Changing the Culture of Alcohol Use in New South Wales

May 2004

Section 5: Injury and Trauma

Government Response

The Government has put in place occupational health and safety intervention programs which include measures to help minimise alcohol related risks in the workplace.

The Government has also assisted the Labor Council of NSW to produce a series of fact sheets and principles on drug and alcohol guidelines and testing, which can be used by employers and employees to develop workplace drug and alcohol policies.

Random alcohol testing has been introduced – via the Rail Safety (Drug and Alcohol Testing) and Passenger Transport (Drug and Alcohol Testing) Regulations – for private and public transport providers to help ensure passenger safety. Testing is underway for operational rail workers, while it will begin by 1 July for State Transit and Sydney Ferry workers. Private bus and ferry operators are required to implement alcohol testing by 1 July 2004.

The Government will establish a Working Group on Alcohol Related Injury and Trauma in the Workplace, convened by the Department of Commerce and WorkCover. It will consider what more should be done to help ensure that workplaces, where alcohol is a factor, are healthy and safe. It will include employer and employee representation, and will be asked to report to Government with a range of measures to reduce alcohol related risks and injuries in the workplace.

Government Response

The Government includes alcohol education in the Personal Development, Health and Physical Education (PDHPE) syllabuses, which are taught from Kindergarten to Year 10. The syllabuses encourage students to make informed decisions relating to health and physical activity and develop positive attitudes towards a healthy lifestyle.

The focus of alcohol education in the PDHPE syllabuses addresses consequences of alcohol use, peer pressure, strategies to minimise harm including assertiveness and refusal skills, impacts of alcohol use on the community, road safety issues, and management of basic first aid situations including poisonings and overdose.

The Crossroads Personal Development and Health Course is mandatory for all Government school students in Years 11 and 12. It focuses on relationships and drug use, and provides young people with opportunities to explore personal values about drug related issues including effects on relationships, safe partying, binge drinking, polydrug use and alcohol and driving. Students are taught about responsible behaviour surrounding drug use and the hazardous and harmful effects of drugs, particularly alcohol use. Students also explore the effects of drug use on personal behaviour and employment potential, and identify personal and community support networks.

The Department of Education and Training in conjunction with the NSW Board of Studies will review the content of the Personal Development, Health and Physical Education syllabuses during 2004.

Aboriginal young people in Aboriginal communities will also be provided with information and assistance through new components in the NSW Health Aboriginal Safety Promotion Strategy.

The new Alcohol and Education Information Taskforce will oversight a review by the Office of Children and Young People of existing alcohol related information and education strategies aimed at young people. The response to Recommendation 1.3 outlines the role of the taskforce in considering a coordinated approach to community information programs, including strategies to educate young people about the harms of alcohol misuse.

The Roads and Traffic Authority will introduce new secondary school resources for Stage 4 (Years 7 and 8) which include coverage of alcohol as one of the risk factors in traffic crashes. As well, the new Stage 5 (Years 9 and 10) resource will provide a focus on the effects of alcohol in road trauma.

The response to the following recommendations also includes relevant detail:

§          the issue of parents and carers and safe partying is dealt with in Recommendation 1.10
§          Schoolies Week issues are dealt with in Recommendation 1.11
§          Recommendation 2.28 refers to guidelines on consuming alcohol on school premises and at functions held in the name of the school
§          school based education and prevention initiatives are detailed in Recommendation 2.29.

Government Response

Marine safety laws currently allow NSW Police to breath test vessel operators on New South Wales waterways where they believe the operator may have a blood alcohol level higher than 0.05.

The Government supports random breath testing on New South Wales waterways as a way of reducing alcohol consumption on the water and ensuring safer boating, and is in the process of implementing changes to the marine safety laws which will facilitate that.

The Government will develop legislative proposals to enable random breath testing on New South Wales waterways during 2004.

Police will utilise existing vessels and ensure they carry appropriate breath testing equipment. NSW Police and Waterways will conduct an information/education campaign so that boating operators are aware of the new arrangements.

NSW Police will develop standard operating procedures addressing issues such as what occurs when a positive breath test is recorded, what to do with the pilot’s boat, testing approaching boat ramps, and timing of the breath test.

Government Response

The Government has established the NSW Water Safety Taskforce which has developed the NSW Water Safety Framework 2001-2003 as a strategic approach to water safety in New South Wales. The taskforce includes Government agencies, industry and community organisations, local government representatives and unions.

Key safety initiatives undertaken by the NSW Government to assist in reducing alcohol related harm on the waterways include:

§          the SafeWaters website www.safewaters.nsw.gov.au containing a wide range of water safety information, including information on alcohol related issues
§          production of the Alcohol and Water Do Not Mix brochure cautioning on alcohol use and boating
§          patrols of waterways include education/compliance campaigns in relation to alcohol
§          conduct of safe boating campaigns identifying the dangers of mixing alcohol and boating
§          promotion of safe boating, including responsible consumption of alcohol, through the media
§          SafeWaters initiative teaching safe boating practices – alcohol education is a component
§          participation in the Australia and New Zealand Safe Boating Education Group (ANZSBEG) which promotes awareness of boating safety issues including alcohol
§          conduct boating safety seminars at various venues throughout New South Wales including a component relating specifically to alcohol on the water.

During 2004 the NSW Water Safety Taskforce will develop a new Water Safety plan for New South Wales. The Government has commissioned an independent evaluation of the NSW Water Safety Framework 2001-2003 so that a new plan can be developed during 2004. The new plan will specifically address alcohol use around aquatic activities.

In developing the new plan, the taskforce will review current water safety initiatives and bring forward proposals to reduce the number of child and adult drownings and near drownings associated with alcohol use in waterways, swimming pools and dams. The taskforce will also work with the Royal Life Saving Society, Surf Life Saving NSW, Austswim and local councils in developing the new plan, and will be asked to make recommendations for further action and develop prevention strategies by the end of 2004.

During 2004, the Waterways Authority will also develop new safety broadcasting initiatives, and multilingual campaigns to promote responsible use of alcohol in connection with aquatic activities.

Recommendation 1.9 refers to accreditation for surf life saving clubs under the Good Sports Accreditation Program. This will help to ensure surf clubs promote responsible use of alcohol.

Government Response

The Government has asked the Roads and Traffic Authority to convene, in conjunction with other stakeholders such as the Motor Accidents Authority, a Country Road Safety Summit. The Summit will be held in Port Macquarie on 27 and 28 May 2004. The Summit will provide a forum for Government, non-government organisations, and the community to work together to reduce trauma on country roads.

The Summit will be asked to bring forward recommendations in an agreed communiqué which can be followed through by the Government in late 2004 and future years.

Government Response

The Government is tackling the worst scale of drink driving offences. The Government obtained a guideline judgement for driving in a manner dangerous causing death/grievous bodily harm in 1998.

The Government sought a guideline judgement for high prescribed concentration of alcohol (PCA) offences from the Supreme Court in September 2002. Crown submissions were made to the Court of Appeal in December 2003. The Court has set a hearing date from May 2004.

The Government will establish a Working Party on Drink Driving Offences to be convened by the Criminal Law Review Division of the Attorney General’s Department and comprising NSW Police, Attorney General’s Department and the RTA to report to the Government on the use of s.10 dismissals and good behaviour bonds under the Crimes (Sentencing Procedures) Act 1999 to high range PCA (blood alcohol concentration above 0.15 percent). These are serious offences which place the community at high risk of alcohol related injury.

The Working Party will also consider whether a magistrate’s discretion not to record a conviction for high range PCA should be limited to first time offenders, whether there should be additional penalties for repeat drink driver offenders, whether options such as the loss of demerit points or downgrading of licence status should be applied to some drink driving offences, and whether there is a need for further judicial education.

Following the Court’s determination of the high range PCA application, the Government will consider whether there is a need for further guideline judgements in this area, or whether there are alternative approaches available. The Working Party on Drink Driving Offences will also examine this issue. 

In regard to the application of demerit points and other licence status options to drink driving offences, the RTA has also arranged for the Road Safety Taskforce to review this issue.

Government Response

Following the recommendation made by the Summit, the Government has introduced a new zero blood alcohol level for learner and provision licence holders. The new laws are contained in the Road Transport (Safety and Traffic Management) Amendment (Alcohol) Act 2004, and commenced on 3 May 2004. They prohibit learner and provision licence holders from driving with any alcohol in their blood.

The previous penalty provisions for special category drivers apply to the new zero alcohol limit. For a first offence a minimum disqualification period of three months and a maximum penalty of $1,100 applies. For a second or subsequent offence a minimum disqualification period of six months and a maximum penalty of $2,200 applies.

A limited defence has been introduced for L and P plate drivers to take account of the use of medicines and foodstuffs that contain small amounts of alcohol, and the consumption of alcohol within a religious context. This defence applies only where the driver’s BAC is less than 0.02.

The Roads and Traffic Authority has implemented a communication strategy to inform all New South Wales licence holders affected by the new law that they are now subject to a zero BAC limit. All high school road safety education and novice driver resource materials are being updated to reflect this new law. The updated Road Users’ Handbook is being produced in ten languages. The Roads and Traffic Authority will undertake an evaluation on the impact and operation of the new law over a four year period.

Government Response

The Minister for Roads has referred the proposal for alcohol interlocks in all new vehicles to the Australian Transport Commission. Installation of interlocks on new vehicles would require an amendment of the relevant Australian Design rule by the Commonwealth Government. The RTA has commenced a feasibility study of interlocks for all new vehicles.

The Minister for Roads has also placed the issue of mandatory alcohol ignition interlocks in all new imported or Australian made vehicles on the agenda of the Australian Transport Council of Ministers at its next meeting in 2004.

The Government commenced a new Alcohol Interlock Program on 8 September 2003. The program provides courts with an additional sentencing option for drivers disqualified as a result of conviction for a major alcohol related offence. Participation in the interlock program is voluntary. The interlock penalty consists of a reduced disqualification period, followed by a period on a conditional interlock driver licence during which time the driver is restricted to driving a car fitted with an interlock device. The first interlock driver licence was issued on 20 November 2003.

The proposal for a mandatory alcohol interlock device for all repeat drink drive offenders as a prerequisite for obtaining an unconditional licence will be examined by the new Working Party on Drink Driving Offences.

Government Response

The Road Transport Legislation Amendment (Interlock Devices) Act 2002 and the Road Transport (Driver Licensing) Regulation 1999 requires that drivers who wish to obtain an interlock driver licence complete a brief medical consultation to enable drink driving offenders to discuss their alcohol use with a doctor. This intervention, known as the Drink-less Program has been established throughout New South Wales, and completion of this program is a mandatory prerequisite for the issue of an interlock device. Over 100 medical practitioners and drug and alcohol specialists throughout New South Wales have been trained to deliver this intervention.

In addition, the NSW Sober Driver Program, a court based, post conviction, mandated educational program targets repeat drink drivers and has been rolled out throughout New South Wales. The program is jointly funded by the RTA and MAA to June 2006. Participants are directed by Magistrates to attend the NSW Sober Driver Program by a range of options which include a good behaviour bond under s.9 or s.10 of the Crimes (Sentencing Procedure) Act 1999, a deferral of sentencing for rehabilitation under s.11 of that Act, a good behaviour bond under s.12 (suspended sentence), a community service order, or a direction of a probation or parole officer.

The NSW Sober Driver Program is intended to complement other sanctions such as fines and/or licence suspension imposed by the court. Magistrates may also refer offenders to the program as a condition of a Home Detention Order.

The RTA will commence development of a state-wide, whole-of-government drink driving education and rehabilitation program for young, high range offenders during 2004/2005. The program will target those drivers at the greatest risk for involvement in alcohol related injury and trauma on New South Wales roads.

Government Response

Important action in this area is being undertaken:

Local Government Road Safety Officer Program: This program is funded by the Roads and Traffic Authority which funds Council Road Safety Officers to implement alternative transport schemes in periods of high alcohol consumption such as the Christmas/New Year period and the snow season, and for special events such as race days and music festivals. This program is ongoing. Alternative transport schemes operate in a number of councils including Canterbury, Hawkesbury, Ballina, Port Macquarie, Bathurst, Cessnock, Gosford and Goulburn local government areas.

State Transit has a long history of community involvement such as the contribution of buses at minimal costs for some under 18 functions and providing venue funded bus services to assist police in moving large crowds that spontaneously congregate at venues.

The State Transit bus operation has developed specific programs with NSW Police, local councils and venue licensees to implement workable solutions to transport issues such as the Linking Public Transport to Planned Venue Events initiative in the Pittwater Local Council area. Other measures include:

§          supervision of bus stops located in front of hotels and clubs by security guards employed by the venue
§          venue funded bus services between late night venues
§          the sale of bus tickets at licensed venues, thus preventing ticket related disputes between passengers and bus operators
§          planning to ensure sufficient bus services are provided to cater for specific events or functions.

In Newcastle, the Attorney General’s Department has been working with the council to provide an integrated, managed late-night transport system involving bus, train and taxi services in Newcastle. This initiative aims to reduce anti-social behaviour in the inner Newcastle area. During the summer months, a Nightrider bus service works in conjunction with Nightcare, an initiative providing hospitality staffed by local welfare agencies at strategic points around the Newcastle CBD. Nightrider and Nightcare have considerably reduced the incidence of offences such as malicious damage and assault.

New directions under consideration:

The Ministry of Transport will facilitate discussions between Government and the taxi and hospitality industries to investigate further options in providing alternative transport. The key context of these discussions will be that transportation initiatives and solutions must be supported by service providers and venue operators if they are to be successful.

Currently, some licensed venues have arrangements in place to assist patrons with transport, for example, direct phone connections to local taxi companies or courtesy buses.

The Government will ask the Liquor Industry Consultative Council for advice so that a catalogue of options such as this can be prepared for use when developing safe transport programs.

The NSW Liquor Industry Consultative Council has developed principles that can be used in a house policy by licensed venues. One principle is that venues be able to provide advice to patrons on safe transport options. The requirement to implement such a house policy is often imposed as a condition on liquor licences by the Licensing Court. The Government will ask the Liquor Industry Consultative Council for advice on applying this house policy requirement to all relevant licensed venues.

The Government will also promote the guide produced by the NSW Taxi Council for implementing a late night taxi voucher system at licensed venues.

The Ministry of Transport is developing plans for a Sydney-wide trial of 'no destination' bookings during 2004. The 'no destination' trial will stop drivers ‘cherry picking’ longer jobs, disadvantaging patrons leaving licensed venues who want to book a taxi for a shorter trip.

See also Recommendation 8.35.

Government Response

The Drinksafe program is a brief intervention program providing information resources for at-risk drinkers, i.e. essentially regular drinkers in bars and taverns. Brief interventions may be particularly beneficial for those drinking at risky and high-risk levels.

Operation Drinksafe is a community education program that is based on World Health Organisation-standard Alcohol Use Disorders Identification Test (AUDIT) combined with a blood alcohol concentration (BAC) reading and well established brief intervention strategies (identification of a drinking problem, information regarding cutting down, and referral to drug and alcohol services if necessary) by a health professional and a police officer.

Patrons in licensed venues are invited to fill in the Drinksafe questionnaire that is scored by a health worker, provided with immediate feedback and a brief intervention. They can choose to be breathalysed and are given feedback about their blood alcohol level by a police officer. Information on what the patron’s score means, self-help booklets, tips on responsible consumption are provided and, where appropriate, respondents are provided with a referral and details of alcohol counselling services available in their area.

The Drinksafe program was run by the Northern Rivers Area Health Service between 1994 and 1996 and was evaluated in 1998. The review found that it reduced weekly consumption of alcohol by 13 percent and binge drinking by 19 percent in persons who undertook the program.

The findings indicated that brief intervention strategies may be used successfully in bars and taverns. The project helped demonstrate the potential of using brief intervention strategies to reduce alcohol related harm in a wide range of community settings.

NSW Health has funded Central Sydney Area Health Service to conduct Operation Drinksafe in 2004. The purpose of this project is to implement, evaluate and report on the effectiveness of the program in reducing drink driving and associated road accidents caused by alcohol and involving young people, 18-24-years old, in an urban and university setting in the Central Sydney region.

Following that evaluation, NSW Health will identify how the Drinksafe program might be conducted in Area Health Services with differing demographics.

Government Response

The Government will ask the Liquor Industry Consultative Council to explore ways to decrease the risks of alcohol related injury resulting from accidents such as falls and from drink walking in and around licensed venues. The Council’s advice will also be sought on the effectiveness of responsible service of alcohol programs in reducing alcohol related injury to patrons. Working with the Council will ensure peak liquor industry associations and unions are consulted.

The Council will be particularly asked to examine the effectiveness of barriers which ensure people emerging from alcohol venues are forced to cross roads at marked crossings.

NSW Health will consider ways to identify people treated in hospital emergency departments with a fall injury as a result of excess drinking in the home environment. This will facilitate better data collection so as to inform future policy on alcohol related injuries in the home.

Government Response

The Government has funded a range of local government road safety programs and community health programs that aim to reduce drink walking – eg. education initiatives of Council Road Safety Officers in Manly and South Sydney which target licensed venues, drivers and pedestrians. Road safety media campaigns are also conducted during high alcohol consumption times (Friday evening to Sunday morning) and to coincide with major events. These campaigns target drivers warning them to be aware of pedestrians and to slow down.

The Government has also invited local councils to implement 40km/h speed limits in areas of high pedestrian activity – such as in commercial areas where hotels may be located – to reduce the risk to vulnerable road users, including alcohol affected pedestrians.

The lower speed limit has been implemented by a number of councils in the Sydney metropolitan area (including in the North Sydney CBD, parts of Darlinghurst and Surry Hills, and in the Balmain Peninsula). Around 30 councils throughout New South Wales have commenced negotiation with the RTA to implement 40km/h zones, focusing on high volume pedestrian areas.

The Government has funded the Drink Driving and Drink Walking in the NSW Pacific Island Communities project, by the Drug and Alcohol Multicultural Education Centre (DAMEC) which will identify ways to reduce the risks from drink driving and drink walking in the Australian Pacific Islander community.

The Government’s Road Safety Taskforce has been asked to:

§          review current measures to increase the awareness of pedestrians about the risks associated with intoxication, and to promote awareness of drivers of pedestrians
§          identify key initiatives to reduce the number of pedestrian fatalities and injuries associated with alcohol abuse by pedestrians
§          consider the structural and environmental aspects around pedestrian safety and licensed venues
§          report by the end of 2004.

Government Response

New South Wales contributes to the Alcohol and Other Drug Treatment Services National Minimum Data Set which is published annually through a national report prepared by the Australian Institute of Health and Welfare. However, alcohol involvement in trauma events is not comprehensively captured in these collections.

The Australian Alcohol Indicators, 1990-2001 Patterns of alcohol use and related harms for Australian States and Territories, was commissioned by the Australian Department of Health and Ageing and developed by the National Drug Research Institute, Curtin University and Turning Point Alcohol and Drug Centre.

This report presents health, road safety, industry and survey data to describe trends in risky alcohol use and serious alcohol related harms for all Australian states and territories. It has been guided by principles set out in the World Health Organisation’s International Guide for Monitoring Alcohol Consumption and Related Harm (WHO, 2000).

The NSW Government will continue to contribute data to the Australian Alcohol Indicators project and participate in the dissemination of the project’s finding, where appropriate.

NSW Health will also develop alcohol related questions for inclusion in the inpatient data set for all trauma cases. This will include cases where the patient is not necessarily alcohol affected but where other parties who have contributed to the event are alcohol affected.

The NSW Health Centre for Drug and Alcohol Information and System Integration Committee (ISIS) will also identify necessary data development, make recommendations for standardising data collections, develop performance indicators and facilitate reporting by NSW Health to inform effective health care service delivery. This committee includes representation from Area Health Services, drug and alcohol clinicians, the Network of Alcohol and Drug Agencies, and NSW Health Information Management Division. The subcommittee meets bi-monthly and reports to the NSW Health Drug and Alcohol Council.

The NSW Ambulance Service will be asked to investigate coding all cases in which alcohol involvement is suspected.

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