1.1
The drug testing trial has now been considered by this Committee twice,
first during the course of the 2017 Inquiry in to the Social Services
Legislation Amendment (Welfare Reform) Bill 2017 and through this Inquiry.
1.2
In both instances, the Committee was overwhelmed by evidence from the
health sector, including from specialists in addiction medicine, as well as the
community sector that the proposal to drug test income support recipients will
not be effective, will further exacerbate long waiting times for treatment,
will be very expensive and also risks increasing levels of crime and
homelessness.
1.3
Further, in this Inquiry, the Committee was able to hear from Local
Government in each of the proposed trial areas: Canterbury-Bankstown in New
South Wales, Logan in Queensland and Mandurah in Western Australia.
1.4
Labor Senators are of the view that there has been insufficient
community consultation in the proposed trial areas, and that there is a clear
lack of community support for the trials in these places.
No Evidence of Effectiveness
1.5
The Committee heard from a number of witnesses that there is no evidence
to suggest that drug testing jobseekers will assist them to find work or
encourage those who do live with drug dependence to access treatment.
1.6
Clinical Associate Professor Adrian Reynolds, an expert in addiction
medicine said that the drug testing trial is 'unlikely to bring about any
sustained changes in patients' drug use behaviours and may even be counterproductive.'[1]
1.7
Additionally, A/Prof Reynolds told the Committee that 'this drug testing
trial is clinically inappropriate and not designed in a way that will address
the issues of substance dependence.'[2]
1.8
A leading researcher in the area, Professor Lisa Maher explained further
that:
The proposed measures are inconsistent with evidence based
approaches to public policy...the Australian National Council on Drugs concluded
that there is no evidence that drug testing welfare beneficiaries will have any
positive effect for those individuals or society and some evidence indicating
that such a practice could have high social and economic costs.[3]
1.9
The Committee also received evidence that the concept of the drug
testing trial is based on a failure to understand the nature of drug
dependence.
1.10
Professor Alison Ritter of the National Drug and Alcohol Research Centre
told the Committee that the Bill, though claiming to implement a trial, does
not conform with the requirements of a trial and that:
...the bill is not written like a research trial, it's written
as policy by stealth...and if this is about introducing new policy, then...it
misunderstands the nature of drug problems and drug dependence.[4]
1.11
A number of witnesses to the Inquiry explained that a drug testing trial
is highly unlikely to bring about positive behaviour change, due to the nature
of addiction. The Committee heard that:
According to the DSM-5, the Diagnostic and Statistical Manual
of Mental Disorders of the American Psychiatric Association, which is the gold
standard of diagnosis in this area, one of the diagnostic indicators of a
substance misuse disorder is that people continue using despite adverse effects
of their use. So, by definition, if someone has a genuine disorder, they will
continue using despite the hardship of being placed on income management, for
example.[5]
1.12
The Committee heard from many witnesses that the drug testing trial was
incapable of successfully addressing the drug problem in Australia.
1.13
The proposal was described to the Committee as a '...a simplistic approach to a very complicated problem.'[6]
1.14
Dr John Falzon from St Vincent de Paul said that:
This legislation will not lead to the desired outcomes and
will actually divert resources from services and evidence-based approaches that
would be successful. It also has the potential create greater levels of harm,
including increased stigma, marginalisation and poverty.[7]
1.15
Academic Associate Professor Kylie Valentine explained further that:
The evidence on the barriers to participation for people in
receipt of welfare payments is growing and is very strong and highlights the
importance of many things that have nothing to do with drug consumption, let
alone drug problems.[8]
1.16
Labor Senators on the Committee note the Australian Labor Party's
commitment to evidence based policy development.
1.17
In light of the overwhelming evidence, both in person and through
written submissions, presented to the Committee during the course of both this
Inquiry and the Inquiry in to the Social Services Legislation Amendment (Welfare
Reform) Bill 2017, Labor Senators on the Committee are strongly of the view
that the proposal to trial the drug testing of some income support recipients
is counter to empirical research and should be abandoned.
High Cost
1.18
Labor Senators on the Committee note that the proposal to trial drug
testing of income support recipients was initially announced in the 2017
Budget.
1.19
However, despite the proposal being a Budget measure, and before the
Parliament in various forms for a year, there has been no clear evidence
provided as to the cost.
1.20
The Committee received evidence as to the general, high cost of drug
tests, and heard that 'there is evidence from New Zealand and other
international domains of the poor cost effectiveness of drug
testing.'[9]
1.21
Labor Senators on the Committee understand that there are a number of
factors which impact on the price of a drug test.
1.22
Dr Kym Jenkins of the Royal Australian College of Psychiatrists
explained that:
The cost of testing for substances depends on the amount of
tests that the laboratory is doing at that time and on how many substances you're
actually requesting in that test and how many samples the lab has to run for
that particular substance at that time. If you're in a small centre then costs
per test are going to be greater than if you're in a laboratory that's running
many tests looking for that particular substance. If you are in a regional,
rural or remote centre then there's the cost of getting the drug samples to a
main drug testing centre as well. Then you add in the cost of the personnel
taking that test, the transport and the reporting and looking after people
afterwards.[10]
1.23
The Committee heard that 'Philip Alston, the UN Special Rapporteur on
extreme poverty and human rights...estimated that the cost of drug testing, doing
it properly, would be anywhere between $500 and $900 per test.'[11]
1.24
A/Prof Reynolds also provided evidence as to the potential cost of a
drug test, and explained the complexities of analysing results. He told the
Committee that:
It is roughly $100 per drug class tested for a urine test.
For hair testing, it is around $180 per class tested...if you want month by month
it can be triple that...those costs do not include the cost of the medical expert
to examine those tests in the context of comprehensive medical and other
histories...finding medicos who have that knowledge and skill across toxicology
as well as clinical assessment of patients to assign meaning to those test
results will not be easy. In fact, it is logistically impossible for this sort
of process to be rolled out across the country.[12]
1.25
Dr Martyn Lloyd-Jones from St Vincent's Health Australia explained
further that, in order to ensure the validity of positive tests, it would be
necessary to undertake a confirmatory test, which was likely to greatly add to
the cost:
It's important to distinguish the difference between the
screening test and the confirmatory test. The screening test, which might be of
a salivary sample or for a urine-screening drug test, may be reasonably
cheap...but, if you then return a positive test, that is required to be confirmed
with a confirmatory test which might be a very expensive process...it's important
to understand the difference between the two and that particularly the former
form of testing was subject to significant numbers of false positives as well
as false negative results.[13]
1.26
Labor Senators on the Committee understand that internationally, the
process of mandatory drug testing has been expensive to tax payers, without
providing a satisfactory return on investment.
1.27
Anglicare Australia told the Committee that:
When we investigated and looked overseas at where mandatory
drug testing had been tried, in essence was that people in the countries that
had tried it, such as the United States and New Zealand, had found that it was
extremely expensive and pretty ineffective.[14]
1.28
Labor Senators on the Committee are concerned that the Government has
not revealed details about the cost of the proposed drug testing trial and have
serious concerns based on international experiences and the stated cost of
testing in Australia, that the drug testing trial will be very expensive to
administer and represent poor value for taxpayers.
1.29
In light of the evidence regarding the significant likelihood that the
drug testing trial will completely fail to meet its stated objectives and the
high cost involved, Labor Senators on the Committee believe that undertaking
the drug testing trial would be both fiscally and socially misguided.
Concerns of Treatment Experts
1.30
The Committee heard from numerous witnesses and submitters that there is
currently a large deficit in public funding for alcohol and other drug services
in Australia, and that the demand for services far outstrips what services have
capacity to provide.
1.31
The Committee heard that in Australia 'about 200,000 – 500,000 people a
year go out looking for drug treatment and aren't able to access
it.'[15]
1.32
Professor Maher explained further:
There's an undersupply of drug treatment in Australia at the
moment. Demand exceeds supply. In any given year we currently treat about half
of those people who are indicated for and seek treatment.[16]
1.33
Ms Rebecca Lang from the Queensland Network of Alcohol and Other Drug
Agencies told the Committee that:
...the treatment sector has been chronically underfunded for a
number of years now...I would be very surprised if you didn't find that a number
of the folks who test positive and who are indicated for treatment hadn't, in
fact, tried to access the treatment system voluntarily in the past and were
turned away, or discouraged by long wait lists or a lack of access.[17]
1.34
In two of the three named trial areas, representatives from local
government told the Committee that services in their areas are currently
incapable of meeting the demand, and would not be able to cope with an
increased need for their services.
1.35
The Mayor of the City of Canterbury Bankstown told the Committee:
We have only one drug rehabilitation centre, which is Odyssey
House at the Canterbury outreach centre. Odyssey House provides counselling,
education and mental health support. One is certainly not enough.[18]
1.36
These views were echoed by the Deputy Mayor of the City of Logan, who
said that:
We do have some facilities in the city, but we don't have
enough for the need that's there already.[19]
1.37
The Committee heard evidence that the funds for treatment to be provided
for the Government were insufficient to meet the current need, let alone the
increased demand that is expected to be generated by the drug testing trial.
1.38
The Committee heard that in Queensland alone, the state is 'about $75
million short of what would be considered an adequate treatment system to meet
the needs of those people who voluntarily want to enter the
system,'[20]
and that this figure does not take in to account an amount to enable services
to meet increased demand.
1.39
Nationally, Professor Ritter estimated that:
Treatment investment that would meet existing demand would
need to be double. The current national treatment investment is around $1
billion, so an additional $1 billion nationally would be required to meet current
unmet demand for treatment.[21]
1.40
Additionally, the Committee heard from a number of Alcohol and other
Drug Service Providers that there is currently a wait list to access treatment.
1.41
One provider, Lives Lived Well, explained the impact of the waiting list
in terms of the opportunity cost for people to access treatment at all:
...there is likelihood that they'll drop off – high
likelihood...the longer the gap between initial contact and intervention, the
higher the drop-off, because there are other strong forces out there that draw
people back into their substance use.[22]
1.42
Further, the Committee heard evidence that forcing people with drug
dependence to undergo treatment would be unlikely to be successful, and also
jeopardise others' chances of recovery.
1.43
Witnesses to the Committee shared a number of concerns as to the impact
the drug testing trial would have on service providers and those seeking
treatment.
1.44
St Vincent de Paul Society told the Committee that the drug testing
trial:
...would further stretch already under-resourced services and mean
that people who actually are waiting for those services and do have a drug and
alcohol issue will have to wait longer...we're going to see those who are
actively seeking treatment and support and who do have a problem with drug and
alcohol use having to wait longer. Even with additional resources, if the
demand on services is increased, then that's a real concern.[23]
1.45
Both Anglicare Australia and the Salvation Army shared this view,
explaining respectively that:
...it [the drug testing trial] will have a major impact on
those who want to be in that treatment who are forced to share it with people who don't want to be there.[24]
1.46
And that:
...the precious and sometimes scarce publicly funded treatment
places for AOD [Alcohol and other Drug] issues will go to people that won't benefit the most from them.[25]
1.47
Medical experts told the Committee that better outcomes would be gained
through an expansion in treatment services nationally, not a drug testing
trial. Labor Senators accept this assessment.
1.48
Dr Jenkins from the Royal Australian College of Psychiatrists told the
Committee that the College is:
Concerned that a significant amount of time and resources
will be spent on developing and implementing this trial and those resources
could be better utilised by expanding treatment services and enabling people to
seek help and return to employment voluntarily.[26]
1.49
Professor Reynolds argued:
In this context of severe shortages of treatment and
addiction medicine specialists, referral to treatment services of all those who
test positive under this drug testing trial will be a poor use of scarce
resources and will impact on services which are already stretched beyond their
capacity. The drug testing trial could also potentially impact those people
already waiting for treatment and highly motivated to undertake it, and the
question arises: do they get bumped down the queue?...One needs to consider
whether they might benefit more than those who are not at this stage so
motivated for treatment.[27]
1.50
Labor Senators on the Committee are of the view that a drug testing
trial of income support recipients is an inefficient allocation of resources,
and that the Bill should be rejected.
Workforce issues
1.51
In addition to the lack of evidence supporting the drug testing trial,
the high cost involved in undertaking drug testing and the existing unmet
demand for Alcohol and other Drug treatment services, the Committee heard that
there is an insufficient workforce to implement the proposed trial.
1.52
Professor Ritter explained that:
The workforce doesn't exist at the moment. Alcohol and drug
services struggle to find appropriately skilled and qualified staff. They're
actually not funded at a level where some disciplines can be employed, so there's
a funding barrier as well as a workforce barrier.[28]
1.53
Both the Salvation Army and the Queensland Network of Alcohol and Other
Drug Agencies reported experiencing difficulty filling vacant positions:
1.54
They told the Committee respectively that:
The Salvation Army frequently has the need to get a bit
creative in staffing our AOD services particularly when establishing new
services. For example, we may need to swing experienced staff across from
related sectors and then train them up specifically in drug and alcohol
knowledge...I'd agree that there is a shortage of well-qualified,
trained staff.[29]
1.55
And also:
With the investment that came through the National Ice Action
Strategy our members reported having difficulty recruiting for
positions.[30]
1.56
Labor Senators on the Committee are of the view that the drug testing
trial will increase pressure on scarce services without investing in the
workforce that is critical to effective alcohol and other drug services.
Unintended, Unproductive and Unfair Consequences
1.57
Labor Senators on the Committee are deeply concerned that there will be
serious, unintended consequences as a result of the drug testing trial, in
particular, that it will lead to increased crime, homelessness, prostitution
and poverty.
1.58
The Committee heard compelling evidence that there is a high likelihood
that the drug testing trials will lead to increased crime in the trial areas.
1.59
Community organisations that work closely with people with drug
dependence explained this risk to the Committee.
1.60
Ms Melanie Walker from the Australian Injecting and Illicit Drug Users
League explained as follows:
What do we think will be the logical conclusion if we cut off
their income support payments? It's not going to be that they suddenly stop
using drugs, with no assistance from drug treatment; it's going to be that they
are going to find the money where they need to in order to address their
addiction and the other needs that they have that are no longer being met by
the social security system....there's a genuine danger, in that it could drive up
rates of crime and exacerbate harms to not only the individual but potentially
the communities in which this is implemented.[31]
1.61
Mr Matthew Noffs, from the Ted Noffs Foundation provided the Committee
with a case study:
Let's just pick a person I know. She is 18. She was raped by
her father repeatedly since the age of four. She was then forced to become a
sex worker at 14. By 16, she was using ice to get by. She is continuing to use
ice at 18 and she is on the dole. This is the only thing that is keeping her
alive. The drug is the one thing that is keeping her alive. She had broken
countless laws by the time she was a teenager. She doesn't care about being
arrested for this...She will find any which way she can.[32]
1.62
The Queensland Network of Alcohol and Other Drug Agencies was also of
the view that:
...there will be a proportion who will move into activities
that maybe previously they wouldn't have thought about doing, like sex work or
crime, usually property crime, to get things that they can pawn or sell to buy
drugs or swap with their dealer to get drugs.[33]
1.63
In addition to an increase in crime, the Committee heard that the drug
testing trial could also exacerbate other community problems.
1.64
The Mayor of the City of Canterbury Bankstown explained that the trials:
...may lead to crime...it could also potentially exacerbate
issues of depression and anxiety, which, from what I understand, is one of the
common reasons that people are taking drugs in the first place.[34]
1.65
Professor Maher told the Committee measures like the drug testing trial
are inappropriate mechanisms to address societal problems in communities of
disadvantage. She said that:
Vulnerable communities such as Bankstown need a comprehensive
range of harm – as well as supply – reduction interventions, including drug
treatment combined with improvements in social conditions such as housing,
education and employment. Blood-borne viruses such as HIV and hepatitis C are
clearly transmitted along the fault lines of poverty, inequality, structural
violence and...public policies which increase socioeconomic
inequality.[35]
1.66
The Committee also heard evidence that there is a danger of drug users
developing more dangerous habits or disconnecting from health services entirely
as a result of the proposed drug testing trial.
1.67
St Vincent's Health Australia told the Committee that:
We're concerned that the unintended consequence of the
proposed bill will increase stigma and marginalisation; exacerbate addiction
issues and the factors contributing to addiction...there is a real risk of
individuals changing their substance use to substances which are undetectable and potentially more harmful.[36]
1.68
And that:
The use of drugs that do not test positively on a test is a very significant concern.[37]
1.69
St Vincent de Paul Society told the Committee that:
...this program may well drive some behaviours further
underground, further off the grid, and people, rather than being able to access
the support they need, will be driven further away from the supports because they want to escape detection.[38]
1.70
Labor Senators note that in the longer term, policies that stigmatise
people and force them 'underground' will have much higher costs to the
community and Government.
1.71
Labor Senators on the Committee also understand that there is a
significant chance that drug tests could generate false positives.
1.72
Dr Jenkins explained that:
...various common antidepressants, or even cough medicine, may
give you a false positive for a substance of abuse. Then there are some food
substances such as poppy seeds that can give you a false positive for opiates.[39]
1.73
The Australian Council of Social Services explained that the requirement
to repay the cost of drug tests undertaken through the trial would push already
vulnerable people deeper in to financial hardship:
If someone fails a second test or subsequent tests they would
be required to pay for the cost of that test. If you are on an income support
payment...that would represent a large sum of money going out of your weekly
budget just to pay back the cost of a test that you had to get otherwise you
would not be able to get income support.[40]
1.74
Given the unintended consequences that are likely to arise as a result
of the drug testing trial, Labor Senators on the Committee are of the view that
the Bill should not be passed.
Lack of Local Community Support
1.75
Further, Labor Senators on the Committee are of the view that, based on
the evidence provided by all three local Governments from the proposed trial
areas, local community support for the trials is not evident.
1.76
The Mayor of Canterbury Bankstown told the Committee that '[b]y using
our city as the trial site, the government is further stigmatising and
discriminating against our local community,'[41]
and also that:
[the money would be] better spent on investment in education,
in training, in upskilling members of our community to transition them from
potential welfare status to being able to get gainful employment but also on
investment in jobs in our community to provide people with an opportunity to
have jobs within the area of Canterbury Bankstown.[42]
1.77
The Cities of Logan and Mandurah also told the Committee that they
believed they were unfairly targeted by being named as a trial area.
1.78
The Deputy Mayor of Logan told the Committee that:
Unfortunately for Logan we tend to get targeted for all these
sorts of things, and this was just another arrow in the bullseye...and we
seriously get a bit tired of being targeted.[43]
1.79
The City of Mandurah explained to the Committee that:
...we have some concerns that the rationale or justification
behind Mandurah being chosen as a site doesn't clearly indicate that Mandurah
exclusively has a greater problem than perhaps some of our other
regional counterparts.[44]
1.80
And that:
the lack of consultation and the lack of evidence to justify
Mandurah as a location...we're left asking: where is the evidence that justifies
this policy, and why is it that we weren't heavily engaged with the consultant?
Why weren't we, as the organisation that probably has the most tentacles into
the community and the greatest awareness of what the community challenges are, not engaged in that process?[45]
1.81
Labor Senators on the Committee are very concerned about the lack of
community engagement in the selection of proposed trial sites. Further, Labor
Senators note that local communities have been overlooked in the same way that
the advice of experts in treating addiction has been ignored.
Recommendation
1.82
Labor Senators on the Committee note recommendations 1 and 2 of the majority
report, that the Department of Social Services should establish and publish the
evaluation strategy of the trial prior to its commencement, and that the
Department should also publish the outcomes of the trial.
1.83
Labor Senators on the Committee are of the view that these would be
sensible steps for the Department to take, if the trials were to proceed.
1.84
However, in light of the overwhelming evidence presented to this
Committee on a number of occasions that these trials will not be successful,
Labor Senators on this Committee are nonetheless strongly of the view that the
Bill should not be passed.
Recommendation 1
1.85 Labor Senators on the Committee recommend that the Senate reject the
Bill.
Senator the
Hon Lisa Singh Senator Murray Watt
Senator Louise
Pratt
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