Drug Summit Legislative Response Amendment (Trial Period Extension) Bill
Page: 3438
Second Reading
Debate resumed from 5 September.
Mr O'FARRELL (Ku-ring-gai—Deputy Leader of the Opposition) [10.00 a.m.]: While I lead for the Opposition, I make it clear that the Liberal Party has decided that this will be a free vote for its members. So I speak as the honourable member for Ku-ring-gai in this place, not as the Deputy Leader of the Opposition or as shadow Minister. I welcome this debate, as I welcome the opportunity to assess the aims of the heroin injecting centre against the final report of the evaluation committee. I welcome it because it allows the findings and issues that essentially have been omitted from the public debate to be raised. I shall start by looking at the stated aspirations of the medically supervised injecting centre [MSIC]. Among the most often stated reasons used by promoters to support the facility was the hope that it offered to heroin users access to rehabilitation. The Premier told the Daily Telegraph on 28 July 1999:
The point about this is to get heroin use off the street … and to get people into an environment where treatment is part of it [the environment].
On 21 June 2001 he told the House:
It is a way of introducing people who are taking unsustainable risks with their lives to the possibility of rehabilitation and treatment.
A year earlier, on 2 May 2000, the Special Minister of State had told the Legislative Council:
The aims of the centre are to save lives, provide a gateway into treatment and counselling …
He further said:
… one of the most important criteria is to ensure the medically supervised injecting room in its trial form as a gateway to treatment. The Government is working … to ensure the centre will be supported by a mix of services, and that referrals are progressed in a systematic, timely and efficient manner.
That statement reflected two earlier statements the Minister had made in the Council. On 23 September 1999 he said:
There is consensus about the problem, about the urgency to deal with it and about the two core issues—the punishment of drug dealers and the rehabilitation of drug addicts.
On 21 October of that year he said:
Two fundamental principles stood out. The first is that people who have become drug dependent for whatever reasons or whatever circumstances deserve our compassion and assistance to end their drug use and resume a more healthy life.
I re-read the debates, media releases and media stories in endeavouring to decide what I would say in this debate. I had them in mind when I read the Medically Supervised Injecting Centre Evaluation Committee's 214-page report entitled "Final Report of the Evaluation of the Sydney Medically Supervised Injecting Room". I was looking to assess the report against the aims set out for the facility by the Premier and his Special Minister of State, especially in relation to the referral of users to rehabilitation services. I am disappointed in what I found, and I am appalled by the shifting of ground on the rehabilitation and referral issue by the Premier and the Special Minister of State. These issues are principally dealt with in chapter 5 of the final report, although, to be fair, there are references to them throughout the report. On page 8 of the report the Executive Summary states:
• Uptake of referral
o Around half of the 1385 referrals were made in writing and, of these, 20% were confirmed to have resulted in the client making contact with the specified agency.
o The MSIC provided referrals to treatment for drug dependence for 11% of clients. The more frequent attenders at the MSIC were more likely to be referred for treatment and take up referral.
The Minister's media release announcing this legislation stated:
1385 written and verbal referrals were provided to 577 clients. A referral card system required the drug user to retain the card and give it to the medical service. The medical service was then asked to mail it back to the evaluators. Of 534 referral cards issued, 20% came back.
The use of statistics is confusing—and, I suggest, deliberately so—because on any reading the final evaluation report does not support the hopes of either the Premier or the Minister that the facility would act as a "gateway to treatment" or provide "rehabilitation of drug addicts" or "assistance to end their drug use". A key target of this trial has failed to be met. Chapter 5 makes clear that only 15 per cent of the facility's clients were provided with written or verbal referrals to all types of referral services. Of these 1,385 referrals, only 601, or less than half, were for drug treatment, that is, for drug rehabilitation as opposed to referral for sexually transmitted diseases testing or social welfare assistance; 300 of those 601 drug rehabilitation referrals were written referrals involving the referral card system; and only 49 cards, representing just 16 per cent of all written referrals, were returned to confirm that clients had turned up for treatment.
Reading chapter 5, it is hard to determine how many clients are represented by that latter figure. Oddly, the number of clients represented by those 49 returned referral cards is not given, and I note the Minister in his release stated that 577 clients received 1,385 referrals, which suggests that a client could have received multiple referrals. However, to be generous, it can be concluded that the evaluation report finds that, out of 3,810 people registered to use the facility, fewer than 50 are confirmed as attending drug treatment referral appointments. That represents just 1.3 per cent of the facility's clients.
By no stretch of anyone's imagination can the MSIC be seen as successful in meeting the Premier's desire that it "introduce people who are taking unsustainable risks with their lives to the possibility of rehabilitation". Without labouring the point, there are two other issues I want to deal with. The chapter's authors make reference to "methodological limitations" on their study results. Given the findings of chapter 5, I am not surprised that there is within the report an attempt to divert attention from them. But I note that, in announcing the centre and its trial in 1999, the Special Minister of State declared:
The committee's greatest challenge will be the development of transparent evaluation methods for the extent to which the injecting room contributes to rehabilitation and treatment of addicts.
I do not think the authors or the committee can have it both ways. They cannot seek to discount findings that are adverse to the trial by claiming problems with measurement methodology when the Minister charged them with the responsibility for developing a workable measuring system before the trial commenced. Last week I heard the centre's director, Ingrid van Beek, interviewed by Sally Loane. In responding to statements by a group questioning the centre's efficacy, and Ms Loane's questions about how aggressively the centre advocated rehabilitation, Dr van Beek noted that when hosting "240 visits a day", "one every three minutes", "we don't necessarily approach each and every person" about rehabilitation. That underscores my concerns about this facility. It is more about managing an existing heroin problem than seeking to reduce the extent of the problem by providing a gateway to services where addicts can seek advice on ending their addictions.
On Dr van Beek's own admission, the demand upon services works against the centre's ability to offer rehabilitation to clients. There is more than a faint echo of the experience with the State's methadone program in that admission. Setting aside meeting the rehabilitation criteria set out for the centre and the trial by the Premier and the Special Minister of State, I viewed the rest of the report from the point of view of the other goals set for it by those advocates. But again the reader is confronted with the difficulty of assessing the study's findings. For instance, the issue of overdose and preventing overdose deaths was a major factor for those arguing for the facility. On page 61 these paragraphs appear:
3.4.3 Interpretation and implications
Prevention of heroin overdose deaths was a major argument put forward for the establishment of the MSIC. The expectation, however, that any single facility operating for a third of the day could prevent a large number of deaths was optimistic.
Initial analyses of ambulance attendances at opioid overdoses across the years 1995-2002 provided no evidence that MSIC had decreased opioid overdose events occurring in the community. There was, however, a large decrease in opioid overdose events attributable to a reduction in the availability of heroin which was sustained in the Kings Cross drug market throughout 2001. Secondary analyses of the number of overdose events occurring in the other major Sydney drug market, Cabramatta, and across the rest of NSW specifically showed that the heroin shortage did not reduce the number of deaths occurring. There was a further reduction in the number of overdose events around the time the MSIC opened but the fact that the same trend occurred in Kings Cross and Cabramatta, one of which did and the other which did not have a MSIC, suggests a continuing effect of the heroin shortage rather than an effect of the MSIC.
Further analyses of the pattern of ambulance attendances at opioid overdoses through the 24 hours of each day also provided no evidence that MSIC had decreased opioid overdoses. If the MSIC were exerting a specific effect on overdose events in the community one would expect to see a reduction in overdose events when the MSIC was open for business (8 to 10 hours per day) and no such reduction when the MSIC was closed. The analysis of the effect of the MSIC on the pattern of ambulance attendances during the MSIC opening hours in the Kings Cross area showed no detectable impact on opioid overdoses.
The data suggests that the opening of the MSIC occurred at the same time as a reduction in opioid poisoning presentations at St Vincent's Hospital and Sydney Hospital. It is likely that the reduction in opioid poisoning presentations at St Vincent's and Sydney hospitals were part of the general trend associated with the heroin shortage (as was observed in the ambulance attendances time series in the rest of NSW and in Cabramatta).
I challenge anyone reading this section of the report to reasonably conclude that it was the MSIC—whose operations we are asked this morning to extend for four years—rather than the heroin drought, that was responsible for the recorded reduction in opioid poisonings over the period of the trial. But still the centre's supporters, ministerial and other, make media claims about the centre's continuing success in this area. I should note, however, Minister Della Bosca's release of 1 September where truth surely sought to shine out through his statement that "Importantly, the report found the trial made nothing worse..." While a number of people would dispute that claim, it is in terms of the Carr Government ministry less than a resounding endorsement for a project that had the combined muscle of the Premier and Mr Della Bosca behind it. It is a one on a political Richter scale where Carl Scully's claim that he was a good Transport Minister makes it a ten. I want to conclude using the Special Minister of State's own words. On 21 October 1999 John Della Bosca told the Legislative Council:
... the Government remains committed to the view that self-injection of addictive substances cannot be normalised, and must be rejected as a behaviour on social, health and moral grounds.
This view I wholeheartedly support. The Minister went on:
There will be medical supervision in clean and hygienic conditions.
That certainly occurred during the trial. The Minister continued:
The model that will be trialled for 18 months aims to save lives and reduce the spread of disease...
This report does not support that claim. There is an absence of evidence to allow anyone to conclude that the centre, and not the heroin drought, is responsible for the reduction in heroin overdoses. On that occasion Mr Della Bosca went on:
… but especially focuses on providing a gateway for referral to treatment and counselling.
Neither the report nor Dr van Beek's statements support such a claim for this facility. The Special Minister of State said in 1999:
Its effectiveness will be clinically assessed on all those grounds.
The report itself raises questions about the centre's clinical assessment despite the Minister charging the evaluation committee to develop a transparent evaluation method before even starting the trial. The Minister went on to say:
This is a centre for rehabilitation, a centre for treatment, a centre for counselling and referring—it offers a gateway to treatment.
The report offers no such evidence. Fewer than 50 people referred to drug rehabilitation were confirmed as turning up. And with a client presenting every three minutes, how on earth could the facility do so? Less than 1.3 per cent of the centre's registered clients were referred to drug treatment and actually turned up for that treatment. Finally, Mr Della Bosca stated:
It offers to those who have reached the extreme end of injecting drug use a continued option for rehabilitation and treatment.
Sadly, regrettably, unfortunately, this report makes it clear that that statement is not true and, on the basis of this report, that goal has not been met. If trials and evaluations mean anything, if they are genuinely meant to determine public policy and the allocation of scarce public resources, their results should be critically examined and not simply used to support a predetermined position. I oppose this legislation because that is what any study of the evaluation report demands. I also oppose it because of my concerns that the State's harm minimisation policy pays too little attention to advocating no drug use and rescuing people from drug addiction and too much attention to managing addiction. Finally, I oppose this legislation—as I did in 1999—because I do not think there is any safe level of drug abuse and, however dressed up, a legal medically supervised injecting centre sends the opposite message.
Ms KENEALLY (Heffron) [10.18 a.m.]: The medically supervised injecting centre at 66 Darlinghurst Road, Kings Cross, was established as part of the Government's new approach to drug policy following the 1999 Drug Summit. The focus of the summit is clear: prevention, education, treatment and law enforcement. The injecting room seeks to reduce supply, reduce demand and reduce harm. The injecting room at Kings Cross is a specific response to a specific need in a specific community. It is not meant to be a solution for all drug users or a solution for all communities. The Drug Summit recognised that no one approach fits all. The outcomes of the Drug Summit saw the Government fund abstinence-based approaches, methadone and other similar treatments.
The medically supervised injecting centre at Kings Cross was established as a trial. This bill seeks to extend that trial for a further four years. The bill amends part 2A of the Drug Misuse and Trafficking Act to extend the trial so it will finish on 31 October 2007. The bill will also make sure that a review of the operations of the centre and the legislative framework is finished by May 2007. The Government's approach to drug policy is evidence-based, and the recent evaluation of the medically supervised injecting centre made the following findings: that the operation of the centre is feasible in Kings Cross; that the centre made service contact with its target population, including many who had no prior treatment for drug dependency; that a small number of opioid overdoses managed at the centre may have been fatal had they occurred elsewhere; that there was no overall loss of public amenity; that there was no increase in crime; that the centre made referrals for drug treatment, especially among frequent attendees; and that the centre afforded an opportunity to improve knowledge that can guide public health responses to drug injecting and its harms.
It is important to note the client profiles and the gateways to treatment aspects of the injecting centre. Some of the clients of the centre are being referred to rehabilitation services. In the 26 months to June 2003, 79 referrals were made from the centre to residential rehabilitation. Referrals are also being made to detoxification and drug treatment—233 referrals to detoxification, 156 to methadone treatment and 250 referrals to other forms of methadone-related treatment. This is not surprising when one considers the profile of a typical client who came to the injecting centre. The profile is of a 31-year-old male, high-risk injecting drug user, who has been injecting for many years—most of them for more than 12 years—and who has either previously failed drug treatment or who has never been in drug treatment before.
Most of these clients did not complete secondary schooling, and 43 per cent did not complete year 10. Social Security was their main form of income. About half the clients had injected daily or more in the past month and about 40 per cent had injected in a public place; 44 per cent had previously overdosed; 60 per cent, roughly, had been in drug treatment at some time and failed; more than 1,000 attendees at the centre had never been in any form of drug treatment; 26 per cent had been in prison in the previous 12 months and 25 per cent of these clients returned 11 times or more. We are talking about people who lead very chaotic lives, people at the margins of society who do not have traditional pathways or gateways into treatment.
The evaluation that was set up to track the referrals and whether or not further treatment was sought was a complicated process that relied on a card that was given to the client and which had to be taken to the treatment centre. It was quite complicated for people who have chaotic, non-traditional lives. It suggested that the number of referrals may be quite high and it may be that the evaluation process does not reflect accurately the number of people who received treatment. Privacy laws made it difficulty in some cases for the evaluators to follow up on whether the clients received treatment. So, while the statistics may not indicate an overwhelming uptake of treatment services, the injecting centre is providing, for a very marginalised part of the population, opportunities to access services.
In some sense we may need to look at whether the evaluation of the effectiveness of the injecting room has been adequate. Part of extending the trial of the injecting room for a further four years will involve the appointment of a special case manager, who will build relationships with clients who come to the centre. We know from the statistics that the more often people visited the centre the more likely they were to follow up with treatment and additional services. If we get someone in the centre whose job is to build those relationships, to take a proactive approach with the clients and with the local community, and to monitor that, we may see an uptake of services for people who do not have any other traditional way to access them.
The evaluation took place over the first 18 months of the injecting room's operation. This was a start-up period. Many other distractions were in place, not the least being the media spotlight on the injecting centre. If we are able to evaluate it over the next four-year period, when it is established, well-running and working for that marginalised part of the population, it is worthwhile to continue this trial. There is majority community acceptance of the initiative in Kings Cross. Prior to its opening 68 per cent of residents expressed agreement with the centre's operation, and 58 per cent of the business community approved of it. Those figures have now increased to 78 per cent and 63 per cent respectively. I would like to see the centre continue. The injecting centre is meeting the needs of some of the most marginalised members of the community. It is not a panacea for all drug problems. It is not a solution that will fit all communities, but it is part of a package of initiatives that this Government put in place after the Drug Summit. The evidence we have merits a further four-year trial of this medically supervised injecting centre.
Mr STONER (Oxley—Leader of the National Party) [10.27 a.m.]: I oppose this legislation. The National Party has chosen to have a free vote on this issue, but interestingly, with a free vote, every National Party member of this Assembly has come to the same conclusion—that the legislation ought to be opposed, and for some very good reasons of which I will enlighten honourable members. Through the Drug Summit Legislative Response Amendment (Trial Period Extension) Bill the Government seeks a further four-year trial. The title of this bill is a misnomer. It ought to be the Drug Summit Legislative Response Amendment (Extension of Social Experimentation) Bill, because, simply put, this is not a trial. How long is a piece of string? How long does a trial have to go on before one recognises that it is not a trial, it is something that has been put in place and is set to continue? We were told in 1999 that the trial would go on for 18 months. Last year we were told there would be an extension of the trial until after the March 2003 State election.
Now we are asked again to endorse a further extension until after the 2007 election—that is, in 3½ years time. We are looking at a total of more than seven years of this so-called trial. This could have been well and truly evaluated. We could have made a firm judgment on the success or failure of this experiment by this point and certainly well within seven years. The Government is attempting to hoodwink the public by continuing to extend this so-called trial, but it is definitely more than a trial: it is a continued experiment by this Government. It is asking the taxpayers of New South Wales to commit a further $2.4 million per annum, which, over four years, is another $9.6 million when the evaluation report shows clearly that the medically supervised injecting centre [MSIC] is of questionable benefit.
The evaluation report is highly contentious on a number of fronts. I have some correspondence from a group called Drug Free Australia, which has undertaken some very extensive research. I have all the references, which I will not go into, but I will summarise some of the research findings. The most conservative estimates from national statistics on heroin use and overdoes indicate that nationwide there is one overdose fatality for every 45,000 injections. Yet the injecting room supervised 35,000 heroin injections over 18 months and claims to have saved 6 lives. This claim simply cannot be sustained.
The implications are that if the injecting room continued at a rate of 35,000 heroin injections every 18 months it would, based on Australian national averages, take almost two years and cost $4.6 million of the estimated $2.4 million a year before it could claim that it saved just one life. The organisation states that 96 per cent of heroin overdoses nationally are not fatal, therefore the 329 overdoses recorded at the injecting room are alarmingly above national averages. Conservative national estimates indicate one overdose for every 1,700 heroin injections, but the injecting room has one overdose for every 106, which means that the injecting room has 16 times more overdoses than the rest of the community. The findings of the evaluation report and the statistics used therein are contentious when compared with research and national statistics on heroin use and overdoses. The report highlights further contentious issues, and indicates that the number of ambulance call-outs has not changed since the medically supervised injecting centre opened.
During the Drug Summit I visited the Metropolitan Ambulance Centre. Ambulance officers use motorcycles that are fully outfitted with the appropriate medical equipment to enable them to revive drug users who have overdosed. The officers carry Narcan on the back of their bikes. They whiz down the alleys and the back streets to resuscitate drug users who have overdosed. It is an effective way of reviving addicts who have overdosed, and I congratulate the ambulance officers on the work they do. But the evaluation indicates that there has been no change in the number of drug overdoses and related emergencies attended by the Ambulance Service as a result of the injecting centre. One must question the value of the centre and whether the additional money spent over and above what is being spent by the Ambulance Service to treat those people is money well spent. The effects of the injecting centre on local business are also quite contentious. I have received this correspondence from Michael Robinson:
I was interested to watch the effect the room is having locally. While speaking to business owners who still complain of needles on their door step each morning and escalating crime, in the rear laneway adjacent to the rear/exit door of the injecting room 3 middle aged males were standing on the footpath drinking a cup of coffee having just exited the facility, and a number of younger males were hanging around the street.
While talking we observed an undercover police operation detain and arrest one alleged dealer almost directly opposite the rear doors of the facility. Within 2 minutes of this occurring half of the people on the street cleared out, business owners can point them out, but the injecting room draws them in like a honey pot. Dealers know where their 'customers' are going to be and who they are, their customers are the people using the injecting room…
The business owners I spoke to all had one thing to say, the crime is worse, it's driven business down and they want a solution, clearly the injecting room isn't helping them either.
I have also received correspondence from the President of the Kings Cross Chamber of Commerce and Tourism Incorporated which states:
This facility is ruining the Cross and similar centres have the potential to ruin other local communities.
The evaluation mentions that police anecdotally reported an increase in drug-related loitering in the train station opposite the MSIC. The effects of the injecting centre on local business are contentious. We hear that most people in the business community support it, but the evidence I have is that it is definitely impacting on the community at Kings Cross. The report also noted that the majority of injections occur elsewhere, not in the centre. People are continuing to inject at home and elsewhere. The average individual attendance at the centre was 15 visits in the 18-month trial period. However, this figure was skewed by one individual who attended on 646 occasions. Despite the presence of the MSIC the vast majority of its users inject elsewhere, and certainly not under the supervision of MSIC staff.
I am not without compassion, and neither are my colleagues. Every life saved is worth the effort. As members of Parliament, we ought to endeavour to save lives, but we must question whether this is the best use of taxpayers' money. I have already pointed out the effectiveness of ambulance officers in that environment. But would the money be more effectively spent on rehabilitation and detoxification? How many more lives could be saved by getting people off drugs? We have heard about referrals from the centre, but only 15 per cent of the so-called clients of the centre received referrals and only half of those were for drug rehabilitation. When we talk about drug rehabilitation and detoxification to help people get off drugs, we are talking about the quality of life rather than the quantity of lives saved—although the quantity of lives saved is an important consideration.
Rehabilitation and detoxification add to the quantity of lives saved, but the question is how many more lives would be saved by helping people to get off drugs rather than by providing a centre that helps them to maintain their habit. Another consideration is the quality of life. I would be happy to debate this, but I imagine that the quality of people's lives would be greater if they were off drugs. I cannot imagine that people's addiction to a substance that drives them to do whatever they have to do to feel good—for example, commit crime—would result in a very high quality of life. That was certainly my experience during the Drug Summit. When I visited some of the rehabilitation centres and spoke to some of the addicts, they expressed dissatisfaction with their lives and their desire to get off drugs.
It is not simply about the quantity of lives saved but also the quality of life. That is why we should put our resources into rehabilitation and detoxification. The $2.4 million per annum to run the centre would fund more than 100 rehabilitation beds for a full year at, for example, the Salvation Army. Therein lies the question: Is the money spent on this centre to maintain people's habit the best way to spend the money, or should we direct those resources towards rehabilitation and detoxification? As I said, more than an additional 100 rehabilitation beds could be provided for the same money it takes to run the centre. My view is that the injecting centre is an ineffective and costly social experiment that has clearly failed. The evaluation was unable to conclude in any way that this money is well spent. We have now had three years to come to this understanding.
The Government is asking us to endorse another four years of this failed ideological experiment, which has been trialled at taxpayers' expense. The proposition is indefensible. The $2.4 million per annum spent on this facility would be far better spent on programs aimed at helping addicts to stop taking illegal drugs, rather than assisting them to maintain their habit. The Government's notion is contrary to the opinion of the United Nations Narcotics Control Board, which at paragraph 559 of its 2001 report stated:
The Board regrets that local authorities in the Australian State of New South Wales have permitted the establishment of a drug injecting room, setting aside concerns expressed by the Board that 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 Board notes that the national policy in Australia does not support the establishment of drug injecting rooms. The Board urges the Government to ensure that all its States comply fully with the provision of the international drug control treaties to which Australia is a party.
I hear some noise from the other side of the Chamber. The Labor Party takes notice of the United Nations when it suits them, but simply makes a lot of noise when it does not. It ought to listen to what the United Nations Narcotics Control Board has to say. I cannot support this legislation, which seeks to perpetuate this farce.
Mr Orkopoulos: You never have.
Mr STONER: I never have, and I never will.
Ms MOORE (Bligh) [10.41 a.m.]: I support the Drug Summit Legislative Response Amendment (Trial Period Extension) Bill 2003. This legislation extends the trial from the 2002 Act. The bill will take effect from 31 October 2003 and will enable the medically supervised injecting centre [MSIC] in Kings Cross to continue its operations until 31 October 2007. In effect, the bill extends the trial period to October 2007 and requires that the review into the operation of the centre apply to the whole of the trial period rather than to the first 18 months. Another evaluation will take place in 2007.
In my August newsletter, which was hand-delivered to 50,000 householders in Bligh, I informed my electorate that the independent evaluation report on the Kings Cross medically supervised injecting centre had endorsed the facility. The report showed that the centre's operations had decreased overdose deaths, provided a gateway to treatment, and reduced the problems of discarded needles and users injecting in public places. Up to April 2003 more than 4,700 registered users underwent full health assessment and there were more than 1,800 referrals to drug treatment, rehabilitation, and health and welfare services. There has been no increase in crime or loitering in the Kings Cross precinct, there has been no evidence that the centre has increased drug dealing or drug use, and there has been no honey-pot effect. Two-thirds of the clients come from Kings Cross. The report found that 78 per cent of residents and 63 per cent of businesses were supportive of the centre and estimated that the closure of the service would result in nearly 230 injecting episodes per day reverting to the streets of Kings Cross.
In my electorate newsletters I have kept my constituents informed about the establishment of this Australian-first health facility. In 1999 I reported on the heartbreaking photograph in Caroline Lane just before the State election. The Drug Summit, which was preceded by the challenge of the Wayside Chapel supervised injecting room, focused the attention of legislators on one of our most serious social problems and a major cause of crime. At the Summit members of Parliament were presented with expert evidence and local and overseas research. They heard from community leaders, people who work with users, and the users themselves and their families. They visited treatment centres and talked to health workers.
As the State representative of an inner-city electorate, which includes Kings Cross and now Eveleigh Street, I approached the Drug Summit with a determination to instigate action. I was elected to the special resolutions committee as the Independent representative of the crossbench. I pushed the policies and reforms that would address the growing drug-related problems in our area. I promoted a trial of a supervised injecting room on the basis of evidence given at the joint parliamentary select committee that it would save lives, give marginalised young addicts a gateway to treatment, and reduce public injecting and the disposal of needles on the streets of Kings Cross, Darlinghurst and Redfern. At the request of the Minister for Health I moved a motion for the trial, and I received overwhelming support from delegates. Other recommendations endorsed by the Drug Summit included education and prevention programs and increased funding for detoxification treatment and rehabilitation. I also moved a motion, which was narrowly defeated, for a heroin trial for chronic addicts in an attempt to undermine heroin trade and reduce crime. I believe that the Summit provided a way forward in dealing with drugs and hope for inner-city residents who have endured the impact of government inaction. My goal is to ensure that the Government implements the Summit's recommendations.
One year later in my winter newsletter of 2000 I reported on my active involvement with the community consultation committee, which was set up by the Uniting Church, and my work with church and community representatives, and service providers and users to ensure that these lifesaving projects succeed and get injecting off the street. Although there is broad local consensus in support of the facility, its location is a problem. People do not want it located near them. I have asked the Government to ensure the availability of essential back-up services, such as policing.
One year on, in the winter newsletter of 2001 I reported that the medically supervised injecting centre had opened in May, initially operating four hours a day to get established and to train staff. It now opens from 10.00 a.m. to 6.00 p.m. on weekdays and from 2.00 p.m. to 6.00 p.m. on weekends. The hours will later be extended to 10.00 p.m. The project includes a panel of local residents, business people and police who meet every six months, and there is further assessment of community response through telephone surveys. I work in conjunction with the community consultation committee.
While it is too early to assess the full impact of the project, there have been four overdoses, which could mean that four lives have been saved. Fifty referrals have been made for young users who have not previously accessed treatment. I again suggest a trial of prescription heroin for chronic users. Such a trial needs to be considered, as drug-related crime is on the rise. International evidence of reduced crime, overdoses and homelessness persuaded many New South Wales Drug Summit participants to support my motion for a heroin trial, but it was narrowly defeated.
In my summer 2001-02 newsletter I reported that 1,507 private users are now registered at the centre and that there have been 88 drug overdoses, all non-fatal. Of the registered users, 623 people, many with no prior history of access to medical services, have been referred to treatment programs. Ambulance call-outs in the Kings Cross area have decreased and residents report less shooting up and fewer needles in the streets. The majority of people who voted for me in the election this year—where I received 65 per cent of the vote—support my approach for seeking progressive solutions to complex and tough inner-city social issues, such as the establishment of a medically supervised injecting centre. The Australian Labor Party, Liberal and Green candidates in my electorate all supported the facility, as did the local council.
I now turn to a number of crucial issues, including the rigorous independent evaluation of the centre. Seventy-eight per cent of local residents and 63 per cent of businesses support the facility, and that support has increased since the centre began its operation. Out of 200 businesses polled, only 1 per cent indicated that the centre had adversely affected them. Opposition to the centre has dropped from 26 per cent to 17 per cent since it began its operations. A vocal minority has voiced concerns about the centre and has been opposed to it from the start. At a community meeting held by the Chamber of Commerce on 20 August this year—to which I and Dr Ingrid van Beek, the director of the centre, were invited—only eight community members attended.
I would like to refer to the benefits of the centre. Every day 240 users—that is 1,000 per month—inject at the centre. The centre estimates that up to 25 lives per year have been saved. Overdoses have decreased since the centre began its operations. An important aspect to note is that those who overdosed were treated in the centre without injury to brain and other vital organs. Such injuries occur when overdoses occur on the street. The centre has treated more than 550 overdoses in two years.
Another important piece of information I ask members to note is that the rate of blood-borne infection, such as hepatitis B and C, in Kings Cross has remained stable, whilst other areas, such as Cabramatta, which has twice the average rate, have experienced an increase. There have been no new drug-related HIV infections in Kings Cross during the MSIC evaluation. I note that a September Washington Post article reported that Canada has dramatically shifted its approach to drug users, from a punitive approach to a policy of harm reduction. Canada has adopted the stance of Germany, the Netherlands, Switzerland and, I am pleased to say, Australia. A representative of Vancouver's Coastal Health Authority said that the new policy also makes good economic sense. She pointed out:
When we get someone with HIV it costs $150,000 to treat [that person] over a lifetime. Some people say we are enabling addicts, but if we prevent 10 people from contracting HIV the injection site pays for itself.
That is a salutary observation that this House should contemplate. The MSIC is also a gateway to help. Sixty per cent of its users had never had any contact with other drug services, yet are more likely to start treatment for drug dependence and more likely to test for blood-borne diseases, which will assist to prevent disease from spreading. The centre has estimated that half of its clients were successfully referred to other services. The centre is also able to reach people that other treatments have failed; and it has reached injecting users in the early stages, with the result that there is less chance of an entrenched drug use pattern forming.
To summarise the benefits of the centre—people live longer with fewer health problems, and hopefully long enough to get help with their drug problem. The amenity of Kings Cross has improved because 550 overdosers have been taken off the streets. It is distressing for anyone to see someone injecting or, worse, dying from an overdose, but that was happening regularly in back lanes. If the facility closed tomorrow, there would be 240 injecting episodes in the area each day. Of course, there has been a reduction in syringes and other drug paraphernalia in the street. Another issue that is important from the point of view of my constituents is crime and drug use. Kings Cross police commander Dave Darcy is on public record supporting the centre, and the crime rate has dropped. Currently the area has the lowest assault rates on record and a sustained drop in all types of crime in the Kings Cross command, at the same time as use of the centre has increased.
We have low and decreasing rates of drug-related crime, especially theft and robbery. Loitering around the centre dropped as soon as the centre opened, and there has been no adverse impact on drug-related loitering in Kings Cross. Some claimed that the centre was responsible for increased drug-related activity at the railway station, but that increase was reported before the centre opened. Heroin availability dropped before the centre opened, and is only now increasing with the end of the heroin drought.
Kings Cross police report that there is no relationship between the availability of drugs in Kings Cross and the operation of the centre. As well as other benefits, the centre acts as an early warning system. Through its direct contact with drug use, health personnel and police can be alerted to changes, for example when a higher strength in drugs becomes available. Members have also referred to the honey-pot effect, and concerns were expressed about that even before the centre opened. The independent evaluation has shown that this has simply not eventuated.
The users of the centre are already in Kings Cross because they live in the area or are there in order to buy drugs. Eighty per cent of the centre's clients spent the night before their visit to the centre in the South Eastern Sydney Health area, and two-thirds were in Kings Cross itself. The more frequent users are more likely to live locally. The evaluation report states that the centre did not result in an increase in drug-related loitering in Darlinghurst Road, and that loitering declined over the period of the evaluation. The centre is sited in the area where drug users are, rather than attracting them to the area. The cost of the centre is another issue that is bandied about. I again remind the House that the injecting centre was paid for by the confiscated proceeds of crime, including proceeds from drug dealing. The point is worth re-emphasising: the centre was paid for by the confiscated proceeds of crime, including proceeds from drug dealing. The funds have been used to help the victims of the drug trade. [Extension of time agreed to.]
I also wish to respond to claims that the centre has not been cost effective. There were problems setting up a new and innovative service. The Catholic Church pulled the Sisters of Charity out of the agreement, and the centre was taken over by the Uniting Church. Negotiations about the venue or site were complicated and delayed its establishment. There was a court challenge by the chamber of commerce which delayed the centre's opening. The new service had a one-off set-up and fit-out, and additional funds had to be allocated for evaluation and monitoring. However, costs have decreased. The centre is now operating at twice the rate that applied during the 18-month evaluation period, and there are now nearly three times the number of injecting visits compared with visits made during the evaluation period. The centre has the normal operating costs for its type of facility but it has had to cope with extraordinary costs for insurance and rent for its premises in Darlinghurst Road.
Another issue relates to the site. The 66 Darlinghurst Road site was chosen after extensive work by both the Sisters of Charity and the Uniting Church to meet the specific criteria, which included proximity to Springfield Plaza, distance from residential areas, and the site owner's ability to pass a probity test and to agree to the site being used for the trial. The Kings Cross Chamber of Commerce, the Kings Cross Community and Information Centre, and the 2011 Residents' Association all undertook to look for alternative sites that met these criteria, but without success. A site in Earl Place and a site at the foot of the residential tower, The Elan, were rejected. I supported siting the service in the commercial area rather than in the residential area.
Darlinghurst Road and its future are currently being discussed in a number of venues such as community meetings, Police Accountability Community Meetings, and Council of the City of Sydney meetings. One per cent of businesses polled, have opposed the Medically Supervised Injecting Centre from the outset, blame the facility for the retail downturn in Darlinghurst Road. I challenge that view, as do others. The Kings Cross area is changing. Hotels are converting to apartments, which the manager of the Kings Cross Partnership claims has crippled sex and tourist trades. The Pink Pussycat nightclub closed in February, the Vegas is up for sale, while the Bourbon and Beefsteak is having a $7 million facelift and the Kings Cross Hotel is undergoing $4 million renovations. The Sydney city council plans a $7 million upgrade for Darlinghurst Road, which I hope will maintain the cosmopolitan feel of the area and also be a stimulus to revive the retail trade, particularly shops that serve the increasing local population.
I will briefly refer to criticisms of the service. I place on the record that Drug Free Australia comprises a number of people who opposed the trial at the 1999 Drug Summit, as well as in their submission to the Commonwealth's inquiry into substance abuse in 2002 before the trial or the Kings Cross evaluation report was available. That organisation has no standing as a drug expert. Its members are reported to have wasted $1 million setting up a rehabilitation centre in Port Macquarie which subsequently closed down due to poor management. As well, the association's figures are not statistically sound but rather are based on a misunderstanding of the data and what it means. The head of the National Alcohol and Drug Research Centre, Richard Mattick, said that the calculations done by Drug Free Australia were "back of the envelope" calculations, and I think they should be dismissed by this House.
In conclusion, I point out that the Medically Supervised Injecting Centre [MSIC] has demonstrated its effectiveness. I believe the trial should be expanded to other areas. I acknowledge that this legislation does not deal with that issue but I think that matter should be taken on board by this Government. I also call upon the Government to amalgamate the K2 needle exchange with the MSIC as both are located in Darlinghurst Road. I wish to conclude with these comments that I made when moving the motion to establish the trial at the Drug Summit:
Much has been said about sending the wrong message, but I would like to say on behalf of those who support this proposal that the message we really want to send is one of tolerance, compassion, help for survival and keeping young people alive long enough for them to be able to come off drugs.
I believe that the trial has achieved its aims. I commend the bill to the House.
Mr McLEAY (Heathcote) [10.57 a.m.]: I would like to start with a general overview of the safe injecting centre's operations. During the 18-month trial, 3,810 individuals were registered, of whom 73 per cent were male. On average they were 31 years of age and had commenced injecting at approximately 19 years of age, so they had been injecting for approximately 12 years; 44 per cent had previous non-fatal heroin overdoses and two-thirds had already been receiving drug treatment; there had been 56,000 visits, with an individual average of 15 visits per client.
As has been previously alluded to, sometimes statistics can be skewed. The number of individual visits ranged from one to 646. Heroin was most frequently the drug of choice, followed by cocaine. With approximately one in every four visits, health care services in addition to the supervision of injecting were provided to the client. Most of the advice given related to injecting and vein care. One in every 44 visits resulted in a referral to obtain further assistance. A point of some criticism by others in this place, but nevertheless a key point, is that a heroin injecting centre is not a pleasant place. A person must be at least 18 years of age before being allowed to walk through the door, and proof of age must be provided. It is a non-smoking environment and it is a quite sterile atmosphere. But the point is that it is a safe place in which to inject, and some health care facilities are provided.
I was not a member of Parliament when the Drug Summit was held. However, I have read a great deal of what was said. Many people believe that heroin addicts eventually grow out of their addiction. The trick is to keep them alive until they are ready to stop using. When they are ready, the appropriate people must be there with advice and support to assist them, and that is one of the centre's primary roles. Medical services are offered by nurses on site. The majority of access to primary health assessment is through referral to St Vincent's Hospital, Sydney Hospital and other services. Non-urgent cases are referred to a local general practitioner. Occasional crisis drug and alcohol counselling is also offered on site with referral for ongoing treatment. Health education is a core on-site service, in particular, education pertaining to injecting-related health issues, drug overdoses, blood-borne viruses, sexually transmitted diseases [STDs] and other sexual health issues.
Referral to drug and alcohol detoxification and rehabilitation services is also offered to outpatients. If a client expresses the desire to undertake drug or alcohol detoxification and rehabilitation an expert is available to issue a referral to the Langton Centre, Rankin Court, Regent Street Clinic, Kobi Clinic and other detoxification and rehabilitation providers. Referral is offered for methadone and other drugs and testing for blood-borne diseases and STDs. An on-site service is available for needle and syringe exchange and referral to vending machines and pharmacies. As I said previously, clients must be 18 years of age and be carrying identification. If they are not 18 years of age they are referred to the appropriate youth services for individual assessment; for example, to Oasis. The staff are medically trained, the clinical services manager is an accredited trainer for NSW Health, and staff must undertake child protection training and ongoing professional development. It was suggested that statistics are low.
Mr Stoner: What statistics are we talking about?
Mr McLEAY: The Leader of the National Party said there is little ongoing referral and the Deputy Leader of the Opposition said that it is disgraceful that only 1.5 per cent of the clients are referred for assistance. That is not true; in fact, 7,732 clients obtained advice about injections and vein care, and well-woman advice was given to 424 clients. That advice covers contraception and reproductive health information. Drug and alcohol information was provided to 284 clients, sexual health was provided to 243 clients, drug treatment advice was provided to 149 clients and other health education was provided to 129 clients. Advice for all basic services was provided to nearly 9,000 clients. Medical advice was also provided for 624 miscellaneous medical cases, 421 wound dressings or tissue trauma cases, 200 skin disorders and 26 asthma or chest infections. In addition, 2,333 clients received general counselling, nearly 400 were provided with referrals for accommodation and legal services, and crisis counselling was provided to 247 clients. Other crisis counselling and financial advice was also provided.
The report is critical and suggests that the trial be extended over another four years. In 18 months the centre has experienced 409 overdoses among 267 clients. The report suggests that lives have been saved, and that is the primary goal. Staff say that if the injecting room did not exist the target population would be injecting on the street. The centre is reaching a high percentage of users. The registration rate and the quick uptake of clients are good measures. Even after people score they still make the effort to get to the injecting room. It is less hassle for clients than injecting on the street and they regularly bring a friend with them to share the information that is available. A great deal of advice has been given about injecting techniques, which reduce illness and the risk of death. The staff say that the objective is to stop people dying. People who overdose in the injecting room may otherwise have overdosed on the street. It is suggested that clients like the staff because they can potentially resuscitate them and they choose to use the facility because they feel safe. That safety is reinforced when someone overdoses on the street. Clients who use the injecting room know they will be looked after.
Sound advice is obviously available. As has been stated, $2.4 million a year is spent on the service. That should be put in the context of a few other initiatives. Drug and alcohol services have been significantly expanded across New South Wales as a result of the Drug Summit. The summit allocated a total of $113 million for expanding health care and treatment over four years. That does not include enhancements such as the Adult Drug Court, the Cabramatta Anti-Drugs Strategy and internal agency funding. The second drug budget allocated NSW Health a total of $129.2 million over four years, including $30 million for 2003-04. Over the next four years the Government will build on the significant achievements resulting from the Drug Summit. Drug treatment capacity will be further expanded and programs introduced to respond to emerging drug issues.
A significant amount has been spent on detoxification and rehabilitation, including $1.6 million to introduce medicated detoxification at the Lakeview Unit at Belmont Hospital in the Hunter; $1.6 million to introduce medicated detoxification at Orana House at Port Kembla Hospital in the Illawarra; $1.3 million for a new youth detoxification service in Western Sydney; $2.4 million for 40 additional residential rehabilitation beds in non-government organisations around the State, including 20 beds to move patients from methadone to abstinence; and 212 detoxification beds and 753 rehabilitation beds have been provided in New South Wales—that is more beds than ever before. In addition, $2.7 million has been provided for cannabis intervention and treatment strategies; $750,000 has been spent on a psychostimulants strategy with new projects targeted at ecstasy, amphetamine and cocaine use; and $1.2 million has been provided for telephone information services and counselling support, including increased funds for family drug support services providing advice and services for families affected by drug use, and for the Alcohol and Drug Information Service.
The budget has also provided $1.4 million for a rural integrated care trial on the North Coast, providing intensive case management of drug-dependent women, linking them to drug treatment, housing, employment, child protection, financial advice and parenting services; $1 million has been provided for the heroin overdose prevention strategy; $1 million has been provided for an infrastructure program for non-government organisations to help these valuable services maintain their premises for fire rating and accreditation purposes; and $2.5 million has been provided for the Mid North Coast Drug Treatment Service for a multipurpose drug and alcohol service in Port Macquarie, Kempsey, Coffs Harbour, Taree and Forster, including home detoxification and counselling. A comprehensive range of treatment options is available. The Medically Supervised Injecting Centre is but one service and the continuation of the trial will give us a better opportunity to save lives and help users to get well. It should be commended.
Mr KERR (Cronulla) [11.09 a.m.]: Once again I place on record my opposition to shooting galleries. Before I deal with the contribution of the honourable member for Heathcote—
[Interruption]
I am being interrupted, when I was about to say something nice about the honourable member for Heathcote. I wish him well in his personal quest to find out whether blondes really do have more fun! Obviously, anyone reading his speech and the statistics he threw around with gay abandon would know why he is a numbers man. No doubt he thought that numeracy would compensate for the lack of literacy in his speech. I will deal with some of the matters he spoke about.
Mr Tripodi: That's very personal.
Mr KERR: I have only come within a hair's-breadth of being personal. The best part of the honourable member for Heathcote's speech was when he spoke about the facilities that are being funded in other areas. Those facilities are being used by people who are motivated to get off the drug habit. For the benefit of the honourable member for Heathcote, if the funds that have been raised for the medically supervised injecting room—where criminals are having their habit facilitated—had been used for the other facilities that he referred to, we might be making a little more progress in those areas.
In her speech the honourable member for Heffron referred to law enforcement as one of the aims of the injecting room. Even under her Government, obtaining heroin remains a crime. Every person who goes to that injecting room having obtained heroin is a criminal. The honourable member for Heffron spoke about the chaotic lives that many of those people live and their lack of income. How did they get their income? As the Premier said some time ago, "junkies", as he called them, get the money to enable them to do a deal by breaking into homes. It could well be that a number of homes in the Caringbah area have been broken into in order to support a drug habit. Money is raised through breaking into homes, the criminals do a deal, and they go to the injecting room and get injected with heroin. It could happen in any electorate. Homes are being broken into to enable people to raise the money to do a drug deal to get heroin.
It is a furphy to suggest that the injecting room may save lives. The habit is ongoing. A few days after going to the injecting room the person may take an overdose in the streets of Fairfield or Cabramatta, and two weeks later he is dead. That life has not been saved. That is the problem with the shooting gallery. The honourable member for Heathcote referred to the contributions of the Leader of the National Party and the Deputy Leader of the Opposition, who spoke about referrals. His argument is not with those members but with the independent evaluation, and the small number of people who make a sustained effort. At least the honourable member for Heffron sought to provide an explanation in terms of the chaos and complexity of these people's lives. But she certainly did not dispute the independent report, which is the whole basis of this legislation. I do not believe that anyone—even the honourable member for Bligh—would argue with the proposition that taking illicit drugs is wrong, because it harms the body, dulls the mind, diminishes self-control and ultimately can, and does, kill. Drug taking is probably the most dangerous problem we face as a community.
Mr Orkopoulos: Cigarette smoking is.
Mr KERR: Tobacco is a drug.
Mr Tripodi: I reckon a Liberal government is the biggest threat to community welfare.
Mr KERR: I acknowledge the interjection. We have at the table a man who regards that threat as bigger than the drug problem facing Australia. I look forward to hearing the contribution of the honourable member for Fairfield. Next time he goes to a caucus meeting and he leads the singing of "What a Friend We Have in Bobby", I suggest that just after that little rendition he should say to the Premier, "Why don't we have a Liberal government summit, and bring everybody together to talk about the threat. It's toast." I digress a little. This is an extremely ill-considered bill. Someone whose opinion the honourable member for Heathcote would probably regard as being at an even higher level than mine would be Archbishop Pell, who had this to say on this subject—
[Interruption]
The honourable member for Swansea laughs. He should talk to the honourable member for Heathcote. I am modest enough to think that the honourable member for Heathcote would not regard my opinion with the same—
Mr Brown: Point of order: I refer to the standing order that provides that members shall not construct speeches on interjections, and I ask you to rule on that point of order.
Madam ACTING-SPEAKER (Ms Andrews): Order! There is no point of order. The honourable member for Cronulla will confine his remarks to the subject matter of the bill.
Mr KERR: With regard to the bill Archbishop Pell said:
We cannot risk sending a message to society generally, and young people in particular, that seems to give a green light to drug abuse.
Mr Tripodi: You keep back flipping. Hurry up!
Mr KERR: I would hurry up, if you stopped interrupting me.
Mr Tripodi: You have been going on for 10 minutes.
Mr KERR: I do not mind a bit of constructive criticism, but I object to the continuing delaying tactics of the honourable member for Fairfield. Archbishop Pell continued:
There is a host of practical problems surrounding the proposal. We need more than band-aid solutions. We need more places in detox programmes, more halfway houses for those leaving such programmes, more help for the families involved and better prevention strategies. Effective compassion will cost money and involve much greater efforts.
The sort of money that is being channelled into the shooting gallery could be better used in detoxification programs, more halfway houses for those leaving such programs, more help for the families involved and better prevention strategies. The millions of dollars we are pouring into the shooting gallery could be provided for those worthwhile projects. The honourable member for Heffron made no reference to what is happening in America and what happened during the Clinton administration. Did they set up any injecting rooms? No. The honourable member for Bligh spoke about establishing injecting rooms in other areas. However, she did not refer to what other areas. Will they be established in the electorate of the honourable member for Fairfield or the electorate of the honourable member for Bathurst—
Mr Tripodi: It might be Cronulla.
Mr KERR: That is right, and I would oppose it being established there. Is the honourable member for Fairfield, who is at the table, saying that the Government now has a proposal to establish an injecting room in Cronulla? Is that the agenda? As the Australian pointed out:
The real culprits are the drug dealers with an estimated global market of between $700 billion and $800 billion a year. The Kings Cross injecting room is a very small player in this vast, malevolent business, its impact local, its effectiveness questionable.
I would say its effectiveness is highly questionable, even based on the report. The article continued:
If what began as a limited experiment is to become the norm, a proliferation of injecting rooms would be the next demand—
And that is the demand of the honourable member for Bligh. People who believe that the centre is a solution for Kings Cross are morally bound to support such centres in other areas where there are drug problems, be it Cronulla or the electorate of the honourable member for Fairfield. The Australian editorial continued:
—of the advocates of drug tolerance. But increasing the number of injecting rooms would do nothing to stop the spread of drugs throughout the community.
Mr Martin: It might save a few lives though—but that is not important to those over there.
Mr KERR: Yes, it is. It is a pity the honourable member for Bathurst was not here earlier because I dealt with that very thing. The honourable member for Bathurst talks about saving lives. A person can go into the injecting room and be injected, but they could be in Bathurst the next day and not be able to get to the injecting room. They could end up dead in a backstreet of Bathurst.
Mr Martin: We've got you on line with technology there. At least you got the terminology right.
Mr KERR: I am being interrupted again when I am trying to enable the honourable member for Bathurst to make a contribution in this debate. [Extension of time agreed to.]
Madam ACTING-SPEAKER (Ms Andrews): Order! Honourable members will listen to the contribution of the honourable member for Cronulla in silence.
Mr KERR: I conclude with these words: This is not the answer. The message being sent is, "Yes, go ahead, commit a crime, obtain your heroin, and the State will provide the facility for you to use the fruits of your crime. You are not required to enter any program, and the money that we do not spend on providing a halfway house or a detox program we will not use to help people who are genuinely motivated to get off drugs. You will take it away from them. But we as a State believe that is all right. We as a State will continue to support that, and we will pour millions of dollars into providing for and facilitating your drug habit."
Mr BROWN (Kiama) [11.22 a.m.]: I support the Drug Summit Legislative Response Amendment (Trial Period Extension) Bill, especially after listening to the speech of the honourable member for Cronulla—what he lost in logic he certainly made up for in literary ability. However, this issue should be debated on logic rather than on the literary ability of the honourable member. The Carr Government does not condone drug use but it is compassionate, as opposed to a number of the zealot ideological conservatives who are members of the Liberal and National parties. The Carr Government is committed to do all it can to prevent people from using drugs. The medically supervised injecting room is only one part of the many measures to prevent people from using drugs. This bill should be seen in that light and not used as a grandstanding opportunity by Opposition members. The people who use the centre need our help. Only 28 per cent of the people registered have completed the Higher School Certificate, 26 per cent have been imprisoned in the past year, and 11 per cent are homeless. Closing our eyes to these people is not a solution.
The initial trial period is coming to an end, but there is evidence that we should keep the medically supervised injecting room open. An extension period clearly makes sense. The extension period will be used to trial and assess new approaches to encouraging drug users into treatment. For example, a special case manager will be appointed to the centre to build relationships with clients and service providers in the area, and to take a proactive approach in client referral and follow-up. The honourable member for Cronulla mentioned that the most dangerous dilemma facing the community is the drug problem. If that is the case, simply closing the trial injecting room is not addressing one aspect of that very important problem. The final report on the evaluation of the medically supervised injecting centre was recently released and it is interesting to note some of its key findings. The operation of the centre was considered feasible in Kings Cross and the centre made service contact with its target population, including many who had no prior treatment for drug dependence. That in itself is a very important conclusion and a significant argument towards keeping this trial going.
A small number of opioid overdoses managed in the centre may have been fatal had they occurred elsewhere. The centre made some referrals for drug treatment, especially among frequent attendees. There was no increase in the risk of blood-borne virus transmission, there was no overall loss of public amenity and there was no increase in crime. The centre has afforded an opportunity to improve knowledge that will guide public health responses to drug injecting and its harmful effects. According to the most plausible estimate, it is likely that about six heroin overdoses may have been fatal had they occurred outside the centre during the trial period. That is a saving of six lives. I do not know how any member of the Opposition can say that this trial injecting room is a waste of money. It is likely that the centre played a role in reducing overdose-related morbidity. Early intervention can minimise brain and vital organ damage.
One of the centre's key aspects is the ability for a person to make a connection with these drug users and refer them for better health and drug treatment. The centre made 1,385 verbal or written referrals for health, drug treatment and social services for its 577 clients. A number of honourable members have referred to crime but, according to these key findings, the centre has minimal impact on drug-related activity in the area. As the honourable member for Bligh said, there was no honeypot effect; there was no increase in crime. There was a very slight increase in drug-related loitering but, from those key findings, I am pleased to affirm that there was a downward trend in theft and robbery in the area.
As I mentioned earlier in my contribution, this trial injecting room is one part of the Government's plan of action on drugs and it should be seen in that light. The 1999 Drug Summit established a new direction for drug policy in New South Wales that recognises the complexity of drug abuse and the need for a comprehensive approach. The Government, in partnership with the community, is responding to the drug problem through prevention, education, treatment and law enforcement. In July 1999 the Carr Government allocated $176 million in additional funding to implement the Drug Summit's recommendations over four years. Building on that work since 1999, a new four-year $230 million plan has been announced. This is the Carr Government putting its money where its mouth is. This is not about the Carr Government grandstanding in this place about one small section of the plan against drugs. The New South Wales drug treatment system is the most comprehensive in Australia and it provides a range of treatment options.
Since 1999 the Government has opened three new drug detoxification and treatment centres and has funded a further 62 residential rehabilitation beds to treat an extra 523 people each year. The Government has opened new youth drug rehabilitation facilities and appointed new drug and alcohol counsellors to work with young people in regional areas. The Government has also funded 2,000 additional places for home and outpatient detoxification treatment and has provided 3,000 extra places in an improved methadone program. It has introduced buprenorphine treatment as an alternative treatment. In addition, the Government has opened a new residential rehabilitation service for young people in Western Sydney and has established the trial of the medically supervised injecting room.
Over the next four years the drug treatment capacity will be further expanded and programs will be introduced to respond to emerging drug issues. These include the introduction of a medicated detoxification unit at the Lakeview unit at Belmont Hospital in the Hunter and at Orana House in Port Kembla Hospital. The Government has provided funding for 40 additional residential rehabilitation beds in non-government organisations around the State, including 20 beds to move patients from methadone to abstinence. A new youth detoxification service has been set up in Western Sydney. The Government has introduced a psycho-stimulants strategy, with new projects targeted at ecstasy, amphetamine and cocaine use. The strategy will include a community information and education campaign to warn drug users and their families of the risks associated with these types of drugs. The Carr Government has also provided funding for telephone information and counselling services. It has increased funding to Family Drug Support, which provides advice and support for families affected by drug use. It has also increased funding to the Alcohol and Drug Information Service, which provides general drug and alcohol information statewide.
The Carr Government has provided funding for the rural integrated care trial on the North Coast and for the heroin overdose prevention strategy. The Government has established an infrastructure program for non-government organisations to help those valuable service providers maintain their premises for fire-rating and accreditation purposes. Prevention and education have been debated at length in this Chamber and, in my opinion, will be the key to the future. The Carr Government has taken up the challenge by putting its efforts and funding where they are most needed. More help and information have been made available for parents, including support for parents with new babies, and advice has been provided on how to broach the subject of drugs with teenagers.
Young people now have ready access to accurate information on drugs. As well, communities receive encouragement and support to tackle drug problems locally. Since 1999 many programs have been funded. These include the Families First Program, with funding of $117.5 million being provided over four years to support all families with children up to eight years of age. Families First helps parents build skills and confidence in parenting, improves children's health and helps parents respond to problems early. For example, nurse home visits are now provided to 30,000 babies each year.
The Government has introduced a new mandatory 25-hour course called Crossroads into all government secondary schools for year 11 and year 12 students. It also introduced into 44 schools across the State a program entitled Healing Time, which is a resource for junior secondary Aboriginal students, with a further 83 schools receiving material in the first semester of 2003. A new Healing Time resource is also in all New South Wales Government primary schools. The Carr Government, in partnership with young people, produced the Drug Smart Z-card and distributed it throughout the State during Youth Week. The Family Matters drug information kit for families has been extremely popular in the Kiama electorate. When I visit constituents in their homes I see the information kit used as a fridge magnet; it contains more important information than some of the propaganda sent out by the Liberal Party.
The drug information kit was sent to all families of government high school students and distributed to Catholic and independent schools. The Carr Government established 72 community drug action teams in metropolitan, rural and regional New South Wales. These teams include members of church organisations, businesses, welfare groups, councils and government agencies. The teams devise innovative ways of raising awareness of drug problems in local communities. In 1999 the Leader of the Opposition spoke in the debate on the Drug Summit Legislative Response Bill. He stated:
I was one of only six Liberal members of Parliament to support the motion to trial a medically supervised injecting room, but my decision to exercise my free vote in support of this proposal came the week before the Summit.
He concluded by stating:
The real test of this bill and the Government's total response will be measured in human life and a reduction in drug addiction, drug availability and drug usage … those are the real tests for the Government, and I and others intend to maintain a critical review. We await the results.
The results have been debated in this Chamber as a result of an independent report, and I urge honourable members to consider the facts. Like the Carr Government, members should take an evidence-based approach and support the extension of the trial to 2007.
Mr CONSTANCE (Bega) [11.36 a.m.]: As a representative of a rural constituency that does not face the same challenges as those faced in the Kings Cross area, I spent considerable time researching and examining the Carr Labor Government's independent evaluation of the medically supervised injecting room. My reason for not supporting the bill is based on statements and facts in the report. I have spoken to many members of the legal profession who believe there is some merit in supporting the concept of an injecting room as a means by which drug users can be rehabilitated. However, the report is inconclusive in many respects. It states:
There was no evidence that the operation of the MSIC affected the number of heroin overdose deaths in the Kings Cross area.
It also states:
The proportion of ambulance attendances to opioid overdoses in the Kings Cross area that took place during hours of MSIC operation changed little during the Evaluation compared to the equivalent calendar period prior to the Evaluation.
The report continues:
Subsequent to the opening of the MSIC, there were further reductions in the number of opioid overdose ambulance attendances in the Kings Cross area and across NSW. These reductions were associated with the ongoing fall in heroin availability. It was not possible to distinguish the role of the MSIC in reducing demand on ambulance services from the effect of the continued reduction in heroin availability.
Even after a trial period of 18 months the independent evaluation is inconclusive. The Government should have the guts to put its real intention on the table and make the injecting room a permanent fixture. It will not do so because it knows that the majority of people throughout the State are uncomfortable with the concept of an injecting room. That is why we have legislation relating to a trial, rather than legislation that will make the medically supervised injecting centre a permanent fixture.
I listened to the honourable member for Bligh, and I understand that compassion is required when dealing with these problems. However, we must work our way through the problems so that we achieve the best and most viable outcomes for the entire New South Wales community. With the trial, we are sanctioning the use of an illegal product in a legal way. I am concerned about the Government's intentions in relation to drugs and drug law reform. The Government needs to put that on the table, because the issue was not raised during the recent State election campaign.
The report contains a number of alarming figures. There has been spin doctoring in the press because the Government wants to soften the political impact of the trial. When I read the report I was astounded to learn that there had been 56,861 visits to the medically supervised injecting centre during the 18-month trial, with an average of 15 visits per client, ranging from one visit for one person to 646 visits for another person. That person has made 646 visits to an injecting centre but we have not been able to get that person into a referral centre or into the care and support they need. The report has produced some alarming outcomes. In relation to the independent evaluation, the report states that the injecting centre provided referrals to treatment for drug dependence for 11 per cent of clients.
I suppose the best spin is that the more frequent attendees at the centre were more likely to be referred for treatment and to take up the referral. The report further states that of that 11 per cent, only 1 per cent of the 4,000-odd registered users of the centre—that is, fewer than 50 people—took up referrals to deal with their drug dependence. That is a tragedy. That means that the Government, in experimenting with this approach, has not been able to put in place necessary referral procedures to ensure that more people are getting off drugs, which was the original intention of the trial. That means that the trial is not a success—or not the success the Government hoped it would be. The report is inconclusive. The fact that the report does not spell out clearly the number of lives that were saved, the nature of the referrals, and the way people were successfully taken from the injecting centre and put into referral procedures is reason to no longer support the concept of the trial. National Party members will have a conscience vote on this bill because we want the public to have greater input into and debate on this issue.
The State Government, through the Southern Area Health Service, spends $1.6 million to service 200,000 people. In the Bega electorate that is $300,000 spent annually on dealing with drug rehabilitation. The report states that the annual injecting centre operating costs would be sufficient to fund approximately 100 residential rehabilitation beds in non-government organisations offering residential drug dependents treatment based on a daily cost of $65. The initial cost per client visit to the injecting centre was $63.01, and it is now projected to be $37.23. The broader community does not know that it is costing New South Wales taxpayers $63 per visit to the injecting centre, yet in regional areas, such as Bega, $8 per capita is spent annually on drug rehabilitation.
The cost benefit of the injecting centre to the community must be questioned. It strikes me that the inequity between an injecting centre and the opportunity cost of putting 100 rehabilitation beds into non-government organisations is not being debated. The report further states—and this is one of the most concerning aspects of it—that whether the money could have been better spent in other areas is a matter for public debate. That is taken from the independent evaluation of the trial. We will debate this bill and vote on it today, and we have not had a public debate as to whether the money could be better spent in other areas of drug rehabilitation.
I am concerned that the report does not stipulate the number of lives saved. In terms of benefit, the evaluation committee recognised that there were 380 heroin overdoses and that not one life was lost. That says something. But then we must ask this question: How many lives were lost in regional and rural areas as a result of drugs, youth suicide or any one of the many other issues confronting the local community? The honourable member for Bligh said that the confiscated proceeds of crime are used to fund the injecting centre. Based on what is contained in the independent evaluation report, I believe that the confiscated proceeds of crime could be better spent in funding 100 residential rehabilitation beds in non-government organisations across the entire State. For those reasons, I will not support the bill. If the Government intended to make the injecting room a permanent fixture it should have introduced legislation to that effect. I firmly believe that in four years time, when another independent evaluation of the injecting centre at Kings Cross is undertaken, the results will be the same.
Mr MILLS (Wallsend) [11.47 a.m.]: I am pleased to support the Drug Summit Legislative Response Amendment (Trial Period Extension) Bill. The Drug Summit was a watershed in policy debate and formulation regarding how the community should deal with the problem of people addicted to illicit drugs and the use of those drugs. At the Drug Summit a significant change occurred in public attitudes to illicit drug addiction. I believe that that was largely thanks to the positive and co-operative approach taken by members of Parliament and other delegates in assessing the various policy options available so that we could move forward to achieving a national drug strategy. For the first time, during and after the Drug Summit people like Tony Trimingham from Family Drug Support became widely heard. They explained the nature of drug addiction and the devastating consequences on families affected by the drug addiction of a family member.
Having lost his son to an overdose, Tony Trimingham had the courage to rethink his position and to set up a group of people who could help other families to cope with the problems that drug addiction causes to their families. Prior to the Drug Summit and in the immediate period afterwards one of the many problems often referred to in my electorate office was how families and particularly parents—sometimes grandparents as well—dealt with the problems caused by a drug addict living with them and causing them great grief. So I applaud Tony Trimingham and others like him for having the courage to come forward at the Drug Summit and help change community attitudes.
The Summit recommended, by majority, some difficult, awkward and controversial steps as well as some well-agreed steps. The key was that those steps were designed to try to save the lives of drug addicts. They placed the appropriately high value on every life and respected the life of every person, even if that person was addicted. Steps were also taken to acknowledge that addicted people have a health problem and that their addiction should be treated as such and not perceived as a criminal justice problem deserving punishment. The Labor Government responded to the Drug Summit with a legislative package that contained many steps. One of those was the establishment of a trial of a medically supervised injecting centre. Importantly, that was part of a package of an extra $170 million of funding over four years for drug rehabilitation, treatment, education, detoxification, and so on. A necessary part of establishing the trial of the medically supervised injecting centre was a good, independent and proper evaluation of it.
Listening to the debate this morning I have been reminded of where I started in this debate, that is, when I was elected to serve on the Joint Select Committee into Safe Injecting Rooms in 1997. That committee was initially chaired by the Hon. Patricia Staunton, MLC. When she left Parliament the chair was taken over by the Hon. Ann Symonds, MLC. A number of present members of the two Houses served on that committee 5½ or six years ago. They include the honourable member for Cronulla and the honourable member for Bligh, both of whom took part in debate this morning. I seem to be following those two members of the committee in debating these issues. It is interesting to reflect on some matters raised in the report on the establishment or trial of safe injecting rooms, as they were called. The executive summary on page XV of the report stated:
This Inquiry has its genesis in a recommendation made by Commissioner Wood in the Final Report on the Royal Commission into the New South Wales Police Service. Evidence had been presented to the Royal Commission that illegal shooting galleries, that is, places where drug users go to buy injecting equipment and rent a room for a short period of time to inject drugs, were operating in Kings Cross often with the approval of the police. Given that such a situation could give rise to corrupt practices, and that illegal drug use is an ongoing phenomenon in our society, Commissioner Wood recommended that "consideration be given to the establishment of safe, sanitary injecting rooms under the licence or supervision of the Department of Health, and to amendment of the Drug Misuse and Trafficking Act 1985 accordingly".
That is where we are coming from. That idea has flowed through the Drug Summit and the injecting room now being trialled thanks to the previous legislation. We are in the process of extending that trial. The honourable member for Cronulla seems to be an unreconstructed reactionary. He still uses the term "shooting gallery" even though the rest of us have moved on from there. He probably still refers to Qantas as TAA and to Westpac as the Bank of New South Wales. He has not moved on. At the suggestion of a Liberal member of the Legislative Council at the Drug Summit the term "safe" was abolished. That was done as an acknowledgement that people who inject poisonous substances into their veins are not doing anything that can be called safe. The Hon. John Ryan made an excellent suggestion late in the Summit that we should change the term to "medically supervised injecting room". I commend him for that. The commonsense of that approach is acknowledged in what we are now doing.
I have heard all the arguments before. In the report of the Joint Select Committee into Safe Injecting Rooms the arguments for the establishment or trial of injecting rooms from a health perspective were noted as having the potential to reduce fatal overdoses and to reduce the transmission of blood-borne viral infections. The report also noted that such facilities may provide injecting drug users with better access to primary medical care and improve the likelihood of them accessing drug treatment programs, and that injecting rooms may improve the occupational health and safety conditions of health workers and emergency service personnel. They are all matters that have been addressed in the evaluation of the trial of the medically supervised injecting centre. Arguments against the establishment or trial of an injecting room were also presented in the report. They were that injecting rooms could lead to an increase in drug use or in the number of injecting drug users, that they may delay injecting drug users from seeking rehabilitation, and that there are potential health and safety implications both for those using, and for those working in, the injecting room.
The report went on to give the arguments for the establishment or trial of injecting rooms from a social perspective. Those arguments included the possibility that they may lead to a reduction in the public nuisance aspects of injecting drug use, that they may reduce opportunities for police corruption and the incidence of some criminal activities, and that they may improve the likelihood of reintegration of injecting drug users into mainstream society. Again, arguments against the establishment or trial of injecting rooms were presented from a social perspective. Arguments for the establishment or trial of injecting rooms from an economic perspective were given in that report. They included reducing the cost to the community associated with the treatment of overdoses and the treatment of people who contract blood-borne viral infections, and so on. We have been there before.
There are no new arguments, but the key difference 5½ years on, thanks to the courage of the Drug Summit delegates, the Carr Government and the majority of members in this Parliament, is that we have our own evidence in New South Wales. I thank the Premier and the Special Minister of State for having the courage to continue to implement the recommendations of the Drug Summit. That evidence is in the evaluation report. We have not had that report before; we only had the arguments. Whether one agrees with the bill or not, the Government has done the responsible thing and gathered the evidence. Those who gathered the evidence were independent people of great integrity and competence. We can have great respect for this report because of those people.
They were Professor John Kaldor, the Deputy Director of the National Centre in HIV Epidemiology and Clinical Research at the University of New South Wales; Helen Lapsley, formerly a senior lecturer at the School of Public Health and Community Medicine at the same university; Professor Richard Mattick, the Director of the National Drug and Alcohol Research Centre; Dr Don Weatherburn, the Director of the New South Wales Bureau of Crime Statistics and Research; and Dr Andrew Wilson, formerly the Chief Health Officer in the New South Wales Department of Health. I commend them for their report and for the thoroughness of it. Their evidence concerning the injecting centre at Kings Cross revealed some warts. The uptake of the opportunity for referral to detoxification or treatment is lower than I would have hoped, but it is there and it has been measured by the evaluating committee. I refer to this dot point in the report:
• Approximately one in 41 visits resulted in a referral for further assistance. Among the 1,385 referrals for further assistance made for 577 clients, 43% were for the treatment of drug dependence, 32% were to primary health-care facilities and 25% were to social welfare services.
One of the great benefits of the centre is that we have been able to measure the referral basis for it. There was success in referring people who may well not have been referred for treatment or to social services if the centre had not been operating. Other evidence relates to overdoses. In this regard the report stated:
It is likely that the MSIC staff had prevented some overdose fatalities among those who used the Centre …
On the basis of clinical and epidemiological data on heroin overdose outcomes, at least four deaths per year are estimated to have been prevented by clinical intervention of the staff at the MSIC.
Lives have been saved! The objectives of the first stage of the trial are being achieved. We cannot ignore the evidence in the report to that effect. Some Opposition members said that the money spent on the centre should be spent on detoxification and rehabilitation programs. That argument is not sustainable. The Government is already spending some of the Drug Summit response package funding on such programs. I know from my activities as a local member of Parliament that money is being spent all across New South Wales, including in regional areas, to fund those programs. Before the Drug Summit, once or twice a month a desperate addict would knock on my office door seeking my help to get a place in a detoxification and rehabilitation program. But in the Hunter region, and in many parts of New South Wales, places simply were not available. People were told they had to wait three months for a place, but often by that time the addict had changed his mind.
Since the Drug Summit, the injection of money, and the additional places for detoxification and rehabilitation—which previous speakers have referred to—I have been approached by only a couple of people and in both cases I have been able to refer them for immediate placement in a Hunter-based detoxification and rehabilitation unit. While I am sure that some people are still not able to get immediate referral, the Government has provided extra money for the programs. The Opposition cannot use the argument that the money spent on the centre should be spent on detoxification and rehabilitation places, because those places are already funded.
During the recent Alcohol Summit I took a trip, together with other interested members—including the Minister for Justice, the honourable member for Vaucluse, the honourable member for Davidson, and the Leader of the National Party—to Silverwater remand centre and Mulawa women's prison. We were told that 50 to 70 per cent of incoming prisoners needed immediate detoxification, almost all for alcohol dependency. That is an expensive process that occurs throughout all New South Wales gaols.
Another element of the drug treatment package that the Government has implemented following the Drug Summit is a 12-bed unit at the remand centre to which the Drug Court at Parramatta can refer offenders for drug treatment. I also had the opportunity to talk to some of the offenders. I commend the Government for the introduction of the medically supervised injecting centre at Kings Cross and I commend the extension of the trial period.
Mr MAGUIRE (Wagga Wagga) [12.02 p.m.]: I am on record as having participated in the Drug Summit and for my opposition to the injecting rooms. I have read the report and the evaluation on the injecting centre, and they contain nothing new that would change my mind. For the many reasons put forward by previous speakers today, particularly the Deputy Leader of the Opposition and the honourable member for Bega, I will not support the extension of this so-called trial. I would not support the supply of alcohol to alcoholics, nor the suggestion to allow underage drinkers to experiment with alcohol. I would view favourably the allocation of extra funding for rehabilitation and extra resources for prosecuting peddlers of illicit drugs, particularly heroin, of death and destruction. For those reasons I will vote against this bill.
Mr ORKOPOULOS (Swansea) [12.03 p.m.]: I support the legislation. Firstly, I would like to address some of the issues that have been raised by Opposition members, who, surprisingly, although they can have a conscience vote, have all indicated they will vote against the bill. The Deputy Leader of the Opposition tried to construct an argument on the basis of the evaluation that the trial was wrong and should be abandoned, and that other forms of therapy or treatment should take place. If I could be so bold, I suggest that the Deputy Leader of the Opposition is hardly a visceral model of constraint. Just to say no to drugs or to implement other more extreme versions of treatment, which he advocates, does not address the problem.
Following the Drug Summit in 1999, it was imperative that the Government chart a new course of treatment. It was important that we not only expand the range of treatment options for people addicted to heroin but also expand the methadone program, particularly in rural and regional New South Wales, where there was an absence of such programs. We had to provide treatment to people who had identified a problem with a whole range of illicit drugs. The Government has done that, and this bill will ensure that the excellent work started at Kings Cross will continue.
The Government has focused on prevention, education, treatment, and law enforcement. We have introduced a suite of treatments to deal with drugs in our community. Our focus on prevention and education includes drug education for our young people. Through the personal development, health and physical education [PDHPE] curriculum in our schools, which is considered one of the best in the world, our young people receive the best education and information on drugs. However, as was pointed out at the Drug Summit, our young people are often better educated than their parents. Some parents get drunk at home or take various types of drugs. We have to also reach the older generation and educate them about drugs. As to treatment, this bill provides for one aspect of a suite of treatments for illicit drugs.
I am not impressed with the Opposition's argument that because the results of the evaluation of the centre show that only a small number of lives have been saved the centre should be closed. Every life saved should be cherished. You cannot have the philosophy that abortion or termination is wrong because of the value of life, yet say that this trial should be abolished because only one or two lives have been saved. You either value life or you do not. As to promoting the value of healthy lifestyles to people who, unfortunately, are addicted to heroin or other illicit substances, we need to ensure that these people are referred to rehabilitation programs and continue with them. Even if the evaluation is inconclusive, we must ensure that we refer these people to programs that will lead them to a healthy lifestyle.
I believe that any opposition to this bill is opposition to life and a healthy way of dealing with this difficult problem. It continues on from the old 1999 opposition, sponsored by the former Leader of the Opposition, Mrs Chikarovski, and does not bring anything of value to this debate. The Opposition has not introduced any new element into the debate, other than the interesting point made by the honourable member for Bega. He asked why the Government is not treating this as a permanent solution or preventative strategy in its armoury to deal with this problem. Why are we continuing with a trial? Without consulting the oracles, I believe we must continue the trial and the evaluation process so we can improve access to drug rehabilitation programs to ensure that addicts live. Every life lost would be a stain on my conscience if this trial were scrapped. For that reason I cannot oppose this bill, and I commend it to the House.
Ms HODGKINSON (Burrinjuck) [12.11 p.m.]: I oppose this Government bill. Once again I voice my opposition to the medically supervised heroin injecting room, as I did four years ago when I spoke at the Drug Summit. I can never condone the use of illicit drugs. Community leaders such as members of Parliament have a responsibility to act as role models for our constituents, who look to us for advice and leadership. The drug house at Kings Cross condones heroin use and I can never agree with that. This Parliament should provide incentives for people to stop using heroin once and for all; it must never encourage its use. We should provide more beds and rehabilitation services for the many people who want to stop using heroin; that must be our priority.
When I hear that millions of dollars are being spent on this interjecting room I cannot help but think how much more effectively that money could be used in providing beds and an opportunity for people to get off heroin. Some people start taking drugs in gaol and elsewhere. It is our responsibility to discourage them from using drugs and to help them to get off them. We have a responsibility as members of Parliament to act responsibility in this regard and to provide disincentives, community education, rehabilitation, and so on. Very simply, I oppose the bill.
Ms BURNEY (Canterbury) [12.14 p.m.]: I support this bill and welcome the extension of the heroin interjecting room trial in Kings Cross until 31 October 2007. I speak from a slightly different perspective in supporting this legislation. Like many other honourable members, I was a delegate at the 1999 Drug Summit. I did not attend as a politician but as a community representative. After the Summit I was invited to be a member of the expert advisory group responsible for overseeing the implementation of the Summit's recommendations and decisions. Therefore, I do not speak from a position of ignorance. I understand the range, flexibility and diversity of the Summit outcomes and recommendations regarding the interjecting room, juvenile justice centres, school education, and the prison system. I understand the entirety of the Drug Summit's goals.
As parliamentarians and lawmakers we have an obligation to think compassionately about the extension of the trial. I have just come from the launch of the Catholic Church's annual social justice statement, which deals with compassion and the way in which we act as a society. I am not trying to be dramatic but, from my perspective, one of the shining lights in the implementation of the Drug Summit outcomes is the bravery and flexibility displayed and the desire to have as many options as possible for dealing with the issue of drug use, particularly injecting drug use, in Sydney.
I have met people who have used the facility at Kings Cross. More importantly, people in my family and young people very close to me have died as a result of heroin use. We cannot step away from that as individuals and as members of society. We cannot simply say that heroin use is wrong and that junkies are hopeless and should be able to cope as well as anyone else. Many heroin users are young people; any of them could be our daughters, sons and cousins—in fact, many are. They all have families who love them and who are as desperate as they are to do something about their addiction.
We live in a very tough world in which some people find reality impossible to bear. Many people's lives are destroyed almost from the moment of birth. We live in a world that questions many of the things we hold to be true and is changing rapidly. Of course, some people feel they cannot cope and as a result they get caught in a terrible downwards spiral to injecting drug use. Many users also suffer from diseases such as hepatitis C. The evaluation of the injecting room considered those issues. I would like all honourable members to think about the many things that lead to people putting a needle in their arm and possibly dying as a result. If there is anything that lawmakers can do to help deal with this situation—whether it be by providing more beds, more detoxification centres, or a safe place to use heroin, and therefore providing assistance and support to do something about this terrible addiction—I believe we have a responsibility to support it. At the end of the day, what is so dreadful about it? We need to remember that anyone who walks in the door of the injecting room could be near and dear to us.
Heroin does not choose a certain socioeconomic group; it does not choose between males and females; and it does not choose between people who have had a dreadful life and those who have had a good life. It is simply a dreadful reality of our society that this drug is a part of it, and part of the solution is that we have to deal with it from a very real perspective. As I said earlier, if there is a suite of ways in which we can deal with this scourge, and an injecting room is part of that, we should all embrace it, and it should be within the framework of compassion.
I emphasise once again that drug addiction can touch every one of our lives. Indeed, it has touched the lives of my family and friends. We sat with my 18-year-old niece for 25 minutes after a life-support machine was taken off her, until her heart stopped. My niece was not a bad person; she was a kid who got caught up in the dreadful web of heroin use. Notwithstanding the evaluation and the fact that the heroin injecting room has become an accepted part of the community in which it exists, I feel absolutely compelled to support any measure whatsoever that will support people who are caught up in the awful spiral of heroin use. For those reasons, I believe that supporting this trial for the next four years is the brave thing to do, it is the right thing to do, and, above all, it is the compassionate thing to do. I commend the bill to the House.
Mr APLIN (Albury) [12.23 p.m.]: The honourable member for Canterbury asked what is wrong with the injecting room. One may well ask: What is wrong with heroin? What is wrong with alcohol? What is wrong with abuse? What is wrong with violence in general? All these go to the heart of the issue: that we have laws in this land. As parliamentarians we also have a responsibility to acknowledge the weakness of the human condition, and to support those who fail in some way to support themselves. Sometimes it is easy to take a cop-out and abuse the law that we ourselves set. I ask whether this is an example of such a cop-out.
I recently spoke in support of, and voted for, the extension of police powers to examine and detect drugs in border regions. I find it incompatible that I should then turn around and support the use of drugs. I find the support of the drug trade despicable. I believe that the peddlers of death and destruction deserve the highest possible penalties for wreaking the havoc they do on our society. I also find it incompatible that we should support the weakness by feeding the habit. I believe in rehabilitation, and that we need to spend much more money on it. I believe that this area is not supported wholeheartedly by the Government.
During the recent Alcohol Summit I, along with other members, visited a rehabilitation house in the Illawarra. The staff told me about the extent of their work in the detoxification and rehabilitation of young people who are caught up in the web of drug and alcohol dependency. I know of people who have been caught up in drug addiction and had their lives ruined, and I also know of those who have had the strength and support to come through on the other side and rebuild their lives. That is what we should be aiming at; that is the mission we should be setting ourselves.
Last week I participated in the launch of a rehabilitation fundraising drive organised by Albury-Wodonga Community Care. It is entitled "The Drug Run", because in the current climate that terminology attracts attention. The purpose of the fundraising drive is not to run drugs but to raise funds to support the rehabilitation of those who, unfortunately, have got caught up in a drug addiction. The rehabilitation unit, Granya House, whose establishment I played a role in, receives not one single dollar in New South Wales Government support. Shame, shame, shame!
Granya House serves the border region as a whole and receives people from all of southern New South Wales and even further afield. Indeed, I believe that some people who live in northern areas of the State register for attendance at Granya House. Granya House is now run by Faith City because there is no government support for it. The unit raises its funds from the community, and it involves itself in the mission of rehabilitating people who, unfortunately, have been caught up in drug addiction. That is the mission we should be setting ourselves: the rehabilitation of those individuals, and the hard work that it takes to accept that they have been caught up in the addiction and to work their way through it so they can return to their lives as worthwhile, supported citizens who can play a proper role, rather than the role they have been forced into in some cases, or have sunk into through their own weakness or whatever condition affects them. It is up to us to support those people, and to support those who are raising funds for their rehabilitation. For those reasons I cannot support the bill.
Mr ARMSTRONG (Lachlan) [12.27 p.m.]: I listened with interest to this morning's debate, which reflected that a number of Government members have been either requested or told to support the Government's position on the continuation of the trial of the medically supervised injecting room at Kings Cross. However, very few members addressed the real issue in this debate: the continuation of the injecting room as a trial. The purpose of this debate is not to canvass the plethora of ideas regarding the use of drugs in the community. The question that needs to be asked is: What has been achieved by the injecting room that has been set up in Kings Cross at a cost of $18 million? I do not think anyone has been able to demonstrate that the injecting room has achieved any beneficial result in reducing the number of drug addicts in this city and saving any more than some, at best, 13 lives.
Last night at about sunset as I walked through Martin Place I noticed behind the fruit and flower barrow about eight men who had received an evening meal from one of the charities. I glanced quickly at the men and it was obvious that some of them were suffering, or had suffered in the past, from the effects of alcohol. The weekend before last I met with a man whom I have known for many years who is dying of lung cancer. The Government is not advocating that we should set up establishments where people can go and drink because they have a drinking problem, like some of the eight men I observed last night. The Government is not advocating that we should set up smoking rooms for people who have an addiction to smoking, despite the fact that people are dying as a result of that addiction. However, for some reason—perhaps because it has no other thought on the matter—it has decided that the answer to the drugs problem is an injecting room in Kings Cross.
Mr Cansdell: An easy way out.
Mr ARMSTRONG: It is. If it worked I would be the first to say, "Well done". But there is not one scintilla of evidence that the injecting room has done anything to reduce the amount of drugs in the community and the effect they have on young people's lives and on middle-aged people's lives. As the honourable member for Albury said, drugs are non-selective—they apply to all socioeconomic classes in the community. I suggest that rather than continue with this experiment to placate a few academics and maybe backroom people in the Government we should have a look at advertising campaigns. If an advertising campaign against alcohol is working, if an advertising campaign against smoking is working—smoking is banned in virtually every building in the State and every children's playground, which I support—why do we not have the same sort of advertising campaign in relation to drugs? Has the Government got it right? The Government cannot have it both ways. Tobacco is a drug, alcohol is a drug and heroin is a drug. They are all drugs. They have a common bond. Why are we saying that hard drugs—injectable drugs—are different from other drugs? There is a lack of common thinking on how to manage a community problem.
The injecting room has been an interesting experiment. It has cost $18 million and the results are there for all to see: it has achieved very little. On the other hand, we believe that the heavy advertising campaigns against smoking may be preventing some people from taking up smoking—and that is a good thing. We would hope that the advertising in relation to alcohol consumption is working as well. The Alcohol Summit was held three weeks ago and we talked about alcohol consumption for a week. If it is good enough to treat tobacco and alcohol, two of the hard drugs, in that manner why not the so-called injectable drugs as well? Let us forget this poppycock about creating a pleasant place in ideal conditions for people to continue their habit, which in many cases will lead to their downfall if not their death. I suspect that the Government is well behind the eight ball on this. It has been badly advised. It should re-examine the whole program and the advice it has been getting. The Government should reassess the position and have a look at the parallels of other drugs in the community.
Mr GEORGE (Lismore) [12.32 p.m.]: Along with the honourable member for Lachlan, the honourable member for Albury and the honourable member for Wagga Wagga, I am concerned about where we are going with this issue. As I have said in the House before and as I will say again: drugs are like cancer; no-one is immune to them—families, friends and relatives are not immune to them; young people and old people are not immune to them. It is common knowledge that when there has been a shortage of heroin on the drug market there has been a significant reduction in overdose deaths and events throughout New South Wales and Australia. As I understand it, from the figures that I have seen, clients who used the injecting room still did 98 per cent of their shooting up away from the room. We all know that the use of drugs causes a loss of production in the workforce and in households.
Money should be put into law enforcement and treatment because there is no such thing as safe drug use. I might be asked, "Well, where would you put the money?" My electorate of Lismore has a wonderful Riverlands detoxification and rehabilitation unit. However, although it helps people and puts them through the process, if family or friends do not pick them up from the unit on the day their treatment finishes they go back out on the street. This is where we can put the money. We need what I would term a halfway house—for want of a better description. Sadly, if friends or family do not pick them up they go straight back onto the streets, straight back into the cycle they have just come out of. It is a never-ending cycle.
Rural areas have drug problems and we need to provide non-government organisations with the means to support these detox and rehabilitation units. I would like to see a lot more funding put into education and the prosecution of the dealers who peddle death and destruction. I am sure I speak for the majority of people in the Lismore electorate when I say that we certainly do not want an injecting room in the area. More funding is needed for drug rehabilitation centres in rural areas in this State. I certainly will not be voting in favour of the bill. All members have been touched by the drug stories and the drug tragedies. I certainly will be voting against the bill.
Mr NEWELL (Tweed—Parliamentary Secretary), on behalf of Ms Meagher [12.38 p.m.], in reply: I thank all members for their contributions to this debate. I also restate the Government's position. The purpose of the bill is to extend for a further four years the trial period of the medically supervised injecting centre at Kings Cross so that it now concludes on 31 October 2007. The 1999 Drug Summit established a new direction for drug policy in New South Wales. It recognised the complexity of drug abuse and the need for a comprehensive approach.
The Government, in partnership with the community, is responding to the drug problem through prevention, education, treatment and law enforcement. In July 1999 the Government allocated $176 million in additional funding to implement the Drug Summit's recommendations over four years. Building on the work since 1999, a new four-year, $233 million plan has been announced. The Medically Supervised Injecting Centre is just one part of the Government's comprehensive approach. I point out to the honourable member for Lismore that the cost of the Medically Supervised Injecting Centre at Kings Cross is not the $18 million that he claimed, but is more in the vicinity of $8.3 million.
All aspects of the current licence, the terms and conditions for operating the centre and the trial remain unchanged for the additional period. The trial will continue to be carefully monitored over the next four years. The extension period will be used to trial and assess new approaches to encouraging drug users into treatment, and other research suggested by the New South Wales Expert Advisory Group on Drugs and the independent evaluators of the trial. The extension will provide an opportunity for information and data to be collected over a longer period and to take account of any changes in the drug market, such as any changes in the supply of heroin. The fact that the trial has a limited life gives the government of the day in 2007 the opportunity to consider its suitability both in terms of location and purpose. The Government has made the decision to extend the trial based on the report entitled "Final Evaluation Report of the Medically Supervised Injecting Centre—Trial" released on 9 July 2003 and on advice from the New South Wales Expert Advisory Group on Drugs.
I should like to make a few comments about some of the issues raised in this debate. In terms of the evaluation report, the independent evaluation of the Medically Supervised Injecting Centre was conducted by a group of respected academic researchers from highly regarded institutions. They relied not just on the data collected for this evaluation but used other research and references to analyse and verify their results. The Government is confident about the reliability of the results. The independent evaluators provided a comprehensive and well-documented report to the Government in July. They found that, even by the most conservative estimate, lives were saved during the 18-month period under review. In the 12 months since, it is likely more lives would have been saved. Further, the evaluators found that 329 heroin overdose incidents were managed in the centre with no deaths. More than 500 such overdose incidents have now been managed by the centre. The evaluators have stated that had the centre staff not intervened, had they sat back, it is possible that some of these people might have died. It is also likely that some may have suffered serious brain or vital organ damage. The report tells us that 44 per cent of the people registered to use the centre had previously overdosed.
We should be quite clear that the typical client is a person dependent on heroin, engaged in a chaotic lifestyle, at high risk of overdose and injecting in public places. This is the centre's target client group. The centre, where help is at hand and where there is also the possibility of receiving other referrals for assistance, is a better place for these people than on the streets, injecting in the parks and back alleys of Kings Cross and perhaps dying there. Now more than 5,000 people are registered with the centre. The centre is building a relationship with some of these people. There are very limited comparable cost-effective options to engage with this particularly high-risk and intractable group of injecting drug users. Since the Drug Summit we have funded 100 rehabilitation beds and detoxification places and beds, drug treatment programs have been improved by the introduction of case management for clients and alternative pharmacotherapies such as buprenorphine have been introduced.
Many people have been able to deal with their drug addiction through these measures. Clients of the centre up until now have not succeeded in engaging with the health or justice systems where they might be encouraged or compelled to enter drug treatment. At least here we may still have a chance to help them. In relation to comments on referral for treatment, according to the evaluators, although the rate of confirmed referral uptake was not high, the rate of confirmed uptake was three times higher among clients who were regular attendees at the centre. Clients who visited the centre on more than 10 occasions were statistically almost 18 times more likely to have confirmed referral uptake. Almost one-third of written referrals for drug treatment were provided for clients who had not been in treatment before. The extension of the trial period will be used to assess new approaches to encouraging drug users into treatment. A special case manager will be appointed to the centre to build relationships with clients and service providers in the area, and to take a proactive approach in client referral and follow-up.
It is not possible to determine the number of people successfully completing treatment, as the evaluation did not follow individual clients across time if they did not stay in contact with the Medically Supervised Injecting Centre. Investigation of impediments to properly monitoring referrals, including impediments posed by the current New South Wales privacy legislation, will be undertaken during the trial extension. I should emphasise that the extension of the trial for four years is not a radical proposal. It will continue to be very carefully monitored. The Government will also continue to roll out its broad-based drug program. This is only one of many projects that are a part of our $230 million package for the next four years. I commend the bill to the House.
Question—That this bill be now read a second time—put.
The House divided.
Ayes, 56
Ms Allan
Mr Amery
Ms Andrews
Mr Barr
Mr Bartlett
Ms Beamer
Ms Berejiklian
Mr Black
Mr Brogden
Mr Brown
Ms Burney
Mr Campbell
Mr Collier
Mr Corrigan
Mr Crittenden
Ms D'Amore
Mr Debus
Ms Gadiel
Mr Gaudry | Mr Gibson
Mr Greene
Ms Hay
Mr Hickey
Mrs Hopwood
Mr Hunter
Ms Judge
Ms Keneally
Mr Knowles
Mr Lynch
Mr McBride
Mr McLeay
Ms Meagher
Ms Megarrity
Mr Mills
Ms Moore
Mr Morris
Mr Newell
Ms Nori | Mr Oakeshott
Mr Orkopoulos
Mrs Paluzzano
Mr Pearce
Mrs Perry
Mr Price
Dr Refshauge
Ms Saliba
Mr Sartor
Mr Shearan
Mr Stewart
Mr Tripodi
Mr Watkins
Mr West
Mr Whan
Mr Yeadon
Tellers,
Mr Ashton
Mr Martin |
Noes, 27
Mr Aplin
Mr Armstrong
Mr Cansdell
Mr Constance
Mr Fraser
Mrs Hancock
Mr Hartcher
Ms Hodgkinson
Mr Humpherson
Mr Kerr | Mr McGrane
Mr Merton
Mr O'Farrell
Mr Page
Mr Piccoli
Mr Pringle
Mr Roberts
Ms Seaton
Mr Slack-Smith
Mr Souris | Mr Stoner
Mr Tink
Mr Torbay
Mr J. H. Turner
Mr R. W. Turner
Tellers,
Mr George
Mr Maguire |
Question resolved in the affirmative.
Motion agreed to.
Bill read a second time and passed through remaining stages.