of your conference?

CHAIR: Absolutely.

Mr Wilson : Yes. We actually did invite you to come along to be part of the FASD panel.

CHAIR: Yes, and I think that parliament is sitting. When is that happening?

Mr Wilson : It is on 2 to 4 June.

CHAIR: I might be able to get leave. I will try. I declare the hearing closed.

Committee adjourned at 12 : 42