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Community Affairs Legislation Committee
24/07/2012

MOORE, Adjunct Professor Michael John, Chief Executive Officer, Public Health Association of Australia Inc.

[09:22]

Evidence was taken via teleconference—

CHAIR: Welcome. We have your submission, thank you very much. You have been through this many times. We invite you to make an opening statement and then we will go to questions.

Prof. Moore : I would like to make just a short opening statement. You have our submission, so I will leave that and go to a slightly different area. When I looked at the legislation and the approach taken, I was thinking about the successful public health campaigns that have been run in the past. It is important to remember that successful public health campaigns are never about one thing; they are about a whole series of things. They are about individual responsibility but they are also about tackling underlying causes and operating within particular settings. There is a snowball impact for effective campaigns—that is, you begin to get everybody on side and it reaches a point where you cannot get the last few, and that is when it is time for legislation.

If I can draw just a very quick analogy: when our community tackled motor car related morbidity and mortality, we began a process of trying to explain about accidents and the power of cars and trying to get people to drive sensibly and lower their speeds. Then a whole series of things happened. There was legislation to improve motor cars, to change the speed limits and particularly to prevent driving under the influence of alcohol, and seat belts requirements and so on. And each one of those steps combined was done, first of all, with general understanding in the community, which was then followed at the last bit by legislation. I think what is happening here is applying the same sort of principles, and that is why the Public Health Association is supportive of the Low Aromatic Fuel Bill 2012.

CHAIR: Thank you very much.

Senator SIEWERT: Thank you. In terms of the legislation itself, am I to take from your comments that what you are saying is that this is the next step in how we address dealing with the issue of petrol sniffing and rolling out low aromatic fuel?

Prof. Moore : There are two ways of looking at this, and I am conscious that just yesterday Minister Snowdon has written to other ministers to try to get them to have a coordinated approach on this issue. I suppose in one sense, in my mind, it does not really matter whether it is coordinated legislation between the pertinent states and the Northern Territory or whether it is done on a federal basis, provided that it is done. It is much more difficult to achieve what Minister Snowdon is trying to achieve, which is to get a coordinated approach that actually works, that does have legislation and that is effective. In my mind, either way works. What I like about this particular piece of legislation is that it leaves the power in the hands of the minister to identify particular areas as Opal areas and then to bring them in, rather than using a blanket system. That allows flexibility so that the minimal impost is put on industry and corporations but at the same time there is enough flexibility for the minister to make sure that what needs to be achieved is being achieved.

Senator SIEWERT: I would like to follow up your comment about 'blanket'. Do you mean just outright mandating?

Prof. Moore : An outright mandate, which I think would be very difficult for a number of reasons—for example, the level of octane in the fuel—whereas when you have the flexibility for the minister to make regulation around specific areas, and within that in the legislation there is also a specific regulation around types and storage of fuels, that flexibility is really important.

Senator SIEWERT: Could I go to the coordinated approach and the comments you started touching on there. You said you do not mind which one—and I prefer the one that is going to have the speediest results, and my personal opinion is that this one would, so I will put that on the table straightaway. Quite frankly, as long as we come up with a solution, I just want a good solution, so if a coordinated approach is going to offer the better solution then I want to know what the pros and cons are. You started touching on it and you made some comments and hinted that you thought that it would be more difficult. What is your experience with that sort of coordinated approach across the states and territories?

Prof. Moore : The biggest issue that the Commonwealth always wrestles with is how much the states are prepared to work with the Commonwealth on these issues and how much power they perceive they are giving away. There is the ability for industry to put pressure on a whole series of ministers instead of, in this case, basically the parliament. So I think that that makes it muckier. However, there have been many things in Australia that have been done in a coordinated way by agreement between the states and territories, and often the motivator is that there is a piece of legislation like this in the pipeline, when the states and territories say, 'Yes, but we do not want to have our powers reduced in any way.' There is a general feeling in state and territory cabinets that what we therefore have is basically a pressure on states and territories to take action simply because this legislation exists. But it would only work if the federal parliament were prepared to pass this legislation or if this committee recommends it is sensible.

Senator SIEWERT: So what you are saying, if I am not misinterpreting you, is that you could still have a coordinated approach even with this legislation. If the legislation were in place, that would not stop the states and territories taking a coordinated approach. Is that what you are saying?

Prof. Moore : That is not what I was saying. I am quite happy for that to be considered and I think that is also true. What I was saying was that the very existence of this bill rather than legislation puts pressure on the states and territories.

Senator SIEWERT: I want to explore this a bit more, because one of my most recent experiences with coordination between states and territories involved end-stage kidney disease and dialysis. Quite frankly, it is still not resolved. As I understand it, in my home state of Western Australia there are still issues with South Australia, and it has taken a great deal of public lobbying and effort to get to where they are now. So I suppose my most recent experience does not fill me with joy or the expectation that it is going to be different with this issue.

Prof. Moore : I understand exactly where you are coming from. The way the Public Health Association views this particular bill is that it is on the table, it does what is necessary, it does it in a rational way and therefore it should be proceeded with. So that is our priority. That is what we think should be done. At the same time, we recognise that, should there be resistance to this bill, at the very least it is putting pressure on ministers and governments around Australia to deal with this issue in a sensible way. But I agree with you: I suspect it will take much longer if it is done by agreements and negotiations with ministers.

Senator SIEWERT: The problem, of course, is we are more than five years down the track and we still have retailers refusing to stock it. I sense a degree of frustration in the community that, if we are going to go for this coordinated approach, it will take even longer.

Prof. Moore : I think it is also worth looking at what has been achieved over the last few years since the rollout. The reduction, according to d'Abbs and Shaw in 2008, was something like 94 per cent. That having been said, there is no doubt that like all public health campaigns settings are incredibly important. The reduction might be good in the broader Territory, but for the communities that are still affected of course it is devastating.

Senator SIEWERT: We have been focusing on Central Australia, but low-aromatic fuel has now been rolled out in the Kimberley, Queensland and the NT. Have you had any experience of looking at how it has been rolled out in other places, outside of the Central Australian area?

Prof. Moore : The Public Health Association has some of the information that is fed through from our network, but certainly we know there are concerns in South Australia, in the APY lands, and we know there are concerns in Queensland. So I think it is incredibly important that the whole area is covered, that we do not just focus on the Northern Territory.

Senator BOYCE: I want to explore your comment here that a number of retail outlets are not prepared to stock Opal. You say:

… and in some cases this situation is likely to be contributing to the incidence of petrol sniffing in nearby communities.

Could you talk about your evidence for that?

Prof. Moore : I was part of a group with CAYLUS—the Central Australian Youth Linkup Service—that went and visited a number of members of parliament recently. I was with that group when we visited Minister Snowdon and a number of other members and senators. With it were two women who were in communities that had Opal but were relatively close to roadhouses that had other fuel. It was very interesting and very moving listening to their stories and I will be very surprised if they do not appear before you. One of those examples was near the Queensland border. The issue was not necessarily that the roadhouses were doing the wrong thing but more that people were fuelling up their cars understandably as they were coming through and then the young people who wanted to sniff were conscious of which cars had the non-Opal fuel. So it actually undermined the process of dealing with this particular problem.

Senator BOYCE: Sorry, I am not quite following that. They are conscious of which car does not have Opal, so that car is targeted. Is that what you are saying?

Prof. Moore : The car is targeted. It is not hard to put a hose down the spout and get some petrol.

Senator BOYCE: We have had evidence this morning for Mr and Mrs Hewitt, who you may know of, who have been very involved in this area for a long time. Some of their evidence suggests that it is a lack of activities in communities and a lack of self-esteem amongst younger Aboriginal men in particular that are the root cause, so to speak, of petrol sniffing. Would you like to comment on that?

Prof. Moore : That is why I started the way I did, that there are areas of individual responsibility, there are underlying causes—all of these things are things that have to be tackled. That is built into some of the goals of the Northern Territory intervention in particular but in communities right across Australia where efforts are being made to try and wrestle with all of those underlying causes. Despite extraordinary efforts, we have not been very successful in dealing with many of those issues. We know the impact of full employment, we know the impact of education, we know the impact of housing. All those things feed into it. It is as much a symptom as anything else? Yes, probably, but we also know that when people turn to petrol sniffing then the impact is devastating. I think that is really what is happening. In all public health campaigns, while you try and address the underlying causes and try to make a cultural shift, you are also dealing with the symptoms.

Senator BOYCE: I guess where I am trying to get to there is that in some ways it is counterintuitive that when Opal fuel became more generally available petrol sniffing decreased significantly. It would appear that without very much was happening in the way of support programs et cetera, substitution did not happen at a very high rate. Is that the case, in your view? If so, have you got any suggestions as to why?

Prof. Moore : We do know that some substitution has occurred. I am taken back to a broader example of the alcopops tax when that debate was happening and everybody said there will be major substitution. Yes, there was substitution, but the substitution was minor compared to the impact it was having. I think exactly the same principle applies here. There is substitution occurring and certainly the leaders of communities I have spoken to are very concerned about cannabis in particular. We do know the impact and health impacts of cannabis. We also know that the health impacts of cannabis are much less than the health impacts of petrol sniffing. I do not think there is any pure 100 per cent solution, and that is normally the case in public health, as much as we would love to get solutions. There are sometimes cases. We have rid ourselves of smallpox and we are very close with polio, but they are the rare circumstances.

Senator BOYCE: And they are not behaviours.

Prof. Moore : Mostly they are not behaviours. We see with HIV and HIV prevention, which is a behaviour one, that we have made great progress, but we certainly do not have a perfect solution.

Senator BOYCE: Thank you.

Senator SMITH: Just going back to your earlier comments, Professor Moore, I am wondering whether or not you are aware of any examples of coordinated approaches between the Commonwealth and states that have been achieved quickly in the public health space.

Prof. Moore : 'Quickly' is a good word. I suppose the one that comes to my mind and goes back to the time when I was involved in politics was coordinated road rules. But it did take some 25 to 30 years, I think, to get that. The other area where I do quite a lot of work is on food, and ministers work together. What used to be a ministerial council is now the equivalent, and decisions made in New Zealand are incorporated in that. The decisions and the coordination that happens over the controversial issues often takes a long time, but almost every time those ministers meet there will eight or 10 issues at least that are resolved sensibly between the ministers, and there are always one or two issues that are difficult and therefore take much longer. I do not see this one as a particularly difficult issue. By comparison, it is probably a mid-range issue, so I would have thought that it could be resolved reasonably quickly, but it will not be anywhere near as quickly as the legislation.

Senator SMITH: Is the success of public health campaigns dependent on or more or less likely if it is coordinated or has a unilateral approach?

Prof. Moore : I think that you already have most communities within the Northern Territory and Queensland et cetera that are dealing with this issue fully supportive, so the setting in which you operate is you have people on side and then your public health campaign is much more likely to be successful. I think it is fair to say that the communities are on side. I think you are asking a slightly broader question, which is: what about the states and territories and a coordinated approach? Where the approach is very straightforward—and I think this one is in legislative and coordination terms—I think they can work and they can be much more successful.

Senator SMITH: Thanks very much.

Senator SIEWERT: I want to go back to the issue of the low aromatic fuel, or Opal, rollout and what happened at the time. Certainly, the evidence that the previous two Senate inquiries received showed that rolling out Opal by itself without support programs was not going to be as effective, and that is why the youth diversion programs, which have been patchy, were rolled out at the same time. Have you looked at where Opal was rolled out with youth support programs and youth diversionary programs and where it has not been? In other words, you had that suite of things that also addressed the underlying causes of sniffing et cetera. Have you done any work around that?

Prof. Moore : No. I would love to have and I have seen some through the Central Australia Youth Link Up Service, but none of our members that I am aware of have done specific working making an academic assessment of how successful that has been. In general terms, we would assume that just doing the rollout of Opal without that kind of support would achieve something but would be nowhere as successful as if you did have those supporting operations happening at the same time. We take that into account in all public health campaigns.

Senator SIEWERT: Thank you.

CHAIR: Professor Moore, you have seen some of the other submissions that we have had. Is that right?

Prof. Moore : Yes, I have.

CHAIR: We have had a couple from providers—service stations and roadhouses. I am particularly interested to hear your comments on the one that says, 'We just can't continue banning stuff. Why don't we ban tobacco? Why don't we ban alcohol?' From your perspective in the public health environment, what is your response to that kind of argument?

Prof. Moore : I think that there is some sense in that kind of argument, which is why the Public Health Association does not advocate the banning of tobacco. What we do is put more and more restrictions on to try to change attitudes. We know that, when we are dealing with things that are prohibited, we wind up with a whole series of other problems, particularly if you look, for example, at illicit drugs, the corruption that is associated with them and the pyramid sales system that develops around them. But where we have been really successful is where there is an alternative. I am trying to remember the name of the drug that Marilyn Monroe used to kill herself and that group of drugs that people were using—barbiturates—that have been banned because the benzodiazepines are available. So there is a sensible alternative that people can use that is not as dangerous. I think that is the same thing we are talking about here. I have not done the examination of this. I know that some of the issues raised were about the octane, but my understanding is that, on the odd occasion when people need a higher octane fuel, you can purchase in little bottles the additive that gives you the additional octane for the odd times that you need it. I would have thought that that is also part of the sensible alternative that is available.

CHAIR: Thank you very much. Is there anything that we have not asked you that you want us to know?

Prof. Moore : No, I think you have covered all the things, and otherwise we have it in our submission. I really appreciate the opportunity to appear before the committee on behalf of the Public Health Association.

CHAIR: Thank you as always to the Public Health Association.

Proceedings suspended from 9:47 to 10:15