Sue Lines (WA, Deputy-President) Share this | Link to this | Hansard source

I inform the Senate that at 8.30 am today five proposals were received in accordance with standing order 75. The question of which proposal would be submitted to the Senate was determined by lot. As a result, I inform the Senate that the following letter has been received from Senator Griff:

Pursuant to standing order 75, I propose that the following matter of public importance be submitted to the Senate for discussion:

The need for more urgent action on alcohol-related harm such as Fetal Alcohol Spectrum Disorder.

Is the proposal supported?

More than the number of senators required by the standing orders having risen in their places—

I understand that informal arrangements have been made to allocate specific time to each of the speakers in today's debate. With the concurrence of the Senate, I ask the clerks to set the clock accordingly, and I call Senator Griff.

Stirling Griff (SA, Centre Alliance) Share this | Link to this | Hansard source

Today I speak about an insidious, serious public health problem. It is one which will have lifelong consequences for those with the condition, and it impacts almost every part of our community in some way. But it is entirely preventable. I'm talking about fetal alcohol spectrum disorder, or FASD for short.

FASD is an umbrella term for a range of physical, mental, developmental and behavioural problems suffered by a child whose mother drinks alcohol while pregnant. FASD has no cure. It can be severe or it can be mild. The baby can often seem healthy at birth, and only a minority of babies will have telltale facial deformities that can form when their mother drinks in the first trimester only. Babies born with FASD might look healthy but the wiring in their brain will be scrambled.

They are destined to have varying problems with memory, learning, impulse control and understanding consequences. They may struggle with emotional regulation, and struggle to plan and organise themselves. They may have difficulty with speech and language, and they might even have sight and hearing problems. In the worst cases, the baby will, tragically, be robbed of the ability to realise their full potential simply because their mum drank while pregnant.

I do want to stress I do not say this with any blame. Often this drinking is done in ignorance or because of peer pressure from a partner or others close to the woman. Research shows us that one in four pregnant women in Australia continue to drink alcohol after they have learned they are pregnant—one in four. Many of them are well educated too, but they're not educated about the effects of FASD. Usually, they don't know about the risks of drinking while pregnant, or they are misinformed about the risks because they received outdated advice from well-meaning friends and relatives, or even, incredibly, from medical professionals. Australia desperately needs a national information campaign to tell women and their loved ones the dangers of alcohol during pregnancy. If we want women to stop drinking during pregnancy, we all need to empower them to make this safe and necessary choice. The entire community needs to be informed of the dangers so we can collectively support the women in our lives.

We are still learning a lot about this disease. The fact that one in four women drink during pregnancy doesn't mean one in four babies are born with FASD. It seemed genetics may play a part in who is impacted and how severely, and the condition is more severe in children whose mothers are sustained and heavy drinkers. Estimates are that FASD affects up to five per cent of the Australian population. The important thing to remember is that, when a pregnant woman drinks, her baby also drinks. In fact, the developing baby will have the same blood alcohol level she does; it might even be higher because the baby's developing liver will struggle to process the alcohol. The alcohol crosses the placenta and enters the baby's blood, where it can damage the developing brain and other organs.

The consequences for affected children are lifelong. Again, there is no cure for FASD. Most children who are later diagnosed with FASD might seem utterly normal when born. Most will have a normal IQ. It won't be until that little boy or girl starts school and starts falling behind and gets into trouble for being disruptive and for not completing their work that the truth of their condition will start to emerge. Even then, their FASD may be mistaken for naughtiness, or misdiagnosed, meaning they won't always get the help that they desperately need. Without intervention, they will struggle to finish school and will be more familiar with truancy, suspension and expulsion than with good grades. Through no fault of their own, children with FASD will quite likely have poorer life outcomes than other children. They will struggle more than others with unemployment, homelessness, mental health issues, and alcohol and drug abuse. They are disproportionately represented in the criminal justice system. A 2018 study found that 36 per cent of juveniles in detention in Western Australia had FASD. Think about that for a moment. What would the criminal justice system look like if we managed to dramatically cut the number of children born with FASD?

This is why I'll be proposing a wide-ranging inquiry into FASD, to pick up on the good work done by the 2012 House of Representatives inquiry into FASD and go further, to look at what the research now tells us; the awareness and handling of FASD in schools and the criminal justice system; the prevalence of FASD in vulnerable populations, such as children in state care; and world's best practice in diagnosis, intervention and prevention.

As it is, FASD costs Australia an estimated $1.18 billion every year. Despite this massive burden on our communities, the government is not doing anywhere near enough to combat this issue. It is tinkering around the edges at most and, actually, its actions are really quite inadequate. Its national FASD Strategic Action Plan follows a recommendation from the 2012 inquiry that was appropriately titled FASD: the hidden harm.

The 10-year strategic action plan on FASD sounds good, but it is currently being funded with peanuts—just $7 million over two years to tackle a public health issue which is entirely preventable and yet has such a widespread impact on individuals and society.

A three-year FASD clinical network to support diagnosis and data collection was funded with just $10 million. All up, the government has spent a measly $20 million on FASD since 2014. The efforts have been so paltry that the alcohol industry's own lobby, DrinkWise, has been granted federal funding to promote awareness about drinking in pregnancy. This was such a stuff-up last year that thousands of posters destined for GP offices had to be recalled after the AMA complained because the messaging was inaccurate and misleading. The recalled posters actually stated:

It's not known if alcohol is safe to drink when you are pregnant.

But it is known: it is not safe.

The DrinkWise posters are limp-wristed at best. The messages include:

It's safest not to drink while pregnant.

Note the word 'alcohol' isn't used. And what do they mean by 'safest'? Is there some sliding scale of safe drinking that we don't know about? Then there is the confusing message: 'When mum drinks, the baby drinks.' That doesn't tell the woman anything about the lasting harm alcohol causes and it leaves it open for people to assume that, if mum doesn't suffer any lasting harm for a night of drinking, maybe the baby doesn't either.

This is the danger of leaving awareness campaigns in the hands of vested interests. If we want to tackle FASD, the messaging has to be clear. It has to be uncompromising. The Foundation for Alcohol Research and Education puts the message this way:

Alcohol and pregnancy:

No safe amount.

No safe time.

No safe type.

Its other messages include:

If you are pregnant or planning a pregnancy, experts advise no amount of alcohol is safe.

It knows from its focus groups that this message works.

We need to treat FASD with much more urgency. I think we should treat it as a national health emergency. How many of us have heard someone say, 'It doesn't matter if you have an occasional drink in the third trimester because the baby is already cooked or finished baking'? As long as there are men and women, and health professionals for that matter, who still think it is okay to drink during pregnancy, it means there is serious work to be done. As long as this type of attitude exists, it means that we are failing to tackle this invisible but entirely avoidable scourge.

Slade Brockman (WA, Liberal Party) Share this | Link to this | Hansard source

I too rise to speak on this MPI. It is a very significant issue in the Australian community and one that all sides of politics, all parts of this chamber, would certainly acknowledge as such. I certainly agree with Senator Griff that it is an absolutely tragic set of circumstances and an issue that society as a whole needs to get a lot better at tackling.

One thing I perhaps would be very interested in finding out—and I had a quick attempt earlier today to try and find this information; I couldn't find it—and it is perhaps contrary to what Senator Griff said, is: how many people out there truly believe it is safe to drink alcohol during pregnancy? Not whether they do it or not, because people do many things that, unfortunately, they know are very dangerous, both to them and to their unborn child but how many people actually know? I suspect the vast majority would know. What that percentage is is probably worthwhile finding out to know just how effective the public health campaigns in this space have been. I would certainly endorse that. Sadly, in my home state of Western Australia, this is a very real issue. There was a significant study undertaken by the Telethon Kids Institute, which is a wonderful institute in my home state of Western Australia that looks into a variety of health matters affecting children. It was undertaking groundbreaking research into the prevalence of FASD in Western Australia. Sadly, this research is now a little out of date. It looked at the situation from 1980 to 2010. There was something like 210 identified cases, which is remarkably small, I would say. Unfortunately, I think everyone in this chamber knows that the problem has grown significantly worse since then. It is important that government focuses on it and tackles it, which this government has been doing.

The impacts of FASD cannot be understated. It produces significant problems with learning and behaviour. Again, as Senator Griff pointed out, the number of people involved in the criminal justice system who are affected by FASD is quite significant. It includes physical changes. There are certain facial characteristics and certain facial features that have been associated with FASD, such as a short horizontal length of the eye opening from the inner corner to the outer corner and changes the structure of the upper lip and the nose. We're actually not just talking about changes to the structure of the brain but also talking about actual physical changes to those children. Obviously, those children grow up to be adults.

There are learning and behavioural problems, obviously, which are the most well known aspects of this. These include learning difficulties, memory problems, trouble with impulse control, trouble with attention span, ease of distraction, a degree of hyperactivity and difficulty in understanding the consequences of one's actions, which obviously has significant flow-on effects in terms of potential aggression and encounters with the criminal justice system. There is also difficulty in following instructions, difficulty with abstract thinking, slow cognition and difficulty with social relationships, something that is obviously very important to the wellbeing of children and children as they grow into adults.

The National Health and Medical Research Council does publish guidelines on reducing the health risk of drinking alcohol. That guidance is fairly clear on drinking alcohol whilst pregnant or breastfeeding. The guidelines state:

Women who are pregnant, planning a pregnancy or breastfeeding should not drink at all.

The guidelines on this matter are very clear. They go on to say:

The greatest harm to the foetus or breastfeeding infant occurs when drinking is at high and frequent levels, but no level of drinking is considered safe.

That has been the NHMRC guidelines since at least 2009. Again, I tried to check whether it predates that—I suspect it does—but I couldn't find that out. That is a very clear guideline from the NHMRC and something that I think needs to be—if it's not, and, as I say, I do not know the level of knowledge in the community on this issue—very, very well known.

Again, contrary to Senator Griff's position, the government has taken action and continues to take action in this area. The government is committed to reducing alcohol-related harms to all Australians. Since 2014, the Australian government has committed $27 million to reducing the impact of FASD, fetal alcohol spectrum disorder. This began in the 2016-17 budget, when the Australian government committed $10.5 million over four years—that is, 2016 to 2019-20—to take more action on FASD by building on earlier action plans. Funding is being provided for a range of activities including online telephone support for individuals and families affected by the disorder, improved access to diagnostic services, and prevention and education action across the country, obviously with an emphasis on communities of highest need, because, sadly, what the evidence shows is that this problem is not exclusive to but has a significant impact on Aboriginal communities in my home state of Western Australia. Therefore, the messages, the information and the support that need to be given have to be highly targeted and need to get to the people where it can have the most effect.

In November 2018, Minister Hunt launched the FASD Strategic Action Plan. To support the FASD Strategic Action Plan, the Australian government committed further funding of $7.2 million for activities that align with the priority areas of the ongoing strategic action plan: prevention, screening and diagnosis, management and support, and funding of priority groups. Funding is broken down: $1.47 million for prevention; $1.2 million for screening and diagnosis; $1.2 million to inform schools and workplaces and to support the justice and policing sectors; $1.27 million to tailor solutions to local communities; and just over $1½ million to continue existing activities, including the continued development of a one-stop shop digital hub for information tools, research and consumer support.

This is a life-long physiological and neurodevelopmental impairment. It's a condition that is an outcome of parents either not being aware of the dangers of alcohol use or not being supported to stay healthy and strong during pregnancy. There is no cure for FASD and its effects will last a lifetime for those impacted. People with FASD can get help to do with learning and behaviour to maximise their independence and maximise their achievements over the course of their life.

Once again, this is a very important issue. It's something that the government and the health minister take very seriously and it's something that the government is acting on.

Louise Pratt (WA, Australian Labor Party, Shadow Assistant Minister for Manufacturing) Share this | Link to this | Hansard source

I'd also like to thank Senator Griff for giving us the opportunity to debate this critically important issue today. As we've already heard in the chamber, fetal alcohol spectrum disorder does have a lifelong and devastating impact on people and the wider community. It's a lifelong neurological and developmental disorder that can be seen in children. It's indeed a lifelong phenomenon, triggered of course by alcohol consumption during pregnancy. We know that it is likely to be more severe and more likely when consumption is excessive and frequent throughout the duration of a pregnancy. I do note, though, as has been highlighted, that there is no safe level of alcohol consumption according to health recommendations. It is also important to point out that it is more detrimental in families with intergenerational health problems. There is the influence of FASD in a single pregnancy. If drinking then occurs during the next intergenerational pregnancy, we can also realise intergenerational health issues. In cases of severe FASD, life expectancy can be seen to be only 34 years of age.

But I really would like to highlight that it is a condition that we shouldn't stigmatise as belonging to particular communities or within particular social groups. If people drink during pregnancy, it is likely to have developmental and neurological impacts on a person, despite the fact that they might otherwise be succeeding in life more broadly and that FASD, as a phenomenon, may not be particularly noticeable or attributable to the way that someone is in the world. So I think we should steer away from tagging or stigmatising particular communities with these issues.

I'd highlight that a Canadian study found people with FASD are 19 times more likely to be arrested at some point in their lives compared to neurotypical counterparts and that a significant number of young people in juvenile detention have FASD. The symptoms go unnoticed until a child reaches school age and they become more visible through activity. I notice that it's actually quite difficult when young people have developmental or learning delay to get a proper diagnosis for FASD. The diagnosis is incredibly expensive and quite often difficult for people to access, particularly when you're trying to work through and rule out a whole range of developmental or cognitive disorders. There might be cognitive, behavioural, health and learning difficulties that need to be assessed. It's a problem that FASD is not recognised as a disability in Australia, as per the Department of Human Services' disability list. I think that is a problem, particularly when other learning disabilities are so well recognised.

I want to give a particular shout out to Aboriginal leaders in the Fitzroy Valley, who've been very active in addressing FASD in the community since the early 2000s. This is the Lililwan study, initiated by leaders in the Fitzroy Valley. They interviewed mothers and researchers and found that 55 per cent of women in that community had been using alcohol during the pregnancy but that women at that point in time simply did not know that alcohol could harm their unborn children. One of the report's authors said:

Alcohol was used in over half of those pregnancies, but when women did use alcohol they did so at high levels, now this wasn't due to any intent to harm …

It was simply out of ignorance. They had no idea that drinking alcohol could harm their unborn child.

That community pushed for their own alcohol restrictions and they've been able to slow down the rates of alcohol use amongst pregnant women in that community very dramatically. James Fitzpatrick, one of the researchers, said:

… we have worked incredibly hard on a strategic prevention strategy and we are starting to see the rates of fetal alcohol syndrome and alcohol use in pregnancy decrease.

I want to pay tribute to June Oscar, a proud Bunaba woman and a strong advocate for Indigenous Australians. She is the current First Nations commissioner in the Human Rights Commission. She received the Menzies School of Health Research medallion in her work with FASD.

I'd particularly also like to commend the work of the Western Australian government. In January 2019, the Western Australian alcohol and drug interagency strategy was released by the WA Minister for Health, Roger Cook. It provides a guide for government and non-government organisations as well as the wider community to prevent and reduce the adverse impacts of alcohol and other drug use in WA. It has five key strategic areas, several of which make specific reference to FASD.

I also want to highlight before the Senate today the state coroner's inquest into the deaths of 13 children and young persons in the Kimberley. The report of the state coroner's inquest was published on 7 February this year and had 42 recommendations, seven of which addressed the issue of FASD. It was very clear that there were concerns in a number of these deaths where the children had been parented by someone with FASD or they were impacted by FASD themselves. I would really encourage the government at a national level to look at those recommendations.

Health minister Roger Cook has also led the charge for compulsory labelling of alcoholic beverages. This was successful last year in achieving this change with the Commonwealth in terms of there being mandatory pregnancy warnings on all alcoholic beverages. The AMA released a statement acknowledging the presence of the disorder in Australia and has recommended an approach to reducing FASD that is consistent with the broader campaign for combating problem drinking in Australia, including efforts to reduce the availability, affordability and accessibility of alcohol.

So, today I join in calls on the government that we need a national approach on this issue—that the national FASD strategic plan requires funding and requires support from the states to reduce the impact of FASD on the Australian community. I want to highlight that the drinking habits of Australians are changing and that public health education campaigns are working, including messages to pregnant women from all walks of life. But, sadly, it is still all too common to see pregnant women drinking, including women who are highly intoxicated during their pregnancy, in all walks of life in Australia. So we really do need to pay special attention to this issue to make sure that women have the message and that they get the support they need. Managing addiction, including alcohol addiction, is very difficult. It is not uncommon for pregnant women to have a conversation with each other to say, 'Goodness, how are you coping without having a drink?' Quite often we don't recognise how alcohol-dependent our society is or how much people reach out for and crave a drink. (Time expired)

Richard Di Natale (Victoria, Australian Greens) Share this | Link to this | Hansard source

Many people in Australia drink responsibly—they drink occasionally—and for many it brings them pleasure. We know drinking patterns have changed over time. We know there is some social benefit to people consuming alcohol. But that shouldn't disguise the fact that alcohol consumption has an overwhelmingly negative impact on people's health, not just here in Australia but right around the world. It's the third-largest risk factor for disease burden globally and the eighth-highest risk factor for death worldwide. That means that almost four per cent of all deaths have alcohol as a major risk factor.

As somebody who worked as a GP, as a drug and alcohol doctor and then in public health, I know that you can't ignore the obvious consequences of alcohol consumption, particularly alcohol-related harms and alcohol dependence. Every GP in Australia would have experienced patients every day for whom alcohol is their major presenting factor. They may present because of social problems resulting from alcohol dependence. They may present with physical illness. We know there are hundreds of physical illnesses that are linked to alcohol consumption, whether it be cirrhosis of the liver or other metabolic conditions. And of course there's the huge toll of injuries associated with alcohol consumption. It has a major impact on individuals and our community.

And we're learning more and more about FASD—the effect of alcohol on a developing fetus. We heard in some of the contributions about what it can do—its physical manifestations, its impact on young children's ability to learn, particular behaviours, higher rates of incarceration and so on. It has a significant impact on the lives of those individuals, their families and their local communities. It is a debilitating collection of disorders, and they are entirely preventable—entirely preventable. Let me acknowledge and welcome the work of the Foundation for Alcohol Research and Education on raising awareness of FASD, but it's now time to ensure we do everything we can to turn things around.

We know that, like for so many other preventable health conditions, Indigenous people suffer disproportionately from the harms of alcohol. We know that ill health due to alcohol dependence and harmful use in the Aboriginal and Torres Strait Islander population was 4½ times greater than that experienced by non-Indigenous Australians in 2003. So we know what to do. The evidence is there. It's just a question of whether we're going to follow the evidence about what works.

At the acute end of the spectrum, we've got to make sure that people who need treatment can get it; it's as simple as that. But we also know that, in Australia, half the people who are seeking alcohol and drug treatment can't access it, which is why, of course, the Greens want to see double the commitment to funding AAD treatment at the Commonwealth level, and we want the states to follow suit. We've got to do better when it comes to primary care. We know that brief intervention from a GP, a practice nurse or a maternal child health worker can have a big impact. But we know that, if we're going to really have an impact, prevention is where it's at.

We've got to make sure that we close the loophole that, when it comes to the advertising and promotion of alcohol during children's viewing times, allows young kids to be targeted if they're watching sport. We've got to close that loophole, and that could be closed by the communications minister today. We know that, when logos like VB and XXXX are emblazoned on sports heroes' jumpers, we're sending the wrong message. Price is another factor. We know that, if we addressed the dog's breakfast that is the current taxation of alcohol, particularly the wine equalisation tax, and moved towards a volumetric type tax, it would have a huge impact. There is also labelling, and at the moment the dismal state of labelling is something to be ashamed of. We know availability, zoning and all those sorts of things also have an impact.

One of the reasons we haven't made changes is that this is an area where big, powerful, vested interests dominate the national debate. They lean on government through their lobbyists and through their donations, and, until we address the cancer in our democracy that is the role of these big vested interests, we cannot do what needs to be done to address the scale of this enormous challenge.

Malarndirri McCarthy (NT, Australian Labor Party) Share this | Link to this | Hansard source

I rise to speak on this matter of public importance, and the issue of fetal alcohol spectrum disorder, or FASD, is very important. It is often referred to as the invisible disability. But I share with the Senate that, as far as my families and clan groups are concerned, it's not so invisible. Unfortunately, it's a very visible part of our daily life, a very visible part of the community life and a very visible part of the educational system in trying to deal with students across the Northern Territory, but in particular in our remote communities, who are suffering from FASD.

FASD refers to the spectrum of fetal outcomes linked to alcohol use during pregnancy, and they may include physical, cognitive and/or developmental symptoms. It's often not noticed until the child reaches school age. From their learning and how they relate to their peers, it becomes apparent. The majority of children and adults who have FASD live with significant cognitive, behavioural, health and learning difficulties which are lifelong. And, unfortunately, a lack of research and data means we do not have a really clear picture of FASD prevalence in Australia—that is, from an academic research perspective. But I can certainly tell the Senate that there are many personal stories and information about FASD just in the Northern Territory, and concerns about FASD, I'm very aware, across WA and Queensland.

It is believed up to half a million Australians could be on this spectrum. We know from the AMA that FASD is not confined to a particular community or demographic; it is a disorder that crosses socioeconomic, racial and educational boundaries. We also know that alcohol consumption statistics and epidemiological data on FASD prevalence from comparable countries suggest that FASD prevalence in Australia is higher than previously thought. In the US, for example, it's estimated that FASD affects, roughly, between two and five per cent of the population. The AMA also tells us that in some high-risk Indigenous communities the prevalence may be as high as 12 per cent.

This disability is entirely preventable, and this is where our main efforts need to be focused. Again, in my home of the Northern Territory, the lack of reliable data means we don't know much about how many children and families are affected. But we do know from the 2015 Australian Early Development Census that some 37 per cent of children in the Northern Territory were considered 'developmentally vulnerable' across one or more domains. In some communities, it was as high as 50 per cent. Experts also estimate that in Central Australia one in five children could suffer from FASD—one in five. Again, all of these cases are entirely preventable. I'm pleased to say that in April last year the Northern Territory's first diagnostic centre for FASD opened in Central Australia. The centre, opened by the Central Australian Aboriginal Congress, helps ensure early diagnosis and immediate access to services. Early intervention and support improves psychosocial and behavioural outcomes for those affected by FASD. Wraparound services such as this provide important support for children and families.

In Darwin in May last year, Aboriginal Peak Organisations Northern Territory, APO NT, hosted a landmark Top End forum on FASD. That forum brought together 180 delegates from 37 organisations across the Northern Territory including Aboriginal leaders, FASD experts, Aboriginal Community Controlled Organisations, government representatives, medical professionals, and non-government organisations. That forum heard from specialist neonatal and general paediatrician, Dr Mantho Kgosiemang. She spoke of her experience as a paediatrician in the Northern Territory, and said the common effect that she sees with children affected by FASD is that they are born smaller than they should be. These children end up staying for a prolonged period of time in hospital—whether it's in Royal Darwin Hospital, Katherine Hospital or Tennant Creek Hospital, or in Alice Springs or Nhulunbuy, our children are spending way too much time in these hospitals. These prolonged hospital stays also affect family members, who may then be separated for longer from kin, culture and community. For remote communities, access to a paediatrician might be at most once a month, for example, in larger communities like Maningrida. But what about the smaller communities, like Yarralin? They may only get a paediatrician once every three to four months. In between, they are seen by GPs who, again, may just be visiting for a number of weeks. Aboriginal medical services and Aboriginal Controlled Community Health Services have a key role in working for change and driving change in our communities.

FASD also increases the likelihood of a person coming into contact with the criminal justice system, and we've been hearing that from other senators here speaking to this MPI. Canadian research has found that people with FASD are approximately 19 times more likely to be arrested than their peers. Here in Australia, Dr James Fitzpatrick, a paediatrician and researcher working with children who have FASD, says 36 per cent of people in juvenile detention in WA have the disorder. That's just in WA. Not only would early diagnosis help get children listed on the National Disability Insurance Scheme and able to access support, he believes it could help lower prison rates. Early intervention can provide the skills that reduce the likelihood that an individual with FASD will come into contact with the criminal justice system. Furthermore, it is vital that these interventions are culturally and linguistically appropriate. Let's remember: in the Northern Territory alone we have over 100 Aboriginal languages.

Dealing with issues such as FASD also relies on a willingness to take strong action overall on alcohol related harm. The extreme levels of alcohol related harm in the Northern Territory are well documented. Updated research from the Menzies School of Health Research indicates alcohol related harm costs the Territory upward of $1.38 billion per year. We know alcohol related harm is hurting the Territory, both socially and economically. For this reason, the Northern Territory Labor government introduced the most wide-ranging alcohol reform agenda in the country. The NT Alcohol Harm Minimisation Action Plan 2018-2019 was introduced nearly 18 months ago as an evidence based approach to tackling alcohol related harm. The plan is focused on delivering generational change through alcohol reforms.

The implementation of 75 of the 219 recommendations is complete, and significant progress is being made against the remaining recommendations. There are some early positive results from the reforms, with reductions in alcohol fuelled assaults, domestic violence, antisocial behaviour and emergency department presentations—a really, really critical aspect of monitoring the steps in this action plan. NT-wide emergency department presentations had reduced by 24 per cent at December 2018, compared to 2017. Non-government organisations, community groups and industry are closely involved in the successful implementation of the recommendations. A major problem in many NT towns and communities is the secondary supply of alcohol. Coordinated measures such as the Banned Drinker Register are stopping problem drinkers from accessing takeaway alcohol.

It is critical that the parliament of Australia be acutely aware of FASD and of the need for thorough research to take place in our country to protect families and their children from this disease, which is incurable.

Perin Davey (NSW, National Party) Share this | Link to this | Hansard source

In rising to speak on this matter, I note that this is not my first speech. I thank Senator Griff for raising fetal alcohol spectrum disorder, or FASD. I also thank Senator McCarthy for her contribution, because I recognise that this is an issue in the Territory. But it is also an issue across all of rural and regional Australia, which makes it an issue that we must all be aware of and that we must all address.

FASD is an overarching term. It's used to describe a range of cognitive, physical, mental, behavioural, learning and developmental disorders that result from fetal exposure to alcohol. Given the prevalence of FASD in rural, regional and remote Australia—especially, but not exclusively, in our Indigenous communities—I am very proud, as a Nationals senator for New South Wales, of the work the coalition government has done since 2014 with respect to this issue.

Despite its prevalence, FASD often goes undiagnosed. The National Rural Health Alliance has observed that children suffering from FASD might be regarded as wilful or undisciplined, when in fact they have little control over their behaviour. That is why it is a very important issue for us to continue to work on. It is an entirely preventable but incurable condition caused by a baby's exposure to alcohol in the womb. If an expectant mother has zero alcohol consumption during pregnancy then her child has zero risk of the developmental abnormalities from exposure to alcohol. I am very pleased to say that awareness of this issue is increasing and therefore more expectant mothers are aware of the risks.

FASD is currently the largest cause of non-genetic at-birth brain damage in the country and, tragically, the average life expectancy for a child born with FASD is only 34 years of age. It is at epidemic proportions, particularly in rural and regional Australia, which is exactly why the coalition government continues to pursue a national approach, in collaboration with families, communities, service providers and state governments, to tackle it.

As a National, I'm very proud that the National minister at the time responsible for rural Indigenous health, Senator Fiona Nash, commissioned the FASD Strategic Action Plan and provided $9.2 million in funding for its development. This was a watershed moment for Australia. It was the first time there was national recognition that we have an epidemic in Australia of babies born with brain damage because of alcohol consumption during pregnancy. In the 2016-17 budget, the coalition committed $10.5 million over four years to take action on FASD. The funding was provided for a range of activities, including providing online telephone support for individuals and families affected by FASD, improving access to FASD diagnostic services, and undertaking prevention and education across the country. The focus of this funding has been very strongly directed at communities of high need, which, as I've already mentioned, is predominantly in rural, regional and remote Australia.

In 2018, Minister Hunt launched the FASD Strategic Action Plan, which this original funding developed. This plan provides a clear pathway of priorities and opportunities to improve the prevention, diagnosis, support and management of FASD in Australia. Critically, the strategic action plan recognises that, with early and accurate diagnosis, along with early individualised interventions for children and adults who have FASD, the quality of life outcomes for individuals and their families can be substantially improved. Upon the release of the strategic action plan, the coalition government committed further funding to support the delivery of activities that align with the planned priority areas—namely, prevention, screening and diagnosis, management and support, and priority groups.

FASD is an epidemic in rural, regional and remote communities and, given the scale of the issue in Australia, the Liberals and the Nationals, in government, continue to take a national approach to combat it. Since 2014, the total funding committed to reducing the impact of FASD has been over $27 million. We are delivering on the FASD Strategic Action Plan and are investing in the activities which have been shown to be effective, and these activities are working. Awareness of FASD is growing and, through various government supported programs and initiatives, mums-to-be are being supported and are receiving clear and consistent advice as to what is safe and that it is safest not to consume alcohol while pregnant.