Drug Summit Legislative Response Amendment (Trial Period Extension) Bill 2007
The Hon. PENNY SHARPE (Parliamentary Secretary) [9.30 p.m.], on behalf of the Hon. John Hatzistergos: I move:
That this bill be now read a second time.
As the second reading speech has already been delivered in the other place, I seek leave to have it incorporated in Hansard.
I am pleased to bring before the House the Drug Summit Legislative Response Amendment (Trial Period Extension) Bill 2007. The bill provides for the continuation for a further four years of the trial of the Medically Supervised Injecting Centre, which commenced in Kings Cross more than six years ago, in May 2001. The bill enables the centre to continue providing a service for a group of marginalised long-term drug users with significant health and social problems who have either failed drug treatment or never sought it before. A further trial period will also enable a longer-term evidence base to be established as to the effectiveness of the centre. This is of particular importance, given the long-term drug use of its client group and will inform any future decisions on permanency of the centre.
Members will be aware that the Medically Supervised Injecting Centre arose from the 1999 New South Wales Drug Summit, which called for the trial of this sort of facility in an area of high drug use. It is clear from the independent and final evaluation report released today by the National Centre in HIV Epidemiology and Clinical Research at the University of New South Wales that the trial of this facility has clearly met the Government's objectives to decrease overdose deaths, provide a gateway to treatment, reduce discarded needles and drug users injecting in public places, and help reduce the spread of diseases such as HIV and hepatitis C.
The report states that the evidence shows the centre has provided a service that reduces the impact of overdose-related events and other health consequences of injecting drug use, reduces public injecting and community visibility of injecting drug use, provides access to drug treatment and other services to highly socially marginalised people and has not led to an increase in crime or social disturbance in its immediate vicinity. In addition, on 21 December 2006, the Director of the Bureau of Crime Statistics and Research reported that there is no evidence that the centre has had an adverse impact on drug-related crime. It is clear also from this independent evidence that without the centre and its services this group of drug users would be at extreme risk of drug-related death and morbidity.
The centre has managed more than 2,100 drug overdoses without death or serious brain or vital organ damage; made more than 2,800 referrals to drug treatment and more than 3,400 referrals to health or social welfare services; helped reduce the spread of diseases such as HIV and hepatitis C, with advice on safe injecting practices provided on more than 21,700 occasions; and distributed more than 205,000 needles and syringes. I am sure I do not have to remind members of the great cost and burden such adverse outcomes would have for the individuals involved, their families, the community and services in increased policing and health system costs, and diminished public amenity in the Kings Cross area.
As members would know, there were significant local business concerns amongst some operators when the trial was being developed. They were concerned about the possible adverse impact of such a facility in Kings Cross. I am pleased to report that the independent evaluator has also found that since the trial started the support of local business for the centre has increased. In fact, there is now, to quote the evaluator, "high and sustained" support from the majority of business operators, with support now at about 68 per cent. In addition, since the centre opened in May 2001 9,778 individuals have been assessed and registered with the centre; there has been a total of 391,170 visits by registered clients, with approximately 6,500 visits in April 2007; and 113 in every 1,000 visits have resulted in provision of health care, medical and social services by centre staff on a total of 44,082 occasions.
Residents and business operators in local areas have reported that there are fewer discarded syringes and less public injecting. Between January 2000 and January 2007 there was a 48 per cent decrease in needles and syringes collected within 500 metres of the centre. The Government believes it is crucial to maintaining the positive outcomes that have been identified to date for this marginalised group by continuing to operate the centre, while at the same time striving to improve their likelihood of accessing and remaining in drug treatment and associated social welfare support. These good outcomes are confirmed in the report on the statutory review into the centre and its legislation required under section 36B of the Drug Misuse and Trafficking Act.
The report concludes that the centre is operating well, that it is conducted to an appropriate standard and is regulated and monitored to a high degree, as is appropriate for a service of this nature. I remind members that the Medically Supervised Injecting Centre is just one component of the Government's comprehensive response to the complex problems of drug abuse in our society. Law enforcement continues to be our first line of defence in the war on drugs. As just one example, in 2006 New South Wales police laid more than 20,000 drug-related charges. Almost 1,000 of them related to heroin.
Education and early intervention is our second line of defence. Since the 1999 Drug Summit the Government has invested more than $406 million in two dedicated drug budgets on a range of anti-drug initiatives across the areas of treatment, education, prevention and law enforcement. The third line of defence is harm minimisation. Programs such as the Medically Supervised Injecting Centre and the needle and syringe exchange program are both reducing disease and saving lives. While demand remains we will provide these services but we would like nothing better than for demand to decrease. That is why the bill will include, for the first time, a threshold for client attendance levels. If client attendance falls below 75 per cent of current daily levels, a formal review of the need for the centre will be triggered.
I turn now to the provisions in the bill. The bill amends the Drug Misuse and Trafficking Act 1985. Part 2A of the Act currently permits the operation and use, under licence, of a single medically supervised injecting centre but restricts the period during which such a licence can have effect to a trial period to conclude on 31 October 2007. The primary amendment in the bill is to change the period during which such a licence can have effect to a trial period to conclude on 31 October 2011, under section 36A. The provisions allowing only a single centre and single licence will not change. The Government recognises that the programs should be subject to continued review, not least to ensure that it is meeting its medical objectives. To this end, section 36B will be amended to provide for ongoing review of the centre. This will include review of the relevant provisions of the Act and review for the purposes of medical and scientific research into the treatment of drug addiction.
The Government is also mindful to ensure accountability for public moneys provided to operate the centre and to ensure it remains financially viable. To this end, the bill also includes provision, in new section 36K (2), to enable the regulations under the Act to prescribe a level of service activity for the centre. Schedule 2 to the bill amends the Drug Misuse and Trafficking Regulation 2006 to set the level of service activity as 208 client visits per day averaged over any one-month period. This figure is based on the average client visit levels reported over the last four years of the operation of the centre in the review report.
As I mentioned earlier, amendments to section 36K will require the responsible authorities to conduct a specific review of the viability of the centre if service levels fall below 75 per cent of this figure. If, after such a review, the responsible authorities consider there is no longer a need for the centre, or it is no longer economically viable, the authorities will be entitled to revoke the licence. The Government has taken a cautious approach with this initiative and it will continue to do so. We will continue to strictly regulate and tightly control the program by retaining the existing legislative framework and licensing system with the Commissioner of Police and Director General of NSW Health remaining as the responsible authorities.
We will continue to closely monitor and rigorously evaluate the program to ensure its ongoing effectiveness against the Government's objectives. We will continue to review all available research and evidence to help the Government make informed decisions about how to deal with the drug problem. Research as to the medical and scientific effectiveness of the centre will also provide information critical to support such decision-making. In closing, the Government would like to recognise the efforts of Reverend Harry Herbert and Uniting Care as well as the director of the centre, Dr Ingrid van Beek, and all the dedicated staff at the centre over the past six years. I commend the bill to the House.
The Hon. MARIE FICARRA [9.30 p.m.]: I indicate that the Liberal members of this House will have a conscience vote on the Drug Summit Legislative Response Amendment (Trial Period Extension) Bill 2007. The purpose of the bill is to extend the operation of the Kings Cross heroin injecting room for another four years, until 31 October 2011. Australia is considered one of the world's most advanced harm minimisation countries. Adopted in 1985, harm minimisation puts little or no emphasis on the prevention of drug use. We now have one of the highest rates of illicit drug abuse among OECD countries. So, after 22 years of a failed policy, why are we continuing this farce? This is the longest drug injecting trial ever. One would have to ask: Is it just another step in the eventual decriminalisation of drugs in the State? We already have personal use cannabis in this category. Many of us ask: What next?
Harm minimisation has been a failure. This injecting room has been a failure. The Minister has admitted that no more are planned to be opened in the near future. If performance criteria were to be applied to the operations of this drug injecting room it would be found to be wanting. For example, how many addicts have been cured of their addiction? How many addicts are now living happy, productive lives? How many referrals have occurred from the drug injecting room to rehabilitation and detoxification centres? What a waste of resources! Meanwhile government and non-government rehabilitation programs are suffering from a lack of resourcing and a lack of funding. The Government is very out of touch with New South Wales families.
The drug injecting room should be closed and the funding redirected to the establishment of more beds in rehabilitation centres, which will focus on abstinence from the use of illicit drugs. The injecting room trial should have been completed four years ago with the publication of the 2003 government-funded evaluation, which I will touch upon later. At that time the evaluation should have been sent to the International Narcotics Control Board and the centre should have been closed. In 2001 the International Narcotics Control Board declared the trial to be a breach of the United Nations drug treaties. The ongoing operation of the facility, under the guise of a trial, means that the breach continues. Twelve years is not a trial; it is institutionalisation, as stated often by the organisation Drug-Free Australia.
The original purpose of the trial—to prevent overdoses from heroin—is no longer relevant. According to the United Nations Office of Drug Control and Crime Prevention Australia's statistics indicate the highest level of illicit drug abuse amongst the OECD countries, due to our inappropriate harm minimisation policies predominating over drug prevention policies. Australia has the highest level of cannabis and amphetamines use and the fifth highest use of cocaine. The Federal Government's prevention messages and top work by Federal police have seen solid reductions in illicit drug use in Australia despite harm minimisation still predominating.
Adopted in 1985, harm minimisation accepts that people will use illicit drugs and seek to minimise the harm of their doing so. Consequently, harm minimisation places little emphasis on the prevention of drug use. Prevention and early intervention programs send a clear message that the harmful effects of drug use are too great to be socially acceptable and that Australians support a drug-free society. What are we doing to help heroin addicts now? Studies show that up to 45 per cent of methadone patients still use illegal heroin, and many stay on methadone for decades.
In relation to the heroin injecting room trial we are told that the Minister for Health in the other place has made such approval conditional upon client visits not declining below 75 per cent of current daily rates of 208 clients per day. If this happens, a formal review by the Commissioner of Police and the Director General of NSW Health will examine the economic viability of the centre. The Government needs this formal review now, and it has lots of performance parameters, as well as social, medical and environmental feedback, to conduct such a review. Drug addiction can only be reduced through large-scale and well-funded preventive measures such as detoxification, treatment and rehabilitation.
This review cannot be an inside job—like the so-called independent, government-funded evaluation in 2003, done by a research team of five, three of whom were colleagues in the same New South Wales university medical faculty as the medical director of the injecting room. A fourth researcher developed, during the 1999 New South Wales Drug Summit, a structure for the proposed drug injecting room trial. The public and the Opposition have the right to question the independence of such an evaluation team.
The centre has always been a vehicle for illegal drug consumption and has not been successful in helping drug users kick their addiction. Addicts are given assistance to continue their deadly lifestyle. The injecting room is clearly a facility that does not meet its publicised reason for existence. The centre supports the use of any drug that users want, as often as they want. The United Nations International Narcotics Control Board stated in its 2001 report:
? the operation of such facilities, where addicts inject themselves with illicit substances, condones illicit drug use and drug trafficking and runs counter to the provisions of the international drug treaties.
The trial does not utilise legal heroin but, rather, depends on clients illegally procuring heroin, illegally transporting heroin, and illegally using heroin. Furthermore, as I have said, the injecting room trial should have concluded in 2003, when the evaluation should have been forwarded to the International Narcotics Control Board and the injecting room should have been closed. There are five common myths associated with drug injecting rooms, as reported by the Drug Advisory Council of Australia. These are: injecting rooms are widespread internationally; injecting rooms are legal; injecting rooms provide a solution to injecting drug use; injecting rooms are safe; and injecting rooms have widespread community support. The only countries that allow injecting rooms are Germany, Switzerland, The Netherlands, Spain, Norway and Luxembourg.
The Hon. Penny Sharpe: And Canada.
The Hon. MARIE FICARRA: I am not sure about that, but I appreciate the interjection if it is correct. Injecting rooms—and the Kings Cross injecting room in particular—facilitate drug use and maintain drug addictions. An illicit drug injecting room fuels demand for illicit drugs and channels money into the hands of drug criminals. Australia's high demand for illicit drugs causes problems for government agencies trying to stop drug imports and cash to criminals. It is of the greatest significance in this debate that New South Wales is the only State in Australia to approve a drug injecting room. More than $15 million has been spent running the injecting room since it opened. At least another $10 million will be spent running it if the trial is extended to October 2011.
The injecting room costs this State $2.5 million a year to operate. This would be enough to fund 109 drug rehabilitation beds or supply more than 700 dependent heroin users with life-saving naltrexone implants for an entire year. In fact, we hoped that the Government would see fit to allocate in its budget moneys to such programs to free drug users from their deadly addiction and rehabilitate them back into society, into their family and social units, to live productive and happier lives. But I fear we will not have progress on that front.
For instance, implants of naltrexone—a substance similar to narceine in that it blocks the opioid receptors from responding to opiates—last up to six months and feed naltrexone into the bloodstream, reducing cravings for opiates and preventing any chance of overdose. Trials with more than 2,000 naltrexone implants have thus far had excellent long-term and short-term success. Such programs need increased government priority, resourcing and funding. Drug Free Australia found that the rate of overdose in the injecting room is 36 times higher than on the streets of Kings Cross, at least 40 times higher than the clients' previous history and 49 times higher than the estimated national overdose averages.
Why was this high overdose rate not analysed in the government-funded evaluation report? There were the three overdose rates I mention that it could have been compared with. The local heroin overdose rates in Kings Cross are one overdose per 3,820 injections compared with one overdose per 106 injections in the centre—a staggering 36 times more overdoses in the so-called safe injecting room than on the streets of Kings Cross. The report could also have used a comparison with drug overdose rates of the clients before they started using the injecting room facilities, and comparisons with Australian national rates. None of these statistics were reported or examined.
Why are there so many overdoses associated with this injecting room? There is a line of thought that clients may be using this facility to safely experiment with high doses of heroin as well as combinations with alcohol, other opiates and benzodiazepines—a lethal mix. I quote from the injecting room's own evaluation:
In this study of the Sydney injecting room there were 9.2 heroin overdoses per 1000 heroin injections in the centre. This rate of overdose is higher than amongst heroin injectors generally. The injecting room clients seem to have been a high-risk group with a higher rate of heroin injections than others not using the injection room facilities. They were more often injecting on the streets and they appear to have taken greater risks and used more heroin whilst in the injecting room.
High doses of injected heroin and more injections in general mean more heroin sold by Kings Cross drug dealers. The injecting room did not, as was promised, improve the local public amenity. It has been a focal point for drug dealers and still is. The reduction in needles and actual injections on the streets of Kings Cross were due to the heroin drought that was experienced recently, and already we are seeing this trend reversed as more heroin hits the black market. Andrew Strauss, the owner of Blinky's Photos, which is next door to the injecting room, has been quoted as saying:
You see drug dealers at the front of the injecting room every day. It hasn't reduced illegal drug taking, it has encouraged it and the police walk up and down the footpath doing nothing.
The centre's evaluation in 2003 indicated that police noted a correlation between loitering and the injecting room's opening times. The centre is 25 metres from being opposite the entrance to the Kings Cross train station on Darlinghurst Road. CityRail workers have given evidence of loitering at the station entrance. There have been public complaints about the drug users, dealers, drunks and homeless individuals hanging around. All in all, this creates an adverse environment for the locals, for the workers and for the travelling public. In 2005 discarded syringes were still rated as one of the top three annoyances for the residents and businesses surveyed in the Kings Cross area.
But let us return to the so-called reasons for the establishment of the injecting room. Regular heroin addicts inject three to six times a day, as heroin is a fast-acting drug that lasts about four hours per shot. Clients average two to three visits per month. One does not have to be a mathematical genius to work out that these addicts leave themselves open to a fatal overdose for the rest of the time they inject. My point is that this injecting room does not provide regular injector safety, due to the pure logistics of there being one site and so many drug users.
For the centre to be maximally effective, addicts would have to travel back and forth all day, and we realise that is totally impractical. All the more reason for these unfortunate individuals to be channelled into properly supervised and operated rehabilitation programs where they can receive counselling and around-the-clock attention. Follow-up in regard to their social, family and workplace needs means the difference between addicts falling back into their vicious cycle of drug use or being encouraged and supported back into mainstream society to live productive and happy lives with healthy relationships and social networks around them.
What is of concern also is the level of multiple drug usage that occurs in this Kings Cross drug injecting room: heroin is 38 per cent of usage; cocaine 21 per cent; methamphetamine, particularly ice and ecstasy, 6 per cent; and cannabis and prescription morphine 31 per cent. The link between cannabis and psychosis is well established: it has been proven that one in ten cases of schizophrenia in the United Kingdom is directly linked to current and/or past cannabis usage. We have seriously underestimated the danger of cannabis use in the past. Cannabis today is more readily available, stronger and cheaper than ever before, which all adds to the dangers in increased and/or prolonged usage.
Laws that permit cannabis cultivation and possession must be reviewed as a matter of urgency. An article recently published in the reputable medical journal The Lancet has shown how cannabis is more harmful than LSD and ecstasy. Australia has the highest ecstasy usage per capita in the world. Ecstasy is the third most common illicit drug used in Australia, with approximately 100,000 tablets used nationally every weekend. Young people aged 20 to 29 are the most common ecstasy users, with one in five having used ecstasy at some time in their life. In the past ecstasy has been imported into Australia from western Europe, but more laboratories are being detected in Australia every day. Ecstasy use causes death, brain damage, Parkinson's disease, psychosis, birth defects and learning and memory problems. Ecstasy users need to be diverted into court ordered and supervised detoxification and rehabilitation to avoid being permanently damaged.
We are told that Australia is experiencing a heroin drought and hence there is a concurrent reduction in heroin deaths. However, the United Nations is warning of heroin production in Afghanistan being at record high levels. The illicit drug deaths in Australia indicate the need for more detoxification and rehabilitation programs to get users free of drugs. When we add the deaths in Australia caused by methadone usage it becomes clear that our current policy of harm minimisation is not working. The Labor Government's failure to invest in drug rehabilitation is putting our children at risk. The report of the Australian National Council on Drugs released last month found that in New South Wales:
treatment options are limited and would not be indicated as treatments that were likely to improve family functioning in multi problem families with parental substance abuse.
Failure to invest in rehabilitation programs that help break the drug-abuse cycle with whole-of-family treatment will continue to have cumulative adverse effects on our younger generation. Reports indicate that children in families where one or both parents use illicit drugs are subject to domestic violence, neglect, abuse, high stress levels, a lack of routine, absence from school and in general a negative social environment. The Australian National Council on Drugs states that more than 230,000 Australian children aged two to 12 years are being raised by adults who abuse alcohol, cannabis or methamphetamines. The council said that worse figures could be expected when the council improves its methods of data collection and includes teenagers and infants in its estimates. The total figure equates to 13 per cent of Australian children, higher than international estimates that 10 per cent of the world's young live in these conditions.
The Australian National Council on Drugs said that less than 50 per cent of addicts sought treatment and programs were so stretched that people would not get sufficient help to kick their habits. As often quoted by the Drug Advisory Council of Australia, the best way to deal with abuse of children is to deal with problems of the parents by using our courts to direct the addictive parent into family friendly detoxification and rehabilitation programs to get them drug free and to give them the social support needed to get their lives back in order. Whatever funding it takes, governments should give these social issues top priority because we are investing in the future of our children, the adults of tomorrow. To break the chain of generational abuse, programs need to include the entire family and address problems faced at home, school and in the workplace.
I congratulate the Federal Government on providing $79.5 million to expand the non-government organisations treatment grants program to ensure more treatment places and services, particularly therapy and detoxification for families struggling with drug addiction. The Federal Government will also provide $23 million to better equip organisations to deliver effective treatment for methamphetamine users and $74 million over four years to improve non-government services for people with alcohol and other drug-related mental illness.
The Drug Summit in 1999 was a good initiative but there has been no follow-through from this Government and those before it with respect to resourcing anti-drugs programs, especially for our younger generation. According to the Australian Institute for Health and Welfare, funding for anti-drug initiatives has fallen by 24 per cent. Drug education program spending has fallen in line with the explosion of drug use! The Australian Institute for Health and Welfare report shows that drug prevention activities now make up only 5.2 per cent of the New South Wales public health programs budget, down from 10.2 per cent in 1999-2000. New South Wales spends less than half that spent by most other States on anti-drug activities. The latest figures show that in 2004-05 New South Wales spent just $5.81 per person compared to $7.81 in Victoria, $11.27 in Queensland and $15.81 in the Australian Capital Territory. That is not good enough for families in New South Wales.
Is the heroin injecting room effective when only 11 per cent of people attending are referred for detoxification and drug rehabilitation treatment? In actual fact, of this 11 per cent, only 3.5 per cent of clients were referred to detoxification and only 1 per cent to rehabilitation; the remaining 6.5 per cent were placed on maintenance. None of Sydney's major rehabilitation centres such as Odyssey House, We Help Ourselves or the Salvation Army ever sighted any of these referrals. Salvation Army Recovery Programs Manager, Gerard Byrne, stated that in the five years of the drug injecting room's operation, only five users have been referred to Salvation Army treatment centres. Mr Byrne said that when the centre started they were expecting large numbers of referrals. They thought it would be an opportunity to interface directly with drug users so they could get help, but that has not translated to referrals.
This bill will be the third extension of the so-called trial. Two of these extensions have also followed election wins by Labor in New South Wales. We had been told by Dr van Beek, the medical director of the drug injecting centre, that 2,100 drug overdoses have occurred without death or serious brain injury since its inception. Over the six years 10,000 addicts have used the centre, mostly for heroin. We know that 6 per cent of clients are now using the centre for methamphetamine interjections, including the dangerous drug ice. Are these statistics seen as a success? The addiction has not lessened; it is being satisfied and a lifestyle is being encouraged that could lead to death, physical and mental injury, permanent or otherwise. Why is little attention given by the media and left-wing policy hacks to examining and trialling initiatives that would encourage a return to a drug-free, healthy and successful lifestyle? I guess it is too hard, it is not trendy and it tends to steer towards church-based and non-government based programs. What is the problem? What is the resistance from this New South Wales Labor Government to not equipping these non-government agencies, which have done the job so well, with more resources?
The Drug Advisory Council of Australia, a reputable peak organisation that should be consulted and listened to when dealing with these complex social and medical issues, supports more detoxification and rehabilitation measures that will get illicit drug users drug free. This peak body supports court-ordered and supervised detoxification and rehabilitation programs, fewer illicit drug users and drug deals and consequently fewer drug-related crimes. All illicit drug users suffer physically in many ways. For instance, United Kingdom Metropolitan Police are now using a series of photographs of young women to show the ageing effects of cocaine drug use. In as little as three years of drug use, premature degenerative effects are seen in the damaged faces of young women and it is proving to be effective in reducing drug use. However, we should not forget that cannabis is known to suppress the human immune system and assist in causing cancer, so the risks go beyond merely ageing.
By using our courts to divert illicit drug users into detoxification and rehabilitation, we can help users avoid future health burdens and save community costs. The Government should be encouraged to use similar photo images or at least trial them as part of tailored drug prevention education campaigns to turn teenagers away from future drug use. I am totally opposed to the bill and I believe that the drug injecting room should be closed and funding redirected to the establishment of more beds in rehabilitation centres, which will focus on abstinence from the use of illicit drugs. I believe that the New South Wales Government should follow the lead of the Western Australian Government and significantly fund naltrexone implants for those wishing to be free of addictive drug use, including drug-dependent prisoners. The latter opens up another big issue for debate on another day soon, I hope.
I believe that the New South Wales Government should investigate the Swedish model and its restrictive drug policies. This includes the adoption of a strong anti-street selling program, a replica of the Cabramatta model, which resulted in a significantly lowered overdose rate; and that the New South Wales Government should examine abstinence-based rehabilitation programs, which have shown considerable success, including Australian programs such as those operated by the Salvation Army, DrugBeat from South Australia, as well as international programs such as Hassela from Sweden, San Patrignano from Italy and Daytop International and Phoenix House from the United States of America.
We legislators should send the right message on drug usage. The Coalition's position in the lead-up to the March State election was quite clear: the heroin drug injecting room should be closed. Possession, use, cultivation and trafficking in illicit drugs, including ice, heroin and ecstasy, must remain illegal in New South Wales. The Coalition policy on drug reform concentrated on education for families and others at risk by continuing to support drug education at school, ensuring that it commences before drug use becomes prevalent among peers; engaging parents fully in drug education programs, including access to up-to-date information and resources about how to handle drug education with your children; employing at least 20 additional police to work with young people in our police youth and citizen clubs; and providing $5 million to run an innovative and hard-hitting targeted advertising campaign to reduce falsely labelled recreation drug usage amongst 15 to 29-year-olds.
Treatment of drug users was an important part of the Coalition's policy—namely, to commit $60 million more than the existing Government commitment to boost places in treatment and rehabilitation programs, including $40 million for 10,000 naltrexone treatment places, $10 million for 100 residential treatment places, and $10 million for 20,000 outplacement withdrawal programs, including supporting non-government organisation and abstinence programs such as the Salvation Army's Catherine Booth House, Odyssey House in Surry Hills, the Ted Noffs Foundation, Mission Australia's Triple Care Farm, and We Help Ourselves.
The Coalition also committed to reviewing Labor's take-home methadone policy, particularly for parents with young children, and requires doctors to refer methadone patients for rehabilitation treatment after twelve months if this referral has not occurred previously. These initiatives should be considered by the Government. If it is its intent to help drug users to quit and lead healthy lifestyles, all of these initiatives should be treated seriously. I repeat my opposition to the bill. The heroin injecting room should be closed and the funding should be redirected to the establishment of more beds in rehabilitation centres, which will focus on abstinence from the use of illicit drugs.
The Hon. DAVID CLARKE [10.01 p.m.]: I was opposed to the Kings Cross drug injecting centre when it was first established by the State Labor Government back in 1999. In 2003 I voted against the bill to extend its existence until 2007. And today I oppose the Drug Summit Legislative Response Amendment (Trial Period Extension) Bill 2007, which extends the centre's operations until October 2011. I believe in drug rehabilitation and drug abstinence. I do not believe in drug minimisation. I want to see a drug-free Australia—and we will not get that by passing bills like the one before us. We will get the opposite.
The Kings Cross drug injecting centre has been a failure from day one. Instead of pumping more money into it, we should close it down, and do so without any further delay. It has helped make Kings Cross the drug capital of Australia. It relies on the illegal sale and possession of illegal drugs in order to stay in business. It sends a dangerous message to young people that the use of illegal and dangerous drugs is condoned by the Government and is even acceptable. And it diverts significant funding away from genuine anti-drug programs—programs that have a proven success rate in curing drug addicts of their addiction, programs that rehabilitate addicts, programs that reject the premise that in condoning and legalising drug taking you can in some way assist addicts.
This whole Kings Cross operation is the very opposite of what the State Government should be doing to combat drug addiction. It has in effect legalised the illicit drug industry, and it has turned Kings Cross into a disaster zone; businesses are packing up and leaving in droves. It has become a honey pot where drug dealers descend in droves spruiking their wares of death. In 2001 the United Nations International Narcotic Control Board said in its report:
The operation of such facilities, where addicts inject themselves with illicit substances, condones illicit drug use and drug trafficking and runs counter to the provisions of the international drug treaties.
The opposition of the United Nations to such facilities is, no doubt, why this Government still refers, even after eight years of operation, to it as "a trial", because it is a means to evade undertakings we have committed ourselves to under international covenants that oppose such facilities. The truth is that the great majority of nations have rejected the concept of drug injecting facilities and the false arguments that are used to justify their existence.
In one of the few countries to allow such facilities, Canada, drug injecting rooms in the city of Vancouver have been a massive failure according to the highly respected Royal Canadian Mounted Police. From their experience, they have found that the existence of injecting rooms decreased the perceived risks of illicit drug use and that those who use the drug injecting rooms are not being diverted into the rehabilitation programs that such centres are supposed to encourage. Earlier this year the Drug Advisory Council of Australia noted that:
A further myth about injecting rooms is that they divert illicit drug users into rehabilitation to get them free of their addiction.
How true this has proved to be with the Kings Cross injecting centre, with only 1 per cent of its clients being referred to rehabilitation and with the number who actually presented for rehabilitation being significantly less than even that paltry 1 per cent. Some of the most effective drug rehabilitation programs, such as those operated by Odyssey House and the Salvation Army, have never had even one person present themselves for rehabilitation pursuant to a referral from the Kings Cross injecting centre. The Drug Advisory Council of Australia also observed that:
Injecting rooms facilitate drug use and maintain users in their addiction.
An illicit drug injecting room fuels demand for illicit drugs and channels money into the hands of drug criminals.
The main argument touted by those who support the Kings Cross operation is that it saves lives, namely the lives of the addicts who, had they not had the availability of medical supervision when they overdosed at the centre, would now be dead. Without going into the detail of the myriad statistics quoted to support this proposition, I point out that Drug Free Australia— The main argument touted by those who support the Kings Cross operation is that it saves lives, namely the lives of the addicts who, had they not had the availability of medical supervision when they overdosed at the centre, would now be dead. Without going into the detail of the myriad statistics quoted to support this proposition, I point out that Drug Free Australia—a peak body of 87 community organisations—has done an exhaustive and detailed analysis of all the available statistics and has come to the conclusion that the number of lives claim to be saved is highly dubious at best. It is of the view that had the resources that have been pumped into the Kings Cross injecting centre over the past few years been used to support drug rehabilitation programs operated by institutions like the Salvation Army, Hillsong and Odyssey House—programs that have a proven record of rehabilitating addicts and saving lives—the number of lives saved would have been far greater than that claimed to have been saved by the Kings Cross injecting rooms.
I believe that organisations like Drug Free Australia and the Drug Advisory Council of Australia have got it right and that the State Government has got it wrong. The Kings Cross injecting centre is a failure, it is a waste of resources, it has cost lives because of its misplaced use of resources, and it sends the wrong message to young people. That is why the United Nations opposes injecting rooms. That is why the Federal Government is opposed to them. That is why all the other States of Australia are opposed to them. And that is why the great majority of nations are opposed to them as well. I oppose this bill and will vote against it, and I take great pride in being part of a parliamentary Liberal-Nationals Coalition because, when its members have been given a conscience vote, the great majority of them have chosen to oppose and vote against the bill as well.
The Hon. AMANDA FAZIO [10.08 p.m.]: I support the legislation. Indeed, I think it is very important. In order to see why the legislation and the injecting centre are so important, we need to cut through some of the highly charged emotional rhetoric that is trotted out whenever we discuss this matter, and look at the facts surrounding the drug injecting room. The first question we must ask ourselves is: What is the target for this scheme? With whom are we dealing through the drug injecting room? Independent evaluation reports by the National Centre in HIV Epidemiology and Clinical Research have shown that the centre has been successful in reaching its target group of long-term drug users, public injectors, homeless injecting drug users, and those engaged in sex work. These people are frequently marginalised and face significant social disadvantage. This group is at the highest risk of drug-related death and morbidity, and it is often unwilling to consider drug treatment during initial visits.
Offering heroin addicts a place in a drug rehabilitation scheme will only work if they have reached a point in their lives where they want to be rehabilitated. If they have not reached that point or desire to remain a user of that illicit drug, we should not as a society turn our backs on them. We should try to provide a safe environment for them to use their drugs where they have regular contact with professionals who may, over a longer term, be able to persuade those people to re-evaluate their lifestyle and try to do something about their drug addiction. It is not going to happen on a one-off basis when people visit the injection room, but we have to look at who is going there.
It might surprise some members of this Chamber and some opponents of the drug injecting room to know that there are long-term heroin addicts for whom the financial side of being a heroin addict does not preclude their regular use of the drug. They have homes and jobs, and regularly would not confront the other health problems that in the main confront the target group for the drug injecting room. To all intents and purposes they function as normal members of society. We are talking about the most disadvantaged people who are using heroin. They are the targets of this scheme and we should not lose sight of that.
The independent evaluation has shown that, in the main, clients of the centre have long-term injecting habits and have failed treatment or have never been in contact with the health system. They are people who inject in public places, and that brings with it a whole range of different problems. The water they use when they are cooking up can come from a puddle or from a tap and it might not necessarily be clean. There is the problem of them being seen in public, and members of the public do not like to see people shooting up or sitting in the gutter. There is a problem if they overdose in back lanes. Who is going to find them? Will they be found in time? There is also the problem of whether they will be using clean needles. If somebody in that situation tries to turn their lives around later it is no good, if by the nature of their drug use they have become infected with HIV or hepatitis B or hepatitis C. It is not going to do them any good to turn their life around when they have another major health problem layered on top of that. That is the sort of issue that a lot of people opposed to the injecting room simply ignore because they choose to ignore some of the positive benefits that this program has for people.
The evaluators have found that the average client of the centre is a 33-year-old male who began injecting at 19 years of age and has been injecting heroin for an average of 14 years—not social skin poppers but people with a long-term problem. The evaluation reports have shown that 72 per cent are not accessing local primary health care services; 60 per cent have attempted drug treatment previously but have not given up drugs; 61 per cent are on social security payments; 49 per cent have injected in a public place; and considering the health epidemic confronting us, 42 per cent are hepatitis C positive—imagine if they were not using clean needles all the time or if they were discarding those needles in public places where somebody else could be contaminated by a needle stick injury; 35 per cent of them have overdosed one or more times; only 27 per cent have completed high school; 24 per cent are in unstable accommodation; and 23 per cent have been imprisoned in the previous 12 months. They are not exactly high achievers in life and are people who should be given a helping hand.
The myth is, according to what one hears and according to some of the contributions made tonight, that just about anybody can use the centre, and can use it not only for heroin but for ecstasy—which most people would not shoot up anyway. Somehow cannabis has been thrown into the debate. Quite frankly, you cannot shoot up cannabis in the Kings Cross injecting room and if you try to smoke cannabis in the Kings Cross injecting room you would be thrown out. So, trying to raise the issue of cannabis and all of the health reports about co-morbidity between people with mental health problems and cannabis use is just a smokescreen. It is a red herring and has nothing to do with the debate about the operations of the Kings Cross injecting centre.
Who can use the centre? People under 18 years of age, women who are or appear to be pregnant and people who are accompanied by children are excluded from using the centre due to health and social welfare concerns. The internal management protocols for the centre establish detailed procedures for referring those individuals to appropriate services and require staff to notify the Department of Community Services of young persons under 16 who are considered to be at risk in accordance with the Children and Young Persons (Care and Protection) Act 1998. In addition, the centre will not admit a client who appears to be intoxicated by alcohol or other drugs, due to the increased risk of drug overdose. These clients are discouraged from further drug and alcohol use at this time and are encouraged to consider drug detoxification or other treatment options.
Let us look at the issue that the centre is somehow a honey pot. The New South Wales Government closely monitors any changes in drug use trends within the centre. Over the past six years the primary drugs injected at the centre have been 62 per cent heroin, 14 per cent cocaine and 12 per cent prescription opioids. The use of amphetamines and methamphetamine by the centre's clients has slowly increased from 3 per cent in mid-2002 to 7 per cent in early 2007. Arguably this reflects increased use in the community and may also be due to a reduction in heroin availability. However, the rate remains low compared to other drugs use, with the trend to being relatively stable. It does not matter if you are using a syringe to inject heroin, cocaine, prescription opioids, amphetamines or methamphetamines. All those issues in relation to contracting aids, hepatitis B or hepatitis C still apply, no matter what you are injecting. There is also the contamination of what you are injecting, the risk of suffering an overdose still remains the same regardless of what drug is being injected but, as I have said, the majority, 62 per cent, are heroin users.
I want to look at some of the other issues raised by honourable members in this debate. Particularly, I was quite surprised to hear reference made to what was said to be the policy of the United Kingdom metropolitan police when looking at drug users. In March this year the Association of Senior Police Officers of the United Kingdom called for the decriminalisation of heroin and said it supports addicts being given heroin on prescription. It had a whole range of reasons for doing that. It was a package of crime reduction, health concerns and a whole range of other issues. These are the police who, on a daily basis, believed that rather than spending a huge amount of social, policing and legal resources in tracking down and trying to contain the heroin problem in the United Kingdom, it would be better for addicts to get their heroin on prescription, which is to be the case, and there are still some old registered addicts.
The centre is not a honey pot for ice. It is not a honey pot necessarily for heroin. People sell drugs in King's Cross and they have done it for donkey's years, long before the heroin injecting centre was open. If you look at the target group of long-term drug users, public injectors, homeless injecting drug users and those engaged in sex work, there is no surprise that you find a large number of those people in King's Cross. I cannot think of a better place to have the heroin injecting centre than in King's Cross. Where a large number of people sell drugs, a lot of people use drugs; where a lot of people use drugs, sellers will go. So, it is a catch 22. You cannot blame the injecting centre for that.
Much has been made about the policies of the International Narcotics Control Board. The policy of that board is almost completely driven by the drug policies of the United States of America. It is pushing it and promoting it. Let us look at what the United States has done in more recent years about the problem with heroin. Its failure, after invading Afghanistan and not having long-term policies to suppress the poppy crops in Afghanistan, has led to Afghanistan suppling 85 per cent of the very cheap heroin that is flooding the United States market, and that is one of the reasons why that body of senior police officers said it had a change of view. So, until the International Narcotics Control Board comes up with some firm policies and until its backers in the United States do something about suppressing the poppy crops in Afghanistan, we should take some of its pronouncements as being pretty useless and not realistic in the longer term.
We should all say "No." Everyone should be drug free, everyone should be referred to rehabilitation and everyone should have a happy outcome. Nancy Reagan said, "Just say 'no' to drugs" in the 1980s. It did not work then. It should have been called the campaign to "Just say 'no' to a sensible drug policy" or "Just stick your head in the sand." It does not work. A huge number of underlying problems cause people to be so unhappy in life and so dissatisfied that they look for some release and they want to use drugs, like heroin. If we were being fair dinkum and we looked at the family backgrounds and life experiences of a lot of people who are in the target group for the centre, we would realise that "Just say 'no'" is about as good as saying "Have a nice day" to them. It is unrealistic and it does not work. But the bottom line is that we have to look at what it costs. Since 1999 the New South Wales Government has spent $406 million on dedicated drug and alcohol programs, a small part of which is spent on the heroin injecting centre in Kings Cross. What price do we put on human life? What price do we put on the lives of the people whom I have described as being the target group of the heroin injecting room?
Sometimes those who complain about how much the injecting room costs and how we spend that money think it depends on whose life it is. We should support the legislation. The life saved of someone who has overdosed and been revived in the injecting room is the life of one person who, if circumstances and their will allow, will perhaps have a chance at a later time in life to redeem his or her position. But shooting up on the streets, running the risk of contracting HIV, hepatitis B and hepatitis C, or dying in a back alley with a needle sticking out of an arm does not give a person that second chance in life. It is really saying, "You are such a loser that we really don't want to waste any more money on you." Rehabilitation is fine, if that is what people want. But we have not yet got to the stage of dragging people off the streets if they have not committed a criminal offence and locking them up in a rehabilitation centre until they have been permanently detoxed. I certainly hope that we do not reach that stage and that we continue to respect people's civil liberties and their right to choose what they do with their lives. The injecting room is serving a useful purpose: It saves lives. As long as it is saving lives we should support the legislation.
Ms LEE RHIANNON [10.22 p.m.]: The Greens are pleased to support the Drug Summit Legislative Response Amendment (Trial Period Extension) Bill 2007. I congratulate the New South Wales Government on its continued support for the Kings Cross Medically Supervised Injecting Centre. However, it is a shame that the bill is not for the conclusion of the trial stage and, instead, for the establishment of a permanent facility at Kings Cross. We should make the Kings Cross facility permanent and expand these services to other areas of need. This could be the longest ongoing trial in history for what is patently a successful service. It seems obvious that the centre has well and truly proven its worth. This is borne out in evaluations conducted by the National Centre in HIV Epidemiology and Clinical Research and by the New South Wales Bureau of Crime Statistics and Research.
The National Centre in HIV Epidemiology and Clinical Research found that almost 10,000 people have registered with the Kings Cross injecting centre since 2001. That is a success figure. The centre has prevented more than 191,000 public injections, made more than 6,000 referrals for medical consultation, drug treatment and social welfare assistance, and helped reduce local needle syringe collections in public places by 50 per cent. The report shows that overdoses are being treated more quickly and effectively and that, in turn, has decreased the demand on emergency medical services and ambulances in the area. Over its lifetime the centre has managed more than 2,100 overdoses that may otherwise have lead to death or serious harm. An independent evaluator has found that there is high and sustained support from the majority of local business operators—around 68 per cent.
The centre has been successful in removing injections, drug overdoses and syringes from public places. It has reduced the risk of morbidity and mortality associated with drug overdoses and transmission of blood-borne infections. Importantly, it has also provided a space for drug users to have contact with health professionals and, in turn, the social welfare system if necessary. I have visited the Kings Cross safe injecting room, and I was extremely impressed by the dedication of its staff, and the professional and dignified approach of the centre to its clients. The allegations of Mr David Clarke that the centre promotes drug taking are ridiculous. The criticism was not evidence based, but a biased attack designed to back up the discredited war on drugs policy. I understand that the centre now handles more than 200 visits a day; that is 200 visitors who may otherwise be forced to inject, unsupervised and unsafe, in inner-city backstreets.
I put on record my concerns about the new licence conditions that the bill imposes on the centre. The bill requires that the centre maintain an average of 208 client visits per day over a one-month period. Is this really necessary? That question has not been answered, but the Minister should give us a response in reply. The licence conditions seem to put unnecessary pressure on what is already an overstretched service. The bill also imposes an obligation on the Commissioner of Police and the Director General of NSW Health to review the economic viability and ongoing need for the centre if service levels drop below 75 per cent of the required 208 visits per day. If this happens and it is found that the centre is no longer economically viable, the bill requires that the licence of the centre be revoked.
Is economic viability really the basis upon which the Government will judge whether health services will remain open? Obviously, it would be difficult to justify keeping open a centre that had only a handful of participants. But even if service levels at the Kings Cross injecting centre dropped by 75 per cent the centre would still handle upwards of 150 people a day. That is a huge achievement and a contribution to the community. I urge members who are speaking so strongly against the bill to consider that the work of the safe injecting room is a contribution to our whole community and of benefit to all of us. The real question is: Why is the Kings Cross injecting room being singled out amongst other health services and subject to these onerous conditions? Clearly, all health services have to show a basic level of utilisation, but why is this service the only one in the State, potentially in the country, that has this licence condition written into legislation?
We hear the arguments that safe injecting rooms send the wrong message to people. On the contrary, I believe that safe injecting rooms send the right message: we are a caring and compassionate society and we are a society that offers support, care and treatment to those suffering from drug-related problems and to their families. What sends the wrong message is heavy-handed policing that damages public health, community safety and relations between the police and members of our community. Tony Newman, Director of the Drugs Policy Alliance in Canada, recently commented on the worth of the tough-on-drugs approach of the United States. I urge members who heard Mr David Clarke quote from the Royal Canadian Mounted Police to consider these comments from an expert in the field:
For 30-plus years, the US has pushed a war on drugs that is more accurately a war on drug users. This war on drugs has not delivered on its promise to keep drugs off our streets or prevent people from using, but it has filled our prisons beyond capacity and led to far too many cases of HIV/AIDS relating to sharing contaminated needles.
His comment about filling prisons could well apply to New South Wales. We have the interesting situation in New South Wales where the public face of the Labor Government is very much "Lock 'em up and keep 'em there". But beyond the scenes Labor has established a number of harm-minimisation programs on which it should be congratulated, of which it should be proud and about which it should speak more frequently in public. The Drug Court is a good example, as is the Magistrates Early Referral Into Treatment Program. It is a shame that the Labor Government chooses to sweep such programs under the carpet and, too often, criticises the Greens in the media for our harm minimisation approach when it suits their political agenda.
I remember the Drug Summit well. As a newly elected member of Parliament I felt privileged and excited to be part of a rich and diverse discussion with drug users, families of drug users, police, researchers, parliamentarians and government officials all together at the same table. I believe we made headway at the summit. The Kings Cross Injecting Centre is a great example of a project that came out of the Drug Summit. Unfortunately, we still have a long way to go and too many recommendations that came out of the summit are collecting dust on bookshelves rather than being put into practice. Last week I was fortunate to visit the St Vincent's Drug and Alcohol Centre. I was extremely impressed by Dr Wodak and his hardworking staff and the programs they offer at the centre, which sees over 300 people per week—an amazing feat for a small centre with few resources. When I was there probably 30 people were crammed into the waiting room. Unfortunately, the centre simply does not have the capacity to meet demand. People who want to get off heroin and reclaim their lives cannot get into the clinic because of inadequate funding. It is disappointing, to say the least.
The Greens are pleased to support the bill and we urge the Labor Government to put more resources into harm minimisation programs. I acknowledge some of the courageous people and organisations that were integral in laying the groundwork for the centre and keeping it running, in particular, the Wayside Chapel, UnitingCare, the AIDS Council of New South Wales and NSW Users and AIDS Association, Reverend Ray Richmond, Reverend Harry Herbert, Dr Alex Wodak, Ms Ann Symonds—a former member of this House—Mr Tony Trimingham, Dr Ingrid van Beek and many others. We need to thank courageous people, and we must remember their hard work and make sure we continue the fight.
Reverend the Hon. Dr GORDON MOYES [10.31 p.m.]: The purpose of the bill is to continue the trial of the Sydney Medically Supervised Injecting Centre for another four years, until 30 June 2011. The Christian Democratic Party has always strongly opposed the Kings Cross injecting room. We opposed its establishment in 2001 and we remain opposed to it. Our opposition is based upon one fundamental principle: harm reduction is far better than harm minimisation. There is no such thing as a safe level of drug use. Drug addiction can be stopped only through preventative measures, such as detoxification, treatment and rehabilitation. This facility does not help drug users kick their habits. It simply provides a legal rubber stamp for users to continue their deadly habits. If this disgraceful bill is passed and the room remains open until 2011, it will have been operating for 10 years. Ten years is not a trial; it is government-supported drug institutionalism.
The International Narcotics Board specifically stated that the Kings Cross injecting room breaches the international conventions against illicit drug use. Currently 8 per cent of injections in the room are for ice. We all know the impact of that drug. On the one hand, the New South Wales Government spends millions of dollars fighting the spread of drugs in the community. On the other hand, the Government says that people can use drugs so long as they do it in "our place". The drugs consumed at the centre are illegal. They are illegal in the community. They are illegal at my house and they are illegal at your house. The guise of extending a trial will not save the Government from being accused of acting outside the law. Public funding of at least $2.5 million per year is being wasted on committed drug addicts who have no intention of quitting. The Hon. Amanda Fazio admitted that fact in her speech. Why are New South Wales taxpayers encouraging the habit of these drug users when others who want to quit cannot access facilities? Ms Lee Rhiannon referred to the crowds of people wanting help. The funding for the centre could pay for 109 drug rehabilitation beds or 700 naltrexone implants for heroin users for one year. New South Wales can use the funds much better elsewhere. In a State where the Office of the Director of Public Prosecutions has to stop prosecuting child sex abusers to save $4 million, we can still find $2.5 million to provide facilities so that people can continue to abuse themselves.
What have been the so-called benefits of the injecting room to date? Newspapers report that 1,700 overdoses have occurred on the premises without one fatality. So the New South Wales Government has supported 1,700 episodes where people willingly put themselves close to death. How is that a success? This centre, which receives $2.5 million in funding per year, resulted in zero occasions when a person walked away from drugs. It resulted in zero occasions when anyone became free from drugs or was rehabilitated from drugs. Unfortunately, two other countries followed New South Wales in setting up injecting facilities—the United Kingdom and the INSITE Program in Canada. In the current issue of the What have been the so-called benefits of the injecting room to date? Newspapers report that 1,700 overdoses have occurred on the premises without one fatality. So the New South Wales Government has supported 1,700 episodes where people willingly put themselves close to death. How is that a success? This centre, which receives $2.5 million in funding per year, resulted in zero occasions when a person walked away from drugs. It resulted in zero occasions when anyone became free from drugs or was rehabilitated from drugs. Unfortunately, two other countries followed New South Wales in setting up injecting facilities—the United Kingdom and the INSITE Program in Canada. In the current issue of the Journal of Global Drug Policy and Practice , Dr Colin Mangham, who is one of Canada's foremost leaders into theory and practice of drug prevention, draws out the problems and failings of injecting facilities. His article analyses the assessments that are done in these types of injecting rooms, and Dr Mangham concludes that a bias exists to retain these facilities, backed by the philosophy of harm reduction. Policy pundits and the media lent their support without fully considering harm reduction. The article states that evaluations of these injecting rooms include:
? considerable overstating of findings as well as underreporting or omission of negative findings, and in some cases the discussion can mislead readers. The reports show no impact on the key issues that would most warrant its existence ? getting clients into treatment and off of drugs, reducing overdose deaths.
New South Wales shows a similar bias. The so-called independent evaluation of the injecting room, which was released in July 2003, was put together by five researchers. It is interesting to note who those five researchers were. Three were colleagues of the injecting room's Medical Director at the University of New South Wales medical faculty and a fourth shaped the proposed injecting room trial at the New South Wales Drug Summit in 1999. I question the independence of the evaluation. It is like getting five alcoholics to report on the impact of alcohol abuse. Earlier this year Drug Free Australia released a report on the so-called merits of the centre. Over 1,700 overdoses that did not result in one death may sound good, but not one user went off drug use or overcame drug addiction. On the information provided, we could conclude that 1,700 lives were saved. But not so fast! An overdose is not always fatal. Earlier this evening the Hon. Marie Ficarra spoke movingly, with insight and in detail about this issue. The Government estimated that the injecting room saved four lives per year. However, that does not account for the enormously increased overdose rate. When this is factored in, the injecting room may claim to have saved 0.18 lives in its 18 months evaluation period. When the figures are annualised, on average the centre saved one person every eight years.
According to the final report on the evaluation of the Sydney Medically Supervised Injecting Centre, 1 per cent of dependent heroin users die each year from heroin overdose and they inject at least three times per day. The injecting room would have had to host 300 heroin injections per day before it could claim to have saved even one life per year. The room currently hosts 87 heroin injections per day. At this rate, this method of treatment may save one life every 3.5 years. Judged on its results, the centre would be closed down. The injecting room was set up to handle 330 injections per day. But the room's own figures show an average of 208 clients per day, which is only 63 per cent of its proposed capacity. The New South Wales Government has already wasted a third of its investment. This bill seeks to keep the injecting room open till levels drop to 75 per cent of current levels. That is only 156 clients per day—less than half the level the room was designed for. The supporters of this room know that community support for and use of the centre are dropping and are seeking to keep it open as long as possible.
At school, an effort rated at below 50 per cent is marked "fail", but with the New South Wales Government it means an extra four years! It does not mention that the overdose rate in the room is 36 times higher than that on the streets of Kings Cross, at least 40 times higher than the client's average before they entered the injecting, and 49 times higher than estimated national overdose averages. According to their own registration data, before the room opened clients were overdosing only once every 3,200 injections. The rate of opiate overdose inside the room now is one in every 129 injections. This begs the question: Why so many overdoses in the injecting room? The injecting room's own evaluation stated:
In this study of the Sydney [injecting room] there were 9.2 heroin overdoses per 1,000 heroin injections in the MSIC, and this rate of overdose is likely to be higher than among heroin injectors generally. The [injecting room] clients seem to have been a high-risk group with a higher rate of heroin injections than heroin injectors who did not use the [injecting facility], they were often injecting on the streets, and they may have taken more risks and used more heroin in the MSIC.
I repeat that—"they may have taken more risks and used more heroin in the MSIC", according to the centre's own report What really concerns me is that there have been no referrals over the last period of investigation. The Salvation Army had a total of five referrals in five years. Wesley Mission Drug Arm, which is filled to capacity every week with people seeking rehabilitation, has never had a referral from the Medically Supervised Injecting Centre. Gary Christian from Drug Free Australia was able to interview two former clients of the injecting room who confirmed this view. I will read a brief transcript of a recorded conversation that Gary Christian had with two former clients of the room.
DFA: Have you been a client of the injecting room?
Ex-client: I have, I have. To me I believe it has got a lot to do with the pills, people using pills in injecting rooms. They shouldn't be allowed to inject pills in my opinion.
DFA: Our understanding was that they weren't allowed to be polydrug [using], you know, mixing ? drugs [and pills].
Ex-client: Yeah, but they don't know that, do you know what I mean? Like they go in there, and they start using, I have seen that they are going in for one thing but really they are going in for two [or three], with the heroin on top of the pills, but they won't ? [tell anybody that].
DFA: And the kinds of pills, I mean, benzodiazepenes we know are very dangerous when it comes to mixing with heroin and overdose. They are an extremely dangerous mix.
DFA: What other kind of pills are you talking about?
Ex-client: I was talking about Normasins, Oxycodones, just yeah all that kind of stuff. Xanax. Everyone I have seen drop in there, like one every now and again will drop on heroin, but it is the pills and the heroin [that they mix] together.
DFA: That's very revealing. There is something that has been going on in the injecting room, but we just haven't been able to work out why there are such high overdoses. And we've imagined that it must be experimentation ? Is it the case that people would be experimenting with drugs in a way they wouldn't ? [out] on the street?
Ex-client: They feel a lot more safer, definitely because they know they can be brought back to life straight away. They know ? they can, like some people go to the extent of using even more. So in a way they feel it is a comfort zone, and no matter how much they use if they drop [meaning, die] they ? [might] be brought back. What users look for in heroin and pills is to get the most completely out of it as they can, like virtually be asleep ? For ? [example] to get that you have to test your limits. And by testing your limits that is how you end up dropping [dead].
DFA: This does put some question marks on how the injecting room is being used and how lax they are, if they are being lax and allowing people to experiment.
Ex-client: Really people are sneaking behind their backs. They [don't know what is going on in there. They don't] ? do it in front of them, but they're sneaking ? they're criminals. You can hide anything from everybody. If you are doing it every day, night and day, you are only going in there for 10 minutes and you can just put yourself in front of your needle, something there so you can mix them up and then you can mix it up again, and they don't know you are mixing up again something different if you are just mixing up pills or mixing up heroin, they are just standing behind you and you're covering or you get the guy beside you to mix up something and [they look at him and] you can get kicked out for it—I've seen people get kicked out for passing things over, but they try and stop it, it is not the workers [fault] ? they try their best, it is just [that we] are [all] sneaky people ?
A second former client was questioned by Drug Free Australia. I will not read the transcript of the questioning in full. He revealed that the safety of the room allows clients to use much higher doses of heroin, which he did, and that clients are using the safety of the room to get the biggest rush they can, even if there is the risk of overdose.
Consequently, far from combating the problem and helping these people to stop harming themselves, the injecting facility has actually encouraged them to try harder, to try wilder mixes of drugs, and to push themselves right to the point of death. For six years the New South Wales Government has funded a drug experimentation laboratory where users can push their boundaries and where they have medical help immediately on hand from a nursing sister if they go too far. We are now extending that so-called trial for another four years.
The final evaluation of the Sydney injecting room was released in mid-2007. The spin doctors have communicated success without the full facts being conveyed or maybe even closely considered. The injecting room cannot save lives when it encourages addiction. The addictions have not gone; if anything, they have increased. The voices of addiction are still calling and the likelihood of emotional and physical death is still very high. If a person does not quit, the injecting room at best can only delay the inevitable. The person is not likely to quit while the New South Wales Government is telling them it is okay to continue.
As the Hon. Amanda Fazio said, those who go to the Medically Supervised Injecting Centre are the most drug-dependent and most needy of people—people who are the most vulnerable. Because the centre has no program of treatment or referral for rehabilitation, they are totally dispensable. No-one cares as they decline into death. Some asked: What price do we put on a drug abuser's life? Our concern is the total elimination of death and their successful rehabilitation to life. Ms Lee Rhiannon says that we should care for the users of the Medically Supervised Injecting Centre so that they can use the centre to inject themselves. That kind of care is as useful as the care of a florist at the crematorium. I oppose the bill in the strongest terms.
Mr IAN COHEN [10.47 p.m.]: I support the comments made earlier by Ms Lee Rhiannon, who led for the Greens on this bill. I state at the outset that I support this bill and the Government's initiative on this matter. I listened with interest to a number of comments made by other members in this debate. Some of the accusations made about misinformation and spin really were just a case of more and more spin, and that disturbs me greatly. However, it is not unexpected, given the extent of some of hypocrisy in this debate. At the outset I give thanks and recognition to Reverend Harry Herbert, who is a member of the Uniting Church and is the Executive Director of Uniting Care. Reverend Herbert is also the licensed operator of the Medically Supervised Injecting Centre, which is operated on a yearly budget of $2.5 million. Reverend Herbert has stated:
The board feels as strongly now as it did back in 1999 when the original decision was taken. It is serving a very important social purpose and it is appropriate for a church body to be involved.
I am really heartened by the involvement of people such as Reverend Harry Herbert and Reverend Ray Richmond, whom I have met and with whom I have had a very productive association in regard to this and other matters. They are deeply involved and are working with The Wayside Chapel. They strongly support the institution and continuation of the Medically Supervised Injecting Centre. They are caring, true Christians. They are brave; they stepped forward when the vehement, narrow-minded opposition, some of which we have heard tonight in this House, was baying at them. They stood firm and supported—
Reverend the Hon. Dr Gordon Moyes: And neither of them runs any rehabilitation programs.
The PRESIDENT: Order! Reverend the Hon. Dr Gordon Moyes will cease interjecting.
Mr IAN COHEN: Let him interject. I understand why the injecting centre would not send people in such a weak and vulnerable state to the organisations for which some members have said they are responsible. I will deal with that later. The members who oppose this centre do not recognise the different levels of addiction and the levels of despair that people are living in and that they cannot escape their cycle of addiction. I was on the original safe injecting room inquiry and I was happy to be one of those who helped it along in a small way. I acknowledge the great contribution of Ann Symonds, a former member of this House, who drove the reform that in part led to the Drug Summit and to the Carr Government taking positive steps. The vital issue that is missed in this debate is that the levels and types of addiction and the reactions of addicts are as intricate and complex as human personality itself.
No one system or remedy will solve the problem. We have seen the naltrexone magic bullet, naltrexone deep-sleep therapy and other radical approaches. In some cases they work, but in many cases they do not. In many cases methadone is of great assistance and in a significant number of cases abstinence and churches have a role to play for people who are at their most vulnerable. In other cases, all of these methods fail. It is important to keep these drug addicts alive until they turn their lives around and voluntarily see their way out. It is extremely difficult for people who have not been addicted to these sorts of substances to understand the hell that addicts go through. If we can keep them alive and in reasonable health for long enough for them to see their own way out, that it is a good thing. A Sydney Morning Herald article entitled "1,700 overdoses that didn't end in death", dated 8 July 2006, referred to an addict named Sally. The article stated:
"If they close the centre it is going to go back to how it was—the mess in the street, the overdoses in the street, the death in the street will be a recurring nightmare," says Sally, who fought and beat a 17-year heroin habit.
One of the first drug users to register when the centre opened on May 6, 2001, she gradually moved from heroin to methadone, and from the streets to public housing.
In August she celebrates three years off methadone, and four years of sleeping indoors.
With assistance from staff at the injecting centre, Sally gathered the strength to move away from drugs when she discovered that her partner of eight years had cancer.
It took something like that for a long-term heroin addict to be shocked into another reality that gave her the strength to change her life. She said:
It didn't matter how many times I had overdosed and been brought back, it wasn't until I was confronted with my boyfriend's mortality that it made some sense to get straight.
She was kept alive and in a healthy condition by the injecting centre until she could take her own steps towards rehabilitation. The article continues:
A long-time Kings Cross resident, Margaret Harvie, said the centre had made a huge difference to those who live and work in the area.
"The injecting centre has significantly improved things—you do not have people overdosing, there are not ambulances screaming around the streets."
Ms Harvie dismissed the idea that the centre is a honeypot for dealers and users.
People have been hanging around Kings Cross for years, she says, attracted by the nightclubs and the prostitution rather than the injecting centre.
The purpose of this bill is to continue the trial of the Medically Supervised Injection Centre for another four years until 30 June 2011. The Greens support the bill, and I certainly support it. The trial centre has been operating at 66 Darlinghurst Road, Kings Cross, since May 2001. It was established in response to recommendations made by the New South Wales Drug Summit in 1999. The centre has been operating successfully for six years. Lee Rhiannon, who led for the Greens in this debate, has already covered many aspects of this issue, but I would like to add some comments. The centre has come under increasing fire from a group called Drug Free Australia.
The Hon. Christine Robertson: What does it mean?
Mr IAN COHEN: I have an interpretation, and I will come to that in a minute. Members have probably received glossy brochures that the group has put together. The book entitled The Kings Cross Injecting Room: a case for closure , written by Gary Christian of Drug Free Australia, confines itself to analysis of the centre's first 18-month evaluation period, which ended in October 2002. Over the past four years the centre and a range of respected health professionals working in the addiction medicine field have pointed out the errors in Gary Christian's various calculations and extrapolations based on this initial evaluation period. It is disappointing to learn that Mr Christian has been unwilling to accept any of this expert advice or integrate any of the new information as it has come to hand. Instead, he has continued to convey misinformation to political decision makers at this crucial time.
Evidence provided in the following reports prepared by the independent evaluation team pertains to the entire six-year evaluation period. I urge members to read these reports and inform themselves rather than rely on the word of Drug Free Australia: "Interim Evaluation Report No 1: Operation and Service Delivery (November 2002 to December May 2004)", May 2005; "Interim Evaluation Report No 2: Evaluation of Community Attitudes Towards the Sydney MSIC", March 2006; "Interim Evaluation Report No 3: Evaluation of Client Referral and Health Issues", March 2007; "Interim Evaluation Report No 4: Evaluation of Service Operation and Overdose-related Events", June 2007; and "Crime and Justice Bulletin No 105: Recent Trends in Property and Drug-related Crime in Kings Cross", November 2006.
I will go through the centre's arguments, addressing the six key points presented by Drug Free Australia in the order that they appeared in its covering letter to members. First, the centre points out that heroin injections comprise only 26 per cent of its total injecting capacity. A range of drugs has been injected during the 391,027 visits that injecting drug users have made to the centre over the six years to the end of April 2007. Of them, 62 per cent were to inject heroin, 12 per cent other opioids, 14 per cent cocaine, 6 per cent methamphetamines and 3 per cent benzodiazepines. Over the past year about 75 per cent to 80 per cent of all centre visits have been to inject heroin and other drugs in this opioid class of drugs, and about 350 opioid-related overdose cases were successfully treated. That is 350 lives saved. Members might say that those people experimented in the safety of the injecting room. The fact is that 350 opioid-related overdose cases were successfully treated. Surely that speaks for itself.
Reverend the Hon. Fred Nile: That is if it is correct.
Mr IAN COHEN: I stand by these figures. They come from reputable sources.
The Hon. Charlie Lynn: Who?
Mr IAN COHEN: They come from those who have been oversighting the injection centre and I stand by them, and I am sure the Government will support them. Those who condemn the injecting centre offer mealy-mouthed platitudes and use rubbery figures. Prove them! I ask Reverend the Hon. Fred Nile to prove his figures. The Medically Supervised Injecting Centre further argued that the proportions of the respective drugs injected at the centre have fluctuated widely during this time, and reflect their relative price and availability in the Kings Cross area over time. The centre's ability to monitor this on a day-by-day basis also provides a timely and sensitive early warning system. This information is provided to local police and other health services, NSW Health and national surveillance systems on a regular basis. The article in the Sydney Morning Herald of July 2006 to which I referred earlier states:
"There is no evidence the centre is contributing to crime in the area, or has attracted more drug dealers", said Mark Murdoch, the Kings Cross Local Area Commander for the police.
"There is nothing to indicate that the centre is anything but good for the area".
"Police support Government initiatives such as the [injecting centre] and police are there to enforce the law, which is evidenced by Kings Cross Local Area Command attaining the highest rates of drug detections in the state.
Yet at the same time they support the injecting centre. The centre further argues that like the other 76 supervised injection facilities currently operating in eight countries since 1986, the Medically Supervised Injecting Centre was established to prevent and reduce injecting-related harm associated with all injectable drugs, not just heroin, while also recognising that injecting drug users almost never inject only heroin. Injecting is a way of using drugs and significantly increases the risk of overdose, dependence and blood-borne infections including HIV and hepatitis B and hepatitis C, regardless of the drug being used. All risks are amplified when drugs are injected in public situations, which supervised injecting facilities specifically target.
The second key point presented by Drug Free Australia is that experimentation with dangerous drugs dominates its statistics. The Medically Supervised Injecting Centre relocates injecting episodes that would otherwise occur in unsupervised, less safe, often public circumstances in the local environs of Kings Cross to its clinical premises staffed by health professionals. There is no evidence that attending the centre influences the amount or type of drug injected there by injecting drug users. Staff observations verify that the amounts injected at the centre are standard quantities. A recent anonymous survey among checked-in drug users attending the centre also confirmed that.
Furthermore, intoxication is one of the exclusion criteria of the Medically Supervised Injecting Centre. All injecting drug users who present to inject at the centre are assessed by staff for signs and symptoms of intoxication. That includes breathalysing those who are potentially alcohol affected, thereby preventing hazardous drug use at the facility. Those assessed to be intoxicated are advised about the dangers of injecting elsewhere, an intervention that would not otherwise occur. Injecting drug users are also allowed to inject only once per visit, thereby further reducing the risks of dangerous drug combinations such that injecting episodes at the centre are far less risky than they would otherwise be in all other circumstances.
There is no problem with the Medically Supervised Injecting Centre definition of "overdose". The centre uses the internationally accepted clinical definition of opioid overdose syndrome documented in Harrison's Principles of Internal Medicine , Thirteenth Edition, Volume 2, on page 2426. This includes shallow respirations of between two to four per minute; pupillary miosis, that is pin-point pupils; bradycardia, which is slow heart rate; a decrease in body temperature and a general absence of response to external stimulation, or a decreased level of consciousness. Staff use the validated Glasgow coma scale to assess and monitor the level of consciousness, and oximetry to measure the hypoxia, or low oxygen levels resulting from depressed respiration, of injecting drug users and to monitor the effectiveness of treatment being administered in overdose situations.
The apparently higher rate of overdose measured at the Medically Supervised Injecting Centre, where clinically trained nursing staff are in a unique position to easily diagnose these events, demonstrates the extent of the problem in having previously relied on retrospective self-reporting by injecting drug users, and their cohorts, of their past experience with overdose when attempting to estimate such rates. While researchers have acknowledged the likelihood that such events would be underreported, given that the person involved would necessarily have been heavily drug affected at the time, thus decreasing short-term memory and other cognitive functions, the Medically Supervised Injecting Centre's ability to reliably measure the relative overdose rates of all drugs allows quantification of such under reporting and is an important contribution to the field understanding of the overall incidence of drug overdose in the injecting drug user population. The third key point referred to by Drug Free Australia relates to ambulance call-out rates that are not due to the injecting room.
The Hon. Christine Robertson: A gross improvement.
Mr IAN COHEN: Yes. I acknowledge that comment. The most recent analysis of ambulance call-out data demonstrates definitively that the Medically Supervised Injecting Centre has had a significant impact on ambulance call-outs to drug overdoses in Kings Cross over the past six years, comparable to that attributable to the national heroin shortage. The executive summary of Evaluation Report No. 4 states:
A substantial proportion of the overdoses, 2,106, managed at the site would have resulted in significant morbidity had they occurred elsewhere.
Ambulance call-outs to overdoses in the 2011 postcode, Kings Cross, have decreased 80 per cent since the Medically Supervised Injecting Centre opened in May 2001, whereas they decreased by only 60 per cent elsewhere in New South Wales. However, the neighbouring postcode, 2010, is arguably a better area to use as a comparison, given that it is more likely to share the same drug supplier and drug-using population and therefore the same drug overdose risk characteristics with Kings Cross. Indeed, it was found that ambulance call-outs to overdoses in the 2010 postcode had decreased only 45 per cent compared with 80 per cent in Kings Cross, showing that the centre had a very significant impact on such call-outs, almost doubling that attributable to the ongoing heroin shortage. Evaluation Report No. 4, at page 41, states:
It would be reasonable to conclude that the Sydney MSIC has provided an environment where IDUs at risk of overdose can receive appropriate care and early intervention, without the need to access ambulance services. This in turn may have freed ambulance services to attend other life-threatening callouts within the community.
This reduction in the need for emergency ambulance call-outs due to the Medically Supervised Injecting Centre will also have cost-saving implications. The fourth point raised by Drug Free Australia relates to the trial that finished with the 2003 evaluation. All the countries currently operating supervised injecting facilities including Switzerland, Germany, the Netherlands, Spain, Australia, Canada, Norway and Luxembourg—with the United Kingdom, Portugal, Denmark and Poland considering their introduction in the near future—are signatories to all United Nations drug control treaties. At various times over the years the International Narcotics Control Board of the United Nations Office of Drugs and Crime has contended that these facilities contravene the United Nations drug control treaties by "publicly inciting or inducing as well as aiding and abetting, facilitating or counselling the illicit use of drugs for personal use".
Reverend the Hon. Fred Nile: Hear! Hear!
Mr IAN COHEN: But that is the American war on drugs, which has failed miserably. More people are dying from the American war on drugs than in any facility or organisation on this Earth. It is the American war on drugs that is creating the problem, not solving it. However, a report prepared in 2002 by the legal affairs section of the United Nations Office of Drugs and Crime specifically for the International Narcotics Control Board concluded that drug policy must come up with new strategies to cope with new health threats such as growing rates of intravenous HIV transmission. The report stated:
It could even be argued that the drug control treaties, as they stand, have been rendered out of sync with reality, since at the time they came into force [in the early 1960s] they could not possibly have foreseen these new threats.
(UNODC Legal Affairs Section (2002) The flexibility of the treaty provisions as regards harm reduction approaches. Document E/INB/2002/W. 13/SS5.)
With regard to supervised injecting facilities the report specifically stated:
It would be difficult to assert that, in establishing drug injection rooms it is the intent of parties to actually incite or induce the illicit use of drugs, or even more so, to be associated with, aid, abet or facilitate the possession of drugs. On the contrary, it seems clear that in such cases the intention of governments is to provide healthier conditions for IV drug [users], thereby reducing risk of infections with grave transmittable diseases and, at least in some cases, reaching out to them with counselling and other therapeutic options.
While the Medically Supervised Injecting Centre is therefore very unlikely to contravene these treaties regardless of its trial status, any more than the national needle syringe program, which has had bipartisan support since 1988, the Medically Supervised Injecting Centre appreciates that this would not necessarily prevent the Federal Government from launching a potentially costly legal challenge in the High Court, which is best averted. Given the rates of infection in Canada, which does not have a needle exchange program, it is acknowledged that Australia is at the forefront of life-saving policy with the Government's needle exchange program. The program is saving lives and preventing the spread of disease.
The Hon. Catherine Cusack: The Greiner Government introduced it.
The Hon. Charlie Lynn: It's not an exchange program; it's an issue program.
Mr IAN COHEN: I acknowledge the Hon. Catherine Cusack's interjection. If the Greiner Government introduced the program, it is to be congratulated. It is the way to go, and it is to be supported. The Hon. Charlie Lynn interjected that it is a needle supply program rather than a needle exchange program. I have seen it being undertaken. It is a needle exchange program. If it also supplies needles, and that gives people clean, safe injection equipment—because they are going to do it anyway—I support that.
Reverend the Hon. Fred Nile: It's needle distribution.
Mr IAN COHEN: And it is saving lives. Fifthly, statistically the facility is not capable of saving even one life per annum. In its first six years of operation the Medically Supervised Injecting Centre successfully treated 2,106 overdose cases, 94 per cent of which were opioid related, without fatalities. As noted in Evaluation Report No. 4's discussion section at page 40:
It can be assumed that all of the opioid overdose cases treated at the MSIC would not have otherwise received such prompt assistance and that the early and effective intervention provided by the service is likely to have reduced the morbidity and mortality associated with these events had they occurred elsewhere.
Brain damage and other medical impacts are caused to people who are not treated in time. Even if they are brought back to life, the time lapse involved in the delivery of services is extremely damaging. The tragedy at a human level is significant, but the cost to society of caring for those people—who are in a much worse state than they were before the incident took place—needs to be acknowledged and properly assessed in cold, hard cash terms. Sixthly, the facility provides cubicles for pairs to share the experience of injecting. As I said, the Medically Supervised Injecting Centre accommodates injecting episodes that would otherwise occur in unsupervised, less safe, often public locations in the area, where they would always be more risky. I do not know what other people's experiences are in terms of these situations. Perhaps I hang out on the seedy side of life a little too much. However, I have friends who have been addicted—
Reverend the Hon. Fred Nile: Byron Bay?
Mr IAN COHEN: The Byron Bay and Nimbin areas, as well as the inner-city and Redfern areas. I have friends in most of these areas, right across New South Wales. I also have experience from when I was in fifth year at high school. A friend of mine overdosed in Cronulla when he dropped out of school in 1968. The lives of numerous other people I have known have also been cut short. I am sure that some members of this House know of similar tragedies—obviously not all members, because some simply do not seem to understand the drug problem and have not been touched by that side of life. A friend of mine—I will not mention names—who is a prominent person in my home community had a son who was an addict and shot up in the local public toilets. He did not die from the overdose; he died when he fell unconscious and hit the side of his head on the sharp edge of the toilet dispenser. What a disgusting, tragic waste!
That is the sort of thing that happens to real people—and that is the sort of thing the Medically Supervised Injecting Centre prevents from happening. There should also be one in Nimbin and other areas where there is a lot of drug usage. I have supported that. There should be a medically supervised injecting centre in areas such as Nimbin, where there is a huge amount of heartfelt public support for people who have problems with addictions.
Reverend the Hon. Fred Nile: Byron Bay?
Mr IAN COHEN: I said Nimbin, where the concept is supported. It would be very likely supported in Byron Bay as well. Clinical staff are trained to identify first-time injectors, who are in fact very rare in the Kings Cross area. The average injecting drug user registering to use the Medically Supervised Injecting Centre is 33 years old and has a 14-year history of injecting drugs. Injecting drug users must be 18 years old to be eligible to use the Medically Supervised Injecting Centre. Injecting drug users are not allowed to inject each other at the centre—which is common practice in all other settings and is associated with the transmission of blood-borne infections, including HIV, and hepatitis B and C.
As well as providing clean injecting equipment and a clinical environment, staff at the Medically Supervised Injecting Centre have provided personally tailored advice to injecting drug users about how to reduce injecting risks on more than 21,000 occasions to date. Health promotion campaigns are also regularly conducted at the centre, to prevent blood-borne infections in the injecting drug user population.
While the Medically Supervised Injecting Centre supports all calls for additional funding for drug treatment and rehabilitation programs, unlike Mr Christian we do not accept that this justifies the closure of the Medically Supervised Injecting Centre in Kings Cross. Over the past six years the centre has successfully addressed the range of serious public health and public order problems resulting from a longstanding concentration of street-based, drug-related activity in the Kings Cross area. In this sense the Medically Supervised Injecting Centre is a unique facility for unique problems, which are not addressed by any other programs.
It is worth exploring the background of Drug Free Australia. Last year Federal member of Parliament Laurie Ferguson asked a question in Parliament regarding the $600,000 grant received by Drug Free Australia to "promote abstinence-based strategies". Apparently, there was no submission process and Parliamentary Secretary Chris Pyne, in his response to this question, refused to shed any further light on what Drug Free Australia would actually provide for the $600,000. It is apparent that at least part of this allocation has been used to fund Gary Christian's full-time salary to develop and produce the rather well laid out glossy brochure "The Case for Closure of the Kings Cross Heroin Injecting Room", thousands of copies of which have been distributed to all members of Parliament in Australia, both Federal and State—indeed, twice to New South Wales members of Parliament—and to residents in the Potts Point-Kings Cross area.
Drug Free Australia is basically a lobby group that advocates zero tolerance and is fiercely opposed to harm reduction. While the Medically Supervised Injecting Centre has been its main target in the last four years, the group also advocates closure of the entire needle syringe program. I am advised that the Howard Government has a specific policy that states that government national drug strategy moneys will only fund service provider organisations, not advocacy organisations. So, apart from the lack of transparency regarding how Drug Free Australia got the $600,000 and what it was for, it should not be eligible for this funding in any event.
These facts are probably not unrelated. What binds the group together appears to be its Christian fundamentalism. Gary Christian is high up in the Seventh Day Adventist Church. Other leading lights include its past patron, Major Brian Watters, who is close to the Prime Minister, and who is now Deputy Chair of the United Nation's International Narcotics Control Board, which oversees these drug treaties.
Those quoted as having provided expert advice regarding Gary Christian's analysis of the centre's 18-month evaluation report include Dr Stuart Reece, who is described as an addiction medicine specialist in the brochure but who holds no post-graduate qualifications let alone specialist qualifications in addiction medicine. He was almost struck off the Queensland Medical Board, which investigated him for an usually high mortality rate among his naltrexone patients. In a Federal parliamentary inquiry run by Bronwyn Bishop, Reece cited as part of his evidence Sodom and Gomorrah, the biblical cities destroyed by their immorality.
He suggested that Australia's civilisation was similarly under threat from injecting rooms, syringe programs and methadone clinics. He also gained notoriety for suggesting that condoms caused HIV-AIDS. It shows where these people are coming from when they advocate the closure of a health facility aimed at harm minimisation—a facility that has been operating successfully and saving lives. I commend the Government's decision to extend the trial of the Kings Cross Medically Supervised Injecting Centre and applaud it for its brave stance against these rabid attacks.
The Hon. TREVOR KHAN [11.21 p.m.]: Some members know that this is an issue about which I have mixed feelings. I have mixed feelings for a number of reasons. When I spoke at our State conference I expressed firm views about this issue. I am happy to recount those views. However, let me put this debate into context. I heard views expressed in this debate extraordinarily vehemently. We are talking about people's lives. We are not talking about some academic expression of faith and we are not talking about the passage of some criminal bill that may or may not have an impact on people. We are talking about whether people will live or die and the circumstances in which that will occur. I cannot resile from that.
At the weekend I said in part that I was motivated by the SOD principle, that is, what I would expect to happen to my son or daughter. I think, in particular, in the context of my son, for reasons that I do not need to go into. He is a strong, healthy and intelligent young man who might share many of the weaknesses of his father and other members of his family. I can see that he, like many other young men, could seriously go off the rails. When I look into his eyes I see the possibility that he might not survive young adulthood, and that worries me intensely. I cannot think of this debate in the context of some useless drug addict; I think of it in the context of my family, which worries me.
I have thought about this debate in another context. Harold Metcalfe, the only grandfather I knew, was a printer at Fairfax. He finished at Fairfax without telling his wife or children and, no doubt, that was because he was an alcoholic. He continued to go to work, or so his family thought, for months. But, of course, he did not go to work; he went to the pub. His family never knew that he had finished work. One day when he was coming back from the White Horse Hotel at Kensington he got off the bus on Gardeners Road. He did not succeed in finally crossing the road; he was run over and he died.
When I heard Mr Ian Cohen talking about cycles of addiction I thought of my grandfather in the gutter. When Mr Ian Cohen spoke about friends he had known whose children might have died I thought of Harold Metcalfe, a man of great worth. I can still smell him. I remember the popcorn that he gave me and I can still remember the lawn at the front of his house. Harold died essentially because of his addiction. He died because his addiction was not treated. He died because at that time we found poor excuses for how he could continue to work. We found excuses for how he could cope within his family.
No doubt what was said of him at the time was that he would eventually find a way out of his addiction. He found a way when he was struck by a car on Gardeners Road. I say frankly to Mr Ian Cohen that his way out is appallingly simplistic. It lacks the personal expression of the loss of somebody close. I move next to my school friends. David—I will not mention his second name—died in the toilets at Kings Cross. His life might or might not have been saved if there had been an injecting room at Kings Cross. Tammy, one of my clients and no doubt a prostitute, also died at Kings Cross. There was no question that she had a heavy heroin habit. She died because there were no facilities to help her. She died because she alone would never have found a way out of her addiction.
I come back to my son. Will a heroin injecting room provide him with an answer? It cannot. If he were a heroin addict it might keep him or another heroin addict alive for a little longer, but it cannot provide him with answers. My son, my grandfather and other relatives and friends require appropriate facilities. Drug addicts require additional expenditure on Drug Court facilities that will provide the answers and the motivation for them to give up their addiction. We need people to be placed in appropriate facilities to encourage them to avoid or escape their addiction.
Mr Ian Cohen does not have an answer other than to say that people might find a way out. My experience over 20 years shows me that addicts generally do not themselves have the capacity to find a way out. Despite my great wishes I know that a drug injecting facility will not provide a way out. It might facilitate an injection without infection but it will not provide addicts with a way out of their addiction. I am compelled to state that, at the end of the day, I have struggled with this issue. I still remember that Harold died in the gutter. He needed help. He did not need somebody to provide him with a drink, or even a clean glass; he needed somebody to take him by the arm and show him how not to drink. I oppose this bill.
The Hon. ROBYN PARKER [11.29 p.m.]: I thank the Hon. Trevor Khan for a very moving contribution to the Drug Summit Legislative Response Amendment (Trial Period Extension) Bill 2007. I know that he thought about this issue long and hard. Although I disagree with his conclusion to some extent, I agree very much with the sentiments he expressed and the reasons he gave for his conclusion. Certainly, in part, his conclusion is one many of us can come to. This is the second occasion on which I have had an opportunity to speak in support of the injecting room. On this occasion, honourable members have a conscience vote. I remind all honourable members that we are fortunate in our democratic parties of progressives and conservatives to be able to respect each other's points of view, not only in this Chamber but also outside it, and within the party. That applies not only now but also down the track. We come to these decisions based on our backgrounds, our understanding and perhaps our diversity of experience.
That is the wonderful thing about the Liberal Party. I know Labor members may disagree, but one of the reasons why I am a Liberal is because members of the Liberal Party are progressives, they are conservatives and they are somewhere in between: we are able to agree and we are able to agree to disagree. It seems to me that I am a moth to a flame when it comes to a conscience vote. However, when I looked at my previous contribution in support of the injecting room I found that I have not changed too many of my views. In fact, when I looked back on some of the misgivings I had about the referral rates and other issues, I have been encouraged in my decision.
Why do I come to a decision to support what, to many honourable members, seems to be a facility to encourage drug use? This issue is about people, it is about humanity and it is about having an understanding of humanity. It is about us saying that we value every life if we possibly can; that we value lives that are travelling well by today's standards and by our standards, but we also value those who have fallen by the wayside or those who are ill in a whole range of ways. It is not just an opportunity for us to say we value the lives of some people and not others, because the people who are clients of the Medically Supervised Injecting Centre are someone's son, daughter or loved one. They have grown from the completely innocent life of a small child to a life that is not pure. Many clients of the injecting centre may have criminal pastimes to support their habit; some of them are not nice people, and some probably are; and some of them will have slipped from a high-value life to the point of almost no return.
It is for those people who are on the very fringes of society and at a point where they are almost beyond retrieval that this centre serves a purpose. It is not the only answer to dealing with the drug crisis in our country but it is one of a whole range of measures. To be political for a moment, I might say that this Government needs to lift its act in taking more initiatives in regard to dealing with drug and alcohol addiction. Last week we moved towards some amendments in relation to severe drug and alcohol dependency, but there is much more we could be doing and much further we could go. I know and have visited drug-dependent people. The families whose lives have been disrupted by drugs may surprise many people. Addicts are not just marginalised people living in the suburbs who suffer from social disadvantage; addicts can come from quite wealthy families. In fact, the most recent contact I had was with a mother whose son is the same age as one of my sons. This woman said to me that one minute her son was winning prizes at sport, the school captain, almost the dux of school, and the next minute he suffered a drug overdose in his car on his own somewhere on the outskirts of town. Had there been an intervention of any kind that incident may not have happened.
Many young people drift to inner-city areas. They go to Kings Cross because they know they can procure drugs. But perhaps that is where they can go to find a safe haven, if there is such a thing. The drug problem was almost out of control in Kings Cross when the injecting centre commenced after the Drug Summit. This is the right service, it is appropriately placed and it is appropriate for the clients who use it. However, it is not the only service we should be offering. I do not support an expansion of the service. The service is needed, and I am glad it is there. Many people are alive today because of it. If the injecting centre had not been established, Kings Cross would be no different than it was prior to the introduction of the centre.
On many occasions I have been with drug addicts through their detox process. I have been through squats looking for drug addicts. I have been with parents who have pleaded with police to keep their children incarcerated so they at least stay off the streets and do not overdose. I understand the anguish of people who have the addiction and of their family and loved ones. I understand the powerlessness they all feel. Perhaps the referral rates for clients who go to the injecting room are not as high as they should be. However, honourable members need to understand the types of clients who are going to the centre?they are not the types of clients who are going to be referred immediately, they are at an end point. If we can deal with a number of their other complex health needs—many of them have multiple and complex health needs—if we can solve some of those problems and help them get parts of their lives together, they can be referred on. Let us not forget that other agencies do not have a huge success rate with referrals of drug addicts either. One has to compare apples with apples.
Drug addicts require many opportunities and many referrals into rehabilitation, and they fail more times than they succeed. It is not a perfect situation. The statistics for one group of people cannot be compared to the statistics of another. These people have to be offered referrals to rehabilitation, and we have to keep trying. If they are not referred and if they do not present to particular services, it is because it is just not the right mix of service provider for them. It does not mean that the injecting room has failed as such.
The centre has addressed some serious public health and public order problems in Kings Cross related to street-based drug activity. It is a unique facility that solves unique problems that other programs do not address. It has success stories. The centre's clients are long-term drug users—people on the margins of society—who have not only a drug-addiction problem but also many other health and mental issues. The centre and its amazing staff—whose compassion and humility is an example to us all—are saving lives. Some members are extremely critical of the centre yet they have never been there. They have no idea what it is like inside. They have never spoken to staff or talked to clients. If they visited Kings Cross they could not find the centre in a million years because it does not stand out; it is not a honey pot. The centre has no visible street presence.
I am tired of the virtual hysteria from people who do not understand the centre and its role and who have never been there. It is a health facility. People either support facilities that use a range of measures to deal with drug addiction or they do not. People either support harm minimisation, in all its facets, or they do not. Harm minimisation has worked incredibly well to solve some huge problems with HIV-AIDS. It has certainly improved the amenity of places such as Kings Cross, where disused needles used to litter the alleyways and innocent people could sustain needle stick injuries. This legislation is about harm minimisation, health and a centre that does not condone drug use. It is a medical facility. I remind members that it is called the "Medically Supervised Injecting Centre". It is not a "shooting gallery"—as one of my colleagues likes to call it—but a medical centre. The centre has a clinical, not a party, atmosphere, and caring, compassionate and professional staff. I will relate some of the centre's successes to the House. I have a few anecdotes. Lucille says:
I would like to say a huge thank you to all the wonderful people involved in the centre. I signed up when you opened and now 18 months later I am saying my goodbyes to everyone—hopefully for good.
I'm on methadone now and I'm not going back to the streets any more. I'm looking forward to looking for a place to live and starting TAFE soon—I'm changing a lot at the moment.
Thank you for this service. Lots of my friends have died on the street from overdoses at very young ages. If this service had been around then I'm sure many of them would be alive today. Thank you for this safe, clean and life saving centre.
Drug users often lead very lonely lives. People do not set out to become intravenous drug users; it is on no-one's must-do list. People drift into drug addiction, often very quickly. Intravenous users feel alienated, dirty and alone. Another client of the centre said:
? when I discovered the MSIC I felt safe—safe to know there was help if I needed it.
I hope this service is continued—it is so important to keep people clean and alive until the day they feel they can attack their problems. Too many people die in the gutter—keep up the good work guys. It's good to see that people do care about us—the supposed "dregs of society". We are real people too—with mothers and fathers and people that love us. Your lack of judgement is appreciated.
Contrary to what some members have said, not only drug users appreciate the centre. Many in the business community and many local residents are glowing in their praise of the injecting centre. At a Medically Supervised Injecting Centre Symposium in July last year Tom McMahon said:
When we purchased the Regents Court building in August 1987 we felt that Kings Cross had sunk about as low as it could go. Sadly it continued to get worse into the mid-nineties. The strip actually got to the point where it was controlled by criminals and thugs, the area was awash with drugs and violence was commonplace. Profitable businesses were based on sex or drugs or often both.
Thank God for the Royal Commission without which recovery was impossible.
Mr McMahon went on to explain how Kings Cross had regenerated. There is a real estate boom and people now appreciate living in the area. He said:
Our guests constantly complained about public shooting up, needles left everywhere on the street and drug related assaults often in the middle of the night. Many guests couldn't stomach it and checked out. Ambulance sirens were heard day and night.
He said that he has noticed continuing improvements over the past five years. He continued:
The number of drug affected people on the streets have dropped to almost nil and we are thrilled to see more children in the neighbourhood. Now we have most nights with no sirens ?
Several other businesspeople talked about how centre staff, working in conjunction with the police, have improved the area's amenity. That is a good result for local residents and for businesspeople. I know that people have differing views on that point. Perhaps some businesspeople who are complaining about having to close their doors might consider the impact of extensive and ongoing road closures and repair work on their businesses. Perhaps their businesses simply were not relevant in the King Cross environment. Businesspeople speak of how addicts used to overdose and be found slumped in doorways. There have been big improvements since then.
Some organisations, such as Drug Free Australia—which Mr Ian Cohen mentioned—are peddling misinformation about the centre. Drug Free Australia argues that heroin injections constitute just 26 per cent of the centre's total injecting capacity. When I asked centre staff about this they told me that a range of drugs have been injected during the 391,027 visits that injecting drug users have made to the centre in the past six years. Some 62 per cent went to the centre to inject heroin; 12 per cent, other opioids; 14 per cent, cocaine; 6 per cent, methamphetamines; and 3 per cent, benzodiazepines. In the past year about 75 per cent to 80 per cent of clients visited the centre to inject heroin and other drugs in this opioid class; and about 350 opioid-related overdose cases were treated successfully. I suggest that in a different environment they would have been 350 fatal overdoses.
The proportions of the respective drugs injected at the centre have fluctuated widely and reflect their relative price and availability in the Kings Cross area. The centre performs an important function in monitoring the varieties and availability of drugs. It can tip off local police and other health services about impending dangers and indicate what drugs people are using. As Mr Ian Cohen said, 76 other supervised injecting facilities currently operate around the world in eight different countries. We must remember that the objective of these centres is to prevent and reduce injecting-related harm associated with the use of all injectable drugs, not just heroin. We should recognise also that intravenous drug users are usually poly-drug users—in other words, they use a range of different drugs and are therefore at risk of contracting HIV-AIDS, hepatitis and so on.
Drug Free Australia claims that experimentation with dangerous drugs dominates the statistics. In reply the centre states that it relocates injecting episodes that would otherwise occur in unsupervised, less safe and often very public circumstances. Clients are only able to inject once per visit, reducing the risk of dangerous drug combinations, making the centre far less risky than other places. Criticism has been made about the definition of "overdose". The centre states that it uses the internationally accepted clinical definition of opioid overdose syndrome, which has been documented. People who overdose face an increased risk of damage if left too long and the centre's nursing staff are in a unique position to diagnose these events and deal with problems more quickly than if a paramedic had to be called.
Drug Free Australia also claims that a drop in ambulance call-out rates in Kings Cross is not the result of the injecting room but the result of a heroin drought. In reply to this argument, the centre states the most recent analysis of ambulance call-out data demonstrates definitively that the Medically Supervised Injecting Centre has had a significant impact on ambulance call-outs to drug overdoses in Kings Cross over the past six years, comparable to that attributable to the national heroin shortage and that a substantial proportion of the overdoses managed at the site, which were 2,106, would have resulted in significant morbidity had they occurred elsewhere; in other words, some of those people would be dead.
Given the lateness of the hour I will not go into great detail. The centre has more information on its website available to honourable members, and the centre's staff would be delighted if honourable members visited the facility they are so passionately opposed to. They might get further information that refutes a number of claims by Drug Free Australia. Claims have been made that the centre is not capable of saving even one life a year. I do not know how anyone can say that when in six years 2,106 people have been treated for overdose without one fatality. Potentially a large proportion of those people have been saved.
Many statements have been made about the design of the facility being available for people to share. Centre staff have said they accommodate injecting episodes that would otherwise occur in an unsupervised, less safe environment, and staff are trained to identify people who might be first-time injectors, which would be very rare in the Kings Cross area. Most users are long-term users, on average about 33 years of age, with a 14-year history of drug taking. Staff members do not encourage people to go into the centre to use drugs to shoot up for the first time. It is a facility for long-term users.
There is no question in my mind that the injecting room has been successful and that it should have the support of the House. The bill contains a provision to cover the situation if, over time, the need for the services of the centre decreases. It would be wonderful if we reached the point where we did not need this centre. It would show that the centre had served its purpose and that we were successful in the war against drugs or that perhaps the area was not as attractive for injecting as it once was.
I ask honourable members to think long and hard about harm minimisation and the sorts of people who use the centre. We should be a compassionate, decent and humane society. We should remember that taxpayers' dollars are not funding the centre. To suggest otherwise is just another myth. Money would be better spent on a range of other services but we cannot just deny people in need. To do so is to deny humanity, which we should support. I know the people who developed the centre, including Reverend Harry Herbert, Executive Director of UnitingCare, a compassionate man, who stated:
I am proud that UnitingCare has been able to play an important role in operating the centre. We want to help people get off drugs. But while they are struggling to do that, caught up in the chaotic vortex of drug addiction, should we just abandon them to their fate? No, the essence of Christianity is to help our neighbour, even when we don't approve of everything our neighbour has been doing. The premature deaths of drug users have enormous ripple-on effects among their family and friends. Often whole communities are affected. Keeping drug users alive and safe while at the same time encouraging them to change their lifestyle is a most creative work.
Other members have mentioned the Medical Director, Dr Ingrid van Beek, who is internationally recognised. We are very lucky to have her involved in the centre because she has done an outstanding job. A year ago she wrote:
The MSIC has made contact with a significant proportion of the local drug using population, many of whom had not previously had contact with health services.
Most had not had contact with existing health services for drug users prior to attending the centre. It is estimated that the Medically Supervised Injecting Centre made contact with more than 70 per cent of the local drug-using population in its first 18-month trial period, and its coverage of this population will have increased further since then. These people are now in a cycle that enables them to be referred whereas previously they were not attending any health services. The centre is a gateway, indeed an improved gateway. When it was initially established, the referral processes were in need of improvement and that has happened. People are being referred on to other programs such as naltrexone, morphine and other services.
Honourable members should also remember that many people are estranged from their families and that, where it is safe to do so, the centre works hard to reunite people with their families. Honourable members have dispelled many of the other myths but I am sure we will hear these myths repeated as fact again in the debate. However, I encourage members to go to the centre's website to see the value of this service. I extend my personal and sincere thanks and admiration to the staff and board members. I remind honourable members of the environment in the Kings Cross area before the centre was opened. There was undesirable drug-taking behaviour in and around the streets.
The successes of the centre are the reason we should support its continued operation. Several years ago members agreed to give this project the go-ahead in an attempt to reduce the scourge of drugs on the people of New South Wales, particularly in Kings Cross. The centre has made an enormous difference to the lives of users and enabled thousands to reconnect with society, many with their families. We have the opportunity once again to take the lead and allow the fantastic and necessary work that is being under undertaken at the centre to continue. I ask members to consider the thousands of families in New South Wales who may be helped by this service when their son or daughter, or friend, or mother or father seeks help from this service and takes a giant step forward to making a real change for themselves. Last week I was reminded of some of the very wise statements of Robert Kennedy. In conclusion, I quote one of them:
Few men are willing to brave the disapproval of their fellows, the censure of their colleagues, the wrath of their society. Moral courage is a rarer commodity than bravery in battle or great intelligence. Yet it is the one essential, vital quality for those who seek to change a world that yields most painfully to change.
I urge honourable members to support the bill and allow the work of the Medically Supervised Injection Centre to continue.
The Hon. MATTHEW MASON-COX [12.01 a.m.]: I oppose the Drug Summit Legislative Response Amendment (Trial Period Extension) Bill 2007, which provides for the continuation, for another four years, of the trial of the Kings Cross drug injecting centre. This trial commenced in May 2001, more than six years ago, and was due to end on 31 October this year. The bill seeks to extend its operation until 31 October 2011. I note the statements made by the Minister for Health in the other place as to the rationale for a four-year extension of this controversial trial:
The bill enables the centre to continue providing a service for a group of marginalised long-term drug users with significant health and social problems who have either failed drug treatment or never sought it before. A further trial period will also enable a longer-term evidence base to be established as to the effectiveness of the centre. This is of particular importance, given the long-term drug use of its client group, and will inform any future decisions on the permanency of the centre.
One has to wonder whether the Minister is being a little disingenuous in suggesting that six years is insufficient time to gather evidence as to the effectiveness of the centre. There have been a number of interim reviews as well as the review released last week by the Minister. How many reviews are enough? And when does a trial become a permanent piece of government policy? I suggest we have reached that point with the Kings Cross injecting room.
Indeed, it sounds like the Minister and the Government simply do not want to make a decision and have taken the easy route of simply extending the trial for another four years. Why will the Government not have the courage of its convictions and legislate to keep this centre open permanently or, alternatively, close it down? I wonder. Well, the Government knows that the drug injecting room is a clear breach of Australia's international obligations. The International Narcotics Control Board of the United Nations Office of Drugs and Crime has consistently contended that these facilities contravene the United Nations drug control treaties by "publicly inciting or inducing as well as aiding and abetting, facilitating or counselling the illicit use of drugs for personal use".
Therefore this Government is running from the risk of being painted as soft on drugs by the international community. It is also running from the risk of being seen as soft on drugs by the people of New South Wales, who, I contend, are strongly against the drug injecting room. That is why we continue with this façade of a trial for another four years. The Minister goes on to say that the trial of the centre has clearly met the Government's objective to decrease overdose deaths, provide a gateway to treatment, reduce discarded needles and drug users injecting in public places, and help reduce the spread of diseases such as HIV and hepatitis C. On the face of the recent evaluations commissioned by the Government, this is alleged to be true. It is worth noting that evaluation report No. 4 states:
There are many scientific, practical and ethical challenges involved in evaluating health interventions such as supervised injecting facilities and accurately quantifying their effectiveness.
I emphasise the word "accurately". I note that most of the objectives appear to have been met, at least superficially or in part, in as much as that can be effectively measured. However, there is one critical area—I think the most critical area of the evaluation criteria—in which this centre has been an unmitigated failure. This is drug treatment referrals, a matter about which a number of honourable members have spoken.
In the first few years of the operation of the centre the rate of referral was at about 0.5 per cent of total visits. This exceptionally low rate of drug treatment referrals was acknowledged and addressed in October 2004 by the employment of a case referral coordinator. However, this step led to only a doubling of drug treatment referrals to 1 per cent of total visits in the following year—just 1 per cent of total visits. This rate of referral is appallingly low, reflecting the high percentage of hard-core users visiting the centre. What realistic chance does this offer for a drug-free future for those addicts? Not much, I contend—not much at all.
A community worker recently relayed to me the story of a young man, a drug addict, who had moved to Sydney from the country. When asked how he was settling down in Sydney, he replied that he wished he had made the move years ago. In Sydney, he said, he had better access to drugs, cheaper prices, access to needles and also access to a drug injecting room with all the facilities that such a room offers. Everything was free, the police did not hassle him, he got free food, free coffee, a free place to live—free everything, in his own words. He had never had it so good! He wondered why he had not come to Sydney a lot sooner.
Yesterday I visited the drug injecting centre at Kings Cross. What an eye-opening experience that was! Before going in I stopped about 30 metres down the street, just to assess what was going on in the immediate vicinity. I watched as a dozen or so people appeared near Kings Cross station and openly bought drugs from a couple of drug dealers, then moved across the street and went into the centre to shoot up. It was a bit like a procession. I must admit that I was a bit surprised with the openness and brashness of all that activity. I went and had a chat to the security guard who is posted outside the centre at all times the centre is open, just to get an idea whether that was a usual state of affairs. He pretty much confirmed that it was normal, that the same sort of people came along every day, and it was typical of the process involved—the same faces, the same habits, and the same result.
The Hon. Robyn Parker: Did you go inside?
The Hon. MATTHEW MASON-COX: Yes, I did go inside. I spoke to the staff at the centre and asked a whole range of questions. That was an elucidating experience. But I must admit that it only confirmed my very strong opinion that we must close the centre. I will continue to provide some more information in that regard. In assessing the effectiveness of the drug injecting centre we must consider what is in the best interests of the individual—in this case, the drug user. We must make that assessment against the full gamut of other societal responses in this complex area. We must also consider its impact on the surrounding community and the wider community. In this, like in so many other areas, our actions speak louder than our words.
The Government says that it is tough on drugs, and points to factors like legal prohibition and more police on the street. Yet, in this case, it turns a blind eye to illegal drug use and offers assistance for drug users through the Kings Cross drug injecting centre. I do not doubt that the Government's intention is noble; we have heard many honourable members tonight speak strongly in support of that contention. I respect their views in that regard. I also understand that they are very well meaning in holding those views. But, in my mind the centre sends a terribly confusing message to our young people about drugs and their acceptability in our community. Moreover, and probably more importantly, it offers little hope of rehabilitation for drug users. On its own quantitative assessment, less than 1 per cent of drug treatment referrals is an appalling result for this centre. It does little to get addicts off this merry-go-round, and these intractable users are in need of significant support. However, we have support mechanisms working the other way, in that they retain intractable users in these destructive habits. The drug injecting room is one of those mechanisms.
Instead, we should be considering innovative ways to treat and rehabilitate drug users to get them off their addiction merry-go-round and back into mainstream society. We should be trialling other solutions that put treatment and rehabilitation first, not harm minimisation. It is time for this tired drug injecting room trial to be abandoned. It has been a miserable failure, particularly for those it was meant to assist. It is time we looked at treatment and rehabilitation solutions that build hope for the future rather than continue with this failed trial that merely maintains the misery of the present. I urge honourable members to reject this bill.
The Hon. CHARLIE LYNN [12.10 a.m.]: I oppose the Drug Summit Legislative Response Amendment (Trial Period Extension) Bill. The purpose of the bill is to extend the operation of the Kings Cross injecting room for another four years, until October 2011. However, that is not quite true, but that is how this Labor Government would like to think it was. In reality there has already been a trial, so there is no need for another trial. This is about instituting a facility, making it part of the suburb of Kings Cross and keeping it there, all the while retaining the title "trial" to avoid adverse reaction from the community. Based on all the available information, there is no objective reason why the Kings Cross injecting room needs to continue operating.
There are many reasons to close the injecting room in Kings Cross, but the most compelling is that the heroin injecting room is rapidly becoming the ice injecting room. Currently there is an ice epidemic. In 2006 only 38 per cent of injections in the injecting room were heroin injections. Other substances such as cocaine and morphine, but most frighteningly ice, were commonly used. The injecting centre's medical director, Ingrid van Beek, said 8 per cent of the 220 addicts using the centre each day were injecting ice. That is more than twice the number 18 months ago. An article in the Sunday Telegraph of 10 December, entitled "Ice addicts flood injection rooms", revealed that violent ice addicts are using the Kings Cross injecting room to shoot up as police battle a crime wave fuelled by the drug. Ice is a highly addictive and destructive substance. It changes the user's behaviour in such a dramatic way and also causes aggression and can lead to psychosis. The article reported that outside the injecting centre journalists had approached several addicts who admitted to using ice inside. One man said staff did not check the type of drug he injected. The article reported him as saying:
I just don't tell them. They don't care; they just write you down on a piece of paper.
You just say, "I'm doing hammer (heroin)" and go boom, boom quickly. Just keep it quiet.
Another addict, calling himself Ace, was reported as saying:
Hell yeah, bro, it's a proper sealed joint in there with security guards and all. You can do what you want.
It's amnesty once you cross the door; cops can't touch you.
Kings Cross police duty officer Robert Allison said users high on ice were assaulting people and damaging property in the area. He said:
When they're in the episodes, they commit violent crimes—assault and malicious damage, punching a glass pane.
It's more prevalent now. We have noticed people affected by ice are creating more problems for police and tying up police longer because we have had to stay with them.
Even Premier Iemma said ice addiction was a serious problem and that he was "extremely concerned about the increased use of ice across the community, and the use of the drug at the Kings Cross facility is no exception". This is an absolute travesty. While health professionals and law enforcement agencies on the front line are combating the growing ice epidemic within the community, the State Government is on the other side not only condoning but promoting the use of ice.
Another significant reason for closing the injecting room is that it is, by any reasonable measure, a complete and utter failure. While the main function of the injecting room is to provide a safe environment for heroin addicts, thereby enhancing injector safety and decreasing overdose deaths, it was found that those addicts who accessed the injecting room did so on average one out of every 35 injections. So, on the other 34 occasions they injected elsewhere. If every heroin injection is potentially fatal, this statistic alone surely proves that injector safety is not enhanced and therefore the injecting room is a failure. If the heroin user wanted to avoid a fatal overdose, he would have every injection inside the room, not just one out of every 35 injections.
So underutilised is the injecting room that it has averaged just 200 injections per day despite having the capacity to host 330 per day, rendering the injecting room less than satisfactory. Based on this statistic, the heroin injecting room cannot possibly save a single life. To the contrary, the injecting room has an extraordinary rate of overdose—9.2 overdoses for every 1,000 injections. Page 62 of the injecting room's own evaluation stated:
In this study of the Sydney Medically Supervised Injecting Centre ? there were 9.2 heroin overdoses per 1000 heroin injections in the MSIC, and this rate of overdose is likely to be higher than among heroin injectors generally.
The [injecting room] clients seem to have been a high risk group with a higher rate of heroin injections and heroin injectors who did not use the [injecting room], they were often injecting on the streets, and they may have taken more risk and used more heroin in the [injecting room].
Because medical supervision provides this illusion of safety, addicts are taking higher risks by injecting higher doses of heroin and as a result there is a higher rate of overdoses. It is not until the injecting room overdose rate is compared to other overdose rates that its full magnitude is realised. The heroin injecting room overdose rate is 36 times higher than on the streets of Kings Cross, at least 40 times higher than the injecting room client's previous history, and 49 times higher than the estimated national overdose averages. A probable consequence of clients using higher doses of heroin is that the injecting room is adding to the profits of local drug dealers. This would obviously be of concern to the community.
Honourable members will recall that during the Drug Summit the Government stated its aim was to help people find the path to recovery. Unfortunately, experience has shown that very few addicts who have gone to the Kings Cross Medically Supervised Injecting Centre have been put on the path to recovery. While this was a noble objective, there have been only 6,243 referrals to other services. That works out to be 16 referrals per 1,000 visits. Unfortunately there have been no details of the outcomes of these referrals. While the number of total referrals is hardly impressive, the number of clients referred to treatment or rehabilitation is even smaller. The majority of referrals were to social welfare assistance, which might well be assumed to be Centrelink benefits. Other referrals were for legal matters and counselling for issues other than drugs, such as medical or dental health education and testing for blood-borne viruses and sexually transmitted diseases. However, as previously stated, there is no record of follow-up of any referral. Of course, referrals can also be accomplished by any health worker service, and even a soup kitchen.
The injecting room's 2003 evaluation outlined the failure of the injecting room in achieving its other objective to reduce the spread of diseases. There was no identified improvement in HIV infections, hepatitis B infections, hepatitis C infections, new needle and syringe use, overdose presentations at hospital emergency wards, ambulance overdose attendance in the area, or ambulance overdose attendance during the hours the injecting room was open. In areas where there was some evidence of improvement during the trial, such as the number of public injections sighted by residents and the number of publicly discarded syringes, the improvements can be largely attributed to the significant drop in the supply of heroin in Sydney, which is referred to as the heroin drought. The injecting room's own 2003 evaluation declared that the injecting room showed no impact on ambulance callout rates, and callout reductions were the result of the heroin drought, which started six months before the injecting room opened in May 2001. This drought continues.
It is the heroin drought, not the injecting room, that has reduced public injecting and discarded needles. It is the heroin drought, which came about as a result of the Federal Government's tough on drugs initiative, that is getting results by cutting supply, not the State Government's shooting gallery in Kings Cross, which, for all intents and purposes, legalises using drugs like heroin. It is my strong preference and the preference of many in the community that the injecting room be immediately closed, that all funds instead be made available for treatment and rehabilitation services by all levels of Government, and that the focus be on prevention not harm minimisation. Harm minimisation pragmatically accepts that people will use illicit drugs and seeks to minimise the harm of doing so. Consequently, harm minimisation characteristically places little emphasis on the prevention of drug use. Harm minimisation does not work.
In the 2004 report of the United Nation's Office for Drug Control and Crime Prevention Australia's statistics indicated the highest levels of illicit drug abuse amongst OECD countries, which may well be due to its long history of allowing harm-minimisation policies to predominate over prevention policies. It had the highest levels of cannabis and amphetamine use, and the fifth highest use of cocaine. Australia's more recent prevention messages and excellent work by the Federal police have seen solid reductions in illicit drug use in Australia, despite harm minimisation still predominating. It is certain that these decreases have been produced not by harm minimisation, but by prevention strategies. Ordinary mums and dads in the community do not want to minimise the harm to their children from illicit drugs and, more importantly, they do not want the State Government to minimise the harm to their children from illicit drugs. They want to prevent illicit drugs from harming their children in the first place, and they want the State Government to do all it can to prevent drugs from harming their children in the first place.
My final reason for supporting the closure of the heroin injecting room is that it has attracted worldwide condemnation. There is a legal question mark over its existence and it is a source of shame to Sydney. Not many cities in the world have a Government that actively promotes breaking the law. The only other countries with a heroin injecting room are Germany, Switzerland, Canada and the Netherlands. The International Narcotics and Control Board specifically singled out the Kings Cross injecting room trial as being in breach of international conventions against illicit drug use. The trial does not utilise legal heroin, rather it depends on the client illegally procuring heroin, illegally transporting heroin and illegally using heroin. Furthermore, if the injecting room trial had been valid, the 2003 evaluation should have marked the end of the trial, results should have been forwarded to the International Narcotics and Control Board and the injecting room should have been closed. According to excerpts of a letter to Australia's ambassador to the United Nations published on 15 December in the Canberra Times , the International Narcotics and Control Board President, Antonio Martins, warned:
By permitting injection rooms, the Government could be considered to be facilitating the commission of possession and use crimes, as well as other criminal offences including drug trafficking.
I do not support the bill. I urge honourable members to vote against it.
The Hon. CATHERINE CUSACK [12.23 a.m.]: The genesis of the Medically Supervised Injecting Centre was the Drug Summit, which was held in 1999. The Medically Supervised Injecting Centre did not commence operations until May 2001. At that time it was a pilot program established for a period of 18 months, which we subsequently extended for a period of 30 months. In October 2003 the House debated a bill without the benefit of research to which the Hon. Charlie Lynn referred, which was an evaluation of the program that was promised to the Parliament to enable it to consider further legislation in 2003. Unfortunately, the Department of Health was unable to provide that in time for our debate, which was held very late in October 2003, only a matter of days before the mandate for the centre expired. At that time Liberal Party members were allowed a conscience vote, but members of the Government and The Nationals were not. The bill passed through this House, and the so-called trial was extended for a further four years. Here we are in June 2007 with a bill that again extends the trial for another four years until October 2011, which means we are now looking at a total of 10 years for the trial.
It is difficult to regard the program as a genuine pilot, given the length of the trial will be 10 years. I think the word "subterfuge" would be a better description of what we are debating in the legislation. I note that over the 10-year period there will be no extension of the trial to any other part of the State. There will be no outcome to the trial. As a result of all the evaluations the only outcome is to extend the trial. No other outcomes have impacted on the serious problem of drug abuse in the State. I note that in the Minister's second reading speech one of the outcomes in the current evaluation of the centre is that the Director of the Bureau of Crime Statistics and Research reported that there is no evidence that the centre has had an adverse impact on drug-related crime. In other words, the centre has not increased the amount of crime. It is a pretty pathetic achievement for a drug injecting centre. The fact the centre has caused no additional harm is not, of itself, a rationale to continue it.
I note from the Minister's second reading speech that only 68 per cent of business operators in the area support the centre. These are business operators in the Kings Cross area who are not impervious to the reality of what goes on in Kings Cross. But the centre has been vigorously opposed consistently by surrounding businesses over a long period of time. Many of those businesses will have sold up and moved. The fact that all this time later only 68 per cent of business operators support the centre does no credit to the Government's promises regarding outcomes for the centre. The research I have seen relating to 2003 and, as I understand it, the most recent evaluation, which has been provided to the Parliament in time for consideration of the 2007 bill, shows that overwhelmingly once-only users use the centre. Obviously I do not mean first-time drug users. Those who use the centre will be frequent drug users and some of them will be only occasional drug users, but they tend to use the centre on only one or two occasions.
In other words, it is not, as was suggested to us in 1999, an alternative to the shooting galleries in Kings Cross. Indeed, the centre is better described as a tourist attraction. Many international visitors take the time to visit the drug injecting centre and many young people from the country will visit it. The statistic that it is overwhelmingly once-only drug users who use the centre is telling. In line with remarks made by the Hon. Charlie Lynn, improvements to many of the crime statistics—we have heard figures indicating fewer ambulance call-outs—relate not only to the heroin drought that occurred in that vicinity from around 2002 but also because of the fundamental shift in our drug culture away from heroin use and towards other drugs that are much cheaper, in particular ice and amphetamines. It is a shame that this was not acknowledged in the presentation of the bill. However, I acknowledge the supporters of the bill support it for noble reasons. They believe it saves lives and it assists us in the fight against drugs.
The Hon. Robyn Parker and Mr Ian Cohen typified this approach in their presentations. Because of the hope they have for vulnerable people, I will not criticise the approach they have taken to the bill. However, I do criticise the Government because the bill represents false hope. The injecting room has been open for so long and we are still talking about a trial, not a program. I would have preferred the bill to be presented as a program and a mandate for the injecting centre to continue ad infinitum. For the Government to present the bill to the House yet again as another four-year extension of a trial is an insult to my intelligence and to the intelligence of all members of the House. It is a program; it is not a trial any longer. It is farcical to continue to use the word "trial", as has been said by many previous speakers.
I do not understand why the Government wants to force the bill through the House on this occasion when we all know that we will be back to debate it all over again in 2011—just as we did in 2003. If the Government believes the room is a vital service in Kings Cross, why does it not just leave it there? Why do we have to go through this four-year farce of pretending it is a trial, when clearly it is not? I have searched the evidence supporting a case for the injecting room. I do not believe that the evidence is convincing. It has been claimed that the injecting room has saved 350 lives from overdoses. Reverend the Hon. Fred Nile expressed doubt about that statistic. Mr Ian Cohen's response was, "Well, you prove that it has not saved lives." That is not how the evaluation system works.
Harm minimisation is a valuable strategy. I do not oppose such a strategy, as perhaps other members who oppose this bill do. That is why I wanted to speak on the bill tonight. The needle exchange program has been extremely valuable and other measures that have been implemented through public health have reduced the degree of suffering and the flow-on of other diseases, particularly AIDS and hepatitis C. I support those worthy initiatives. However, I do not believe the injecting room falls into that category. If I were convinced otherwise, I would support it.
As other members have said, to save lives we must address the fundamental drug epidemic that is ruining a generation of young Australians. I do not believe this centre does that. The centre normalises, even glamorises, drugs, and sends the wrong message to young people. In that sense, it may have the opposite effect to that which is intended. Eight years of this injecting room being in operation has not changed the drug culture. The drug epidemic has moved on and intensified into the ice epidemic. This bill is ancient history. It fails to acknowledge that the whole drug culture has changed and we now face new problems. We are no longer in 1999, which is the year that has been snap frozen in time by this legislation. The centre has provided an opportunity to study and learn about the heroin epidemic. For the first time, the drug injecting centre has allowed health practitioners to study drug users and their self-administering of drugs. Such studies have had benefits, particularly in other drug education programs. But those accomplishments, as valuable as they are, are very much in the past.
The drug abuse issue has moved on. As the Hon. Charlie Lynn said, the centre has become institutionalised. The bill is not fighting for a continuance of the study, but rather a continuance of the centre's existence. The bill is not about a trial. I do not understand why the Government continues to pretend that it is. The Government has taken a weak and insipid approach in this legislation, and that typifies its weak and insipid approach to our drug problem. I regard myself as a philosophical Liberal with an open-minded attitude on many issues. But I draw the line on drug abuse in this country. Our approach is dangerous and shameful, particularly in New South Wales. The drug injecting room has become an excuse for inaction in other important areas.
When asked about the drug problem, the Government keeps referring to the numerous pamphlets it has distributed. Members would have heard me interject on many occasions when the Minister for Education and Training has talked about new initiatives arising from the Alcohol Summit and Drug Summit that throwing pamphlets at a problem is not a solution. The Government talks about the drug injecting room, then it puts blame on the Commonwealth and that is it. That is the Government's approach to the problem. As to initiatives in schools, we are still stuck on the same $5 million the Government first allocated in 1995, from memory, when funding equated to the cost of a postage stamp per child. These days such an amount is an insult and barely runs the bureaucracy that administers the school program. The Government's response to the drug problem is to take an insipid approach to a heartbreaking and difficult problem.
Although it may be argued that this centre does no harm, I see it as dangerous and a potential obstacle in the way of better measures that will address the drug epidemic. The centre is sending the wrong message. Worst of all, it is an excuse for the Government to not have a proper drugs policy. As I have said, the Government has not delivered on the high expectations and promises that came out of the 1999 Drug Summit and the 2003 Alcohol Summit. This bill maintains a discredited idea that must be discarded and we need to focus on new approaches and ideas. In 2003 I voted against this legislation and criticised the setting up of the room saying that it was not a trial. A trial has a beginning, a middle, an end and an outcome. I described the bill then as having a buck each way. Today I say it has gone beyond that, and should the bill pass through the Parliament we will be buck-passing. The bill preys upon the good intentions of members such as the Hon. Trevor Khan, who showed great compassion in his speech. I share his compassion for drugs users, but the bill does not deliver any solutions. That is the harsh reality and truth about this legislation.
With a forced Government vote, the bill will pass the House tonight. If all members were given a conscience vote, the bill would probably fail. I am sure there was robust debate in Cabinet as to whether this legislation should be brought before the Parliament again. I am saddened that the fraudulent concept of a 10-year trial is being forced through the House—a concept that will not bring about action but, ironically, will sustain inaction. I urge the Government to revisit the drug epidemic issue more fully rather than perpetuate a drug trial—a trial that has been perpetuated previously on many occasions. I am sickened by the stories I hear in the Parliament and the evidence I see on the street of drug abuse and tragic loss as a result of drug addiction. I am sickened by the Mardi Grass that takes place every year in Nimbin. I am sickened by the deaths on the road, particularly in my region of the North Coast where drug abuse has become part of the culture. I am sick of deaths in public toilets and I am sick of people dying in the gutter— which the Hon. Trevor Khan also referred to. This bill will pass at the expense of those deaths.
The bill normalises and lies about the drug problem. It is an excuse for inaction against the current drug problem faced by the community today. The farce of 2007 is even greater than the farce of 2003. The review provisions in the bill require us to debate this legislation again in four years time for the fourth time. The pathetic and tragic proposition condoned by this bill is a sad reflection on the Government's drugs policies. I make a broader comment and state that the Government's entire legislative program this session is timid. It seeks to fix embarrassing mistakes and it imposes new taxes and charges, but it lacks vision. The resubmission of this bill for a fourth time is indicative of the actions of a moribund government that has run out of ideas. I did not support the legislation in 2003 and I will vote against it again tonight.
The Hon. MICHAEL GALLACHER (Leader of the Opposition) [12.39 a.m.]: I speak on my own behalf on the Drug Summit Legislative Response Amendment (Trial Period Extension) Bill. It is not my intention to be critical of any member but, rather, to be objective, to be conscious of the views expressed by others and to be respectful of those views. However, in doing so I bring to this debate my personal experience of matters concerning the bill and present those as the basis for my decision on how I will vote. I commence my contribution to this debate by congratulating the Hon. Catherine Cusack on her very well-presented argument in explaining her position on this bill. I commend others also for their well-presented expressions of views on the legislation.
I do not believe that, because a member does not support this legislation, he or she therefore is not compassionate toward those who are addicted to drugs and involved in the drug trade. The debate is more about whether this legislation is taking us along the correct pathway to achieving the desired outcome by minimising the number of people who are affected by dangerous drugs and by instituting mechanisms whereby barriers can be placed in the way of the next generation—or any person for that matter—to prevent them from using illegal drugs. Over the past few years this House has heard much debate on the heroin injecting room, or shooting gallery as it has been called. The central point of this debate does not concern the injecting room itself but whether the injecting room has succeeded in its objectives and is therefore is deserving of further support by the Parliament and the people of New South Wales.
We have been told continually by the Government that the core objective of the injecting room is to provide a gateway to assist people to stop taking drugs. However, it has become a means by which people maintain their position in the drug culture—maintain the status quo—just as many in the past have maintained their position in relation to their use of methadone. As the Hon. Catherine Cusack stated, virtually no evidence exists of the injecting room reaching its core objective of providing a gateway to get people off highly addictive drugs. Nothing has been said by the Government on that point during the debate. Much of the debate so far has revolved around the number of lives that have been saved. As Reverend the Hon. Fred Nile rightly points out, how can we measure the success of the centre by statistics? How can we be sure that the figures are correct?
In my view the debate does not concern the ability of medical workers in the injecting room to resuscitate people who are affected by drugs. After four years of operation of the injecting room the debate is more one about whether the centre has lived up to its objective and provides a gateway to enable people to get off drugs once and for all. As I have said, no evidence has been presented by the Government to show that that is the case. The Parliament has been asked for an extension of the trial period. On a previous occasion an extension was granted to the Government because we were told that an extension was required to satisfy the scientific tests or experiments that would determine the success or otherwise of the centre. Although I have maintained a fundamental opposition to the concept, I was relaxed about granting the extension because at that time I believed that it would produce evidence to enable us to determine the success or otherwise of the experiment. I believed that the Parliament would be in a position to draw some conclusions on whether the objectives have been achieved by the centre.
Of course, we have nothing of the sort before us. All we have are the usual mantra and rhetoric about the number of lives that have been saved as a result of resuscitation and the excellent health care that is provided by professionals in the injecting centre. Nothing indicates that we have had significant referrals from the injecting centre to assist long-term users of drugs to beat their addiction. The Hon. Catherine Cusack referred to information of which I was not aware. She told the House that many users are just one-time or two-time users at the injecting centre. It is fair to say that those people are now somewhere else in the system and are possibly still addicted to one form of drug or another. That raises questions about the success or otherwise of attracting people to a safe area that is meant to be a gateway to curing addiction. If people use the centre on only one or two occasions and go elsewhere to use their drugs, it seems that the centre has not been able to achieve its objective.
Emotive arguments advanced in support of retention of the centre have suggested that the centre could be assisting one of us, a loved one or a family member. But it is important to understand more often than not those who use the heroin injecting centre to take amphetamines, heroin or other drugs are involved in serious assaults to obtain money to pay for their drug addiction. The victims and the families of victims of such assaults are traumatised because of the violence associated with such assaults. Sadly from time to time we hear of someone who has been killed by a person who was stealing money to satisfy their craving for drugs. We hear of someone's innocent loved one, someone's innocent child, being killed, maimed or assaulted by someone who is driven by drug addiction to commit serious criminal offences. For many years I was involved with people who had been methadone users. When methadone users and heroin users appear before the courts, they assure the sentencing judge or magistrate that, having been so heavily affected by drugs, they want to get off drugs and will do so if they are given one more chance. And it is no surprise that they spin the very same line before a different judge or magistrate at their next court appearance for drug-related offences.
Most members of Parliament have lost count of the number of times they have heard about people becoming the victims of crime as a result of someone trying to satisfy their craving for methadone or heroin. Perpetuation of the myth that somehow the attendance by drug addicts at the methadone clinic will provide a gateway to curing drug addiction fails to take into account the pre-eminent requisite for any person who goes to the injecting centre, the Salvation Army, the Wesley Mission or any other organisation providing treatment for drug addiction: the person must have a desire to cure himself or herself of their addiction. Is not as simple as drug addicted person standing before the Drug Court and declaring that they want to get off drugs. The person must take the first step; he or she must want to beat the addiction. Although drug addiction is probably the most devastating addiction of all, the first step to curing the addiction is similar to the first step taken by those addicted to alcohol or cigarettes: the person must sincerely want to give up drugs and not continue to use the same spin at repeated court appearances to avoid the predicament of penalty.
The Hon. Catherine Cusack correctly referred to changes in culture and the switch from heroin to amphetamine. Many users of amphetamine, methamphetamine and ice regard heroin as a dirty drug of the 1970s and 1980s—a drug that was used by the old scraggies who used to hang out at the Cross or in the park. Many young drug users think that methamphetamine is okay; that it has been made socially acceptable; that street names like ice make it trendy. That is the future challenge.
Of course, we hear nothing from the Government about this. The Hon. Catherine Cusack is correct in recognising the shift towards more domestic drug production and a home-grown or home-baked product. Much of that relates to the significant improvements in the efforts of customs authorities both here and overseas. There has been a significant move towards amphetamines by outlaw motorcycle gangs, who produce drugs within their network. Generally speaking, they do not bring in drug users from the outside as couriers because they are seen as weak links in the organisational structure. They maintain the drug production and distribution within their organisation. These highly organised outfits have a job security scheme to provide for dependents if a husband or partner is arrested for a drug-related crime and sent to jail for a considerable period. Dependents, whether they be partners or children, are looked after by the organisation.
The other point that is not lost on me is that many of the people involved in the drug trade do not want to take their chances travelling into South-East Asia to access drugs because the ramifications of being caught are far too serious. For that reason they have focused primarily on the domestic, home-grown product of methamphetamine, which is far easier and cheaper to produce, and which is equally addictive as crack cocaine or heroin was seen to be in the 1970s and 1980s. Australian heroin was always far stronger than the heroin produced in the United States and other western nations because it was not as severely cut in the production process as the European, American and British heroin. As a result, it was highly addictive. As I said, the move has been away from heroin towards locally produced drugs.
Mention was made of Mark Murdoch, the local area commander in Kings Cross. I have known him for nearly 30 years and I have a great deal of respect for him. I note that some quotes were attributed to him, and I am not in a position to test to their veracity. However, like a number of other honourable members, I have been there and I know that the place is an absolute mess. Anyone who suggests otherwise simply has no understanding of what is taking place in the central business district. I use that term cautiously because there is very little business going on in the area?that is, legitimate business or business that would be acceptable to the wider community. Any suggestion that there is a business boom in the area is ridiculous.
Honourable members should visit the area and have a look at what is going on. However, they should not go on the organised tour that no doubt members of the Government or some of the bureaucrats would be more than happy to conduct, showing everything nice and clean and welcoming with happy, smiling faces at the gallery. They should go unaccompanied and unannounced; they should go to the street behind the shooting gallery and look at the coffee cups strewn all over the place and have a sniff. They should look at the deserted shops and what has happened over the past few years in Kings Cross.
The Hon. Amanda Fazio: That is all Clover Moore's fault.
The Hon. MICHAEL GALLACHER: It interesting that the Hon. Amanda Fazio blames Clover Moore. She should take time to go there and speak to the last few remaining shopkeepers and ask them for their views. They do have things to say about Clover Moore, but they pale into insignificance compared with what they have to say about the honourable member and her mob. They have the Government well and truly in the crosshairs because of this legislation. As honourable members know, I have worked on the streets in an undercover capacity and I have seen what has happened. Over the past 10 to 15 years the changes to the environment of Kings Cross have been remarkable. I worked there and mixed with drug addicts and witnessed illegal activities; I saw it first-hand.
Years ago Kings Cross was renowned for a number of things. I am talking not about the sleaze but about the boutique clothing and jewellery shops, the banks and food outlets. The fruit and vegetable markets in the main street of Kings Cross outside the Lido—one of the recognised brothels in the area—were outstanding. We used to buy many legal, socially acceptable products, but those shops are all gone. What used to hide the sleaze and the drug culture that existed there has moved away. All that is left to see are the empty shops, backpackers' accommodation and the very small number of shops that rely on the passing trade. There is far from a real estate boom in the area.
It has also been suggested that people are no longer roaming the streets as a result of the establishment of the shooting gallery. That is completely false. The addicts walk in through the front door, which is innocuous with its grey windows, and come out the back door, usually armed with a cup of coffee with up to six teaspoons of sugar to keep them rolling. They go back onto the streets and hang around; they continue to move around the streets affected by the drug they have just injected. They have not overdosed, but they are still affected by the drug. They do not inject drugs to return them to normality; they inject drugs so that they can feel high or comfortable. The suggestion that when they come out of the shooting gallery they get on a bus or take a taxi to work or outside the area in many instances is false. They still hang around the area and can be seen there, particularly in the mornings and late in the afternoon.
The Hon. Ian Cohen spoke about his knowledge of drug use in the Sutherland shire as an adolescent growing up in Cronulla and the death of a close friend who died as a result of a heroin injection. The honourable member suggested it would not have happened if there had been a safe injecting room. The suggestion that flows from that is that there should be more injecting rooms. He also cited Nimbin and other places with a high incidence of drug use. I ask the honourable member to show me a suburb that does not have drugs use of this nature. There would not be a suburb that would not have some form of drug use. How does one determine that the level of use is high? Does it relate to the number of people using or the number of overdoses and ambulances call outs? Bondi has traditionally had a problem with heroin and amphetamines and according to the police drug use is rife in the eastern suburbs.
Honourable members should consider the impact on the local shopping centre of the establishment of the Long Jetty methadone clinic. It was turned into a ghost town and as soon as the Government moved the clinic to the local hospital businesses began to thrive. The Entrance, Port Stephens, Liverpool and Armidale all have recognised drug problems. I am not suggesting that these are the only towns or suburbs with a problem; every suburb would have a problem.
The Greens propose that injecting rooms be spread through suburbs that are determined to have high drug usage. That frightens me. I do not want places such as Bondi, The Entrance, Port Stephens, Liverpool or Armidale, to name a few, to have their own injecting centres. What is being played out on the streets of Kings Cross will be played out in those areas as well. The Greens need to reconsider their policy in relation to injecting rooms and make a decision that is in the best interests of the community. They should say no. The Kings Cross experiment has not met its objective, which is to provide a gateway. Therefore, the Greens should not suggest that other communities be subjected to what has occurred in and around Kings Cross.
Kings Cross is located within five kilometres of the Sydney central business district. Some of its real estate is worth an absolute fortune, but the place is a cancerous sore. There is no other way to describe how Kings Cross looks. Anyone who suggests that somehow everything is hunky dory there, and that the Kings Cross shooting gallery is not having an effect on the community, is being unrealistic. As I said earlier, one need only go there uninvited, sit down, have a good look around and talk to some of the businesspeople there to find out what it is really like. As members have probably determined, I am opposed to the extension of the trial of the Medically Supervised Injecting Centre.
When we talked about this some years ago, I said that the trial of the injecting centre was a modern form of an extension of methadone treatment. In my years as a detective I learned that methadone was a failure. I became sick and tired of talking to people who had committed crimes—break and enters, armed robberies, stealing from persons, or home invasions, one offence after another. At about 3 o'clock in the afternoon, mid-way through an interview, they would often say, "Look, I have to go to the methadone unit at Long Jetty to get my methadone." We had been told that methadone would get people off drugs. It did not; it just maintained the status quo. As I said earlier, it did not satisfy the first criteria, that is, that people wanted to get off heroin. When they eventually appeared before a court methadone simply provided them with an excuse for their criminality. They would say, "I'm sorry, I'm addicted to this drug. I won't do it again." Unfortunately, time and time again they reappeared before the court. I am happy to oppose the bill. Years ago I thought the trial was a failure. Until such time as the Government proves otherwise—and I do not believe it can—it will continue to fail.
The Hon. DON HARWIN [1.02 a.m.]: For seven years beginning in the early 1990s I lived within three kilometres of the Medically Supervised Injecting Centre in Kings Cross, and I certainly wanted the trial to succeed. During those seven years I experienced the drug problem in the area from many perspectives. My home was burgled three times. I was bashed in the street, almost certainly by people who wanted money for drugs. Because of a particular difficulty I had with the property I owned at the time—I had a night carter's lane that I could not secure—I had direct experience of people using my back yard for injecting, prior to the opening of the Medically Supervised Injecting Centre.
Despite coming from a family background which I would characterise as one with zero tolerance for drugs and despite having lived in that area, when I came into Parliament House to attend the Drug Summit, which was practically my first experience as a member of this place, I found it confronting. However, at that time I supported the trial of the injecting centre, because I wanted it to succeed. In 2001, when I again had a free vote, I supported a short continuation of the centre to enable a proper evaluation to be completed. In 2003 I voted against the trial, and I will vote against the Drug Summit Legislative Response Amendment (Trial Period Extension) Bill 2007. Evaluations have consistently shown that the trial has not met the objectives that those at the Drug Summit had high hopes it would meet.
I have read closely the evaluation reports as well as other material sent to honourable members. The latest evaluation report certainly makes it clear that the Medically Supervised Injecting Centre has not been a gateway to further treatment. Basically we are being asked to sanction a continuation of a program that will effectively cost $25 million over 12 years. The public health outcomes from that $25 million trial have not really been demonstrated. The report cannot say definitively that the public injecting problem has been reduced by the operation of the centre. A number of members have touched on this issue. As I foreshadowed in my remarks in 2001, the heroin drought has rendered almost impossible a proper evaluation of the success or otherwise of the injecting centre's objective of reducing the public injecting problem.
Claims made in this debate and elsewhere in that respect are hard to validate and hard for me to rely on as support for a continuation of the trial. I cannot do so. I am greatly concerned about material that has emerged as a result of freedom of information requests about the operation of the centre. The material shows a massive decline during 2006 in the number of people who inject heroin in the centre and an alarming increase in the number of people who are injecting ice there. Injecting any drug is dangerous, but injecting heroin is quite different from injecting ice. It has often been said that it is possible to maintain someone on heroin for a long time and that a heroin addict who has a maintenance dose can lead an almost normal life.
Ice is completely different. I am concerned that the injecting room is a long way from where we envisaged it would be when we gave support to the trial eight years ago. Between 15 and 20 years ago, when I was in my teens and early twenties, people used to say that marijuana was less harmful than cigarettes. We now know how wrong that was. We are only just beginning to understand how damaging ice will be in the long term, but we know that its effect can be absolutely catastrophic. I am very concerned about the increasing use of ice at the injecting room. In summary, I am disappointed that the Government does not have the courage to declare the injecting room a success. If the Government were to do that, it would be extending this model to other parts of the State where there are serious problems with public injecting.
I disagree with some of the remarks made earlier in the debate about the characterisation of Kings Cross. It is clear that Kings Cross is rapidly changing. One simply has to look at the development applications that have been lodged for the precinct to realise the extent to which it is an area under rapid transformation. That brings me to the provision regarding the centre's early closure. In a sense, the Government does not have the courage to admit that the trial has been a failure, and yet it has included the provision. At present the injecting centre is running at, in round figures, 70 per cent capacity. If it drops to about 50 per cent the Government will close the centre completely. As other speakers in the debate have said, not only has the nature of the drug problem changed; the clientele of the injecting centre has moved on as well. Kings Cross is a very different place, and that is one of the reasons why the centre is running at only 70 per cent capacity.
While some members have said that we will come back in four years time to debate all over again an extension of the trial, I believe that the centre will not last for another four years, because Kings Cross is changing so rapidly. My prediction is that the centre will be closed within the next four years, simply because the drug problem has changed and the clientele has moved on. If the Government regarded the centre as a success it might consider establishing it somewhere such as in Caroline Lane in Redfern, where there is a serious drug problem. But it is not investigating that, and it will not do so, because the amount of money involved in doing that would not deliver the required public health outcomes.
The bill will pass tonight. The Government supports it and the Greens have indicated their support for it, which means that it will pass through the House. My prediction is that this will be the last time we will deal with the issue. The trial, sadly—I mean that sincerely, because I had high hopes for it, as did others, including a number of my friends who put time into it—has not met its objectives and I believe that the centre will be closed and this will be the last time this House will deal with the issue.
Dr JOHN KAYE [1.13 a.m.]: I support the Drug Summit Legislative Response Amendment (Trial Period Extension) Bill 2007 and wish largely to echo the comments of Ms Lee Rhiannon and Mr Ian Cohen. First I congratulate all those who were responsible for creating the Medically Supervised Injecting Centre. Regardless of one's opinion of it, one must accept that those people were motivated by the very best of intentions: to save lives. I also congratulate those who operate the centre. Having met a few of them and spoken to them about what they do through the day and how they work, one cannot but be impressed by what they have done.
The evidence on the Medically Supervised Injecting Centre is absolutely clear: lives have been saved. About 350 people who are alive today would not otherwise be alive. At that point this debate ought to end. Once you have a scheme that saves lives it is difficult to say anything else about it. We need to value lives, and we do value lives. Regardless of whether they are people who use drugs or people who have other aspects of their lives that need to be addressed, we should value their lives, and we do value their lives.
The benefits of the Medically Supervised Injecting Centre go on. There is no doubt that there is reduced public injecting, which is both an amenity issue and a safety issue, and the streets are safer. The spread of blood-borne diseases, including HIV-Aids and hepatitis C, has been curtailed. Australia has an enviable record in controlling the spread of those diseases, and the Medically Supervised Injecting Centre has played a role in that.
The injecting centre stands at the crossroads of two very different views on how we should deal with the scourge of drugs in our society. One view involves prohibition, or zero tolerance, prosecuted through a war on drugs: the idea is that governments can control the use of drugs and the damage done by them by introducing ever-tougher laws. Unfortunately for those who support that concept, the war on drugs has been a massive failure. It has turned out to be a war on drug users, who are in many respects the victims of drugs rather than the perpetrators of the crime of drug use. The war on drugs has also been a failure because it has been expensive for our society, it has been expensive for the families of those who are addicted to drugs, and it has been expensive in terms of the damage it has done to the police force, law enforcement, and society in general. The war on drugs has also failed to produce a safer society.
As many speakers have observed, Australia is still awash with illegal and legal drugs. However, no amount of war on drugs seems to be able to address that. When we clamp down on heroin we create an increased use of methamphetamines. There is a fantasy idea encapsulated in the name of an organisation that many members have referred to tonight, the concept of a drugs-free Australia. I would like those who are working towards a drugs-free Australia to go to their local hotel or RSL club and say to the patrons there, "I am sorry, you cannot have your beer, you cannot have your wine, and you cannot have your spirits." To talk about drugs and a drugs-free Australia and not recognise that alcohol is responsible for the overwhelming amount of damage done by drugs in Australia—economic, social and personal—is to ignore the major component of the drugs issue within Australia.
The second view at the crossroads of which the Medically Supervised Injecting Centre stands is the one based on harm minimisation, which I would claim is evidence based. It focuses on the harm done by drugs and seeks ways to reduce that harm. It recognises that prohibition has been a failure. It recognises that people will and do use drugs, and it recognises that we as a society can do best by doing the things that will reduce the damage done by those drugs. The Medically Supervised Injecting Centre has been a successful expression of the harm minimisation view, and the Greens support its continued presence as envisaged by the bill.
I conclude by examining one argument that I find particularly problematic, that if we continue with a harm minimisation approach, if we continue with the Medically Supervised Injecting Centre, we are sending the wrong message to our young people—that somehow or other by having a medically supervised injecting centre that saves lives, that takes addicts off the street, it sends the wrong message. There are three reasons that the argument is wrong. First, there is absolutely no evidence to support that view. I have not seen a single piece of evidence that says that a medically supervised injecting centre creates a desire among young people to use heroin. Indeed, exactly the opposite applies. A medically supervised injecting centre—the name, the style and the clinical nature of it—is a total turn-off to young people who contemplate experimenting with injectable drugs, precisely because it stops it I conclude by examining one argument that I find particularly problematic, that if we continue with a harm minimisation approach, if we continue with the Medically Supervised Injecting Centre, we are sending the wrong message to our young people—that somehow or other by having a medically supervised injecting centre that saves lives, that takes addicts off the street, it sends the wrong message. There are three reasons that the argument is wrong. First, there is absolutely no evidence to support that view. I have not seen a single piece of evidence that says that a medically supervised injecting centre creates a desire among young people to use heroin. Indeed, exactly the opposite applies. A medically supervised injecting centre—the name, the style and the clinical nature of it—is a total turn-off to young people who contemplate experimenting with injectable drugs, precisely because it stops it from being forbidden fruit. Placing it into a hard, cold clinical environment takes away a big component of the attraction that exists for young people.
It has been argued that the Medically Supervised Injecting Centre will send the wrong message and that extreme judgmental attitudes and prohibitions somehow or other will drive young people away from using drugs. I wish it were true, but it is not. To the contrary, all that it does is to create the forbidden fruit that makes young people want to experiment with drugs. So, far from sending the wrong message, the Medically Supervised Injecting Centre sends a good message—that is, that we, as a society, care for all members of our community, regardless of what drugs they use or what trouble they find themselves in. We, as a society, will reach out our hand to them, help them to survive, help them to find time to assess their habits and their use of substances, and possibly find a better way. I commend the bill to the House.
The Hon DUNCAN GAY (Deputy Leader of the Opposition) [1.20 a.m.]: My Nationals colleagues and I oppose this bill. People who dislike our Prime Minister—and I am not one of them—
The Hon. Amanda Fazio: There are a lot that would.
The Hon. DUNCAN GAY: There are not that many. Those people said that the Prime Minister's stance on Tampa should be condemned. They referred to it in a derogatory way by stating that it was the Prime Minister's Tampa moment. Bob Carr, the former Premier of New South Wales, faced a certain situation in the election immediately preceding the Drug Summit. Suddenly the light bulb went on and he decided to hold a summit—a key plank in the final weeks of the election campaign. Immediately after the election we rolled into that Drug Summit.
Earlier the Hon. Don Harwin said it was one of the first occasions on which he entered the Parliament. He might not have known, but long-serving members who had been members of committees such as the Standing Committee on Social Issues and others met people involved in the drug networks and knew that the audience was handpicked. The greatest proportion of that audience was heading in one direction. The Government threw in people such as Major Watters and others to provide colour and movement.
Reverend the Hon. Fred Nile: And ridiculed him.
The Hon. DUNCAN GAY: And it ridiculed him. However, it would never have got the numbers. The Leader of the Government in this House, one of the key architects of the Drug Summit, has just comes into the Chamber. The Medically Supervised Injecting Centre—the key issue on which the Government hung its hat and which came out of the Drug Summit—was the centrepiece of that summit. The Medically Supervised Injecting Centre trial was extended and we have now been asked to extend it again.
If the trial had been successful in the first place the Government would not have sought a further extension. The trial would have been stopped and injecting rooms would have been located in Kings Cross and in other areas. We can be thankful that the first trial was a failure and that we do not have a preponderance of injecting rooms across the State. The Government is now asking for a third injecting room trial. If the first trial had been successful the Government would now be asking us to legalise injecting rooms and locate them everywhere.
Reverend the Hon. Fred Nile: The Greens will.
The Hon. DUNCAN GAY: The Greens will. Many people are keen to locate these injecting rooms in communities other than those in which they live. I spend part of my time in an inner city suburb of Sydney that one of my colleagues suggested tonight would be a good place for an injecting room. The families who live in the area that the Government has been trying to identify as a good site for an injecting room, the young couple with four children who live beside the site in Redfern where the Government wants to locate an injecting room, the family that lives next door to them, the family that lives two doors down, and shopkeepers in Kings Cross are not that pleased about it.
If the injecting room had proved successful we would be passing legislation to enable it to go ahead. It has not been successful and the Government cannot face the fact that it has a disaster on its hands. It cannot admit that the key thing it set out to achieve at the Drug Summit has been a failure. So we now have a further trial on our hands. That is why I oppose the bill.
Reverend the Hon. FRED NILE [1.26 a.m.]: The Christian Democratic Party opposes the Drug Summit Legislative Response Amendment (Trial Period Extension) Bill 2007. I commend Reverend the Hon. Dr Gordon Moyes for his earlier speech. We appear to be on a merry-go-round: once again we are debating the Medically Supervised Injecting Centre, which I still refer to as a shooting gallery. That is the way in which addicts refer to the place in which they shoot up heroin and other drugs. The object of this bill is to amend the principal Act:
(a) to extend the trial period so that it will finish on 31 October 2011, and
(b) to require a review of the economic viability of a licensed injecting centre in certain circumstances.
An usual aspect—perhaps the only positive part of the bill—is the inclusion of a review of the economic viability of a licensed injecting centre if service levels at the centre drop below 75 per cent of the level set in the new licence conditions. Responsible authorities will be entitled to revoke the licence if they are of the view that it is no longer economically viable. It is strange that only the economic viability of such a health facility is being judged and not whether it is medically viable or solving any drug problems. Is this a fallback situation to give the Government an opportunity to close the Medically Supervised Injecting Centre solely for economic reasons? If that is the case, so be it.
The Government referred to this as a trial because of the strong criticism it received from the International Narcotics Board for introducing this whole concept. I do not think such a reference has reduced criticism; that body has still been critical of the Kings Cross injecting room. I believe that the original purpose of this trial was to allay community concern, but it is an ongoing trial. It is the view of Dr John Kaye and other members that the Kings Cross injecting room has no effect on the war on drugs. I believe that it does: it sends a false message to members of the community and to young people that the Government is facilitating the injecting of a drug that is harmful and illegal.
Such a contradictory message undermines all the other things that the Government is doing to get young people off drugs. Earlier the Deputy Leader of the Opposition referred to the Drug Summit. I agree with him that the Drug Summit was stacked: a number of rational speakers such as Major Brian Watters and I were ridiculed by a number of delegates and by many in the audience. That showed a bias in the delegates that were selected to attend the Drug Summit and a collusion to come to certain decisions.
I still believe there was probably greater support on Labor's left wing for an injecting room than on the right wing. During the Drug Summit there was a strong push to approve a motion to establish five injecting rooms in Sydney. It seemed that would be going overboard and there would be much criticism. To satisfy the Labor left wing the Labor Government decided to compromise and have just one. The Labor Government ended up being stuck with it. I believe many members of the Labor Government are still not happy with the injecting room. They consider it to be a lemon and they would get rid of it if they could. They think that the economic evaluation could be a way to close it down.
As honourable members know, I have consistently opposed the concept of the injecting room. I have supported the approach of the Swedish Government. Some honourable members are critical of the term "drug-free". Sweden followed the Green party policies, was very liberal with its drug policies and legalised drugs. Because of its soft approach to drugs Sweden had massive social problems. At one stage the situation became so serious that all political parties, including the Green party, acknowledged that the drug policies had been a failure. All the parties came together and resolved to make Sweden drug-free with a national policy. In 2000 I spent some time in Sweden on a tour studying its drug-free program. The Swedish Government recognised that in adopting a liberal drug policy it had gone so far in the wrong direction it had to re-educate the whole society—teachers, police officers, politicians and all the leadership groups in the community—to convince them to change from a permissive attitude to a drug-free policy.
It was a remarkable success. Drug use rates dropped from the high levels we have in Australia—around 30 per cent—down to 3 per cent, and they gradually edged back to 9 per cent. The Government said it thought it had won the war and relaxed its efforts, but it did not realise it had to re-educate every generation and had to keep the motivation going for a drug-free society for each generation. If the Government relaxed, positive attitudes towards a drug-free society would start to slide backwards.
In Sydney Reverend Richard Raymond was in charge of the Wayside Chapel. He was very keen to provide an injecting facility and announced there would be a facility at the Wayside Chapel for injecting heroin. I knew that this was against the law so I contacted the police and the facility was closed down. The Government realised the only way such a facility could operate would be by legislation: the law would have to be changed because there was a two-year penalty for anyone assisting someone to inject a drug such as heroin, because it was against the law. That was why the initial bill was introduced to set up the injecting room.
I was shocked when it was announced that the injecting room would commence and would be run by the Catholic Sisters of Charity. I waited for some response by Cardinal Clancy but, as far as I am aware, he never issued a statement and he has been silent on the matter. I thought the only thing I could do was write to Pope John Paul, whom I met on two occasions in Rome. I wrote to the Vatican and asked whether it was aware the Sisters of Charity would be running an injecting room in Sydney. Within a few days a directive came to the Sisters of Charity ordering them not to be involved in the injecting room and to withdraw from the project. Sadly, the Uniting Church, of which I was a Minister at the time, stepped into the gap and said it would run the injecting room, particularly under the leadership of Reverend Harry Herbert, whose policies on drugs I totally disagree with. Reverend Herbert has a very different attitude from most clergy towards drugs. He has even advocated the decriminalisation of marijuana. He was quite happy to use his efforts and his department of the Uniting Church to run the injecting room, which it does to this very day.
As I travelled around the Uniting Churches I found no support for this decision. In fact, there was great embarrassment that members of their denomination were running an injecting room. It was not a popular decision within the parishes. I proved that by challenging Reverend Harry Herbert to have a referendum of the parishes of the Uniting Church so they could vote on whether the Uniting Church should be involved. He would not do that. He knew that if he did there would be an overwhelming rejection of the Uniting Church being involved. The Uniting Church would not let the grass roots have any say in that decision made by Reverend Harry Herbert and his department.
I undertook a study tour with my wife, which we called The Drug Epidemic and Solutions, to find out what was happening worldwide. We visited the United Kingdom, the United States of America, Sweden, Switzerland, Egypt, Bulgaria, Taiwan and Singapore. I particularly wanted to see what Asian nations were doing and how their policies differed from those of Western nations. I deliberately picked that range of nations. To sum it up, two nations have adopted almost opposite policies: Switzerland and Sweden. Sweden had tried the permissive approach, reversed it and then had a drug-free nation approach. Switzerland went in the opposite direction and is still going in that wrong direction.
I was quite shocked when I went to Zurich and visited the consumer rooms—they do not call them injecting rooms; they call them consumer rooms. There are about six rooms where people can not only bring their own heroin and have it injected; they can also be supplied with heroin. When I questioned the police and the authorities in Zurich City Council and read its policy documents it became very clear that they had a simple reason for allowing the consumer rooms to operate. They said that Switzerland is totally dependent upon tourism and the tourists get upset when they see young people injecting heroin. There was a big park where some thousands of drug addicts used to converge and use drugs. Many of them came to Switzerland from other nations because of its permissive policies. Consumer rooms were set up to get the drug addicts off the streets. The policy had nothing to do with rehabilitation and reducing the harmfulness of heroin; it was simply a policy so that tourists travelling to Switzerland would never see drug addicts.
As soon as the police identified an addict on the streets that person would be collected and delivered to a consumer room, where he or she could be completely doped up. It would not affect the tourist trade because people would not be lying in the gutters and so on. To me that was a self-centred policy to simply protect the reputation of the city and the country. They did not care about a person's lifetime addiction. Young people were virtually being put into a position where they would be addicts for the rest of their lives. There was even a discussion about drug addict villages, where addicts could go when they reached middle age and older. They could live in a community and have drugs as drug-addicted old-age pensioners. What kind of lives would those people lead?
I acknowledge that, in spite of its permissive drug injecting room policy, the Government is moving slowly in the direction of the Swedish model. In Sweden the police take anyone who is identified as having a drug problem to an assessment centre run by social workers. They make an assessment as to the seriousness of the addiction. Addicts are then taken to a drug court, which has the power to order them into compulsory rehabilitation programs that have proved extremely successful. Some people claim that people cannot be forced into drug rehabilitation programs, but that is the basis of the Swedish policy. Compulsive drug rehabilitation programs work. I know because I visited the centres and talked to addicts.
I have commended the Government previously for establishing the Drug Court—which is a step in the right direction—and, more recently, the Nepean Hospital trial of coercive treatment of serious drug addicts. Those projects are nibbling at the Swedish solution, and I am sure they will be successful. The Drug Court has already proved to be a success and I am sure that the Nepean Hospital trial will achieve good results. The long-term success of such programs depends on the people who run them. They must have special qualifications, including a caring attitude. The Swedish program succeeded mainly because the social workers who ran the program were selected carefully. They identified with the drug addicts and cared for them. The young male and female nurses and social workers were like brothers and sisters to the addicts in their care. They spent nights with addicts who were suffering withdrawal. I was most impressed with their commitment. That was a key part of the program and the reason that so many drug addicts were rehabilitated successfully.
Other members have provided evidence of the failure of the injecting room. The Government had four objectives for the centre: to decrease the number of overdose deaths, to provide a gateway to treatment, to reduce the number of discarded needles and discourage users from injecting in public places, and to help reduce the spread of diseases such as HIV and hepatitis C. I believe the injecting room has failed on all counts. Diseases such as HIV and hepatitis are prevalent in the areas surrounding Kings Cross. For example, the eastern suburbs health region has an extremely high level of HIV and hepatitis infections. So the Government cannot claim that the injecting room has been a success.
I will not repeat arguments that other honourable members have made already in this debate. I simply put on record my opposition to the injecting room. A few months ago I had a meeting outside the injecting room with a number of ex-drug addicts who are associated with an organisation called Victory Outreach International. It is a worldwide organisation comprising thousands of ex-drug addicts who have been cured and who have compassion for other addicts. They are establishing rehabilitation centres around the world. There is one in the Fairfield area of Sydney, one in Brisbane and another in Melbourne. The organisation is similar to We Help Ourselves in that drug addicts are helped by ex-drug addicts who empathise with their problems.
The young men and women from Victory Outreach International told me they would happily volunteer to run the injecting room as a rehabilitation centre. The Government could save millions of dollars if it made the courageous decision to keep the facility open not as an injecting room but as a rehabilitation centre. The young ex-drug addicts could meet addicts on the street, build a relationship with them, take them back to the rehabilitation centre, give them moral support and help them to get off drugs. Addicts could then move from the rehabilitation centre to a residential program at Fairfield and elsewhere. Drug rehabilitation does not happen overnight; it takes months for a drug addict to get clean. I encourage the Government to have faith and trust. I urge it to turn the Kings Cross shooting gallery into a rehabilitation centre run by ex-drug addict volunteers. I oppose the bill and call for the establishment of a rehabilitation centre in Kings Cross.
The Hon. GREG DONNELLY [1.45 a.m.]: The Drug Summit Legislative Response Amendment (Trial Period Extension) Bill is a Government-sponsored bill and, as a representative of the Government in this House, I will support it. I do so, however, with a sense of unease and anxiety. Those who know about my involvement in the Australian Labor Party will be aware that I have argued—obviously unsuccessfully—the No case with respect to illegal drug injecting rooms. My advocacy against them goes back to the 1990s, when I served on the Australian Labor Party New South Wales Branch Health Policy Committee. As I have indicated that I am supporting the bill I do not believe it is appropriate for me to take up the time of the House detailing reasons why I am anxious about doing so. I confirm that I share some of the concerns expressed by other speakers in this debate.
I will conclude my remarks with a small anecdote. In March this year I represented the Minister for Health at the Phoenix Unit Reunion Dinner at Forestville. The Phoenix Unit is a 28-day drug and alcohol rehabilitation unit located at Manly Hospital. The unit has been operating for 14 years, and the annual reunion dinner is a celebration of the recovery of clients who attended the unit. About 130 people were at the function. I spent the evening until about 10.00 p.m. speaking with people who had passed through the rehabilitation program or who were currently enrolled in it. I was also fortunate at dinner to sit across the table from Dr Stephen Jurd, the founder of the Phoenix Unit.
What struck me in all the conversations I had was that, more than anything, in their heart of hearts, those who had an addiction knew that it was something they had to overcome themselves; nobody could do it for them. They also understood that a person cannot be a little bit addicted. Each individual knew that tomorrow could be another day when they remained clean or, alternatively, they could slide back into their addiction—a dreadful scenario. For them all it was a matter of one day at a time. Despite their human frailty—the temptation—they picked themselves up when they fell down. They all knew that there was only one way forward.
I sincerely hope that as a Government we are able to support comprehensive rehabilitation programs like that offered by the Phoenix Unit at Manly Hospital and offer them not just to those who have a illicit drug addiction problem in and around Kings Cross but across the State. It is through such programs that the lives of individuals are truly changed and that the addiction and human misery associated with it are put behind them. As a Government, we must stand by these people and help them get out of the living hell that drug addiction has turned their lives into. They deserve no less.
Ms SYLVIA HALE [1.49 a.m.]: During my four years in this place I have been dismayed to watch a Labor Government undoing so much progressive legislation in a whole variety of areas. It has changed planning laws, undermined key human rights, reversed of the onus of proof, disposed of public assets, changed laws on brothels, and proposed desalinisation plants. This Government has a record of retreating from progressive social measures. Indeed, in the area of addiction the Government has passed bogus legislation with respect to the introduction of smoke-free areas in pubs and clubs. In the undoing of progressive legislation the Government has been supported, generally to the hilt, by its Opposition partners.
The PRESIDENT: Order! I remind the Hon. Charlie Lynn that all interjections are disorderly and invite a response. He should desist.
Ms SYLVIA HALE: I am pleased that for the moment the Government has chosen to stand firm on this issue because no-one can deny that the exchange of needles and injections in dirty conditions in furtive back lanes has resulted in harm and death from AIDS, hepatitis C and other infections. It is bad enough that people should be addicted to drugs; it is worse that the conditions that facilitate the condition increase the chances of people dying or suffering accidental harm.
It is irrelevant that the Medically Supervised Injecting Centre is not operating at full capacity. The fact that it is operating and is providing clean, hygienic facilities for some addicts is justification enough for its existence. However, I am disturbed that by focusing on its economic viability rather than on its record of minimising harm the Government may be laying the basis for backing away from a genuinely positive initiative that has saved people's lives. Together with my Greens colleagues I am pleased to support the bill.
The Hon. PENNY SHARPE (Parliamentary Secretary) [1.51 a.m.], in reply: I thank honourable members for their considered contributions to the debate on the Drug Summit Legislative Response Amendment (Trial Period Extension) Bill 2007. I do not intend to respond to every issue raised but a number of members have asked the Government to respond to certain matters and I shall do so. Basically, the purpose of the bill is to continue to trial the Medically Supervised Injecting Centre for a further four years so that the trial will conclude on 31 October 2011. This will enable the centre to continue providing a service for a group of marginalised long-term drug users with significant health and social problems who have either failed drug treatment or never sought treatment.
The bill set out clear parameters for the continuation of the trial. For the first time they include a provision that if the average number of client visits at the centre falls to 75 per cent of current levels there will be a review of the need for the centre and its economic viability to determine whether the licence should be revoked. Ms Lee Rhiannon asked about this and I can confirm that it is not a condition of the licence specifically and it does not mean automatic closure. However, it will trigger the need for a review if the level of use drops.
The independent evaluators have provided considerable evidence to show that the centre is meeting the Government's objectives. As there has been considerable debate about the evidence, I shall place some of that on the record. The federally funded National Centre in HIV Epidemiology and Clinical Research has undertaken systematic research into the operation of the Sydney Medically Supervised Injecting Centre from its inception in 2001. Its latest findings were released in June of this year and all its reports are publicly available on the web.
Contrary to the material circulated to members by Drug Free Australia, which is based on the distortion of outdated evidence, the National Centre in HIV Epidemiology and Clinical Research has concluded that the Medically Supervised Injecting Centre has been successful in reaching long-term drug users, public and high frequency injectors, homeless injecting drug users and those engaged in sex work. It has provided nearly half of all registered clients with injecting and vein care advice, an important achievement as recent studies show that poor injecting technique is independently associated with syringe sharing and HIV and hepatitis C infection. It has acted as a gateway to drug treatment by providing one in ten clients—11 per cent—with a referral to drug treatment in the first five years of operation. It has targeted those clients at highest risk of drug-related mortality and morbidity for referrals to drug treatment. It has targeted, via the brokerage referral scheme, particularly marginalised and at risk injecting drug users, including those in unstable accommodation, resulting in 84 per cent of clients attending the referred service. It has increased drug treatment referral rates with the introduction of a case referral coordination position. It has facilitated the uptake of drug treatment among treatment naive injecting drug users, with almost a third of all drug treatment referrals made to clients with no previous history of drug treatment; and potentially it has averted up to 234,000 public injections in five years through the provision of an accessible and safe injecting environment.
I turn now to matters raised by honourable members. With respect to breaches of international drug treaties and conventions, the Government believes that the centre complies with Australia's international treaty obligations. The Government obtained legal advice to this effect prior to the opening of the centre, and its most recent legal advice is that continuing the trial at the centre will not be in breach of any international treaties. It is important to note that the report of the 2002 United Nations Office of Drug Control concluded:
It would be difficult to assert that, in established drug injection rooms it is the intent of parties to actually incite or induce the illicit use of drugs ? or even more so ? to be associated with, aid, abet or facilitate the possession of drugs.
Honourable members mentioned referrals. Independent evaluation report No. 3 of March 2007 found:
MSIC provided referrals to treatment for drug dependence to 11% of clients. The more frequent attendees at the centre were more likely to be referred for treatment and take up the referral.
It is important to note that drug treatment referrals from the centre are made to a range of facilities including Odyssey House and the Salvation Army. In reply to whether there is a honey pot effect on crime and drug use in the Kings Cross area, there is no evidence from the independent evaluation that the centre has had the effect of drawing drug users and dealers into the local area or caused any increase in local property or drug-related crime. On 21 December 2006 the Director of the New South Wales Bureau of Crime Statistics and Research reported there was no evidence that the centre has had an adverse impact on drug-related crime. This is supported by the fact that, as similar to downward long-term crime trends statewide, the independent evaluation reported that crime trends have also gone down in Kings Cross.
In reply to Reverend the Hon. Dr Gordon Moyes, trained medical staff at the centre closely supervise clients and supervise the substances being used. People using the centre are asked what drug they intend to use and whether they have used any substance in the past 24 hours. More important, intoxication is one of the criteria for exclusion from the centre. Far from encouraging dangerous experimentation, the latest evaluation results suggest that the centre's clients are taking fewer risks and experiencing fewer overdoses.
The evaluator found that 77 per cent reported improvements in injecting practices since registering at the centre, including 54 per cent reporting they were less likely to share injecting equipment; clients have received advice on safe injecting practices, drug and alcohol counselling, and information and advice on drug treatment on more than 29,700 occasions; and the overdose rate for heroin-opiate use has decreased from 9.2 per 1,000 visits in the centre's first 18 months of operation to 7 per 1,000 in 2007.
In reply to whether the centre is a honey pot for ice, the New South Wales Government closely monitors any changes in drug use trends within the centre. Over the past six years the primary drugs injected at the centre have been 62 per cent heroin, 14 per cent cocaine and 12 per cent prescription opioids. The use of amphetamine and methamphetamine by the centre's clients has slowly increased from 3 per cent in mid-2002 to 7 per cent in 2007. This arguably reflects increased use in the community and may also be due to a reduction in heroin availability as people substitute their drugs. However, the rate remains low compared with other drugs used and the trend appears to be stable.
The Deputy Leader of the Opposition asked about more centres. The Government remains committed to one centre, as provided in the legislation. Kings Cross is unique and has a long history as an illicit drug area, with high levels of drug overdoses and a transient population. The other matters have been well canvassed in the report. The Government continues to do everything it can to eliminate drugs from our society, with tough policing and law enforcement. The outcomes of the Drug Summit have continued to expand beds and treatment across the State. In light of the Government's commitment to evidence-based drug and alcohol policy, it will continue to carefully monitor the trial and look at it again in four years time. Given the late hour, I will not seek to continue the debate.
Debate adjourned on motion by the Hon. Penny Sharpe and set down as an order of the day for a future day.