Thursday, 7 December 2017
Social Services Legislation Amendment (Welfare Reform) Bill 2017; Second Reading
Senator Siewert has outlined the Greens' overall opposition to this bill, and obviously we'll be moving a number of amendments. Let me firstly wholeheartedly endorse her contribution to this debate. We welcome the move by the government today to finally accept that we are not going to allow people to be subject to drug testing as part of our system of income support. It's a long overdue announcement, and we certainly welcome it. We think this is a very significant development.
As someone who has worked as a former GP and drug and alcohol clinician, that's the area I would like to limit my speech to today: those schedules of the bill that relate to drug and alcohol testing. Drug dependence is a health issue. It requires investment and support. It doesn't require punishment through testing and the threat of the removal of payments. What this bill proposed to do was to set up a punitive system, a dangerous system, a system that would actually cause more harm than good, where recipients of Newstart and youth allowance would be randomly selected for a compulsory drug test. When this was first proposed, the Greens came out immediately to signal our opposition to this. We certainly welcome the support of the opposition and some members of the crossbench who have also signalled that they see this as counterproductive.
What the government saw fit to do was to subject people to drug testing and subject those who tested positive to income management for a period of 24 months. It sought to establish a system where if you tested positive more than once, you would be forced to enter treatment. I understand that some people might instinctively think that's a reasonable proposition—that if somebody is struggling with drug dependence we should force them into treatment. Sadly, we know from all of the evidence all around the world that that's actually counterproductive, that forcing people into treatment simply doesn't work and, in some cases, can be counterproductive. It certainly doesn't work when you haven't got enough treatment support facilities and you haven't got rehabilitation, in-patient support, detox services and so on available to people who need them.
The government also proposed that if you failed a drug test you would be charged for the cost of that drug test. We don't know what figure the government put on it because there was such scant information about the sort of tests that would be used and how it would be managed. So the drug-testing proposal in the bill was punitive, it was damaging and it was completely evidence-free. We know that it had the potential to make drug testing worse. It was designed to remove people from income support—people who are vulnerable, people who need help rather than punishment. We know that it was a dog of an idea because it was roundly condemned by every single expert who presented to the committee inquiry. I attended several of those hearings, and it was very clear, whether they were addiction specialists, whether they were drug and alcohol researchers, whether they were people on the front line delivering services—drug and alcohol workers—that drug testing income support recipients would worsen their health issues; it wouldn't have any positive impact at all on drug addiction.
The reality of addiction is that by the time somebody is dependent on a particular substance, they've already lost so much. I saw people in my practice who had lost everything that was dear and precious to them—their family, their partner and their children had often been taken away, their job, their home, their dignity. So the government's threat to these individuals, people in the grip of an addiction to a particular substance, saying, 'We're going to now take more off you in an effort'—notionally, at least—'to try and ensure that you get the treatment you need' was completely meaningless. All it did was to kick someone while they were down. It wouldn't have had any impact whatsoever on the ability of people to get treatment, but it certainly would have made life harder for people already at rock bottom.
The Royal Australasian College of Physicians gave the committee the definition of 'addiction'—it's a chronic, relapsing disorder. I can tell you, again, from the perspective of someone who has worked in this area, that what that means in practice is that people will often get clean and then they'll come back in because they have relapsed. It's a chronic, ongoing, relapsing condition. By the time somebody is able to come through the other side of that, they will often have had a number of attempts at getting into treatment—that's the nature of the condition. Anything that you do to make life harder for an individual in those circumstances just serves to make the transition from being drug dependent to actually living a life where you are no longer dependent on that substance much, much harder. So I am pleased that the government has finally seen sense on this. In fact, the government's own advisory council was set up—not the current one but the one that preceded it—and it was quite embarrassing at the time. I was with Senator Siewert when advice came forward from the government's own committee to suggest that we shouldn't go down this road; we shouldn't ever put in place punitive measures that link drug dependence to income support.
We heard from all of the experts and all of the providers that there has to be a level of ownership in the decision; there has to be a willingness for treatment to work. There are different models of addiction. There is the stages-of-change model where, unless somebody is at the stage where they are contemplating change on their own, no intervention outside of that point is likely to be successful. There are different models and different frameworks that people look at when it comes to the management and treatment of substance dependence, but one thing that most people acknowledge is that, if somebody is continuing to use an illicit substance and they are dependent on that substance and they do not have a desire or willingness to change those circumstances at that point in time, then there's not much you can do about that except support them and help them get to a point where they reach a stage where they are willing to move into treatment and try to get some support. It's often a lifelong challenge for people, and you don't make that challenge easier when you stigmatise and punish people. That's part of the problem we have when it comes to the treatment of substance dependence.
This is a policy that would do more harm than good. In my own medical practice, I've treated hundreds of people with substance dependence. I've got a strong recollection of a young family. It was a young woman and she had two young kids. She was one of those people who lost almost everything. She still had her kids with her when she came in to see me. The kids would often come in—they'd turn the place upside down—and we'd have long conversations. She went through her ups and downs for a long period of time, but she got through it. It was a long and difficult recovery, and she had lots of stumbles and lots of falls along the way. But, ultimately, she got through it. I remembered her when this came up and I thought, 'What would've happened to her during the period where she was really struggling if this had been put in place, if we'd had the government come in and test her for substance dependence?' Obviously, she was in a treatment program, but what if they'd gotten to her before that? She had her two kids. What if they'd gotten to her when she wasn't ready to come in, if they'd gotten to her in the preceding months when she was really at rock bottom? There's a chance she might have lost her kids. I suspect that there's a chance she might not be here if this policy was in place. Ultimately, she came to that decision herself, we went through the journey together and she's now living a very productive life.
We have to start getting away from this mindset that this is something that needs to be punished, where people need to be stigmatised. We need to recognise that, for people who become dependent on a particular drug, there are often serious underlying issues—trauma, abuse. Let's deal with those. Let's help people through that journey. Let's make sure that we provide people with support and assistance.
I know that there are many people who instinctively would look at this and think to themselves, 'Well, we have to intervene in some way. If it requires a heavy hand of government to step into this environment and force people into treatment, well, that's just the price we need to pay.' As I said, the evidence is very clear that that doesn't work. Where it has been tried internationally, it has never worked, and, indeed, in many cases, it has made a bad problem worse.
Of course, it's not just about people who are drug dependent. This doesn't apply to drug dependence; it applies to drug use. So you have to ask yourself the question: why is it that we would intervene in an area where we are linking government support to the use of a particular illicit substance? Where does this go next? Does it mean that, if a young person on a weekend decides to take a pill and they then test positive, we're going to link it to other forms of government support? Does it mean that we're going to reduce support for HECS? Is it going to be linked to access to Medicare? We don't know where this proposal will end. If we start down this road, where does it stop?
The bottom line is: until we start recognising that drug dependence has to be seen as a health issue rather than a law-and-order issue, we're just not going to make the progress we need to make.
One of the things that we learnt through the inquiry process was that there was simply no detail around how this would work. The government had no idea about the sorts of tests that were going to be used, who was going to administer them, how frequently they would be administered and what the overall cost would be, not just to the individual but for the scheme. I was staggered that the government would come up with this—and it sounds like it was a thought bubble; we're pleased it was scotched—and introduce something as significant as this without having done any homework, without knowing exactly how it was going to work. We belled the cat when we learnt that it was rejected by the government's own advisory committee only a short time beforehand.
Even if the government decided to proceed with this, one of the problems is that there is a shocking lack of treatment for people who run into trouble. Drug and alcohol treatment services are chronically underfunded. They have been for many, many years, under successive governments. We know that about half of the people who need help can't find it. I can tell you, again, from personal experience, that it was often difficult to get people in if you were going to begin a drug substitution program. If you were going to try to get people into emergency detox or in-patient rehab—all of those things were chronically underfunded, and the result was that people who needed help were turned away. How can you put in place a system that forces people into treatment when those treatment services simply aren't available? NDRI, a pre-eminent drug and alcohol research body, said they'd done a study to look at the full scope of drug- and alcohol-treatment services across Australia. But we don't know what the outcome of that study was, because state and federal ministers covered it up; they didn't want the community to know how chronically underfunded our drug and alcohol sector is.
The reality is, if we're going to make progress in this area, we have to move away from what we're doing and we have to try a new approach. The threshold question is: are we prepared to accept that this is a health issue, not a law-and-order issue, and are we going to take steps to start allocating the precious resources we have in a much more rational and compassionate way?
I was fortunate enough to go to Portugal in 2015 to look at what they did. The Portugal experience is really interesting. In Portugal, back in the late nineties, there was a huge problem with heroin addiction. As many as one in a hundred people in Portugal were dependent on heroin. People were dropping dead on street corners from overdoses. They had a problem with the spread of bloodborne viruses like HIV and hepatitis C. Governments were throwing their hands up in the air and saying, 'We just don't know what to do with this.' They got together experts from health and medical backgrounds, law and order experts, police, judges and so on. They basically had bipartisanship on the issue. They established a committee, and the committee said something that people who've worked in this sector have known for a long time: 'You're doing this all wrong. Stop punishing people and start providing support for people.' So, Portugal took what was at the time a very radical step—they removed all criminal penalties for individuals who used drugs. The effectively said, 'If you're going to use a drug, we're not going to waste police resources and we're not going to clog up the courts; we're not going to spend time prosecuting you simply for using a substance.'
Instead, they moved to a process whereby, if somebody had problematic drug use, they went before a panel, and the panel made sure that they provided as much support as was possible. They had, for example, employment programs. They subsidised employers and said, 'If we've got somebody who's been through a drug-treatment program, we're going to pay half of the wage of that person if you take them on.' Interestingly, after two years of people having been through the program, 90 per cent of them were still in the same employment because all of the issues that were contributing to their underlying drug use—the social isolation, the lack of support, the inability to put a roof over their heads, the trauma that people had experienced, the psychological help that they needed—were being addressed.
The experience in Portugal has been a very positive one. At the time people said, 'Don't do it. You're going to see a spike in drug use. People will come from all over from Europe'—the so-called honey-pot effect—'to use illicit substances.' Instead, they've seen a decrease in problematic drug use. They've seen a significant decrease in crime. They've seen a significant decrease in the harms associated with HIV, hepatitis C and so on. It has been an overwhelming success, and it's because they decided to follow the evidence, not blind ideology, and not to continue to stigmatise a group in our community who need support—and of course that's something that the Greens have fought for for many, many years.
We recognise that the war on drugs isn't a war on drugs; it's a war on people. We have to change what we're doing. We have to have a much more holistic approach. We know that there are people who work in law enforcement—the former AFP Commissioner Mick Palmer is now a strong advocate for removing criminal penalties for personal drug use and using those resources for health and social supports. Almost overwhelmingly there is support amongst the health community.
I'm pleased that the government has decided to change what they're doing. I am pleased that we're not going to use people who get into trouble with drug use as an opportunity to parade this government's law and order credentials, and I'm pleased that they've seen sense. It is in large part due to the huge backlash that we saw in response to this policy and to a tremendous campaign from community advocates, the drug and alcohol sector and many elements of the law and order sector. I want to congratulate all of them.
I want to congratulate my Greens colleagues—in particular Senator Siewert, who has been a leading voice on this. Let me conclude by saying that Senator Siewert has addressed many other elements of this bill. In particular, Senator Siewert flagged that she would move a second reading amendment during her speech, which she didn't get to. On behalf of Senator Siewert, I move:
At the end of the motion, add "but the Senate is of the opinion that an independent, comprehensive public review of the current jobseeker compliance system should be carried out, including what is needed to reform the system".