Are governments abrogating their public health responsibilities?
This was the title of a presentation to the National Rural Health Conference in Adelaide this week, by David Templeman, CEO of the Alcohol and other Drugs Council.
The article below is based on his presentation – and suggests the answer to the question is a resounding YES.
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A call for national action on our “unfettered access to cheap alcohol”
David Templeman writes:
The Alcohol and other Drugs Council (ADCA) has become increasingly aware of the serious inequities people across Australia suffer at the hands of governments.
Newly elected governments in Queensland and the Northern Territory are highly visible because of their slash and burn mentality towards NGOs in the public health and wellbeing sector.
ADCA is critical of these new administrations – and of the O’Farrell government in New South Wales for its seeming inability to address the problems of alcohol-related violence in so many urban centres.
It was apparent that governments were abrogating their responsibilities toward the health and wellbeing of their subjects. Those most affected lived in rural and remote parts of the country.
Such was the impact of funding cuts on these communities that ADCA proposed it as the subject of a paper at the National Rural Health Alliance Conference in Adelaide.
There was considerable evidence to support the premise but, as the conference drew nearer, it was as if the floodgates opened – giving us with incontrovertible facts to strengthen our case.
Late last month, the ABS released the Socio-Economic Index – a detailed snapshot of the living standards of Australians. The Index ranks local government areas by measuring the resources that allow residents to participate meaningfully in society.
Four of Australia’s most disadvantaged areas on the index are in Queensland – Yarrabah, only a few kilometers from the centre of Cairns, Cherbourg in the South Burnett, Aurukun on western Cape York and Woorabinda west of Rockhampton. This shameful state of affairs – in this case universally in Aboriginal and Torres Strait Islander communities – reoccurs in many others around the country.
At the heart of this and other instances, governments appear to completely ignore the social determinants of health … a key element in equality of access.
The Australian Institute of Health and Welfare recently released the Health Performance Framework 2012 report, which highlights declines of around a third in avoidable mortality and deaths due to circulatory disease over the ten years – and a 40 per cent drop in infant mortality. But chronic disease, high smoking rates and kidney failure and overcrowded housing continued to dog Aboriginal and Torres Strait Islanders.
The Australian Council of Social Service estimates that more than more than two and-a-quarter million people – just under 13 per cent of the Australian population – live in households below the most austere poverty line.
ACOSS’ report is the most comprehensive picture of poverty in the nation since 2006, with the unemployed, children (especially in lone parent families), and people whose main source of income is social security payments, most at risk.
Queensland refuses to reveal its intentions on many issues, but freedom of information access shows it wants to remove alcohol management plans in all Queensland’s Indigenous communities – despite three-quarters of the submissions to a review of alcohol management plans highlighting the risk in their removal.
The NT similarly hints at scrapping alcohol management plans – despite many of its communities being under Commonwealth control due to alcohol and drug related violence.
New South Wales, apparently powerless against the alcohol industry, is more interested in putting extra sniffer dogs in Kings Cross to catch the occasional drug user than addressing alcohol related violence in the same area. It allows takeaway liquor outlets to proliferate despite evidence of their links to violence … and it won’t act against ridiculously long pub and club opening hours.
Queensland has closed a range of special courts – the Murri, Drug and Special Circumstances courts on the expectation of saving $36 million. This was despite the legal fraternity praising their role in rehabilitating offenders, reducing the rate of crime and creating long-term savings. New South Wales also closed its Youth Drug and Alcohol Court – again on the pretext of savings.
And the Northern Territory defies logic in its approach to alcohol and public health. It proposes mandatory rehabilitation facilities for problem drinkers, while many governments explore ways of keeping people out of jail for non-violent crimes.
ADCA strongly questions the veracity of incarceration.
Deloitte Access Economics prepared a report, An Economic Analysis for Aboriginal and Torres Strait Islander Offenders: Prisons vs Residential Treatment and Bridges and Barriers which showed big savings could be made through the adoption of voluntary, community-based treatment in preference to incarceration. While the research was based on Aboriginal and Torres Strait Islander data, there are obvious comparisons with non-Indigenous prisoners.
South Australian alcohol and other drug services are also up against it, facing reviews of all health funded non-hospital and NGO services. The state has suffered a drastic reduction in residential treatment beds and no noticeable improvement to non-metropolitan alcohol and other drug services.
A study of rural workers last year found that nearly half those surveyed – seasonal and mobile workers along with family members and employers – risked their health through excessive alcohol consumption.
Nearly half were identified as risky drinkers consuming large amounts of alcohol frequently. Some employers ignored their employees’ drug and alcohol use because of labour shortages, and there was limited use of health care among those surveyed and no knowledge of drug and alcohol services.
ADCA has written to the Prime Minister stressing that alcohol is a national problem warranting urgent attention. Police, paramedics, staff in hospital emergency departments tell time and again of the hideously injured and abusive patients that pass through their care – all as a result of too much alcohol.
If governments won’t take notice of the people at the front line, who WILL they listen to?
We told the Prime Minister that the rivers of grog she referred to in her Bridging the Gap address to Parliament were not confined to Aboriginal and Torres Strait Islander communities. Unfettered access to cheap alcohol, we said, was a national issue for all Australians and one where the federal government had to act.
The alcohol and other drugs sector has consistently called on the Commonwealth to confront alcohol issues through taxation reform, it being well-established that higher alcohol prices will mean a drop in consumption.
It’s time we shrugged off the glacial pace of social reform in all these areas. We need to bridge the gap between urban and rural Australia, and we need to see some government action.
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Previous Croakey articles on the 12th NRHC
• The story of the Broken Hill Table Tennis Club and its significance for rural health
• Central Qld study shows impact of mining boom on health services
• Online connections critical for rural health
• Recognising an unsung hero – and some vox pops
• NDIS is shifting the paradigm, and the balance of power
• Talking about some good news in Aboriginal health
• An update on efforts to reduce Indigenous smoking
• Spotlight on Indigenous health and the value of physician assistants
• What are the critical health issues for rural and remote communities?
• Introducing a new Croakey service, launching at the national rural health conference
Details and declarations re the Croakey Conference Reporting Service are outlined here.
