Key issues
2.1
Throughout the course of this inquiry, submitters and witnesses expressed
a range of concerns about the proposed drug testing trial.
Evidentiary basis for the trial
2.2
Some submitters, such as 360Edge, the Public Health Association of
Australia and the Kirby Institute, expressed concern that there was a lack of
academic evidence to indicate that drug testing welfare recipients would assist
them to address their substance abuse issues.[1]
2.3
These submitters pointed to a report by the Australian National Council
on Drugs which, in part, concluded that:
There is no evidence that drug testing welfare beneficiaries
will have any positive effects for those individuals or for society, and some
evidence indicating such a practice could have high social and economic costs...[2]
2.4
However, the committee received some evidence to support a mandatory
drug testing trial. The Kirby Institute explained that a 2002 systematic review
of compulsory treatment revealed some studies that found 'superior outcomes for
clients receiving compulsory treatment compared with voluntary treatment'.[3]
2.5
Professor Alison Ritter, Director of the Drug Policy Modelling Program at
the National Drug and Alcohol Research Centre at the University of New South Wales
(NDARC) explained to the committee that there had been some success in the
criminal justice space where individuals had been forced to make a choice between
whether to undergo drug treatment or face significant consequences:
The merit program is a very good example and there are the
police diversion programs. These are compulsory treatment programs. In the
context of a crime having been committed and treatment being a forced choice
for that person to then make, the evidence is that these programs can be cost
effective where that person makes the choice to undergo treatment instead of
the original sentence that the magistrate or judge has made.[4]
2.6
However, submitters noted that these findings were not necessarily
representative of the bulk of scientific evidence in this field.[5]
2.7
Some submitters, such as the Australian Injecting and Illicit Drug Users
League (AIVL), Anglicare Australia and the Penington Institute referred the
committee to international examples where drug testing trials had been
undertaken.[6]
2.8
Submitters expressed concern that in the United States of America and
New Zealand, similar trials had been expensive and relatively few people had tested
positive to illicit substances.[7]
For example, in Missouri in 2014 there were 48 positive tests taken from 446 welfare
applicants and in New Zealand in 2015 there were 22 positive tests taken from
8000 applicants.[8]
2.9
However, the committee also notes evidence that suggests the Australian
context may be different. In his second reading speech on the Bill, the Hon.
Dan Tehan MP, Minister for Social Services (Minister), explained that there was
evidence from the Australian Institute of Health and Welfare to indicate that
drug use is a barrier to employment:
Research shows us that substance abuse is directly impacting
the ability of some jobseekers to undertake job search or other activities...The
Australian Institute of Health and Welfare's 2016 National Drug Strategy
Household Survey shows that those who were unemployed were three times more
likely to have recently used drugs such as ice and other amphetamines than
those who were employed.[9]
2.10
The Department of Social Services (Department) indicated to the
committee that the drug testing trial would be used to assess whether drug use
in the welfare context is inhibiting people from moving into employment:
The underlying policy rationale is to identify in a trial
whether people are using illicit substances. To the extent that that is the
case, it is clearly one of the things that can be a barrier to employment.
Those who have that barrier to employment could then be, after a second test,
referred to assessment as to whether or not they would benefit from treatment
options or other interventions designed to address that substance misuse and to
improve their capacity for and likelihood of addressing that barrier and
returning to work.[10]
Committee view
2.11
The committee understands that submitters have raised concerns about
whether the drug testing trial will be beneficial for participants. The
committee notes that some of the compulsory treatment trials that have occurred
internationally have observed positive results and that some Australian drug
testing approaches have seen positive results when participants are forced to
make a choice between treatment and a less attractive alternative.
2.12
The committee understands that the trials from the criminal justice
setting are different to the welfare context, but the committee considers that
a limited methodologically appropriate Australian drug testing trial should be
conducted in the welfare context to test whether substance abuse issues are
causing a barrier to employment for trial participants.
Methodology of the trial
2.13
A number of drug and alcohol researchers raised concerns about the
scientific method being proposed for the trial.
2.14
In its submission, NDARC commented that it considered that the current
research framework was inadequate:
Were this truly to be a 'trial', then it must conform to the
usual standards of evidence generation (including Australian codes of
responsible research conduct).[11]
2.15
The NDARC observed that proper research design would clearly identify a
target population, primary and secondary research outcomes, definition of
effectiveness, ethics approval, an independent research team and adequate trial
monitoring.[12]
2.16
Similar statements were made by other researchers in the area such as
Dr Anna Olsen and Dr Alex Wodak.[13]
Dr Wodak, President of the Australian Drug Law Reform Foundation emphasised
that medical research must be both scientifically and ethically sound.[14]
2.17
The Explanatory Memorandum states that the trial will be conducted in
accordance with the Drug Test Rules. The Explanatory Memorandum also notes that
the Drug Test Rules will be finalised after advice and feedback from
stakeholders.[15]
The committee notes that it is intended that the contractor will need to
conduct drug testing in accordance with the Australian Standards for specimen
collection and the detection and quantitation of drugs.[16]
All tests will be carried out by accredited laboratories.[17]
2.18
In his second reading speech the Minister said:
There will be a comprehensive evaluation of the trial to
determine which aspects have been successful in addressing welfare recipients'
substance abuse and barriers to employment.[18]
2.19
The Department advised the committee that the evaluation was still in
its early stages and that a consultancy firm would be hired to conduct the
evaluation.[19]
2.20
The Department noted that the evaluation criteria would be developed in
conjunction with the consultant who would evaluate the trial.[20]
The Department also highlighted that evaluation design workshops would be held
in each of the trial sites to inform the design of the evaluation.[21]
2.21
The Department informed the committee that $980 000 has been allocated
to conduct the evaluation.[22]
Committee view
2.22
The committee acknowledges the concerns raised by researchers about the
design of the drug testing trial.
2.23
The committee considers that a rigorous methodology is required if the
trial is to be comprehensively assessed to determine which aspects of the trial
assist participants with substance issues.
2.24
The committee welcomes the commitment to conduct evaluation design
workshops in the trial sites, but the committee is concerned that the trial may
not be properly conducted and evaluated if the methodology and metrics that
will be used to assess the trial are not clearly established at the commencement
of the trial. The committee considers that these should be established and
published before the trial commences.
Recommendation 1
2.25
The committee recommends that the Department of Social Services should
establish and publish the evaluation strategy of the drug testing trial prior
to the commencement of the trial.
Recommendation 2
2.26
The committee recommends that the Department of Social Services publish
the outcomes of the drug testing trial after it has been completed.
Increased demand on services in the trial sites
2.27
A number of submitters raised concerns that the drug testing trial would
increase the demand for drug treatment services in the trial areas because
mandatory drug treatment may be ordered by a medical professional if a trial
participant returns more than one positive drug test.
2.28
Some submitters raised concerns that there are insufficient services to
treat people who are currently seeking treatment voluntarily.[23]
Professor Ritter estimated that, across Australia, between 250 000 and 400 000
people were unable to access drug and alcohol treatment for their addictions.[24]
Submitters raised concerns that the increase in demand for treatment services
by requiring mandatory drug treatment may displace people who are seeking
treatment voluntarily.[25]
2.29
At a recent Senate Estimates hearing, the Department advised the
committee that it expected that the number of people that would need to receive
treatment as a result of the trial would be relatively small.
2.30
The Department explained to the committee that a trial participant would
be referred to a medical professional to consider appropriate treatment options
if the participant returned more than one positive drug test result.[26]
2.31
During Senate Estimates, the Department estimated, based on internal
analysis, the number of trial participants who would be likely to return
multiple positive drugs tests:
Over the trial, the first tests will be conducted in the
first 12 months of the trial. In Mandurah, maybe 50 or 60 positive first tests.
Then, when we look at the number of positive second tests, Canterbury Bankstown
perhaps around 20 or 25, Logan around 50 or 60, and Mandurah 10 or 15.[27]
2.32
The Department confirmed during this inquiry that its expectations had
not changed.[28]
Treatment fund
2.33
In his second reading speech, the Minister announced that there would be
a dedicated $10 million drug treatment fund to support the trial across the
three trial sites.[29]
2.34
Some submitters raised concerns that the government's commitment of $10 million
may not be sufficient to cover the costs of the additional services required.[30]
Mr Matthew Noffs, Chief Executive Officer of the Ted Noffs Foundation told the
committee that the amount was 'a drop in the ocean'.[31]
However, other witnesses thought that the amount could be sufficient depending
on how the money was spent.
2.35
Dr Mary Harrod, Chief Executive Officer of the New South Wales Users and
AIDS Association told the committee that it could be enough:
I would suggest that it could be enough, but it depends.
You'd need to establish a cannabis clinic, for example, of which there are very
few in New South Wales, and I don't think there's one in this area. Even with
the injection of ice funds, given the number of people and the demand for ice,
there are not that many specialist services. I think it would be a helpful
amount of money for the local government area, but there is no sustained
commitment to provide that funding either, which has workforce implications as
well. It's difficult to answer that question.[32]
2.36
The Mayor of the City of Mandurah, Councillor Rhys Williams told the
committee that whether the drug treatment fund was adequate would depend on the
increase in demand that was placed on service providers:
I think one of the really difficult things here is that we
don't really have a grasp of what the impacts will be. Out of this testing,
what's the number likely to be? If it's going to be hundreds, then, absolutely,
$10 million across three sites over two years is completely inadequate. But, if
it's going to be a handful and the organisations aren't going to see that great
an increase in demand, perhaps it is adequate.[33]
2.37
AIVL told the committee that the current level of unmet need in the
community may determine whether the additional funding would be sufficient.[34]
2.38
The Department advised the committee that it had obtained advice from
the Department of Health to determine the amount required for the drug
treatment fund:
It is a top-up; it needs to be borne in mind. We are aware of
the current Commonwealth provision of services, Commonwealth-funded services,
in each of the trial sites. Looking at the numbers that we anticipate will
likely require an intervention, not all of those who test positive the second
time will necessarily require an intervention. That is something that a medical
professional will have to assess. The advice that we have taken, as I
understand it, is that [it is] an appropriate top-up to the current service
provision.[35]
2.39
On notice, the Department advised the committee that the $10 million
drug treatment fund was a decision of government after considering the advice
from the Department and the Department of Health.[36]
2.40
In his second reading speech, the Minister noted that the $10 million
drug treatment fund is in addition to the $685 million the Commonwealth has
already allocated to reduce the impact of drug and alcohol abuse in the
community.[37]
Committee view
2.41
The committee acknowledges that some submitters are concerned about
whether the $10 million drug treatment fund will be sufficient to cover the
increase in expected demand for drug treatment services.
2.42
The committee accepts that, if the Department estimate about the number
of trial participants that will return more than one positive drug test is
correct, there should be a limited impact on treatment services in the trial
sites.
2.43
The evidence the committee received from service providers indicates
that the $10 million drug treatment fund could be sufficient to cater for
any additional demand for drug treatment services that may be generated during
the trial.
Income management
2.44
During both this inquiry and the previous inquiry, submitters raised a
number of concerns about the use of income management as part of the trial.[38]
While some submitters expressed general opposition to income management, others
raised more specific concerns.
2.45
The Australian Human Rights Commission questioned why trial participants
are automatically placed on income management for 24 months as a result of only
one positive drug test.[39]
2.46
Instead, the Australian Human Rights Commission recommended that, if
income management was to be used in the trial, that it 'be imposed for a
defined period of time, proportionate to the recipients' circumstances, with
24-months being reserved for only the most severe of cases' and be subject to
periodic review.[40]
2.47
Other submitters predicted that the drug testing trial may deter some
individuals from seeking income support for fear of being drug tested.[41]
2.48
The Public Health Association of Australia suggested that even the
perception that the jobseeker may be a labelled as a drug user could be
sufficient to deter some jobseekers:
Genuine jobseekers may be deterred from seeking the support
and assistance available to them through Centrelink and therefore be unfairly
disadvantaged through no fault of their own, but simply because they are
actively avoiding being labelled as a potential drug user.[42]
2.49
The St Vincent de Paul Society also expressed concerns that the drug
testing trial may add another layer of stress for young people deciding whether
to seek emergency relief or seek income support:
From a young person's point of view the stigma, the trauma
and the shame of being homeless, it takes quite a lot to bring them around to
show them that Centrelink and other services can be a positive in their
lives... the overt threat of mandatory drug testing will add another layer to
that which will see our young people disengage. The flow-on effect for
organisations like Vinnies that provide emergency relief will increase, because
the word will be out—'Don't go and get income support because they will put you
on the trial and take your money away from you.'[43]
2.50
In his second reading speech, the Minister explained why he considered
that income management was an important part of the drug testing trial:
This is designed to restrict their access to cash and limit
their ability to use their payments to fund further harmful drug use, while not
reducing the amount of payment they receive.[44]
2.51
The Department acknowledged that there may be a misconception in the
community about the drug testing trial that may make people wary of applying
for income support, but representatives from the Department informed the
committee that the Department was well placed to take remedial action to
correct any misconceptions through its local reference groups.[45]
2.52
On notice, the Department confirmed to the committee that trial participants
who were currently on a prescription medication, medicinal cannabis or had
another extenuating circumstance would not be placed on income management.[46]
The Department reiterated that only jobseekers who test positive for an illicit
substance will be placed on income support.[47]
2.53
The committee also received some evidence that trial participants may
welcome income management. Mrs Julie Fursey from the Logan East Community
Neighbourhood Association told the committee about how income management had assisted
one of her clients:
It's helped them to keep a roof over their heads. One
particular lady has two children and has kept the roof over their head. She's
been able to go back and do some study. She's felt like people value her. She
was keen to go and do the Kokoda Trail at one stage because she felt that her
mental health was not a big stumbling block for her anymore because she felt
that she was a valued human being, and that's not always the experience. When
people are suffering from a mental illness they're already stigmatised. Then,
if they go to drugs to try to deal with that mental illness, it's just
compounded—one on top of the other. You've got to peel all these layers off to
help these people.[48]
2.54
However, representatives from YFS Ltd, another community agency which
works in Logan, suggested that income management may not work well for all
cohorts depending on their circumstances:
The people who have come to us who have valued income
management for a short time are often people in domestic violence who are
possibly still with their partner or who may have had partners who had
addictions...it's given them stable money for rent and food for children. Our
experience is that it hasn't worked for young people at all because of their
limited living arrangements.[49]
2.55
Representatives of the Department advised the committee that evaluating
the efficacy of income management was an objective of the trial:
An objective of the drug testing trial is to assess the
efficacy of using welfare quarantining to help people with identified drug
abuse issues overcome these barriers and find work...It will include evaluation
of the effectiveness of welfare quarantining in assisting job seekers to
overcome their drug abuse issues.[50]
Other matters
2.56
In addition to the matters canvassed above, submitters also raised
concerns about the following issues:
-
whether adequate consultation was undertaken with drug and
alcohol experts, community groups and the trial sites;[51]
-
whether the privacy of drug test results would be maintained;[52]
-
whether procedural fairness would be afforded to trial
participants if they returned a positive drug test result;[53]
-
whether there would be an increase in crime, poverty and stigma
as a result of the trial;[54]
-
whether the trial disproportionately disadvantages Aboriginal and
Torres Strait Islander people.[55]
Committee view
2.57
The committee recognises that some submitters raised concerns about the
use of income management as part of the drug testing trial. While the committee
acknowledges these concerns, it also notes that an objective of the trial is to
assess whether welfare quarantining assists trial participants with drug abuse
issues to overcome this barrier to work.
2.58
The committee notes that the Department has advised that the
comprehensive evaluation will consider whether this part of the trial assists
participants.
2.59
The committee considers that this is a modest drug testing trial that has
the potential to benefit up to 5000 individuals across the three trial sites.
Whilst the committee looks forward to the evaluation strategy being published
prior to the commencement of the trial, the committee considers that there is
merit in a trial being conducted to assess whether there is a better way to
assist welfare recipients to overcome their drug abuse issues and find
employment.
Recommendation 3
2.60
The committee recommends that the Bill be passed.
Senator Slade Brockman
Chair
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