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The Shell Issue 3
Achieving policy change - a tale of two Summits
The current public debate about alcohol-related violence presents a rare opportunity to change how society deals with a complex health issue.
With the rapid growth of social media and competing news stories, getting the public to focus on a particular issue and then trying to convince them of the need for change is difficult if there is no burning platform for reform. Actually achieving real change involves political will and leadership.
We all know the expression “timing is everything”. In public policy terms it is no different. When there is an impetus for change coming from the public on such a difficult policy conundrum as alcohol, no right thinking government can afford to ignore it.
The recent, tragic death of a young man in Kings Cross from a single blow allegedly delivered by a drunk and habitually violent man has understandably led to an outpouring of public anger and demand for government action on the issue of alcohol related violence.
It’s a call the Government must heed, not only because the public is right, but because this is an opportunity to really put some decent public policy in place that may actually achieve lasting results and even, eventually, the holy grail of culture or behaviour change.
In 1999 at the height of a State Election in NSW a shocking photograph appeared on the front page of a Sydney newspaper of a young person apparently injecting heroin into the arm of an even younger person in the backstreets of Redfern. Although much of the accompanying story was subsequently found to have been sensationalised, the shocking nature of the photograph alone was enough to galvanise action.
The storm created by the overwhelming public anger and revulsion to the photograph and accompanying story forced Premier Bob Carr to announce a Drug Summit as part of his re-election campaign, which was largely being fought on law and order issues. Bob Carr won the election in March and the Summit was held in May while the issue was still white hot in the public mind and the call for action was unstoppable. The Summit involved a broad cross section of the community, from drug experts to police, magistrates, families and drug users as well, of course, as the politicians themselves.
In political and policy terms, the Summit was an extraordinary event. Unlike the normal process of policy development involving Ministers, their political and departmental advisers consulting with different stakeholders at different times behind closed doors, then making an announcement, the Drug Summit saw the full public policy process played out in the public spotlight. Confronted with the data and research about drug abuse from the experts, stories from families affected by the problem and police and magistrates dealing with the fallout, the politicians were forced to respond honestly to the facts presented to them. Some even changed their previously and often long-held opinions and prejudices about how illegal drug users should be treated by the criminal justice and health systems.
The Summit produced a range of outcomes and measures to address what was seen as a growing problem in the community. The policy response ran the full gamut of government service delivery, including all major government departments but centralising the implementation of around 170 different measures in the powerful Cabinet Office, run by some of the State’s most competent bureaucrats.
One minister had overall portfolio responsibility. Most importantly, substantial additional funding was allocated to ensure departmental agencies actually delivered on the Government’s commitments.
Some of the initiatives from that Summit held some 15 years ago still stand today – and while no-one would ever claim the problem has been solved, gone away or forgotten, NSW is undoubtedly better equipped to manage the problem of illicit drug use than it was before that photograph appeared in the Sun-Herald.
Despite the positive response the Carr Government received from the implementation of its response to the drug problem, health experts constantly reminded the Government that while it was all very well to deal with illicit drugs, the biggest costs to public health, productivity and public safety was in fact alcohol, or rather the abuse of alcohol.
In the midst of another election campaign in 2003, and perhaps seeking to replicate the political and policy success of the Drug Summit, the Carr Government announced an Alcohol Summit.
The Summit was held in August of that year. Clearly not with the same urgency as its predecessor and while the organisation, structure and intent of the two Summits were similar, they could not have been more different.
Again, the evidence for the need for action was overwhelming. It came from the medical experts, professors, families, police, indigenous leaders and most graphically from trauma specialists and frontline emergency services workers. And the recommendations for action spilled forth - 318 in all. Like the Drug Summit, many were worthy and important. They touched upon many themes and addressed the full spectrum of the problem.
But ultimately, the NSW Alcohol Summit was not a success and the degree of lasting change achieved was negligible. This was predominantly for two reasons – the lack of a public call for action on alcohol reform, ie no burning platform, as was the case for the Drug Summit, and political ambivalence towards the issue as evidenced by watered down recommendations and a half-hearted government response with no additional funding.
As the Summit heard many times from many speakers, the use of alcohol is deeply embedded in our culture dating back to the first days of the colony in NSW, it’s a rite of passage, it’s present at every social occasion and celebration, and it’s inextricably associated with Australia’s other favourite pastime – sport. In other words, alcohol is a legal product that’s use is both accepted and prevalent across all ages and levels of Australian society. It’s fair to say the overwhelming majority of Summit participants (in line with the broader public and indeed the media covering the Summit) were to varying degrees themselves alcohol consumers. Add to that the legitimate presence of the alcohol industry as major stakeholders and the debate and outcomes became clouded and compromised. The debate inevitably swung away from some of the more complex and contentious policy responses addressing the widespread nature of the problem, including the supply, availability and marketing of alcohol towards the extreme ends of the problem such as chronic alcoholism and, the usual suspect, youth binge drinking.
But while illicit drug use may also be widespread and prevalent in Australian society, the Drug Summit did not present the same level of personal discomfort for its participants who it would be fair to say were not part of the cohort the Summit was concerned with. The “drug industry” was not present as a stakeholder, and the Summit was at liberty to consider further ways to limit availability and supply. The politicians and decision-makers were free to consider the problem rationally and even contemplate some more courageous policy measures.
Whether or not the majority of the public agreed with all of the measures undertaken as a result of the Drug Summit, there can be little doubt there were some long term outcomes as a result. There was a mandate for change, the Government responded quickly and implemented an evidence-based and well-resourced policy response to which they provided substantial political leadership and follow through. In 2014, the O’Farrell Government has a small window of opportunity to do the same with alcohol. Superficial change will not stand the test of time.