National Interest

There is evidence that even before the intervention, some of the ugly aspects of life for people in and around Alice Springs were starting to get better: Over the last 18 months there has been a sharp drop in the rates of murder, manslaughter, and stabbing.

So is this due to the intervention, or are there other reasons that the Alice is getting less ugly?

Transcript

This transcript was typed from a recording of the program. The ABC cannot guarantee its complete accuracy because of the possibility of mishearing and occasional difficulty in identifying speakers.

Peter Mares: As we've heard, income management - or 'quarantining' - is a key part of the federal government's intervention, to ensure that welfare payments are used to buy food and other essentials, rather than booze.

The aim is not just to get kids better fed, but also to break the link between alcohol and violence. And in Alice Springs there's strong evidence to suggest that restricting the sale or purchase of alcohol does make for a safer community.

Dr John Boffa is Public Health Medical Officer at the Central Australian Aboriginal Congress, an Aboriginal community-controlled health care service. And he's also spokesman for the People's Alcohol Action Coalition in Alice Springs. John Boffa, welcome to The National Interest.

John Boffa: Hello.

Peter Mares: Now, Alice Springs used to have a reputation as the murder capital of Australia. But I gather things have changed...

John Boffa: Yes, there has been a very significant and welcome change. We've seen - since the introduction of supply reduction or restrictions on supply of alcohol on 1st October 2006...

Peter Mares: So, these are restrictions pre-dating the intervention...

John Boffa: Pre-dating the intervention by more than 12 months, in fact. We've seen a very welcome reduction in murders, manslaughters, admissions to hospital for stabbings and other significant alcohol-caused admissions and harms.

Peter Mares: I think the local police inspector said the fact that there hasn't been a murder or manslaughter for more than nine months, was - he felt - unprecedented.

John Boffa: Yes, that was the term he used. And I think the police have been part of the positive change that's happened. I think they're just as excited as anyone else about the improvement.

Peter Mares: Now, statistics like this you have to be very careful with because the numbers are small. A few killings a year... You could have a year when there's none and then it could jump up again. What about the evidence, though, of stabbings and admissions to hospital, which happen - I'm sorry to say - in much larger numbers. Is there clear evidence of a decline there?

John Boffa: Yes. I think what's very encouraging is there's a range of data suggesting that we've seen a major decline in severe alcohol-caused violence. The murder-manslaughter data is one. But we heard Dr Jacob - who's the Chief Surgeon in Alice Springs Hospital - about six weeks ago go public with the fact that stabbing admissions have gone from 200 a year to about 80 per year in Alice Springs Hospital. Now, a lot of those stabbings were very severe injuries requiring emergency surgery. He said that as a result, doctors at the hospital have got a lot more time to focus on out-patients and other, less urgent medical issues. So, that's further corroborating evidence, along with data that's been collected on all alcohol-caused admissions - which is declining - admissions for pancreatitis, liver disease, those sort of things. And there's even a suggestion that the admissions to the Intensive Care Unit has significantly gone down. Now, all of this needs to be pieced together with police data, welfare data, and other data. We are yet to see, for instance, the motor vehicle accident death rate data. The suicide data is also trending down in the same way. There needs to be an independent evaluation, a proper scientific evaluation of this, to make sure that the trends that we're seeing can be correctly attributed to the restrictions. But at this stage it looks extremely positive.

Peter Mares: Well, yes. I mean, there are questions there. I mean, you attribute the changes to restrictions on alcohol sales, but couldn't it be that policing has got better, that there are more police, that they're doing a better job, that they're intervening more in domestic violence cases?

John Boffa: I think it's clear that the restrictions plus the extra police and what's called preventative policing has probably played a part. I think, though, it's fair to say that before we embarked on these restrictions - which are largely centred around price - the international evidence was very clear that if you can reduce the per capita alcohol consumption in the population level, you will have a significant impact on harms. Now, what we've achieved is at least the 10 per cent reduction in per capita alcohol consumption in the town of Alice Springs...

Peter Mares: You can see that from alcohol sales...?

John Boffa: Yes. We've been monitoring the sales of pure alcohol, and the latest figures are actually suggesting a 17 per cent reduction on where we were...

Peter Mares: When you say 'pure alcohol', you mean you work out how much alcohol there is contained in all the alcohol sales - whether it's beer or spirits or wine or what-have-you - and you work out how much pure alcohol has been sold over a period of time...

John Boffa: Yes, that's exactly right. Because it's the amount of pure alcohol obviously that does the damage and that's what we're monitoring. Irrespective of the volume sold, we're actually working out the pure alcohol. Now, it appears that there's been a 17 per cent decline in the sales of pure alcohol at a population level for the whole town. Now, we know from the international evidence that that - in other countries of the world - in cross-cultures has demonstrated will achieve harm reduction. So we went into this assuming that if we could achieve a reduction in population consumption to price-based supply reduction we would see harm reduction. So, again, that's where the hypothesis we're testing here is proving to be true, I think, in the sense that we're now seeing trending downwards homicide, suicide, manslaughters, admissions for stabbings, severe violent-related harm... it's declining - which is what we expected to see, which is again why even at this stage, without an independent evaluation being done, I'm reasonably confident that we've got a cause and effect situation here, that supply reduction measures which have centred around price have reduced population alcohol consumption and have again been proven to reduce significantly population harms.

Peter Mares: And is there a comparison with other urban centres in the Northern Territory? I mean, places like Katherine, maybe, or even Darwin? Can we draw any comparisons between different cities and towns in the Northern Territory?

John Boffa: Well, we can certainly look at the per capita alcohol consumption now in different centres, because the data was published on 24th December last year, and we can see that while we've seen the consumption trending downward in Alice Springs, we've seen very significant increases in Katherine, Nhulunbuy, Darwin and to a lesser extent in Tennant Creek.

Peter Mares: And they don't have the same restrictions that Alice Springs introduced?

John Boffa: No. In most of these centres, for the time-period the data was collected, they had no restrictions. In Tennant Creek they had some. But unfortunately the restrictions were not designed around price, and so major loopholes in the restrictions mean that they did not necessarily achieve the reduction in consumption of true alcohol that we achieved in Alice Springs.

Peter Mares: Just explain how do these alcohol restrictions work in Alice Springs?

John Boffa: Well, it's relatively simple. We know from all the international evidence that price is the principal determinant of consumption of alcohol. So, we basically said 'Well, let's make beer the minimum price benchmark for alcohol'. Beer sells at around 90 cents a standard drink. And let's get rid of all the products on the market, particularly the cheap, bulk alcohol, that the heaviest drinkers choose, which was selling at around 30 cents a standard drink.

Peter Mares: So, this is things like flagon port or wine in casks - that sort of stuff?

John Boffa: Yes, five-litre casks, four-litre casks, three-litre casks of sherry, two-litre casks of port. They all tend to sell at around 30 cents for a standard drink mark. So, once you have... you've removed all of those products from the market, and between 2pm and 6pm the cheapest form of grog on the market is beer at 90 cents a standard drink. So, when the heaviest drinkers turn up to buy their takeaway at 2 o'clock, they can buy beer; so for every dollar they spend on alcohol they're only getting a third of the pure alcohol that they were getting when they used to spend that money on cask wine. So, you can see that if the equation works that that extent, you're seeing a very major reduction in the amount of pure alcohol that the heaviest drinkers are consuming.

Peter Mares: Now, this has really interesting national implications, doesn't it? Because we've had this debate about alcopops - which is around whether the tax on alcopops should be the same as the tax on bottles of spirits, and that was the change the government made in the budget. There's a similar debate to be had as to whether we should have a tax that's the same for all forms of alcohol - that is that liquor is taxed on its alcohol content.

John Boffa: There's no doubt if we introduced a volumetric tax, or a tax based on the amount of pure alcohol in each drink, Australia would achieve a major reduction in harm. We would prevent many deaths in this country across the country and that would have a very significant impact on Aboriginal health.

Peter Mares: I can hear the emails coming in from winegrowers and the wine industry as we speak, John Boffa.

John Boffa: Yes, I can too. And I was aware the draft national policy on alcohol in 1987 suggested we implement a volumetric tax and that was basically shafted by the lobbying of the wine industry. So, for many, many years they've been very effective at keeping this off the national policy agenda. But I think - hopefully - in the Rudd Labor government we have a government that may be prepared to listen and consider taking the hard steps and showing the leadership that's needed to introduce a volumetric tax, which would be a great benefit to Aboriginal health and Aboriginal communities but also to the whole country.

But to show you the impact that you can have with poorly designed restrictions, in 2003 in Alice Springs restrictions were implemented that unfortunately were not based on price, because we had the liquor industry at the time convincing the Licensing Commission that the heaviest drinkers didn't drink according to price, they drank according to taste. So in those restrictions in 2003, two-litre port was left on the market, but four- and five-litre wine was banned. And what we had is exactly what PAAC predicted: we had a massive... we had a 1,000 per cent shift to two-litre port, which is still selling at 30 cents a standard drink. So, we had the liquor industry saying 'This won't happen because the heaviest drinkers drink according to taste, they won't buy port, they don't like it', when in fact exactly what happened is what all the evidence proves, is that the heaviest drinkers drink according to price, not taste, when there's a massive price margin. Certainly, if products are selling at around the same price, taste comes into it; but if you're faced with purchasing a product at 30 cents a standard drink versus purchasing a product at 90 cents a standard drink and you're trying to drink to get drunk, you'll buy the 30 cent standard drink product every time.

Peter Mares: And you'll drink port instead of beer. John Boffa, thank you very much for your time.

John Boffa: Thank you very much.

Peter Mares: Dr John Boffa is Public Health Medical Officer at the Central Australian Aboriginal Congress, and spokesman for the People's Alcohol Action Coalition in Alice Springs.

Guests

Dr John Boffa
Public Health Medical Officer Central Australian Aboriginal Congress (an Aboriginal community controlled health care service) Spokesperson People's Alcohol Action Coalition

Presenter

Peter Mares

Producer

John Standish

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