A former health minister outlines the three reasons why politicians have failed to act on alcohol

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From Crikey

A ban on alcohol advertising needs to be seriously canvassed, according to a former NSW Health Minister, John Della Bosca.

In a speech to the recent  NSW Alcohol Summit (you can read a transcript of his comments below and a wider report of the proceedings from the Foundation for Alcohol Research and Education), he also called for debate to focus on regulation of bottle shops and supermarkets.

He said: “If you wanted my pick on the big policy change that has to happen, then I’ll give it to you, we have to do something about alcohol advertising.

“A fundamental problem is that people, particularly young people, are drawn into culture of abuse not by the drug itself but by the promotion and campaigns around the drug which is why”¦ a lot of our prevention initiatives don’t work, because it’s literally a pea gun fighting a 7-inch cannon.”

Della Bosca suggested that it was not fair to hold local publicans accountable for the poor behaviour that “is encouraged by the more general culture ”” much of which is fostered by large corporations and their advertising campaigns and so on”.

“We kind of think of culture as something that is independent and created just by people living their lives. That’s true, but culture is also something that is created by stakeholders, and interest groups, and powerful players in society from time to time there’s certainly a lot of people with strong vested interest in creating a culture of abuse or risky use of alcohol or who disregard the impact”¦ those who create the risky culture disregard the possible risky impact.”

Della Bosca gave three reasons why politicians have failed to act on alcohol:

“The first is driven, or has been over the years driven by that sort of big alcohol power”¦ the power and influence, the power to go to fundraising dinners, the power to give donations to parties, the power to lobby industry unions who have workers in the industry. I mean, all those things, I’m talking about over the last 20 to 30 years and longer, all those things have played a role”¦ in making, in cowering, if you like, politicians to a certain extent.

The second is local politics. The most important people in any public, not the most important but many of the most important people will be in the local community”¦ will be publicans and managers of local clubs and they’ll often be seen as very solid citizens people and people who give donations to worthy causes and so on, so they have pulling power. Recent campaigns about other side of the agenda on gambling will show some of that pulling power”¦ So it’s local politics. And that goes beyond what you think now there’s licenses so rugby clubs, surf lifesaving clubs, everybody can to a point sell alcohol. So we have that as an issue.

The other is a sort of culture and ideology argument.   And there is an argument, well it’s like the tobacco argument, but I think it’s a bit redundant, it’s a product in a free society but the big thing is nobody wants to be seen – other than my good friend Fred Nile – as a ’wowser’. Nobody wants to be seen as somebody who’s going to ruin fun [things]. And you might laugh at that but that has a big role on the way in which people will conduct this debate.”

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Tackling alcohol requires “big and courageous intervention in the market”

(A lightly edited transcript of John Della Bosca’s speech, provided by the Foundation for Alcohol Research and Education)

The job I’ve been given is to reflect on the alcohol summit that occurred”¦ not actually in this place [the Theatrette] but upstairs in the Council Chamber.

And look, at I suppose its strengths and weaknesses; its successes and failures”¦ a decade down the track..

And I think the best starting point for me to do that is of course to say”¦ – probably partly because I’m no longer a member of this place – I don’t have a record to defend in regard to the Alcohol Summit so hopefully I can be ”¦ brutally frank.

And looking at it 10 years down the track you have to say that both the results and even some of the outcomes of the alcohol summit were relatively disappointing.

I cannot say that it was because of the quality of contributions.

Because there were a lot of good policy there at the alcohol summit, there was goodwill from both sides of politics”¦ there were people from industry there”¦. And there were ”¦ a lot of people who had personal experience – both very negative experiences in some cases and ”¦ I suppose some people would be happy to concede some positive experiences in relation to the use of alcohol.

So it was a pretty vibrant group of people. There was no stone unturned.

We debated pretty well everything: The dreaded thorny issues like alcohol advertising; the key policy issue of whether prevention is better than the cure – a vast oversimplification, I understand.

But where I compare it is ”¦ with the drug summit which occurred 3 and a half years, or 4 years before that.

I would say the opposite is true of the drug summit – the drug summit, which was assumed to be a probable failure.

Almost everyone who went into it assuming it was political whitewash”¦ [but it] ended up being a very significant change in the direction of policy towards illicit drugs.

And I suppose that’s one of the things I would think we have to accept with alcohol policy change: it’s probably not going to be happening in small increments.

Small increments are very important, but to really change some of the big things we’re probably going to need some big block changes.

Because there were some big symbolic and actual changes that came out of the drug summit.

It [The Drug Summit] is such an easy comparison so I’ll keep using it even though it might annoy some people.

That’s one key thing, the Alcohol Summit was unable to produce a big block departure from past policy practices and past approaches.

It [The Alcohol Summit] did in fact refine and concentrate and developed a few initiatives ”” many of which were jeopardised, some of which were completely smothered over, or smothered off, by political developments down the track.

I think in regard to the law enforcement part [of the Alcohol Summit]”¦ which some people might think is an irony”¦ But in regard to the law enforcement part of the alcohol summit and some of the licensing issues were some of the bright points.

Some things happened there that really made a substantial difference”¦

And some trials were put in place: the now famous Newcastle trial .. the trial over at – although not directly related to the alcohol summit it was a knock on effect – experiment at Manly.

These all had clear positive outcomes in terms of issues like ”¦ criminal assaults, violent behaviour, and the effects of severe public drunkenness.

All those kinds of these issues it has to be said were fairly dealt with.

But what we didn’t see was a general change across NSW.

What we didn’t see was those successful experiments”¦ transported across the state and indeed as the Drug Summit – I’d call them experiments – but the Drug Summit initiatives in many cases, not all cases, but many cases became things that were spread right across not only the NSW jurisdiction but right across ”¦ the health and policy jurisdictions across the whole of Australia. And some of them became international.
That was a key reflection, if you like.

I hate to nominate disappointments”¦ but yeah it has been a little bit of a disappointment.

The second thing I think is that ”¦ if you were looking in the direction of where those big block changes need to come it really needs to go back to the basics.

Something people were quite aware of 220 years ago when this place was the ’Rum Colony’”¦ and we were getting all sorts of tastes of that”¦ and you know”¦ Alex [Wodak?] or someone else might want to correct me on this”¦ but you know some people cite as one of the earliest harm minimisation measures was Governor King’s decision”¦ to get the equipment required for brewing beer and importing hops”¦ to make beer as a substitute for rum ”¦ because there were much more adverse effects from drinking rum as compared to the drinking of beer”¦ and changed the allowable hours from consumption of beer and rum and so on.

So therefore Australia gained reputation as abusers of beer than rum.. but a slightly better position if you follow the logic of many harm minimisation positions

So I suppose that’s another thing, that it does require big and courageous”¦ intervention in the market.

And alcohol is a dangerous product”¦ dangerous in the way that”¦ dynamite is dangerous or rat poison is dangerous or all sorts of other things it can have a dangerous effect.

Our problem is that alcohol in that way sits beside not the illicit drugs that have similar kinds of consequences that are negative; but [it] sit beside all the things we associate with”¦ positives in life”¦

It sits beside celebrations, it sits beside relaxation, it sits beside stimulation, conversation and so on.

And indeed probably 90 per cent of people in this room would happily nominate”¦ occasional imbibing of alcohol as part of a positive experience in their life”¦ And would probably argue that it has or has had very few negatives.

If 90 per cent of you don’t, I can guarantee you that about 95 per cent of people walking down”¦ any suburban street would say that.

I think that’s something that’s very important: The notion that alcoholism is an illness that affects small number of people, as distinct from”¦ a potential epidemic that could affect a large number of people.

In fact [for] many people in the community that is not accepted”¦ It may be accepted by policy makers but that is a dangerous territory, which I will get to in my conclusion as to where the directions are.

And the other kind of things I suppose is that intervention needs to be backed up by decisions based on the hard evidence”¦

We know it’s a dangerous product; 200 years ago governors of this place and in fact people all over the world were thinking in ways to make licensing the sale of alcohol something people were very responsible about.

And you now have a kind of specific regime called ’responsible service of alcohol’.

But before that there was this notion that or hundred of year the whole reason ”” other than for commercial monopoly being provided to your favoured friends ”” the whole reason for the notion for a licensing system for alcohol was because it was a special kind of product with special kind of characteristics.

Not the celebratory good side of things but the risks and downsides of alcohol that require a special kind of entitlement or licence to sell alcohol.

Oddly the policy makers and probably at least in part including my self, started moving a long way from here.

So now you go to many ”¦ supermarkets and so on and there’s effectively unsupervised sale of alcohol products or minimally supervised sale of alcohol products.

And I think that’s probably one of the issues we really need to come up against”¦ that if there is going to be a market for this potentially dangerous product which has all these outcomes which anyone in this room can nominate in great detail”¦ But the decisions that need to be made to reduce those harmful effects are fairly straightforward.

And they’re not is the soft preventative area which everybody feels good about; they’re in the hard area where you have to take on the power of vested interests: the power of vested interests like the large corporate alcohol producers and suppliers, and marketers”¦ who are very powerful.

Probably because of the change in regime about fundraising they might be less powerful than they used to me, but they’re certainly able to influence not only directly the political environment but they’re able to influence by their focus on public affairs and opinion making and their impact on popular culture, I mean things as trivial as product placement in movies.

Where is the equivalent alcohol movement to what’s going on with cigarettes at the moment? It doesn’t exist. Why? Because there is substantial revenue for product placement in cinema productions.

So there’s little subtle things there that need to be taken on in its fullest. So there is that big corporate interest.

But there is also [the] smaller interest that is more difficult to deal with politically.

”¦ What are some of the challenges here?

The big challenge from corporate sector is sort of obvious”¦ it comes from advertising, public relations, lobbying, contributions to fundraising campaigns and those sorts of things. So that’s your big corporate liquor interest.

But [with] your smaller [political] interest[s], I think what you need to do is what I failed to do, and what we failed to do at alcohol summit the first time round, [and that] is develop some kind of alliance some kind of notion.. I think probably police have succeeded in doing this more than anybody”¦

Looking at how the local alcohol interest, the local publican, is held accountable almost always for the poor behaviour that is encouraged by the more general culture ”” much of which is fostered by large corporations and their advertising campaigns and so on.

If you wanted my pick on the big policy change that has to happen, then I’ll give it to you, we have to do something about alcohol advertising.

I suspect you can’t do something like simply saying have some guidelines saying we’ll do things differently.

I think the leap has to be about a serious debate about the banning of alcohol advertising”¦ in electronic and probably in print form as well, where at least you know promotions and brochures [may need a] legislative solution.

I think that a debate that has to happen.

Because you can’t make the local publican – if you think about this in a local market sense – you can’t make the publican ”¦ finally accountable for the behaviours that occur in and around their premises even if they’re endearing to all codes of responsibility [such as] asking people to leave and doing all those right things.

But a fundamental problem is that people”¦ particularly young people, are drawn into culture of abuse not by the drug itself but by the promotion and campaigns around the drug which is why”¦ a lot of our prevention initiatives don’t work because it’s literally a pea gun fighting a 7-inch cannon.

Because you can have a bit of prevention in”¦ year 11 or year 10, but the kids watching the movies and listening and seeing the ads and all those sorts of things will be drinking riskily perhaps in year nine”¦ and that’s going to be a problem when talking about youth alcohol but that influences older people as well.

If you want me to nominate”¦ the big challenge it is advertising. There is no doubt about it. Its one we sort of chickened out on the first round”¦ probably would have been the difference between the alcohol summit being very successful last time and it being something we think about over the years and struck out in the right directions but not making a difference. I think that’s the big one.

And then you fit in a whole bunch of things around advertising, a whole bunch of changes occur, because that’s the key.

”¦ We kind of think of culture as something that is independent and created just by people living their lives. That’s true, but culture is also something that is created by stakeholders, and interest groups, and powerful players in society from time to time there’s certainly a lot of people with strong vested interest in creating a culture of abuse or risky use of alcohol or who disregard the impact”¦ those who create the risky culture disregard the possible risky impact.

That’s where I would say we need to go and I’d say that is very strong along the lines of looking at advertising, having a debate, perhaps taking the initiatives, and secondly once you’ve done that have the platform”¦ to look at the regulation around [alcohol promotions].

I think we have to have a serious argument about regulation of bottle shops and supermarkets.

I know there is some care about this, but”¦ in instances you can see the trend line is increasing towards supermarket alcohol like some of the other jurisdictions in the world, and that in the context of Australians approach to alcohol at large that’s the toughest thing.

Lastly, but not least, and I’ll conclude on this point: What’s the problem with politicians? And this is something I was asked to address. Why can you sort of say these things that are pretty obvious to us? Because I’m going to be mean and nasty about politicians I’m going to chuck myself back into the politician side now so I don’t seem self-righteous in hindsight..   Well it’s driven by 3 things and in the end everyone’s accountable for those 3 things.

The first is driven, or has been over the years driven by that sort of big alcohol power”¦ the power and influence, the power to go to fundraising dinners, the power to give donations to parties, the power to lobby industry unions who have workers in the industry. I mean, all those things, I’m talking about over the last 20 to 30 years and longer, all those things have played a role”¦ in making, in cowering, if you like, politicians to a certain extent.

The second is local politics. The most important people in any public, not the most important but many of the most important people will be in the local community”¦ will be publicans and managers of local clubs and they’ll often be seen as very solid citizens people and people who give donations to worthy causes and so on, so they have pulling power. Recent campaigns about other side of the agenda on gambling will show some of that pulling power”¦ So it’s local politics. And that goes beyond what you think now there’s licenses so rugby clubs, surf lifesaving clubs, everybody can to a point sell alcohol. So we have that as an issue.

The other is a sort of culture and ideology argument.   And there is an argument, well it’s like the tobacco argument, but I think it’s a bit redundant, it’s a product in a free society but the big thing is nobody wants to be seen – other than my good friend Fred Nile – as a ’wowser’. Nobody wants to be seen as somebody who’s going to ruin fun [things]. And you might laugh at that but that has a big role on the way in which people will conduct this debate.

So thank-you for listening to me, I’m sorry if I went a bit over time. It’s been fantastic to see all these great faces and all these great people who are looking into a really important issue. Thanks.