House of Representative Standing Committee on Indigenous Affairs Inquiry into the harmful use of alcohol in Aboriginal and Torres Strait Islander communities
Queensland Government submission
May 2014
Contents
SUMMARY ...... 3 BACKGROUND ...... 4 Queensland’s Aboriginal and Torres Strait Islander Peoples ...... 4 Harmful use of alcohol in Queensland ...... 4 Alcohol Management Plans In Queensland ...... 4 The AMP Review ...... 5 RESPONSE TO THE INQUIRY TERMS OF REFERENCE ...... 6 1. Patterns of supply of, and demand for alcohol in different Aboriginal and Torres Strait Islander communities, age groups and genders ...... 6 2. The social and economic determinants of harmful alcohol use across Aboriginal and Torres Strait Islander communities ...... 7 3. Trends and prevalence of alcohol related harm, including alcohol-fuelled violence and impacts on newborns, e.g. Foetal Alcohol Syndrome and Foetal Alcohol Spectrum Disorders...... 8 4. The implications of Foetal Alcohol Syndrome and Foetal Alcohol Spectrum Disorders being declared a disability………………………………………………………………………..9 5. Best practice treatments and support for minimising alcohol misuse and alcohol-related harm ...... 10 6. Best practice strategies to minimise alcohol misuse and alcohol-related harm ...... 7. Best practice identification to include international and domestic comparisons ...... ANNEXURE 1: History of alcohol management in Aboriginal and Torres Strait Islander communities ...... 11 ANNEXURE 2: Alcohol Management Plans in Queensland ...... 15 ANNEXURE 3: The Review of Alcohol Management Plans ...... 23 REFERENCE LIST ...... 26
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SUMMARY Many Aboriginal and Torres Strait Islander people abstain from drinking alcohol. Despite this fact, it has been reported that just over half (51 per cent) of the Aboriginal and Torres Strait Islander adult population in Queensland could be drinking alcohol at a risky/high-risk level (Australian Health Ministers’ Advisory Council, 2012). Harmful use of alcohol in Aboriginal and Torres Strait Islander communities is both a cause and a symptom of the low socio-economic circumstances faced by many Aboriginal and Torres Strait Islander people. Addressing alcohol misuse and harm in Aboriginal and Torres Strait Islander communities is complex with many inter-related issues. In 2002 Alcohol Management Plans (AMPs) were introduced by the Queensland Government to reduce alcohol-related violence in discrete Indigenous communities (see Annexure 2 for list), particularly against women and children. AMPs were progressively rolled-out to 19 discrete Indigenous communities covering 15 Local Government Areas. Despite decreasing trends for reported offences against the person, and for hospital admissions for assault-related conditions in some communities, the rate of hospitalisation for assault-related conditions in 2012–13 was at least five times the Queensland rate of 1.3 per 1,000 persons. In all communities, (except the Northern Peninsula Area), the overall rate of reported offences against the person was at least six times the Queensland rate of 6.7 per 1,000 persons (Department of Aboriginal and Torres Strait Islander and Multicultural Affairs, 2013a). Supply reduction interventions are achieved through regulation and enforcement, while demand reduction interventions require more effort and take more time to yield results. Additionally, effective demand reduction interventions rely on addressing the vexed issue of entrenched socio-economic disadvantage and its link to harmful use of alcohol. A holistic approach is required to address many complex and inter-related issues confronting Indigenous people. Efforts are required to: • improve school attendance and educational attainment • improve parenting skills and effective supervision of teenagers • increase employment and economic participation • improve the effectiveness and number of health and rehabilitation centres • enable focussed and collaborative community leadership and government effort. One of the most significant learnings from our experience to date with AMPs is that community generated and community “owned” proposals can be more effective than government imposed “solutions”. The Queensland Government is working with Aboriginal and Torres Strait Islander communities to review AMPs to encourage communities as a whole to identify their preferred way of reducing alcohol misuse and related harm in their communities.
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BACKGROUND
Queensland’s Aboriginal and Torres Strait Islander Peoples Queensland’s Aboriginal and Torres Strait Islander population is growing. The majority of Aboriginal and Torres Strait Islander peoples live in regional and urban Queensland. One fifth of Queensland’s Indigenous population live in remote communities. This submission focuses on issues confronting Aboriginal and Torres Strait Islander people living in remote communities. However, this submission does acknowledge that Aboriginal and Torres Strait Islander peoples living in urban and regional Queensland also experience high levels of disadvantage compared to non-Indigenous Queenslanders, including alcohol and substance misuse issues.
Harmful use of alcohol in Queensland Many Aboriginal and Torres Strait Islander people abstain from drinking alcohol. A survey conducted by the Australian Bureau of Statistics in 2004–05 found that in Queensland, Aboriginal and Torres Strait Islander adults (28 per cent) were more likely than non-Indigenous adults (13 per cent) to report having abstained from alcohol consumption in the previous 12 months (Australian Health Ministers’ Advisory Council, 2012). However, the survey also revealed that risky alcohol consumption is prevalent among Aboriginal and Torres Strait Islander peoples. One estimate is that in Queensland, just over half (51 per cent) of Aboriginal and Torres Strait Islander adults could be drinking alcohol at risky/high-risk levels over a 12 month period1. This was higher than the identified proportion for non-Indigenous persons in Queensland (42 per cent) and for Indigenous persons nationally (47 per cent).
Alcohol Management Plans In Queensland AMPs were introduced in Queensland to reduce alcohol-related violence in the communities, particularly against women and children. They were progressively rolled-out by the Queensland Government to 19 discrete Indigenous communities covering 15 Local Government Areas, from 2002. AMPs were introduced following the public release of the then Queensland Government’s Aboriginal and Torres Strait Islander Women’s Task Force on Violence Report (Queensland Government. 1999) and the 2001 Cape York Justice Study (Fitzgerald, 2001). • In the period 2003–2006, Alcohol Management Reviews were conducted for each of the discrete Indigenous communities. These reviews examined the impact of the alcohol restrictions on the community, presented the views of stakeholders within the community as well as provided the future directions and actions sought by the community in reducing violence and harm and increasing community safety and well-being. AMPs in Queensland include specific strategies to reduce: • the supply of alcohol through law enforcement (e.g. through alcohol restrictions, licence conditions, enforcement activities, bans on homebrew and homebrew equipment, dry place declarations and liquor accords). • the demand for alcohol through service delivery, including those provided under the Alcohol Management Reform (AMR) Program (for example, through rehabilitation services, detoxification services, and sport and recreation services), education and use of the media.
1Definitions of risky/high risk drinking levels are based on the guidelines set by the National Health and Medical Research Council.
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The AMP Review The Queensland Government review of the AMPs (the Review) examines current AMPs and enables communities as a whole to identify their preferred way of reducing alcohol misuse and related harm. The Review will assess the effectiveness of AMPs to reduce alcohol misuse and related harm. Similar to the Inquiry, It will assess supply and demand reduction strategies and alcohol related harm and violence. The Review is community led and driven and adopts a community by community approach taking into account the unique circumstances, histories, needs and aspirations of the each community. The Review’s paramount considerations are the safety of community residents, particularly women and children, noting the high levels of violence and harm, as well as the need to further improve school attendance and reduce child protection issues in the communities. Similar to the Federal Inquiry, the AMP Review will assess supply and demand reduction strategies and alcohol related harm and violence. Further details regarding the AMP Review, including its Terms of Reference, are at Annexure 3.
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RESPONSE TO THE INQUIRY TERMS OF REFERENCE
1. Patterns of supply of, and demand for alcohol in different Aboriginal and Torres Strait Islander communities, age groups and genders There is little empirical evidence regarding the pattern of supply of, and demand for, alcohol in Queensland’s discrete Indigenous communities. The Queensland Government is currently examining options to reduce the supply of sly grog and homebrew which incorporate point of sale strategies to reduce the supply of alcohol from liquor outlets near the discrete Indigenous communities. One of the main strategies currently operating to address sly grog at the point of sale is a register of takeaway sales maintained by liquor licensees. These registers assist licensees to comply with associated licence conditions by limiting the type and quantity of take away alcohol, and place of consumption where it is a discrete Indigenous community. They assist police to locate the point of sale and the identity of people bringing alcohol into the communities. There are two types of registers: those required as part of liquor licences known as Bulk Sale Registers; and voluntary arrangements agreed by Liquor Accords and licensees. Liquor Accords are voluntary agreements between licensees, councils, Police and other community organisations and are established to address alcohol related problems in a local area. Bulk Sale Registers – these operate, as a condition of liquor licences, in 63 licensed premises throughout Queensland including: 17 in the Ingham region; four in the Weipa region; 10 in Chillagoe/Normanton/Karumba; and one in Burketown. The type of alcohol able to be sold as takeaway in these areas depends on the alcohol restrictions in place in the nearby discrete Indigenous community. Registers record the: purchaser’s name and address; amount and type of alcohol sold; and intended place for consumption. Voluntary Agreements - some individual licensees and some licensees within Liquor Accords implement their own voluntary registers which are not enforceable. For example, some Liquor Accord licensees require all purchasers of take away alcohol to produce identification. If the purchaser’s residential address is in a discrete Indigenous community, the register is completed recording similar information to the Bulk Sales Register. The registers act as an information and enforcement tool for Police to investigate breaches of the alcohol restrictions and sly grog activity. Whilst registers work to some extent, their effectiveness relies solely on the purchaser truthfully indicating their destination. There are currently no penalties for those purchasers who provide false information on the register. Reducing demand Efforts to reduce the demand for alcohol in Queensland have focused on providing health services and diversionary services in discrete Indigenous communities. In 2008, as part of the AMR Program, the Australian Government’s then Department of Health and Ageing committed to constructing and funding the operation of three residential rehabilitation centres as well as two wellbeing centres. The Woorabinda residential rehabilitation centre was completed in March 2013 and the Mornington Island wellbeing centre was completed in February 2013. The residential rehabilitation centre based in Normanton has been constructed and is due to become operational in mid-2014. The residential rehabilitation centre to be based in Cooktown is yet to be constructed. The Doomadgee wellbeing centre has been operational since late 2012. There is also a continuing need for off-community, culturally-capable residential rehabilitation centres to provide Aboriginal and Torres Strait Islander people with treatment and services to break the cycle of harmful use of alcohol.
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Movement to regional centres without alcohol restrictions An unintended consequence of alcohol supply restrictions may be displacement. This occurs when residents of communities where alcohol restrictions apply visit venues in nearby towns where such restrictions do not apply. This issue is currently being examined as part of the Queensland Government’s review of AMPs.
2. The social and economic determinants of harmful alcohol use across Aboriginal and Torres Strait Islander communities Harmful use of alcohol in Aboriginal and Torres Strait Islander communities is both a cause and a symptom of the low socio-economic circumstances faced by many Aboriginal and Torres Strait Islander people (Australian Indigenous Health info net. 2010). The experience in Queensland is consistent with that occurring in other jurisdictions in that the harmful alcohol use is determined by a complex range of inter-related issues including: • poor educational attainment • parenting skills and effective supervision of teenagers • low employment and economic participation rates • lack of and access to culturally capable health and rehabilitation services. Addressing these issues requires collaborative community leadership and government effort.
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3. Trends and prevalence of alcohol related harm, including alcohol-fuelled violence and impacts on newborns, e.g. Foetal Alcohol Syndrome and Foetal Alcohol Spectrum Disorders. Harmful alcohol use contributes to and is caused by low socio-economic circumstances including violence, incarceration, poor health or child protection issues (Australian Health Ministers’ Advisory Council. 2012). Some of these issues may be the result of socio-economic disadvantage – for example, over- crowded housing and difficult access to hospitals due to remote locations. However, many are alcohol related, including the continuing impact on children born to mothers who misuse alcohol (Australian Health Ministers’ Advisory Council. 2012). Levels of violence and high incarceration Researchers widely agree that alcohol misuse is a leading cause of offending and incarceration. The Queensland Government monitors levels of violence in the discrete Indigenous communities on a quarterly basis. Trends on reported offences against the person and hospital admissions for assault-related conditions are reported in the Annual Bulletin for Queensland’s Discrete Indigenous Communities 2012-13 (the Annual Bulletin) (Department of Aboriginal and Torres Strait Islander and Multicultural Affairs, 2013a). The most recent Annual Bulletin indicates: • Decreasing trends for hospital admissions for assault-related conditions in four of the 12 communities where data were available: Hope Vale, Woorabinda, Wujal Wujal and Yarrabah. • Decreasing trends for reported offences against the person in eight communities: Aurukun, Kowanyama, Lockhart River, Mornington Island, Napranum, the Northern Peninsula Area (NPA), Pormpuraaw and Woorabinda. There is some evidence that the AMPs may have resulted in a reduction of violence. Margolis, Ypinazar and Muller (2008) conducted a study using Royal Flying Doctor Service data to evaluate the impact of AMPs on the rates of serious injuries in four remote Aboriginal and Torres Strait Islander communities in Cape York. Comparing the two years prior to and post- AMP, on average a reduction of 51.9 per cent in injury retrieval rates was observed. Retrieval rates for all other causes (other than injury) did not show any statistically significant change (Margolis, Ypinazar and Muller, 2008). The study provided strong evidence that AMPs were effective in reducing serious injury in these Indigenous communities. Further research examined injury retrieval data before and after the Queensland Government introduced tighter alcohol restrictions in 2008 (Margolis, Ypinazar, Muller and Clough, 2011). Results showed retrieval rates for serious injury decreased significantly following the introduction of AMPs. This compares to the two years prior to the AMPs changes in 2008 where higher rates of serious injury were reported. Following the strengthening of alcohol restrictions in 2008, a further substantial and significant drop (an average of 54 per cent across the four communities) in serious injury retrieval rates was observed such that in 2010 they had reached their lowest recorded level in 15 years (Margolis, Ypinazar, Muller and Clough, 2011). The retrieval rate for causes other than serious injury increased by approximately 13 per cent. Child Protection Alcohol misuse has been identified by the Queensland Child Protection Commission of Inquiry (the Child Protection Inquiry) as a leading cause of child protection notifications for Aboriginal and Torres Strait Islander children. About one in 10 Aboriginal or Torres Strait Islander children live in the 19 discrete Aboriginal and Torres Strait Islander communities. In 2012–13, rates of children admitted to child protection orders ranged from nil up to 74.8 per 1,000 children (0-17 years) compared with 2.8 per 1,000 state-wide (rates are highly variable from year to year due to the small size of these communities). It also reported that child abuse and neglect are occurring within a context
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of a much wider set of social problems and dysfunction afflicting these communities (Queensland Child Protection Commission of Inquiry, 2013). The Child Protection Inquiry strongly recommended the need to ensure particular focus is given to the potential harm to an unborn child when alcohol is consumed in pregnancy in alcohol- management strategies (Queensland Child Protection Commission of Inquiry, 2013). This recommendation was endorsed by the Queensland Government and the safety of women and children remain a paramount consideration in alcohol-management strategies (Queensland Government, 2013). Foetal Alcohol Syndrome and Foetal Alcohol Spectrum Disorders Foetal Alcohol Spectrum Disorder (FASD) refers to a range of effects that can result from pre- natal exposure to maternal drinking. Those diagnosed with Foetal Alcohol Syndrome (FAS) or FASD have life-long effects at every milestone including lower levels of education and employment, and high representation in the child protection system (Standing Committee on Social Policy and Legal Affairs, 2012). However, limited research has been undertaken which focuses on the impact of FAS or FASD in Queensland. Alcohol-related mental health and behavioural conditions Alcohol misuse can contribute significantly towards the development of mental health issues in individuals. Most of the discrete Indigenous communities are over-represented in data describing alcohol-related mental health admissions to hospital. Alcohol-related mental health disorders include those brought on by acute intoxication, harmful use, dependence and withdrawal. In 2012–13, across discrete Indigenous communities, the annual rate of hospital admissions where alcohol-related mental and behavioural conditions were diagnosed, ranged from 12.0 per 1,000 persons (15 years and older) up to 162.2 per 1,000 persons (15 years and older). This compares with a state-wide rate of 10.0 per 1,000 persons (15 years and older).
4. The implications of Foetal Alcohol Syndrome and Foetal Alcohol Spectrum Disorders being declared a disability A diagnosis is necessary for a child with FAS and FASD to apply for and be considered for specialist disability supports provided by the Department of Communities, Child Safety and Disability Services. These disorders are often not detected or diagnosed in children until after they have commenced school, or when they are in upper primary school and they are experiencing increasing difficulties with their school work and attending to tasks in the classroom. Having these conditions recognised as an impairment that can lead to a disability could be potentially advantageous, if this resulted in children being screened and diagnosed earlier and were therefore able to access services in a timely way. Specialist disability services
In Queensland, specialist disability services are provided by the Department of Communities, Child Safety and Disability Services (Disability Services) for children and adults who meet the eligibility criteria (demographic, diagnostic, impact) as outlined in the Disability Services Act, 2006 and the Disability Services’ Eligibility Policy. To meet the diagnostic eligibility criteria a person must: • have a disability attributable to an intellectual, psychiatric, cognitive, neurological, sensory and physical impairment or a combination of these impairments; • have a disability that results in a substantial reduction of the person’s capacity for communication, social interaction, learning, mobility or self-care or management; and • need support.
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Commencing in July 2016, Queensland is transitioning to the National Disability Insurance Scheme (NDIS) from July 2016 to June 2019, which may provide greater access to specialist services for all people who are NDIS eligible, with full implementation planned by June 2019. Currently, children with FAS and FASD who meet Disability Services eligibility criteria will continue to be prioritised for specialist disability services and this is expected to continue.
5. Best practice treatments and support for minimising alcohol misuse and alcohol- related harm The Queensland Government response to this item is substantially covered in the Annexure 2 “Alcohol Management Plans in Queensland”.
6. Best practice strategies to minimise alcohol misuse and alcohol-related harm The Queensland Government response to this item is substantially covered in the Annexure 2 “Alcohol Management Plans in Queensland”.
7. Best practice identification to include international and domestic comparisons The development process for Alcohol Management Plans included utilisation of available domestic and international evidence and some of these major sources are included in the Reference List on page 26.
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ANNEXURE 1
History of alcohol management in Aboriginal and Torres Strait Islander communities
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In 1998, the then Queensland Government’s Aboriginal and Torres Strait Islander Women’s Task Force on Violence identified alcohol as a major cause of family violence in Aboriginal and Torres Strait Islander communities (Queensland Government, 1999).
The Cape York Justice Study, led by former Justice Tony Fitzgerald examined alcohol, substance abuse and violence in Cape York and in particular the causes, nature and extent of breaches of the law and alcohol and other substance abuse, and to determine the relationship between the two (Fitzgerald, 2001). The Cape York Justice Study found that mortality and hospitalisation rates were significantly higher and levels of alcohol consumption and alcohol- related harm were extreme (Fitzgerald, 2001). Further, these issues had become socially normalised in Cape York communities. Harmful levels of alcohol consumption were found to be the chief precursor to violence, crime, injury and ill health in these populations (Fitzgerald, 2001).
In response to the Cape York Justice Study, the then Queensland Government established the Meeting Challenges, Making Choices (MCMC) policy in April 2002. The focus of MCMC was to bring government and communities together to develop locally based solutions for the improved health and wellbeing of those living in Indigenous communities, with an immediate focus on addressing the level of alcohol use and related violence (Queensland Government, 2005).
The approach to alcohol management outlined in MCMC involved three elements: supply restrictions and enforcement; separation of the management of canteens from councils2; and demand reduction initiatives, including rehabilitation, treatment and diversion (Queensland Government, 2005).
In 2002, the Queensland Parliament passed the Community Services Legislation Amendment Act. The change provided legislative protection and support for Community Justice Groups along with specific powers to assist them in recommending strategies to address alcohol abuse and violence.
In addition, in 2004 the first comprehensive review of alcohol management reforms was undertaken. The State Government engaged an Indigenous advisor, Mr Col Dillon APM, to lead the consultation which saw the refinement of existing alcohol management reforms and their progression to other communities.
In 2005, the Department of the Premier and Cabinet carried out an evaluation of the MCMC initiative to determine its effectiveness and make recommendations regarding future alcohol management policies (Queensland Government, 2005).
The MCMC evaluation report revealed that while substantial progress had been made in the implementation of the initiative, of the three elements underpinning the approach to alcohol management, only alcohol supply restrictions and enforcement had been implemented.
It found there was no clear consensus among community members about the effectiveness of AMPs and few positive impacts were noted (Queensland Government, 2005).
Several communities were perceived as a ‘better place to live’, although changes were not necessarily attributed to MCMC.
2 Prior to this, canteens had been owned and operated by local councils under general licences issued under the Liquor Act 1992 (Qld). In many Indigenous communities, profits generated from canteen sales provided councils with a means of generating substantial income, which could then be used for any purpose that accorded with the function of the council. This essentially linked alcohol sales to service provision. Fitzgerald recommended that this conflict of interest be minimised by separating the responsibility for developing and implementing alcohol policy in the community from the actual sale of alcohol (Fitzgerald 2001). Following the initial review of AMPs, the Queensland government decided to not only separate the Indigenous councils from the management of canteens, but to legislate to prevent any council in Queensland from holding a general liquor licence. Page 12 of 26
In September 2005, the then Queensland Government launched the Partnerships Queensland: Future Directions Framework for Aboriginal and Torres Strait Islander Policy in Queensland 2005-2010 (the Framework). The Framework aimed to deliver lasting improvements to the quality of life of Aboriginal and Torres Strait Islander Queenslanders through sustained evidence-based action.
The Framework consolidated all existing Indigenous policies, including MCMC, to four key goals: strong families, strong cultures; safe places; healthy living; and skilled and prosperous people and communities. Notably, the ‘safe places’ goal, aimed to support communities to reduce the impacts of alcohol through initiatives such as the introduction of a Queensland Indigenous Alcohol Diversion Program and the Alcohol and Other Substances Demand Reduction Program.
In 2008, the then Queensland Government introduced the Alcohol Management Reform (AMR) Program to achieve a sustained reduction in alcohol-related harm. This objective was to be achieved through tighter legislation and alcohol restrictions, improved services, and partnership between government and community, including support for positive community leadership and actions. The AMR Program comprised: • a Revenue Replacement Program for Councils (following canteen divestment); • alcohol and drug treatment and rehabilitation services; and • diversionary services including the PCYC Community Activities Program through Education (CAPE). To support AMR’s objective, in 2008 three key pieces of legislation were amended: • The Aboriginal and Torres Strait Islander Communities (Justice, Land and Other Matters) Act 1984 was amended to introduce homebrew bans in those communities with a complete ban on alcohol. • The Liquor Act 1992 was amended to make harm minimisation, the Government’s new policy approach to alcohol reform, the first objective of the Act. As a result: councils can no longer hold a General Liquor Licence; drinking in public places is banned (unless the area was specifically designated as a ‘wet area’); certain roads are included in the restricted areas3; houses are included in the alcohol restrictions4; and it is an offence to attempt to enter a restricted area with alcohol in excess of the carriage limit. • The Police Powers and Responsibilities Act 2000 was also amended to extend the existing police powers so that police can search a person without warrant if they reasonably suspect they are carrying illicit alcohol. Police can also search a house without warrant if it is believed the alcohol may be hidden before they can obtain a warrant. AMPs were progressively rolled out from 2002. Commencement dates varied across communities, with the majority being introduced in 2003-04. Aurukun was the first community to implement an AMP in 2002, while Cherbourg was the last to introduce an AMP in 2009. As a result of these reforms, all local governments, including non-Indigenous local governments, were prohibited from obtaining or controlling a general liquor licence from 1 July 2008. Those canteens still in council ownership at 31 December 2008 closed. The councils stated that profits from the canteens were directed to providing social programs. This broke the nexus between canteen profits and social services. State Government funding was allocated to continue with the social services previously funded by canteen profits.
3 Roads serving as major through routes in restricted areas are subject to relevant carriage limits (exemptions apply to tourists or persons moving through the area if they can prove their destination is outside the restricted area). 4 Prior to 2008, alcohol carriage limits only applied in public places in the communities. Page 13 of 26
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ANNEXURE 2
Alcohol Management Plans in Queensland
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AMPs were progressively rolled-out by the Queensland Government to 19 discrete Indigenous communities covering 15 Local Government Areas, from 2002. AMPs aim to reduce alcohol-related violence in the communities, particularly against women and children. They were introduced following the public release of the then Queensland Government’s Aboriginal and Torres Strait Islander Women’s Task Force on Violence Report and the 2001 Cape York Justice Study. AMPs in Queensland include specific strategies to reduce: • the supply of alcohol through law enforcement (e.g. through alcohol restrictions, licence conditions, enforcement activities, bans on homebrew and homebrew equipment, dry place declarations and liquor accords) • the demand for alcohol through service delivery, including those provided under the AMR Program (for example, through rehabilitation services, detoxification services, and sport and recreation services), education and use of the media. Alcohol restrictions Alcohol restrictions are set for each of the 19 discrete Indigenous communities under the Liquor Act 1992 (Qld) (the Liquor Act) and the Liquor Regulations 2002 (the Regulations). The exact boundaries of restricted areas are clearly specified in the Regulations. The restrictions vary across communities and range from a zero carriage limit (complete alcohol ban) in eight communities to a maximum of (in the case of Mapoon): • 2 litres of wine (excluding fortified wine) and 22.5 litres (60 x 375ml cans) and 9 litres (24 x 375ml) of pre-mixed spirits (up to 5.5 per cent) OR • 2 litres of wine (excluding fortified wine) and 33.75 litres (90 x 375 cans) of light or mid strength beer. The restrictions are enforced by the Police. Penalties apply for breaches of alcohol restrictions with maximum penalties for possessing alcohol in a restricted area consisting of a: • $41,250 fine for the first offence; • $57,750 fine or six months imprisonment for the second offence; and • $82,500 fine or 18 months imprisonment for the third or subsequent offence. Homebrew bans Homebrew bans are declared under the Aboriginal and Torres Strait Islander (Justice, Land and Other Matters) Act 1984 (JLOM) and currently apply to eight communities which have a zero carriage limit and to Doomadgee. It is an offence to possess homebrew equipment or homemade alcohol. It is also an offence to supply homemade alcohol to another person in communities where the homebrew bans apply. The maximum penalty is currently a $20,900 fine.
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Dry place declarations A dry place declaration applies to residences where it is illegal to possess or consume alcohol. Tenant/s or owner-occupiers can apply to the Magistrates Court for a declaration that their residence be declared dry. The maximum penalty for breaching a dry place declaration is a fine of up to $2,090. Dry place declarations exist in the following communities: Cherbourg (1); Doomadgee (1); Hope Vale (6); Palm Island (3); and Yarrabah (4)5. AMPs operating in Queensland’s Indigenous communities at 30 June 2012
Discrete Local Current Alcohol Carriage Date the AMP commenced Community Government Area Limit
Aurukun* Aurukun Shire AMP and restriction commenced Zero alcohol carriage limit— Council 30 December 2002 no alcohol Homebrew ban
Cherbourg Cherbourg AMP commenced 17 December 11.25 litres (1 carton of 30 Aboriginal Shire 2004 cans#) of light or mid-strength Council Alcohol restrictions introduced 12 beer March 2009
Doomadgee Doomadgee AMP commenced 9 June 2003 22.5 litres (2 cartons of 30 Aboriginal Shire cans##) of light or mid-strength Council beer. Homebrew ban
Hope Vale* Hope Vale AMP commenced 14 April 2004 11.25 litres (1 carton of 30 Aboriginal Shire cans#) of light or mid-strength Council beer; or 750 ml (1 bottle) of non-fortified wine
Kowanyama Kowanyama AMP commenced 5 December Zero alcohol carriage limit— Aboriginal Shire 2003 no alcohol Council Homebrew ban.
Lockhart River Lockhart River AMP commenced 3 October Zero alcohol carriage limit— Aboriginal Shire 2003 no alcohol Council Homebrew ban
Mapoon Mapoon Aboriginal AMP commenced 14 April 2004 2 litres of non-fortified wine, Shire Council and 22.5 litres (2 cartons of 30 cans##) of light or mid- strength beer, and 9 litres^ (1 carton of 24 cans) of pre- mixed spirits; Or 2 litres of non-fortified wine and 33.75 litres (3 cartons of 30 cans###) of light or mid- strength beer
5 Information as at 31 December 2012. Page 17 of 26
Discrete Local Current Alcohol Carriage Date the AMP commenced Community Government Area Limit
Mornington Mornington Shire AMP commenced 28 November Zero alcohol carriage limit— Island* Council 2003 no alcohol Homebrew ban
Napranum Napranum AMP commenced 9 June 2003 Zero alcohol carriage limit— Aboriginal Shire no alcohol Council Homebrew ban
Northern Northern Peninsula AMP commenced 14 April 2004 2 litres of non-fortified wine, Peninsula Area Regional and 11.25 litres (1 carton of Area (Bamaga Council 30 cans#) of any strength Injinoo beer; or 2 litres of non-fortified Mapoon, wine and 9 litres^ (1 carton of Seisia & 24 cans) of pre-mixed spirits Umagico)
Palm Island* Palm Island AMP commenced 19 June 2006 11.25 litres (1 carton of 30 Aboriginal Shire cans#) of light or mid-strength Council beer
Pormpuraaw* Pormpuraaw AMP commenced 5 December Zero alcohol carriage limit— Aboriginal Shire 2003 no alcohol Council Homebrew ban
Woorabinda Woorabinda AMP commenced 3 October Zero alcohol carriage limit— Aboriginal Shire 2003 no alcohol Council Homebrew ban
Wujal Wujal Wujal Wujal AMP commenced 3 October Zero alcohol carriage limit— Aboriginal Shire 2003 no alcohol Council Homebrew ban
Yarrabah Yarrabah Aboriginal AMP commenced 6 February 11.25 litres (1 carton of 30 Shire Council 2004 cans#) of light or mid-strength beer; or 750 ml (1 bottle) of non-fortified wine
^ 9 litres = 1 carton of 24 x 375 mL cans # 11.25 litres = 1 carton of 30 x 375 mL cans ## 22.50 litres = 2 cartons of 30 x 375 mL cans ### 33.75 litres = 3 cartons of 30 x 375 mL cans * Alcohol restrictions do not apply at licensed premises operating in the community. However, specific licence conditions limiting the amount, type and availability of alcohol apply to each of the premises individually, to complement alcohol restrictions. Note: For more information on licensed premises and alcohol restrictions visit www.olgr.qld.gov.au.
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Liquor licenses and conditions Licensed premises and liquor permits operate in six local government areas with AMPs: Aurukun, Hope Vale, Mornington Island, the NPA, Palm Island and Pormpuraaw. Licences and permits include a range of conditions to minimise the risk of alcohol-related harm and violence in the communities for example: • limited trading hours; • a limit or ban on takeaway sales; • restrictions on the type of alcohol that can be sold (e.g. light or medium strength beer only); and • restrictions on how much alcohol a person can buy and possess (for example a maximum of 2 cans of beer at a time). To complement alcohol restrictions, the Office of Liquor and Gaming Regulation also places special conditions on licensed premises in surrounding towns to reduce the supply of alcohol to the restricted communities. There are 1616 licensed premises in surrounding towns and four basic conditions have been imposed on most licensed premises situated in towns near the restricted area communities to assist in reducing the supply of alcohol , including: • no alcohol sales to taxi drivers who are acting as a third party; • no licensee can hold a patron's bank access cards; • a ban on the sale of pre-mixed spirits in containers exceeding two litres and all other liquor in containers exceeding four litres; and • a ban on the sale of fortified wines, such as port, muscat, and sherry, in glass flagons. If there is evidence that alcohol sold from such premises is directly linked to problems in a community, stricter conditions may also be imposed on the licence. This includes conditions to limit and monitor the supply of alcohol, such as: • requiring a ‘bulk sales’ register for takeaway sales; • prohibiting the sale of alcohol to persons known to be travelling into a restricted area; • limiting or banning the sale of certain products, such as cask wine; and Liquor accords A liquor accord is an agreement, memorandum of understanding, or other arrangement entered into by two or more licensees for the purposes of: • promoting responsible practices in relation to the sale and supply of liquor at licensed premises situated in the locality; • minimising harm caused by alcohol abuse and misuse and associated violence in the locality; and • minimising alcohol-related disturbances, or public disorder, in the locality.
6 As at 12 February 2013, Premises may close unexpectedly and without the knowledge of the Office of Liquor and Gaming Regulation, so this count is subject to variation. Page 19 of 26
While liquor accord agreements are made between licensees, most liquor accords include members from the local business community, local councils, police, government departments, and other community organisations. These members work together to identify and implement practical solutions to liquor-related problems in the local area. Liquor accords play a vital role in harm minimisation and facilitate effective communication and problem solving between licensees and key stakeholders. The Queensland Office of Liquor and Gaming Regulation works with licensees and local communities to enhance and extend the voluntary participation in the development and management of accords; and supports accord groups with a dedicated website and other online tools, as well as hosting an annual conference. Two liquor accords operate in discrete Indigenous communities with AMPs (NPA and Palm Island). There are liquor accords based in areas in close proximity to some discrete Indigenous communities such as Burketown (Doomadgee and Mornington Island), Murgon (Cherbourg) and Cooktown (Wujal Wujal and Hope Vale) which play a role in managing the supply of alcohol to the communities. Alcohol and drug treatment and rehabilitation services Alcohol and drug treatments are provided through local clinics funded by the Queensland Department of Health and residential rehabilitation services delivered by the Australian Government. Health and Hospital Services deliver the Queensland Department of Health’s services which include: withdrawal management, counselling and community support services, screening and assessments, opportunistic interventions, alcohol and drug counselling, detoxification services, and group counselling and education. Residential rehabilitation centres and wellbeing centres In 2008, the Australian Government committed to constructing and operating three residential rehabilitation centres in Queensland. They were to provide a residential program for clients with drug and alcohol-related problems. They also give priority to Indigenous individuals and their family members who are at risk of family breakdown-related effects of alcohol and drugs. Importantly, the services offered at the centres provide a continuum of care for residents of other discrete Indigenous communities as part of the AMR program. Domestic and family violence services Alcohol misuse is known to be a contributing factor to the prevalence and impact of domestic and family violence in discrete Aboriginal and Torres Strait Islander communities. Specialist support services are located in some discrete communities to provide culturally appropriate support to women, men, children and young people at risk of or affected by domestic and family violence. This includes work with perpetrators of domestic and family violence where alcohol misuse is recognised as a contributing factor. The services in these communities also undertake community education activities in an effort to raise awareness and achieve safer communities through prevention and early intervention. In addition, women’s refuges (funded by the Department of Housing and Public Works) are located in many discrete communities to provide places of safety for women and children escaping domestic and family violence. As a result of a 2011 review of Indigenous women’s shelters in discrete communities, the Department of Communities Child Safety and Disability Services (DCCSDS) and the Department of Housing and Public Works are working together to transition existing shelters into women’s resource centres, with secure accommodation retained for women and children escaping domestic violence. Women’s resource centres will operate as service hubs, delivering a range of services for the benefit of women and children of the community. Using a common facility for integrated service delivery increases the value obtained from existing facilities.
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Diversion from drinking services Diversion services offer activities that contribute to crime prevention, health, and wellbeing, including sport and recreation activities, music writing workshops, cultural dance and music, youth discos, after-school programs, wet season holiday programs, and employment opportunities. Other services such as probation and parole are also provided to reduce alcohol- related harm. Men’s Support services, funded by DCCSDS support Aboriginal and Torres Strait Islander men affected by alcohol and violence, including as perpetrators of community, domestic and family violence, to increase their individual sense of healing and personal well-being; and improve the safety and wellbeing of their families and communities. Services support men to address, resolve and build resilience to the underlying causal factors which lead them to consume alcohol (and other substances) and behave in ways which negatively affect their health and wellbeing and that of their families and community; and encourage men to change their harmful and abusive behaviour. Diversion from custody services A suite of services focusses specifically on supporting vulnerable Indigenous people at risk of incarceration or harm resulting from intoxication in public spaces. Services include diversion centres that provide rest and recovery, cell visitor services, community patrols and case management support. Monitoring levels of alcohol-related harm The Queensland Government monitors and reports on levels of alcohol-related harm in the 19 discrete Indigenous communities, Coen and Mossman Gorge on a quarterly basis through the Annual Bulletin on Key Indicators. Monitoring and reporting includes the two direct indicators of alcohol-related harm: • hospital admissions for assault-related conditions; and • reported offences against the person Indirect indictors reported are: • breaches of alcohol restrictions; • new substantiated child protection notifications; • child protection orders; and • student attendance. This data allows community members to see first-hand how their community is tracking against the indicators.
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ANNEXURE 3
The Review of Alcohol Management Plans
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The Queensland Government commenced a review of the AMPs (the Review) in October 2012. The Review’s objective is to examine current AMPs and for communities as a whole to identify their preferred way of reducing alcohol misuse and related harm. The Review comprises three main elements: a community-specific review, a general review, and a convictions project. Mayors, their Councils, Community Justice Groups and other local stakeholders, have the opportunity to take a leadership role to engage with their whole community to identify what it wants to have in place regarding community management of alcohol misuse, while continuing to reduce alcohol-related harm. Some communities may choose to retain alcohol restrictions or even strengthen them to support measures that result in a reduction of alcohol related harm. The Review’s paramount considerations are the safety of community residents, particularly women and children, noting the high levels of violence and harm, as well as to further improve school attendance and reduce child protection issues in the communities. The Review’s Terms of reference are: 1. Previous reviews and the evidence base regarding alcohol misuse and the causes of high levels of violence. 2. The strength of community leadership and capacity to manage alcohol misuse and reduce alcohol-related harm. 3. The effectiveness and impacts of current AMP supply and demand strategies to reduce alcohol-related harm. 4. The impact of AMPs on community members and regional centres. 5. Future strategies to manage alcohol misuse and reduce alcohol-related harm, in each community, with a view to transitioning from AMPs if a community wishes to. The Review will consider all matters related to the five issues outlined in the Terms of Reference, including a detailed analysis of whether people with a history of alcohol abuse move to other regional/urban centres and a report on the levels of breaches of alcohol restrictions. However, where matters are raised that indirectly relate to alcohol management, these matters will be noted and will be referred to the relevant agency for progression under a more appropriate forum. Other matters are likely to be raised in consultation with respect to the Review and may have some indirect relationship to alcohol-related harm and violence in the communities. These may include: unemployment levels; other drug and substance misuse; and community dispute resolution. The general review assesses the effectiveness of the AMPs in Queensland in accordance with the Terms of Reference. It will consider both supply and demand reduction strategies. Supply reduction strategies include the alcohol restrictions, home brew bans, liquor licensing conditions and dry place declarations. Demand reduction strategies include services to reduce alcohol misuse and addiction.
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The community-specific review is community led and driven. It adopts a community by community approach taking into account the unique histories, needs and aspirations of the each community. The Review’s community specific element will be conducted over three broad phases: • communities developing their proposals and government assistance; • developing transition plans or alternative strategies, for those communities who wish to (both of which require Queensland Government approval), and follow up consultation; and • finalising transition plans and alternative strategies, implementation and monitoring. Due to community differences these phases may be adapted to suit the circumstances of each community. To allow communities to work at their own pace, no timeframes have been set for the community specific review.
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REFERENCE LIST Australian Health Ministers’ Advisory Council. (2012). Aboriginal and Torres Strait Islander Health Performance Framework 2012 Report. Canberra, AHMAC. Retrieved from Department of Health website: http://www.health.gov.au/indigenous-hpf
Australian Indigenous Health info net. (2010). Review of the harmful use of alcohol amongst Indigenous Australians. Retrived from the Australian Indigenous Health info net website: http://www.healthinfonet.ecu.edu.au/health-risks/alcohol/reviews/our-review#fnl-10
Department of Aboriginal and Torres Strait Islander and Multicultural Affairs. (2013a). Annual Bulletin for Queensland’s Discrete Indigenous Communities: 2012-13. Unpublished.
Department of Aboriginal and Torres Strait Islander and Multicultural Affairs. (2012b). Annual Bulletin for Queensland’s Discrete Indigenous Communities: 2011-12.
D’Abbs, P., Togni, S. & Hollins, J. (2003). Evaluation of Mt Isa liquor restrictions: Queensland Health and Mount Isa Centre for Rural and Remote Health. James Cook University.
Fitzgerald, T. (2001). Cape York Justice Study, Volume 1: Brisbane: Queensland Government.
Margolis, S. A., Ypinazar, V. A., & Muller, R. (2008). The impact of supply reduction through alcohol management plans on serious injury in remote indigenous communities in remote Australia: A ten- year analysis using data from the royal flying doctor service. Alcohol and Alcoholism, 43(1), 104- 110.
Margolis, S. A., Ypinazar, V. A., Muller, R., & Clough, A. (2011). Increasing alcohol restrictions and rates of serious injury in four remote Australian Indigenous communities. Medical Journal of Australia, 194, 503-506.
Queensland Child Protection Commission of Inquiry. (2013). Taking Responsibility: A roadmap for Queensland child protection. Retrieved from Queensland Child Protection Commission of Inquiry website: http://www.childprotectioninquiry.qld.gov.au/publications
Queensland Government. (2013). Queensland Government response to the Queensland Child Protection Commission of Inquiry final report Taking Responsibility: A Roadmap for Queensland Child Protection. Retrieved from Department of Communities, Child Safety and Disability Services website: http://www.communities.qld.gov.au/resources/reform-renewal/qg-response-child-protection- inquiry.pdf
Queensland Government. (2005). Meeting challenges, making choices. Evaluation Report. Brisbane: Qld Government, 2005.
Queensland Government. (1999). The Aboriginal and Torres Strait Islander Women’s Task Force on Violence Report.
Rothstein, J., Heazlewood, R., & Fraser, M. (2007). Health of Aboriginal and Torres Strait Islander children in remote Far North Queensland: findings of the Paediatric Outreach Service. Medical Journal of Australia, 186(10), 519-521.
Standing Committee on Social Policy and Legal Affairs. (2012). FASD: the hidden harm – inquiry into the prevention, diagnosis and management of foetal alcohol spectrum disorders. The Parliament of the Commonwealth of Australia. Retrieved from Parliament of Australia website: http://www.aph.gov.au/parliamentary_business/committees/house_of_representatives_committees? url=spla/fasd/report.htm
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