Shakespeare on the Provocations of Drink

MacDuff

Was it so late, friend, ere you went to bed,
That you do lie so late?

Porter

'Faith sir, we were carousing till the
second cock: and drink, sir, is a great
provoker of three things.

MacDuff

What three things does drink especially provoke?

Porter

Marry, sir, nose-painting, sleep, and
urine. Lechery, sir, it provokes, and unprovokes;
it provokes the desire, but it takes
away the performance: therefore, much drink
may be said to be an equivocator with lechery:
it makes him, and it mars him; it sets
him on, and it takes him off; it persuades him,
and disheartens him; makes him stand to, and
not stand to; in conclusion, equivocates him
in a sleep, and, giving him the lie, leaves him.

Macbeth Act Two, Scene Two

Alcohol Regulation in Remote NT Communities

There is a broad consensus across the political spectrum that alcohol consumption is a major issue in remote Australia.

All Australian jurisdictions have a regulatory framework which licences the sale of liquor and which restricts the consumption of alcohol in certain locations and contexts. This post focusses largely on the NT, as it has a relatively complex regulatory regime designed specifically to encompass remote areas and it involves regulation by both the NT Government and the Commonwealth.

The NT’s policy framework is set out at a high level on the web site of the NT Department of Business. It provides links to historical data on alcohol sales in the NT, mentions the Commonwealth’s Stronger Futures in the Northern Territory Act 2012 which imposes minimum standards for Alcohol Management Plans (AMPs), lists the AMPs for regional centres, and indicates that AMPs are in place or under development for remote communities, but without providing a list of those communities and the current status of the development of the AMP.

The web site also outlines the framework which controls the licencing and sale of liquor, including arrangements for restricted areas, and for individual revocable permits to allow liquor to be purchased and consumed within a restricted area. However the web site does not provide detail on the NT’s detailed administration of alcohol management arrangements (except in the regional centre AMPs) and nor is there an overarching statement of strategic intent.

The Commonwealth Government’s involvement in the regulation of alcohol derives from the legislation introduced in 2007 to implement the Northern Territory National Emergency Response (NTER), and in particular to prohibit the sale and consumption of alcohol in prescribed areas (which essentially included the majority of Aboriginal settlements and townships across the NT). The effect of this legislation was to modify and toughen the operation of the Northern Territory’s alcohol regulatory scheme in relation to Aboriginal land and townships, and to preclude the NT Parliament from making laws inconsistent with the Commonwealth legislation.

The NTER legislation, which had a five year sunset, was replaced in 2012 by the Stronger Futures in the Northern Territory Act 2012. The Stronger Futures legislation prohibits the sale, possession or consumption of alcohol in an ‘alcohol protected area’, provides that these areas operate as if they were ‘restricted areas’ under the NT Liquor Act, includes provisions which allow the Commonwealth Minister to initiate an assessment of particular licenced premises (anywhere in the NT) if she considers the sale of alcohol by the premises is causing substantial alcohol related harm to the community, and establishes a process for the development of AMPs by communities which must meet five standards promulgated in rules by the Commonwealth Minister, and which then replace the blanket restrictions established by the legislation in that alcohol protected area.

The AMP provisions were incorporated in part to strengthen the Commonwealth’s claim that the alcohol (and other) measures are special measures and thus while they are specifically targeted in large measure at Indigenous citizens, they are not inconsistent with the provisions of the Racial Discrimination Act. The 2007 NTER legislation had explicitly over-ridden the RDA whereas the Stronger Futures legislation removed that provision.

Recently, the NT Government has released the latest Alcohol Management Plan for the Central Australian town of Alice Springs which is focussed on a strategy termed Point of Sale Intervention at take-away outlets. The Guardian has reported that the plan leaves open the possibility of a return to the ALP’s previous policy of a Banned Drinker Register. The Point of Sale Intervention policy is similar to a scheme in Katherine termed Temporary Beat Locations (TBL) which relies on the police to check identification documents of persons buying takeaway liquor.

The ABC recently reported on the NT Chief Minister’s comments that itinerants in Darwin should just ‘piss off and go home’ and the response of Indigenous leaders that these were unprofessional comments.

The ABC reported last year critical comments from the head of the NT Police Association, Vince Kelly, who argued that it was inappropriate that police resources were being tied up managing alcohol sales, and criticised both sides of politics as being constrained by their acceptance of political donations from the alcohol industry:

Nothing is really going to change because both sides of politics are beholden to the liquor industry because they accept so much money off them in terms of political donations.

An admittedly cursory check of the NT Electoral Commission’s web site which lists political donations to parties and candidates does not appear to bear this out, though both parties appear to have access to funding from intermediaries, and the NT business sector is quite small, and both parties certainly work hard not to antagonise business interests. And of course there is extensive academic research documenting the extraordinarily powerful influence of the alcohol industry on public policy both nationally and internationally.

On 16 September 2015, the Department of Prime Minister and Cabinet released a copy of the independent review of the alcohol provisions of the Stronger Futures in the Northern Territory Act 2012 undertaken by law firm MinterEllison. The legislation, which has a ten year sunset provision, mandated an independent review of the alcohol provisions along with the associated NT legislation within five years of its enactment. Interestingly, the Review’s Terms of Reference (which are set out in the Review report) provide that ‘The review will be conducted by the Department of the Prime Minister and Cabinet in collaboration with the Northern Territory Department of Business’; hardly an independent basis for the review, notwithstanding that PMC then subcontracted MinterEllison to undertake the review.

MinterEllison concluded that although ‘alcohol misuse has and continues to cause considerable harm to Aboriginal people in the Northern Territory, we have been unable to determine with any precision whether there has been a reduction , or otherwise, in alcohol related harm to Aboriginal people…’

The reviewers went on to conclude ‘that the scheme established by the Liquor Act and provisions of the Stronger Futures Act provide an effective framework for the regulation of supply of alcohol in the Northern Territory, and that regulation of supply is a necessary but not sufficient means (in and of itself) of addressing alcohol misuse that causes harm to Aboriginal people in the Northern Territory’ (emphasis added).

The elephant in the room (on which the review was entirely silent) is why the Commonwealth continues to over-ride the Northern Territory’s legislative remit in relation to alcohol (and other matters specified in Stronger Futures), and what are the merits and demerits of doing so. This is an issue which would require a separate post to do it justice.

A couple of notable points were canvassed by the MinterEllison review. It notes for example the NT Government’s submission to a recent House of Representatives Standing Committee Inquiry into the Harmful Use of Alcohol in Aboriginal and Torres Strait Islander Communities titled Alcohol, Hurting People and Harming Communities identified the under-representation of Indigenous people in national data sets measuring drinking patters, and called for ‘a comprehensive longitudinal study of drinking patters of Aboriginal people…’ (p29).

The review also referred to the Tackling Alcohol Abuse Implementation Plan of the National Partnership Agreement on Stronger Futures in the Northern Territory and noted that the Commonwealth and the Northern Territory had agreed in this plan that ‘communities will be encouraged and supported to develop local alcohol management plans that meet the regulated minimum standards under the Stronger Futures in the Northern Territory Act 2012’. The report also noted that the Partnership Agreement is being renegotiated and that the alcohol provisions under the new agreement are currently being negotiated as part of this process’ (footnote 15, p25).

Finally, the review while noting the Standing Committee’s observation of strong support for the introduction of a volumetric tax on alcohol as well as a minimum flor price, quoted the Prime Minister and Cabinet submission to the Standing Committee:

International price controls have been found to be the most effective intervention of this type [restricting supply]. However, the Australian Government does not support policies that increase alcohol prices….as they do not target heavy and binge drinkers. These drinkers are less responsive to price than the general population, so higher prices may have a limited health benefit and hurt consumers who enjoy alcohol responsibly.

On 2 December 2015, the Department posted the Commonwealth Government’s response to the Standing Committee report on the harmful use of alcohol in Indigenous communities on its web site. As is standard practice with reports of this kind, the Department in a response presumably approved by the Minister commented on each of the Standing Committee’s 23 recommendations, agreeing, agreeing in principle, noting or not agreeing.

The Department gave no joy to the calls for better national data, nor to the NT Government’s call for a longitudinal study (refer comments on recommendation 1).

The Department also noted that work is underway on developing the next version of the whole of Government National Alcohol Strategy for 2016-21, and the National Drug Strategy, which has a component directed to Indigenous peoples.

In relation to the Standing Committee’s most significant recommendation for the introduction of a national minimum floor price, and that prompt consideration be given to the recommendations of the Henry Tax Review on volumetric tax, the Department could only note the recommendation, commenting vaguely on the Government’s commitment to an unspecified tax reform process!

Interestingly, in relation to recommendation 7  on prioritising community driven strategies to reduce alcohol harm, and a comment from the Standing Committee that the current backlog of AMPs in the Department of PMC need to be cleared by January 2016, the Department  vehemently disagreed, denying a backlog existed. The Department noted:

Eight AMPs have been submitted for approval to the Minister for Indigenous Affairs, Senator he Hon Nigel Scullion, in accordance with the Stronger Futures in the Northern Territory act 2012. To date, the Minister has approved one AMP, in May 2014, covering Titjikala community. Between January and April 2015, the Minister declined to approve the remaining seven AMPs in part because they had the potential to increase alcohol related harm.

The Department provided a range of other comments and information, including in relation to IAS funding for alcohol treatment, and commentary on Fetal Alcohol Syndrome issues.

On 6 December 2015, the Department also published a comprehensive paper from the National Drug Research Institute titled Review of the Aboriginal and Torres Strait Islander Alcohol, Tobacco and Other Drugs Treatment Service Sector: Harnessing Good Intentions. The paper was dated August 2014, some fifteen months earlier, and does not appear to have been utilised in assessing the Stronger Futures alcohol regime in the NT, nor in developing the Commonwealth response to the Standing Committee report.

I don’t propose to summarise it closely, but note a few salient issues which emerge. The report identifies that the level of demand for treatment services amongst Indigenous citizens is more than is currently available. Data of sufficient quality to precisely quantify levels of need or the demand for alcohol, tobacco and other drug (ATOD) services are not available, but available data suggests ATOD related problems are at least twice as prevalent amongst Indigenous citizens as in the mainstream. Gaps in treatment provision are unevenly distributed, and service provision planning is deficient. The report identifies alcohol as the most harmful drug of concern (p5). The report is critical of the transfer of funding for treatment of ATOD harms from the Health Department to PMC in 2013 and concludes that the ‘current system for the provision of ATOD services is fractured’. The report has useful and constructive suggestions for improving the funding models utilised by government, and notes the absence of an Indigenous peak body for ATOD services.

Conclusions

What are we to make of the information placed on the public record by PMC in these reports?

First of all, it is notable that the Minister left it to the Department to publish these reports, without fanfare, on its website.

Alcohol harm continues to a major issue for the Australian community, but it is particularly so for Indigenous citizens. Notwithstanding the focussed attention allocated to alcohol harm by Governments, there remains an evidence base deficit, whereby the commitment to collecting and analysing the data required to understand the scale and depth of the problem is absent, and the most effective policy instruments are ignored.

Given the Commonwealth’s fifteen year legislative foray into NT alcohol issues, and its broader concerns about the downstream costs and consequences of alcohol abuse across remote Australia, the lack of commitment to developing better analytical base is difficult to understand.

The arguments advanced against moving towards a volumetric tax on alcohol, against all the evidence, do not stand up to scrutiny. The argument advanced by PMC (and rejected by the Standing Committee) that the appropriate policy action must specifically target binge drinkers, and measures which don’t are not appropriate, amounts to a pathetically weak rationalisation for a policy position which is deeply entrenched, extremely costly in both human and economic terms, and clearly aligned with alcohol industry advocacy. Even accepting the flawed premise of the Department’s rationale, one of the benefits of a volumetric tax is to remove the incentive for excessive drinkers to find and consume cheaper sources of alcohol such as cask wine.

In the light of the intransigent opposition to the most effective policy instrument available to counter social and individual harm, the extraordinary conclusions of both the MinterEllison report and the National Drug Research Institute that the data does not exist to precisely determine the extent of harm from alcohol in the Indigenous community suggests that the Government’s opposition to a full longitudinal analysis of the nature of alcohol harm is motivated by a determination not to understand the full extent of the harm involved.

The decisions by the Minister to reject seven AMPs are curious. We do not have access to the details which would allow a full assessment, and it is the case that some potentially influential groups within remote communities have an incentive to press for potentially harmful levels of alcohol availability. Yet the policy intent in the Stronger Futures Implementation Plan (and it is also replicated in Minister Macklin’s promulgation of rules relating to AMPs) is for the Department to work with communities to develop AMPs.

When confronted by an unacceptable proposed AMP, it was envisaged that the Minister and his Department would not just decline to approve it, but would engage with the community to assist them to understand what an acceptable AMP would look like.

It seems however that there has been a changed approach, and that notwithstanding earlier comments (and here) to the contrary, the Minister may now be more inclined to leave the NTER/ Stronger Futures prohibitions in place in most locations. There appears to have been no policy announcement or explanation made explaining the Minister’s current approach to these matters, which is less than desirable.

In the absence of such an explanation, one might conclude that the Minister is more inclined to adopt a ‘tough on grog’ policy line, notwithstanding that it is important for communities to ultimately transition to models of responsible drinking, and AMPs are eminently suitable mechanisms for assisting in this transition. A cynic would note that such a tough policy line in commercially insignificant areas provides a measure of political protection against calls for the imposition of taxes or price based incentives against alcohol consumption.

Moreover, the AMPs are key elements in justifying the alcohol restrictions as ‘special measures’, and a move away from them will increase the risk of a court striking down the whole Stronger Futures scheme as racially discriminatory, and almost certainly undermine Indigenous support for the regulatory regime in place.

The suggestion, in a footnote to the Commonwealth Response to the Standing Committee Report, that the Stronger Futures National Partnership Agreement, implementation plan, and alcohol measures are being renegotiated is significant. The National Partnership provides for significant funding in a policy framework which makes it less vulnerable to budget cuts and the implementation plan is by definition a key reflection of policy. There would be merit in the Minister outlining in broad terms his strategic approach to alcohol regulation in remote Australia, and in the Northern Territory in particular.

The adverse consequences of alcohol abuse in remote communities are devastating – for individuals, families, children, unborn foetuses, and whole residential communities. Alcohol abuse negatively impacts individuals’ physical health, cognitive ability, mental health, education, employment, safety, and overall well-being. It has broader social consequences for community cohesion, community governance, and social and economic stability, and even economic development. The opportunity cost of failing to effectively regulate alcohol consumption and failing to minimise alcohol induced harm is enormous, and while those costs fall most severely on Indigenous citizens, the costs also extend to all taxpayers, including those who happen to drink alcohol responsibly.

Shakespeare on Carelessness

There is a sickness 
Which puts some of us in distemper, but 
I cannot name the disease; and it is caught 
Of you that yet are well.

The Winter’s Tale Act One, Scene Two.

Carelessness Abounds: Double Jeopardy for Remote Disabled Citizens

The National Disability Insurance Scheme involving a major reconceptualisation of the delivery of support to disabled citizens is currently being rolled out nationally.

The 2011 National Disability Strategy noted that the proportion of Indigenous Australians 15 years or older reporting they lived with a disability or long term health condition was 37 percent, twice the rate in the general population. The proportion was similar in both remote and non-remote regions, and did not include psychological disability.

The Minister for Social Security Christian Porter recently noted that bilateral agreements with all states and territories except WA and the NT had been finalised, and that in the case of the two outstanding jurisdictions, discussions were progressing.

Reflecting an appreciation that remote regions may have particular issues to address, the Commonwealth and NT Governments agreed in 2013 to establish a trial site in the Barkly region centred on the regional centre of Tennant Creek.

The NDIS released a rather brief and uninformative progress report on the trial in the Barkly region in October 2015.

The Australian Parliament’s Joint Standing Committee on the National Disability Insurance Scheme published a progress report in November 2015, which included an assessment of progress in the Barkly trial site: refer paragraphs 2.74 – 2.86 for progress on the Barkly Trial site and paragraphs 4.56 – 4.80 for a discussion of various issues relating to Indigenous clients and the challenges of implementing the scheme in remote areas.

On the challenges of delivering services in remote locations, the Joint Standing Committee made the following comments:

Challenges in the Barkly trial site

2.84 As outlined earlier, it is anticipated that the Barkly trial will provide valuable experience and understanding in delivering the NDIS in remote areas, which will inform the roll-out across the rest of the NT and other remote parts of Australia. Apart from dealing with the direct challenge of the high rate of disability among Indigenous Australians compared to the general Australian population, the implementation of the Barkly trial presents a number of specific challenges:

• low numbers of Indigenous Australians with disability accessing the disability service system—a contributing factor is the reluctance of Indigenous people with disability to identify as a person with disability. This presents a significant barrier to the successful implementation of the NDIS in this region;

• experience of Indigenous Australians when using services—a lack of confidence in dealing with, and a mistrust of, government agencies and service providers;

 • differences in cultural backgrounds and understanding between service providers and Indigenous Australians—this can form an impediment to effective delivery of support services; and 

• access to services—lack of available and appropriate services due to the remote location.

2.85 The fundamental principle of the NDIS is individual choice and control. Enabling Indigenous Australians to exercise such choice and control may be difficult where the absence of service providers in remote areas precludes meaningful choice.

2.86 The evidence that the committee heard in Darwin regarding the Barkly trial confirms the incredible difficultly in delivering high quality services to regional and remote areas of Australia and as such represents one of the biggest challenges to the Scheme.

Later in the Report, the Committee reported and assessed some of the structural issues underlying these challenges:

4.78 The NT Government's Minister for Disability argued that for some types of allied health services, and in some areas, there is no other option but to restrict the service delivery to only the NT Government:

The experience to date has highlighted gaps in the NDIA service delivery model in particular and around the coordination of disability supports and allied health services. There is no provision in a participant support plan for coordination of allied health supports. The Office of Disability has provided this coordination of allied health services for the trial due to the small numbers; however, it is not feasible on a larger scale. Under the NDIA model, a client may receive allied health services from three different providers, further exacerbating the fragmentation of services and required coordination. In addition to the implementation of a participant's plan is the reliance on a service provider to coordinate the disability supports for an individual. In the Barkly it has been difficult to identify service providers to provide this service.

4.79 According to the NT Government's Office of Disability, service providers 'are inconsistent in their availability to provide services', which leaves the responsibility of coordinating services with the NT Government.  The Minister continued with the conclusion that the unfortunate consequence of thin markets in remote areas is that the principle of choice and control that may be evident elsewhere will have to be sacrificed to ensure access and equity of services:

Whilst the principle of choice and control is supported by the Northern Territory it is not going to be feasible in thin and non-existent markets. In many instances the focus in remote areas needs to be on access and equity as a first step.

The Committee recommended that the Government ‘through the Disability Reform Council, make all haste with the finalisation [of] all the bilateral agreements for the transition phase of the National Disability Insurance Scheme’ (para 5.13).

In an as yet unpublished submission to the Joint Committee, the MJD Foundation (a small organisation based in North East Arnhem Land servicing around 500 people either suffering from or at risk of MJD, a neuro-degenerative disease similar to Huntington’s Disease) pointed to a series of deficiencies in current service provision for disabled citizens in the Northern Territory:

In the experience of the MJDF the following evidence provided at the [previous Committee] hearing reflects the current practice in non-trial sites areas where the MJDF operates (and in the Barkly prior to the trial commencing):

·         Wait times for mobility and other specialist disability equipment are frequently in excess of 6 months.

·         Disability specific transport is a significant an issue in every community and this is compounded by the unavailability of public transport or private transport/taxi options.

·         Services are provider driven, where cost restrictions, maintaining personnel and remote infrastructure challenges heavily impact on the scope of services available.  There is exceptionally limited access to therapeutic intervention and a high reliance on home based programs and family support (where programs are developed), and inadequate support for families to implement them.

·         FIFO/DIDO models are problematic because there are difficulties with getting and maintaining accurate personal information in real time and establishing appropriate relationships conducive to providing specialist disability support services. This is compounded, and demonstrated, by the very high turnover experienced in government provided services.

·         In the compilation of the Disability Audit, MJDF staff identified several people with disabilities in NE Arnhem Land who had previously not been identified or were not receiving services. 

·         There are very high levels of disability creating chronic disease and these comorbidities create a complex interface between primary health care and disability services that is not comprehensively addressed.  There is a siloed approach to the provision of disability care and primary health care, complicated by a delivery model that includes both Aboriginal Medical Service (AMS) and NT Department of Health provision.  See appendix A.

·         Current government provision has not enhanced local capital and capacity, for example there are no partnerships with local communities and other services for repairs and maintenance and equipment provision which would benefit consumers and communities alike.

There are accessibility modification needs across the NT, for infrastructure and public facility access, which will not be addressed through individualised packages.

COAG had originally scheduled the finalisation of the bilateral agreements for July-August 2015. Yet progress in finalising all the bilaterals has been slow, and as mentioned above two remain outstanding, including the agreement to establish the scheme in the NT.

The Commonwealth has made much of the alleged funding gap in supporting the full roll out of the scheme, recently announcing the establishment of a special fund to assist in financing the scheme. While not my main focus here, the rationale for such an account appears rather thin, but it does serve as a useful prop in making the political argument for the existence of a financing gap. What is relevant however is that the scheme involves joint commonwealth/state financial support, and the NT Government is chronically reluctant to commit to a demand driven funding model which it will not control and which will inevitably flow in large measure to the bush.

It is worth making the point that while there is a bipartisan commitment at the Commonwealth level to funding the full costs of the NDIS, the States, and for present purposes, particularly the NT have failed to make similar commitments, and have taken no action to transparently identify the funding to be allocated to the NDIS.

Unsurprisingly then, the Territory Government appears to be delaying signing up to the NDIS. It will be holding out for a greater share of Commonwealth funding (leveraging off its comparatively small scale) and is also arguing that it should control service provision rather than independent service providers. The irony of a political party normally associated with advocating market based policy frameworks which are underpinned by consumer choice and autonomy emerging as a proponent of increased government control and consequential reductions in opportunities for private sector development is remarkable.

If agreed by the Commonwealth, the risk will be that government controlled provider arrangements will increase the likelihood of ‘nickel and diming’ in the provision of individual services, particularly in remote regions. Moreover, the near-absence of advocacy organisations for disabled citizens in remote will minimise the opportunities for holding a government controlled provider arrangement to account.

A recent (unpublished) newsletter from an advocacy group on disability in the NT noted:

1 JULY FAST APPROACHING

Last week on Daryl Manzie’s morning program Minister Elferink was talking about the various “sticking points” there are in relation to the NDIS.  Pleasingly he did say it was not a case of if but when the NT Government will sign the Bilateral Agreement.  However according to the Minister, it will not be on the 1 July like most other States and the ACT.  Unfortunately in trying to justify the delay he firstly said the rollout was due to commence in 2017 not 2016, he failed to use the most recent stats available from the Barkly Trial, in relation to the number of participants, which stood at 127 not 109 and amongst other things he talked about equity and the fact that many people would now not be eligible for the scheme.  Minister it was never envisaged that everyone would be eligible, either because of age or not meeting certain criteria.  It was always going to be the case that State and Territory Governments’ will still have a responsibility to continue to provide services to those people.  Yes we know the Territory is both unique and remote, which does pose some very special challenges when it comes to service delivery, but surely we know enough now as a result of the Barkly Trial to sign the Agreement. Two things we know for certain, 1. There will always be issues regardless of how long we wait and 2. The trial has already been very successful and a real boost to business in Tennant Creek.  Planes are once again flying in and out, the town is very much alive and well and the Territory economy overall is set to continue to improve….

In contrast to the reported comments of the NT Minister, the NT Health Department web site indicates that the NDIS will commence in the NT in July 2016.

The NT Government’s approach to disability support has been opaque to say the least. The delay in signing up to the NDIS displays all the hallmarks of a strategy aimed at persuading the Commonwealth to just hand control of NDIS funding to the NT Government.

The argument outlined above that the provider market is thin in remote regions is accurate. The solution however is to build that market. The experience of the Aboriginal Controlled Medical Services is instructive in this respect. They were originally introduced to address exactly the same type of market failure: GPs were virtually non-existent in remote regions. Government action over a sustained period has essentially filled that gap, and built a network of medical services that while focussed primarily on treating Indigenous patients, increasingly provide services across the whole community in the areas where they operate. Moreover, the economic benefits of building a service provider capability in remote regions will be considerable.

Indeed, there would appear to be a potential social and economic opportunity here for Aboriginal Medical Services to expand their service delivery footprint into disability services as a contribution to building a market in these services in remote regions.

In the event that the Commonwealth caves in to the Territory Government’s hard ball bargaining, the outcomes for Indigenous Territorians living with a disability would be placed at risk given the Territory Government’s structural imperative to over-service (across the breadth of government services) its small and highly demanding urban electorates and the consequential poor record of service delivery to bush communities and in particular to the largely invisible (in political terms at least) disabled people in the bush.

It is time that the both the Territory and Commonwealth Governments got serious about remote Indigenous disability. There is a need for much greater transparency at the state and territory levels on the funding allocations for the NDIS. The Commonwealth should be insisting on a fully transparent model both to ensure accountability and to facilitate future adjustments to the model aimed at improving its effectiveness and efficiency.

The Commonwealth should also be supporting the development of provider capacity in remote regions, primarily because there are strong policy arguments against the establishment of a government monopoly in this service, but also because of the economic development potential in such a strategy.

Finally, consistent with the recommendation of the Joint Committee, the Commonwealth needs to stand up to the Territory, and ensure that an agreement to implement the NDIS across the whole of the NT is reached quickly. The terms of that agreement should ensure that the Territory Government delivers on its responsibilities to its remote citizens, and should provide for the transparency and provider capacity development which will ensure that the NDIS fulfils its potential in remote Australia.

The numbers of remote citizens living with disability may not be large in an absolute sense, however they and their families and carers face enormous challenges and yet they end up being doubly penalised: first as victims of disability itself and second as victims of government neglect and carelessness, in the sense that governments do not appear to care less about ‘invisible’ interests in the bush.

After all, it can hardly just be a matter of chance that the jurisdiction with the largest proportion of the most disadvantaged disabled citizenry is the jurisdiction which is slowest off the blocks in implementing the changes which offer the promise of transformative change.

Edmund on causality and responsibility

This is the excellent foppery of the world, that,
when we are sick in fortune,--often the surfeit
of our own behavior,--we make guilty of our
disasters the sun, the moon, and the stars: as
if we were villains by necessity; fools by
heavenly compulsion; knaves, thieves, and
treachers, by spherical predominance; drunkards,
liars, and adulterers, by an enforced obedience of
planetary influence; and all that we are evil in,
by a divine thrusting on: an admirable evasion
of whoremaster man, to lay his goatish
disposition to the charge of a star! My
father compounded with my mother under the
dragon's tail; and my nativity was under Ursa
major; so that it follows, I am rough and
lecherous. Tut, I should have been that I am,
had the maidenliest star in the firmament
twinkled on my bastardizing.

Edmund, King Lear Act One, Scene Two

RSAS Up: The Commonwealth's Remote School Attendance Strategy

The Department of Prime Minister and Cabinet (PMC) published, on 4 March 2016, an interim progress report dated October 2015 on the Remote School Attendance Strategy (RSAS), the Commonwealth’s flagship initiative in relation to remote education.

The Commonwealth also supports a number of smaller pilot initiatives such as the SEAM program which operates in a number of remote and urban NT (and previously Qld) communities and links school attendance to parents’ welfare payments, and the Learning on Country Program which operates in four Arnhem Land communities.

The SEAM program was assessed by the ANAO in a 2014 audit which found ‘mixed’ results, and the program was evaluated in a May 2014 report which appears very comprehensive, but largely equivocal in terms of its results. The Learning on Country program was evaluated in a report dated May 2015; refer to Minister Scullion’s media release dated 15 November 2015 reporting a qualified yet positive evaluation of the pilot. In addition, one of the five components of the Indigenous Advancement Strategy (IAS) relates to Children and Schooling, and presumably this component funds initiatives proposed and implemented by third parties.

RSAS commenced in 2014 and involves the engagement of around 400 local school attendance supervisors and officers to work with students, families, and school communities, involving 77 remote schools. The program was rolled out in two phases in 2014, across five jurisdictions, and was funded for two calendar years, 2014 and 2015 at a cost of $46.5m. In September 2015, the Minister for Indigenous Affairs announced that the ‘successful’ program was being extended for a further three years to the end of 2018 at a further cost of around $80m.

Extraordinarily poor educational outcomes in remote Australia have been an issue of concern for at least two decades. In our 2007 book Beyond Humbug, Neil Westbury and I identified education as an example of governmental incapacity to implement effective delivery of essential services. We cited 2005 Productivity Commission data which indicated that in remote areas of the NT in 1999, only 3 to 4 percent of Indigenous students achieved the national reading benchmarks.

The most recent NAPLAN report includes data which indicates that current Year 3 reading achievement of Indigenous students in very remote regions of the NT is that 27.4 percent are at or above the benchmarks, and 71.2 percent are below. The comparable national figures for very remote regions are 52.3 percent below the benchmark and 46.6 percent are above (refer Table 3.R6).

For Year 9 students, in very remote NT, 84.6 percent are below national accepted benchmarks, while in very remote regions nationally 69.7 percent are below national benchmarks (refer Table 9.R6).

Clearly there is a strong policy rationale for additional government action. Two in three remote Indigenous students are not achieving a year nine reading standard, with the concomitant lifelong consequences for employment, income-earning capacity, and the substantial personal and social opportunity costs which that entails.

The issue then is what is the appropriate and/or most effective policy response? And which level of Government should drive that response?

Education is primarily a state and territory responsibility, but is an area where the Commonwealth has longstanding interests, normally advanced through the provision of funding to public and private education providers. The Commonwealth has long-standing mechanisms for using the power of the purse to incentivise states and territories to advance Commonwealth priorities.

For the Commonwealth to directly intervene in one aspect of the education system, Indigenous student attendance, as opposed to the other areas which influence indigenous educational outcomes (teacher education, teacher quality, curriculum, capital works, facilities, overall resourcing levels, etc) and to do this only in a subset of all remote schools is, in my view, the most risky and potentially most problematic approach to addressing the issue of poor educational outcomes.

Inadequate investment in all aspects of education by the states and territories, both financial and intellectual, has clearly been a longstanding issue in remote education provision. Unless the Commonwealth is absolutely certain that there is only one issue in remote education, and that issue is poor attendance, then the Commonwealth’s actions are likely to lead to sub-optimal outcomes, and most importantly, will delay the day when effective policy responses will be brought to bear.

In particular, the states and territory have little incentive to take responsibility for outcomes, because in political terms, the success or failure of remote schooling will be seen to be the responsibility of the Commonwealth.

School attendance is an issue the Commonwealth has traditionally left to the states and territories. School attendance is certainly a function of a complex array of factors outside of education, some in the Commonwealth’s domain like welfare policy, but most in the domain of state and local governments. More importantly, school attendance is also a key component in the system comprising a set of complex and inter-related administrative, intellectual and professional activities, which together comprise the schooling system. This system is fundamentally the responsibility of the relevant state and territory education departments.

So I would argue that any policy response to poor educational outcomes should, in the absence of a strong countervailing rationale, be implemented by the states and territories.

As for the design of the most appropriate intervention, this is a huge topic, and I do not claim particular expertise. My own instincts however are that ensuring that remote schools have access to experienced and high quality teachers (with a capacity to engage with their school community as well as running effective education programs) and an effective curriculum are key. Noel Pearson and Chris Sarra have both written persuasively on these topics and have effectively laid out a policy roadmap for governments to consider. If quality teaches and curriculum is the key, then while attendance is important, it becomes essentially a second order issue (insofar as getting the right teachers and curriculum will assist in maintaining attendance rates at acceptable levels). Or to put it another way, high attendance without quality teaching involving high expectations and a quality curriculum will achieve very little.

For better or worse, the Commonwealth has decided to focus its additional intervention virtually solely on school attendance through RSAS and to a lesser extent SEAM. PMC is to be congratulated for releasing the interim progress report on RSAS and for commissioning the evaluative and analytical work which underpins it.

The report includes both quantitative and qualitative components, and concludes that the program has had a positive impact on school attendance overall with an increase in attendance over the first year in a majority of schools – in Queensland and the NT, 72.5 percent of schools (29 out of 40) had an increase, and across the NT, the average number of students on any one day in term three of 2014 was 13 percent higher than in term three 2013.The qualitative evidence was much less clear cut, identifying a range of reasons for poor attendance cited by departmental staff in their weekly reports, but also noting significant issues with recruitment and retention of staff to deliver the program.

The report raises at least four significant issues which are worthy of comment.

In relation to state and territory governments the report notes that they ‘are simultaneously operating their own school attendance programs and strategies which RSAS aims to complement’ (page 3). However the qualitative report which is based on the traffic light reports provided by RSAS staff each week has very little to stay about the inter-relationship with these programs. Moreover, it is apparent (but not explained ) that at least two Governments, South Australia and Western Australia were not prepared to allow data from their states to be utilised in full in the report’s analysis. This is in my view a significant issue as it goes directly to the potential of the program to influence outcomes more generally in the state education systems.

A second comment concerns the data for particular schools. What is immediately apparent from an examination of the tables (and is glossed over by a focus on the percentage change, positive or negative) is that there is a large variability in the absolute attendance levels amongst the various schools, and indeed a number of schools which are improving in percentage terms are nevertheless subject to extremely low attendance levels, particularly in the NT. Thus Table 1.3 on page 6 indicates that 19 of the 29 schools in the RSAS program in the NT had absolute attendance levels in 2014 of less than 60 percent, and 7 schools had attendance levels below 50 percent.

Moreover, the review analysis is focussed entirely on average attendance levels at each school. Yet learning is incremental and requires sustained skills acquisition. Learning deficits quickly emerge if there are gaps in attendance. So it is important to understand whether the non-attendance is confined to a particular cohort within each school, or is more widely shared. Fifty percent attendance might mean 50 percent of students attend every day and fifty never attend, or it may mean that all students miss 50 percent of the school year. The latter outcome has much worse educational consequences than the former, but these differences have not been addressed in the review’s analysis.

Finally, the qualitative analysis is based entirely on the reports of the Commonwealth officials working in each location. This is an inherently limited information base, and merely compiles and analyses the reasons listed for attendance changes by RSAS staff. There is a place for qualitative analysis, but it needs to test particular hypotheses and should engage with actual stakeholders (students, parents, teachers, community members) to have any chance of drawing insightful conclusions which policy makers might then use in devising policy or adjustments to policy.

Conclusion

The Commonwealth’s current policy on remote school attendance appears to be fundamentally flawed. It bears all the hallmarks of a policy initiative designed to be seen to be doing something, yet runs the risk that it will actually allow the states and territories off the hook . There are clearly interactions with the operation of SEAM in the NT (administered by PMC and DHS), but neither program’s design logic appears to recognise the existence of the other. RSAS operates in a limited number of remote locations, and thus will only ever have a partial impact. A more effective alternative would have been to allocate the funds to the relevant education departments utilising an incentive structure which rewards not merely improved attendance (an output), but ideally improved NAPLAN scores (an outcome), leaving the methods to be employed to the education experts.

Of course, RSAS clearly has political benefits for a politician seeking to win votes, particularly in the NT, in that it sets out to create employment for local community members across 29 key school communities. Interestingly, the more structural impediments within communities for improved school attendance appear to make these jobs quite difficult to carry out, leading to high turnover and poor retention. Nevertheless, the potential political motivation is easy to discern. Moreover, naming a program a strategy doesn’t mean that there is a strategy. The Commonwealth has not published a comprehensive policy based rationale for the program.

There would be merit in developing and publishing a strategic plan (or mini white paper) on the overall Commonwealth’s strategy for achieving improved educational outcomes in remote Australia. Such a plan would ensure that a comprehensive and coherent program logic would be devised, and would canvass how best to harness the resources and expertise of the states and territories, and thus lay out a comprehensive rationale for the Commonwealth’s involvement.

If the states and NT were not prepared to cooperate, the Commonwealth should then canvass options for the Commonwealth to take over the whole school education system in remote Australia from start to finish rather than inject random interference as at present.

In the absence of such a strategic rationale for the Commonwealth’s involvement in remote education, interested citizens can be forgiven for seeing RSAS as merely another instance of politics subverting good policy. It will most likely end up on the scrap heap of failed policies in Indigenous affairs, with Indigenous citizens wearing the reputational damage of yet another policy fiasco, taxpayers being $125m worse off, and yet another generation of remote citizens reaching adulthood without the literacy and numeracy skills which will allow them to fully participate in our nation’s future.

When Noel Pearson referred to a crisis in Indigenous policy, he was talking about more than education and schooling. Yet it is apparent that the crisis runs deep in remote education and is embedded not so much in the communities, but in the structures of government itself. Part of the reason we have as a nation found it so difficult to address indigenous disadvantage is that we have been looking for solutions in the wrong places.

The Worsening Crisis in Remote Employment Programs

Last week I attended a very insightful seminar at the Centre for Aboriginal Economic Policy Research at the ANU (where I happen to be a Visiting Fellow).

The seminar reported the results of recent research on penalties imposed on remote welfare recipients undertaken by ANU researchers Lisa Fowkes and Will Sanders. I understand that a research paper is in preparation and will be published in the near future. I have linked to the slide presentation at the seminar, so wont attempt to summarise the seminar in detail, but rather will cut to the bottom line.

The data available shows that since the introduction of the RJCP program in 2013, which has now been replaced by the Community Development Program  (generally known as CDP),  penalties for breaches of job search requirements have increased substantially while in non-remote Australia, the quantum of penalties is steadily reducing. Moreover, these trends are much sharper when one focusses on the most serious breaches which lead to cessation of benefits and complete disengagement from any potential employment.

So for example, serious breaches in mainstream JSAs (with a total caseload of 760,000) dropped from 8000 to around 2000 in the two years up to June 2015, whereas in remote Australia, where RJCP has a case load of 37,000 or around five percent of mainstream JSAs, serious breaches rose from close to zero to over 1000 – refer to the graphs presented in the slide presentation. In other words, the rate of serious breaches imposed in remote Australia is about 20 times the rate imposed in non-remote Australia.

The researchers went on to ask the obvious question: why is this happening?

Their answers boil down to three key reasons: the requirements being imposed on remote job seekers (to use the terminology favoured by these schemes) are more onerous than those applicable to non-remote jobseekers; the protections built into the system to tailor responses to individual needs are weaker in remote Australia than elsewhere; and the responses of local people/job seekers to the incentives established by the penalty regime are counter-intuitive (at least to those administering the schemes).

The arguments for applying different requirements on remote jobseekers are not well articulated by governments, but one can assume that they are based on a rationale that the circumstances of remote communities are different both economically and socially and thus different approaches are required. Indeed presumably this is the rationale for having a separate scheme to JSAs at all.

While the CDP scheme is non-discriminatory in nature, applying to all jobseekers in remote Australia, the vast majority of its caseload – over 80 percent - is Indigenous. It is no coincidence that the Minister for Indigenous Affairs has administrative responsibility for the scheme. There is thus an ongoing potential vulnerability for the scheme related to compliance with the Racial Discrimination Act, although to the extent that it is based on subsequent legislation to the RDA, a court may hold that the subsequent legislation overrides the RDA. This potential vulnerability suggests that the Government would have been wise to have ensured that the second reason identified, the poor protections offered to remote residents by the scheme to ensure that individual needs are properly assessed in taking decisions about access to basic income, would not be an issue.

The third key reason, the counter-intuitive local responses, is in my view potentially the most significant driver of the increase in serious breaches (though it seems likely that all three drivers synergistically reinforce the outcomes we are seeing).

In effect, young community residents are making an assessment that they are prepared to be breached, and lose their benefits for an extended period, rather than comply with the requirements to work twenty five hours every week of the year in order to receive a welfare payment. The trade-off decisions involved are based on a range of factors: innate attitudes to income and cash; attitudes to saving and consumption; availability of alternative sources of income; lack of any normal market infrastructure in communities, availability of access to food and drink from family and kin; and preparedness and capacity to live without an income.

I suspect that it is this third key reason which is of most significance in driving the increase in RJCP / CDP breach rates, and points to the inter-cultural complexity of designing effective programs in remote Australia. Nevertheless, it is not the case that policymakers (or at least those with experience in Indigenous affairs policy domain) have not had an appreciation of these realities. Indeed, the capacity of remote citizens to make these trade-offs have been  an issue in a range of contexts for at least two decades, notwithstanding that they only occasionally surface in public policy debate and discussion.

So for example, much of the justification offered by the Howard Government when introducing income management as part of the NT Emergency Response was to address what they termed ‘humbugging’, a negative inflection on the widespread cultural practice in remote indigenous communities of kin-based sharing. These behaviours can have both positive and negative elements, and can be particularly negative when alcohol or drugs are involved. The existence of culturally embedded kin based sharing obligations is likely a significant element in the trade-off calculus facing remote jobseekers.

Returning to RJCP and its successor the CDP, there seems to be little point in having a stand-alone employment services / welfare program for remote Australia, justified on the basis that circumstances are different in the regions, to then not take account of local realities in designing the program.

The Community Development Program came into operation in July 2015 after Minister Scullion formed the view within months of coming to office that the RJCP program was ineffective, and announced a series of immediate changes. He noted in the media release:

“RJCP is a disaster. People aren’t turning up for work and are returning to alcohol. That’s why I’m acting quickly to re-engage people before it is too late,” Minister Scullion said.

“The design and implementation of RJCP was bungled by Labor, with the late announcement of providers, confusion over the funding model, and a ‘one-size-fits-all’ approach that did not consider the differences between regions.

The Minister has now announced that a revised version of CDP (let’s call it CDP2) will come into operation as of July 2016. PMC has published a fact sheet on the proposed changes. The legislation was introduced in December 2015, and has recently been considered by the Senate Finance and Public Administration Legislation Committee. Perhaps unsurprisingly, the report  splits along party lines, with Government members recommending passage and the Greens and Labor recommending against.

I won’t attempt to summarise the report in its entirety (though it deals with a range of salient issues), but merely point to the major substantive concern of many of the submissions which is the degree of discretion proposed to be granted to the Minister, who will be able to determine areas to which CDP2 will apply and the details of compliance requirements in regulations rather than legislation.

I share this particular concern especially in an environment where government actively minimises the amount of transparency involved in administering the program. For example, the contracts with job service providers administering the program on the ground apparently require PMC to approve any contact with media and researchers and information on the levels of resourcing to the program are not accessible to citizens.

The Minister’s approach appears to be to ‘toughen up’ the incentives for non-compliance with the CDP rules, and as a consequence, we are likely to see continued growth in the levels of breaching applied to remote job seekers, leading to increasing numbers of remote citizens being denied welfare on the misguided assumption that denial of welfare will incentivise compliance.

The consequence will be that levels of income flowing into remote communities will be potentially significantly reduced, with consequent flow on effects for economic activity, and potential exacerbation of social issues such as substance abuse and its correlates.

To sum up, we have now had three years of substantial policy flux, with the concomitant confusion and uncertainty on the ground which is an inevitable consequence. By July 2016, there will have been four major changes to remote employment in three years:

RJCP was introduced in July 2013 following a gestation period of a number of years;

·         ‘immediate changes’ were announced by Minister Scullion in late November 2013;

·         the new CDP program was introduced in July 2015; and

·         substantial further changes (CDP2) are scheduled to come into effect in July 2016.

Moreover, the data presented in the ANU seminar last week clearly indicate that the levels of disengagement with RJCP/CDP are increasing, and if the arguments outlined here are accepted, are likely to worsen as CDP2 adopts increasingly tougher penalty regimes on the mistaken assumption that penalties will incentivise engagement. Yet this was exactly the reason Minister Scullion gave for overhauling RJCP in the first place:

“RJCP is a disaster. People aren’t turning up for work and are returning to alcohol. That’s why I’m acting quickly to re-engage people before it is too late,”

It is little wonder that Indigenous leaders consider Indigenous policy to be in a state of deep crisis.

In the light of the analysis above, what are we to make of this recent statement from Minister Scullion:

For too many years under successive governments, the constant change in approach taken in Indigenous Affairs has, itself, become a barrier to improving outcomes for First Australians.

That is why the Coalition is working closely with Indigenous Australians, community by community, to ensure our approaches are implemented with First Australians – not to them – as the Prime Minister outlined in his Closing the Gap statement to Parliament last month.

The most effective way we, as a Parliament, can help to close the gap is ensure we work across party lines in a genuine bipartisan way. I am hoping this will be reflected in the approach taken to the Community Development Programme legislation currently before the Senate.

For my part, I would like to laugh, but can only cry.

Disclosure: As a former official in the Department of Families, Housing, Community Services and Indigenous Affairs, I had an involvement in the work leading up to the establishment of the RJCP program.