AMA Speech - AMA President A/Prof Brian Owler - Speech to AMA National Alcohol Summit

28 Oct 2014





***Check Against Delivery

I acknowledge the traditional owners of the land on which we meet, and pay my respects to the elders, both past and present.

I would like to acknowledge the Hon Bill Shorten, Leader of the Opposition, Senator Richard Di Natale, Health Spokesperson for the Australian Greens, and the other politicians who will give their time to this important Summit.

I would also like to acknowledge the many other distinguished guests who are in attendance here, and who will be attending over the next two days.

Welcome. I thank all of you for your attendance, and we look forward to your contributions on this topic of national importance.

So, why are we here? Why is it that we need a National Alcohol Summit? And, what is it that we hope to, or need to, achieve? We are here because Australia has a problem with alcohol, and we need to do something about it.

Today and tomorrow, we bring together political, medical, public health, and community leaders; police; families of victims; and other stakeholders to discuss the range of harms that alcohol brings to the Australian community, and develop practical solutions to produce a safer, more responsible drinking culture in Australia.

Alcohol misuse is one of Australia’s major health issues. Alcohol-related harm pervades society.

It is not just a problem of George Street in Sydney or Lygon Street in Melbourne or Fortitude Valley in Brisbane. The devastating consequences of alcohol misuse extend from our cities and into rural and remote areas.

In this country, the number of alcohol related assaults numbers more than 70, 000 per annum.

As doctors, we deal with the terrible results. We see the fractured jaws, the facial lacerations from glassings, the eye injuries that cause blindness, and more.

We see the head injuries, including those from the now infamous Coward’s Punch.

Many of these people are, of course not the ones who consume alcohol in a dangerous way. The people with the injuries are often the innocent victims.

All doctors have worked in emergency departments at one time or another.

We all know the typical scenes, particularly on Friday or Saturday nights.

As just one of many examples, I remember a New Year’s Eve at Westmead, treating a young man, drunk, who had fallen off a balcony.

He survived the fall, but was quadriplegic. It’s an awful scene, a young person lying paralysed on a spinal board, in a hard collar and, as any doctor knows, the room is full of the smell of consumed alcohol, often made worse by vomiting.

Then someone like me has to tell their parents that their son is quadriplegic - all because of a drunken night out.

Alcohol-related harm doesn’t stop at the front door. It enters people’s homes. The number of cases of alcohol-related domestic violence is 24,000.

For far too long, as a society, we have not talked enough about domestic violence. I’m glad that is now changing. Part of that conversation needs to include the contribution of alcohol as a factor.

In addition to those cases of domestic violence, there is also the fact that harmful alcohol consumption can lead to sexual assault or rape.

Another awful statistic is the number of substantiated cases of alcohol-related child abuse. The figure is at least 20,000 per annum. That is staggering.

As is the case for victims of alcohol-related cases of domestic violence, the victim is not the person drinking alcohol. It is, of course, another case of the innocent victim.

That really gets to me, as I am sure it does you. As a paediatric neurosurgeon, it will surprise many people to know that I frequently see the results of willing abuse of a child’s brain. It makes up a surprising large proportion of our work.

The injuries are often devastating. In fact, the brain swells dramatically. And if we do save the child, the brain often melts away on follow-up scans, and the child is permanently disabled.

As we will hear later, it’s not even a matter of drunken violence.

Unsafe drinking behaviours by pregnant women have continued, and fetal alcohol spectrum disorder is increasingly recognised as a problem.

We need to make sure that we get the message across that there is no level of safe alcohol consumption during pregnancy.

If that weren’t enough, alcohol has been causally linked to more than 60 different medical conditions, including cirrhosis of the liver, inflammation of the gut and pancreas, heart and circulatory problems, sleep disorders, eye diseases, and alcohol dependence.

Alcohol consumption also raises the overall risk of cancer, including cancer of the mouth, throat and oesophagus, breast cancer, and bowel cancer.

Alcohol-related problems, whether it be alcohol-related violence or health consequences of chronic misuse, are an enormous burden on the Australian health care system at all levels.

If we are serious about saving costs in health care, then prevention - including prevention of alcohol-related harms - must be a priority for Government.

If the social and human costs were not enough to justify action, the economic costs certainly are. Estimates for the cost to the community range from $16 billion to $36 billion.

So, what do we expect from our Federal and State Governments?

What role does Government have in addressing alcohol-related harms? They clearly have a major role. And so, what we want, what Australia needs, is action.

Too many times we hear that it’s all about personal responsibility. We have heard politicians talk about that before. It’s rubbish.

Tell the child who is a victim of alcohol-related child neglect or violence that it’s a matter of personal responsibility.

Tell that to the mother who lives in fear of their drunken husband.

Tell that to the family of the victim of the drunk driver.

Tell that to Ralph and Kathy Kelly – who are here today - who tragically lost their son, Thomas.

Personal responsibility is important but, unfortunately, we can’t rely on the personal choices and behaviour of others for our own safety and health.

Governments can influence behaviour through deterrents but, most importantly, and more effectively, through shaping individual and societal attitudes to alcohol.

A person’s attitude to alcohol is shaped by the action of their family and friends, by their community, by their education, and by marketing and advertising - including through sport.

Harmful alcohol behaviour or consumption is also influenced by availability and by price.

All of these factors are able to be influenced by Governments - both State and Federal.

The Australian community is exposed to alcohol marketing at an unprecedented level.

But alcohol marketing is nothing new, and has had a profound influence not only on our behaviour, but also on the way we view ourselves.

To drink beer is to be Australian. In fact, not to drink heavily is almost un-Australian.

We have learnt to pride ourselves on our ability to consume alcohol. Is that a view of Australia we want to perpetuate?

I think we have been sold a dud. Australia is a much more sophisticated society than that.

Marketing of alcohol is increasingly sophisticated and multidimensional, integrating online and offline promotions with the sponsorship of music and sporting events, the distribution of branded merchandise, and the proliferation of new alcoholic brands and flavours.

There is an urgent need to tackle this problem with more robust and rigorous policy and regulation to supplement parental oversight and responsibility.

There is strong evidence that self-regulation and voluntary codes are not effective in stemming inappropriate and irresponsible promotion of alcohol to young people.

The regulation of alcohol marketing and promotion should be statutory, and independent of the alcohol and advertising industries - and should carry meaningful sanctions for non-compliance.

The dependence of sport on alcohol advertising needs to end.

It pervades many of our major sports. Instead of being a contest between the best players from Queensland and NSW, the NRL’s State of Origin was more like a game between Four X and VB.

Associating a health-promoting activity such as sport with an unhealthy product such as alcohol is wrong.

The most significant problem with alcohol advertising and sport is that it markets alcohol to young people, establishing brands at a young age.

It circumvents the regulations limiting the times that alcohol can be advertised on television.

For many Australian children, their cricket, AFL or NRL or A-League stars are their heroes.

These walking alcohol ads are their role models. That needs to change. It is time to transition sport away from its dependence on alcohol advertising.

There are groups in the community that need particular attention.

Deaths from alcohol-related causes among Indigenous Australians compared to non-Indigenous Australians are almost 8 times greater for males and 16 times greater for females.

The level of alcohol-attributable deaths among Indigenous Australians aged 15-24 is almost 3 times greater than that for non-Indigenous Australians of the same age.

That is the reason that we have dedicated a session to alcohol policies to improve the health of Indigenous peoples.

There are always excuses why we shouldn’t do more in tackling alcohol-related harms. The excuses don’t cut it anymore.

We will hear from industry and even from this Government that the real problem is illegal drugs mixed with alcohol.

There is no doubt that there is an issue with illegal drugs like ice, and we need to tackle that, too.

But in many, many cases, it is alcohol that is the primary issue.

The use of illegal drugs needs to be addressed, but it cannot be used as an excuse for abdicating responsibility for action on alcohol-related harms.

There will be claims that we don’t have the evidence that proposed strategies are effective. The evidence is there.

The NSW Baird Government’s strategies for lockouts and early closing times, among others measures, in the Sydney CBD and Kings Cross areas, are working.

And as for being accused of advocating for a nanny state? Let me say that if a nanny state is about one that cares about its citizens, shapes attitudes to promote a healthy and safer Australian society, then count me in.

The topics covered here by the experts who have volunteered to participate in this AMA Alcohol Summit should be a wake-up call for the Australian public and for Government’s responsible for policy.

It is time to listen to the experts. It is time to listen to the victims and to the Australian people.

One of the most disappointing moments in my time dealing with governments was to discover that a chief fundraiser for a political party and the CEO of the peak alcohol lobby group were one and the same person.

That is, of course, no longer the case. But it underscores the fact that the alcohol industry enjoys access, and it has influence and it has a loud voice.

It is time to give that access, that influence, and that stage to the experts and to the victims.

Today, we give a voice to all of those Australians who have been harmed through alcohol misuse – those who have lost their lives, those who are too scared to speak for themselves, and even those that are yet to be born.

That is one of the key roles of the AMA National Alcohol Summit.

Australia does not have a National Strategy to deal with alcohol-related harms. We need this strategy.

No longer can we tolerate people, including young men and women, even children, being injured or dying because of harmful alcohol consumption.

To not act would be neglect.

We must have a plan and we must have action from both Federal and State Governments.


28 October 2014


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