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Tuesday, 26 June 2001
Page: 28594

Ms GILLARD (6:15 PM) —A doctor in my electorate is fond of saying that if we could wipe the slate clean and start again, and we were deciding to legislate to make two drugs legal, it is unlikely that the two that we would choose would be tobacco and alcohol. This casual but informed observation is supported by Australian Institute of Health and Welfare statistics on drug use released in May 2001. Each year over 3,000 Australians die from harmful or hazardous consumption of alcohol. Cancer claims a third, followed by alcoholism and alcoholic liver cirrhosis—about 900—with a further 450 deaths caused by road and traffic accidents. As we know, in relation to road and traffic accidents, it is not only people who have been drinking who die; there are others who are affected by their irresponsibility or negligence.

I concur with the comments of the member for Sydney that it is almost impossible to calculate the total cost to our community of alcohol and tobacco use. What we do know is that statistics compiled in 1996 tell us that the total economic cost of alcohol consumption to the Australian community annually is in excess of $4.5 billion. This costing was based on 1994 mortality and morbidity data and comprises $3.5 billion in tangible costs such as loss of workplace productivity and health care costs; and just under a further $1 billion in what The social cost of drug abuse reports describe as intangible costs, including the suffering imposed on the rest of the community. This does not mean that moderate use of alcohol is without its health benefits or its pleasures. I was pleased to read, for example, amongst the various official figures, that sensible use of alcohol may even improve the life prospects of many—mostly older—Australians.

Alcohol is not our biggest drug problem. Each year over 19,000 Australians die from tobacco related illnesses. About 7,500 of these die from cancer, a further 3,750 from pulmonary disease, and approximately the same number from ischaemic heart disease. It is estimated that each year the loss of life through premature death from smoking totals the equivalent of a staggering 200,000 years. I note the comments of the member for Sydney about the increasing uptake rate of smoking amongst young women. Referring to some comments I made to this House yesterday, I wonder whether the increasing use of tobacco amongst young women is in part associated with appetite and weight control perceptions about tobacco.

Just over 1,000 deaths annually are associated with illicit drug use—that is, the use of illicit substances—and the abuse of prescription drugs for non-medical purposes. About 23 per cent of Australians aged 14 and over use illicit drugs in any given year. Of the illicit drugs, the most popular is marijuana, accounting for about 40 per cent of illicit drug usage. As intelligently portrayed in the recent Four Corners program `Beneath the mirror ball', broadcast on 4 June, the use of ecstasy and similar designer drugs also appears to be on the rise. Further complicating matters, many Australians have multiple drug use problems. We know that, of those who reported that they had smoked tobacco recently, about 90 per cent had also consumed alcohol, while around two-fifths had recently used marijuana. To complete the picture, of the top 10 prescription medicines prescribed in 1998, three affected the central nervous system. Together these three drugs accounted for 32 per cent of the total number of scripts for the top 10 most frequently prescribed medicines. Of the drugs that affect the central nervous system, antidepressants were the most widely consumed.

All of this tells us what we already know—that we live in an age where drugs and drug abuse are a fact of life. Of course, there is no such thing as `the drug problem'. What society faces is a series of complex and sometimes interrelated problems. Drug taking is often the end result of deeper unhappiness or distress within an individual. Governments, community groups, expert bodies and concerned individuals are clearly struggling to contain the effects of drug use and I would dare to suggest that, for all their efforts, we are still not adequately addressing the root causes of substance abuse.

That said, one can understand that a number of community bodies have supported the generality of the proposal we are debating today. However, given the timing of their respective media releases, that support is for the commitment of further funding to prevent and control the harmful effects of alcohol abuse, not for the Alcohol Education and Rehabilitation Account Bill 2001, which we have before us today. Let me say that I share their hopes for what is proposed, even if the legislation we have before this House is inadequate in its present form. What they will not want to see is their efforts to address a very serious community problem tarnished by problems in the administration of the proposed scheme or the shortcomings of the proposed foundation.

As we all know, the Constitution requires that this parliament should satisfy itself that money being appropriated for public purposes will be well spent. As previous speakers on this side have noted, what is fundamentally wrong with this bill is not that it arises out of an act of political compromise but that it provides so little reassurance to the parliament that the $115 million to be expended will be well used.

The genesis of this bill is a textbook example of policy making on the run. The funds to support the proposed alcohol education and rehabilitation account and the proposed foundation became available because the government, in its rush to introduce its GST package, departed from the usual parliamentary practice for setting rates of excise duty on beer. New and higher excise rates on beer came into effect from 1 July 2000, even though it was unclear at the time that the necessary validating legislation would pass the Senate without amendment. In this House we have had cause before to talk about the GST cat. By April 2001 the excise cat was well and truly out of the bag. Beer drinkers around Australia felt that they were being comprehensively dudded, and both the government and their GST co-apologists, the Australian Democrats, were looking for somewhere to park the government's embarrassing beer excise windfall.

What emerged was a face-saving attempt to create a memorandum of understanding between the coalition and the Democrats proposing the funding of a new and purportedly independent foundation which would, in ways yet to be specified—except in the very vaguest of generalities—deal with the problems of alcohol and licit substance abuse. We know that this attempt has not really met with ringing endorsement. I refer, for example, to the AMA's media release on budget health initiatives, which was entitled `Health Budget is all smoke and mirrors'. I think there is some cause for cynicism when we look at the rest of the government's initiatives in so-called education campaigns, particularly public education campaigns. We know that this government specialises in spending vast amounts of money on Teflon coated advertising and so-called `public education' campaigns where the specifics are not designed to stick in the public consciousness. All that is important from the coalition's perspective is the impression that, on the march-up to the next election, the government is `doing things'.

One might also share the Democrats' apparent concern when the government initially suggests that, as part of the deal, it will set up a foundation with a board to be selected by the government. After all, this government has a great talent for board stacking: witness the ABC, the Pharmaceutical Benefits Advisory Committee and the Aged Care Standards and Accreditation Agency.

The memorandum of understanding was tabled in the other place on the urging of Senator Cook. The memorandum tries, without the input of relevant experts—including the drafting expertise of the Office of Parliamentary Counsel—to ensure that this government, which no-one trusts, can be held to account for how it administers this scheme. The problem is that this is no more than a private agreement between politicians. It is not legally enforceable and it cannot bind future governments. Allowing a small political party a direct say in selecting members of a board is quite bizarre and a pretty poor substitute for proper parliamentary oversight of the appointment process. Worse still, the proposed legislation only imperfectly reflects the terms of the memorandum and does not measure up to the standard accountability measures that are normally included in legislation establishing government funded bodies of the sort proposed here. If this legislation gets the attention that it deserves in another place, one would hope that these defects will be remedied.

Speaking personally, I was also disappointed that the legislation neither requires nor encourages the proposed foundation to: look at alcohol related violence, including domestic violence; evaluate the effectiveness of existing laws and programs; and give appropriate support for state based measures, including the evaluation of carefully controlled trials and treatment programs. An example of that is the possible addition of vitamin B to alcoholic beverages to reduce the incidence of alcohol related brain injury. If the other place were to include standard regulation making powers in the bill, it might also encourage me to believe that the foundation will be `rigorously accountable' for its actions. The absence of the standard regulation making power suggests that this organisation will be operating on the basis of internal memos and unpublished guidelines, and not through an appropriate administrative framework where major initiatives and policy decisions are the subject of disallowable instruments scrutinised by this parliament. We simply fail any of those tests.

A further cause for concern is how the government's proposal will mesh with other health policies and programs. Criticisms of the proposed national alcohol action plan by the Alcohol and Drugs Council of Australia suggest that the likely success of any new initiative may be prejudiced by what appears to be a fairly sorry record at the national level in recent years. The ADCA's September 2000 submission describes the government's GST package as failing to deliver an alcohol tax that is fair, equitable, easy to administer and health maximising. But the ADCA's lack of support for the government's record and policies on alcohol use and misuse does not stop there. The ADCA is critical of the lack of government accountability generally, noting that it does not state who is responsible for implementing policies or taking action, does not provide targets for harm reduction and does not allocate funding, or funding responsibilities, against specific actions. In the context of the present proposal promoting further spending on educative measures and publicity campaigns, the government might care to heed the ADCA's comment that what is required now is `a wider coverage of primary prevention strategies, not just information giving and awareness raising'. Further, the ADCA asserts that the proposed strategy on alcohol:

... does not at present provide a strong enough link between the key action areas and strategies ... and those in other Action plans, particularly the National Action Plan on Illicit Drugs.

Further, existing or proposed policies do not recognise that specific geographical areas throughout Australia require targeted strategies focusing on the role of communities. The member for Sydney outlined that in respect of her electorate. I would concur with those remarks about the need for local action in respect of my electorate, even though the problems facing my electorate are very different from the problems facing the electorate of the member for Sydney.

Those reformulating the approach to the treatment of alcohol problems in the coming months should heed the concerns of the ADCA. Clearly, the funding to be made available does provide scope for improvement, but at the national level there is also much to be done in establishing priorities and resolving coordination problems. When this House resumes after the dinner suspension, it is my intention to address some of the local initiatives which are being used in my electorate to deal with the problem of substance abuse, whether that be of drugs that are legal or illegal. I believe that it is those sorts of local initiatives that really deserve funding under the bill that we are debating now. On that basis, I seek leave to continue my remarks later.

Leave granted; debate adjourned.

Sitting suspended from 6.30 p.m. to 8.00 p.m.