House of Assembly Fifty-Second Parliament, Second Session (52-2) 52 2 Parliament of South Australia House of Assembly published Motions Foetal Alcohol Syndrome FOETAL ALCOHOL SYNDROME The Hon. R.B. SUCH House of Assembly Fisher The Hon. R.B. SUCH (Fisher) (12:12): I move: That this house calls on the state government and the federal government to intensify their efforts to reduce the incidence of foetal alcohol syndrome. This is a subject I am very passionate about, for various reasons. Within my extended family we have young Aboriginal people who are, for all intents and purposes, part of our family. The two boys, who are now teenagers, have both suffered as a result of foetal alcohol syndrome. When I say 'suffer', it is not only physical deformities such as a cleft palate. They have both had significant surgery, and probably will for much of their lives. This is a very serious matter. The eldest lad will never be able to hold down a normal job because of what it has done to his cognitive abilities, but hopefully the younger one—and I praise Families SA for being innovative in his case. What they are doing is paying for him to go to an inexpensive private school in the country. It is not St Peters College or Prince Alfred, but getting him away from bad influences and so on has really paid off. As a digression, I commend Families SA for what they are doing there, because I think it is bringing great reward. In fact, that lad is keen to enter the police force later on, so we might see him in that role in the future. One important thing about foetal alcohol syndrome is that it is really a form of child abuse. It may not be intended in the same sense that other forms of child abuse are but, nevertheless, it is a form of child abuse. Some of it stems from ignorance. In fact, most of it stems from ignorance, because the surveys that have been done show that a lot of women have little or no understanding of what overconsumption of alcohol can do to the unborn. I will quote from some studies from the health network: 45 per cent of Australian women drink during pregnancy and 36 per cent report drinking alcohol during late pregnancy. We know that many pregnancies are unplanned, so some women who drink would not initially be aware that they are pregnant, but the consequences flow through. Many pregnant women would not appreciate that alcohol is actually a toxin that can harm an unborn child. What needs to happen—one of measures—is to make women of childbearing age, or soon to be, well aware of the consequences of alcohol consumption whilst they are pregnant. Unfortunately, recently, the federal government, and I think the state governments as well, eased off on the alcohol industry and said, 'We won't require mandatory labelling relating to this issue for another two years.' I think that is going soft on an industry that gives most of us some pleasure. They have a responsibility and it should be enforced; it should not simply be a voluntary code. I note that in South Australia some of the small wineries have decided to inform people—and I commend them for that—but the major purveyors and suppliers of alcohol have now been let off the hook for another two years in terms of proper labelling to warn those consuming alcohol that there is a risk if they happen to be pregnant. Within my extended family we have an Aboriginal person—I will just use his first name, Mark—who is very much working with Aboriginal communities and others in terms of health issues. Recently he wanted to demonstrate to one of the audience groups what alcohol can do. He wanted to use an egg to show that you could cook it with a concentration of alcohol. For some reason, the bureaucratic structure here would not allow him to do that. They said it was too confronting for him to demonstrate that alcohol could be used to actually cook an egg. He wanted to make the point that alcohol taken in large quantities over time could have a negative impact on an unborn child and on human tissue, but he was prevented from doing that by senior bureaucrats in the system here in Adelaide who said it was too confronting. I think what is confronting is to see children who have been scarred for life as a result of foetal alcohol syndrome. I have a lot of other statistics about the consumption of alcohol. Members can check them out on some of the websites, such as healthnetworks.health.wa.gov.au. When I was in Western Australia recently, I met the Labor member for Kimberley, Carol Martin, who is an Aboriginal person. I have spent quite a bit of time talking to her about this issue. She says that there is enough in terms of legal authority to deal with this issue but that we need the will of governments and agencies to actually deal with it. She said that there are probably about 50 women in the Kimberley who are very heavy drinkers and who, as a result of that, put their unborn children at significant risk. We are not talking about everyone in any community, whether they are Aboriginal or non-Aboriginal, but we are talking about a particular group that needs special help. I am told that in some Scandinavian countries they take a very strict view on the consumption of alcohol by pregnant women. In the United States—and I am not supporting this, of course—they have even gone to the point of arresting women. One document states: In two cases, women have been arrested for drinking while pregnant...Wyoming officials brought criminal charges against a pregnant woman for drinking on the grounds that her activity, while itself legal, constituted child abuse because it endangered her fetus. I am not suggesting that that we follow the American path. They are pretty heavy-handed when it comes to criminal-type matters, as we can see by the fact that a quarter of the world's incarcerated are in US prisons. What we need is greater education, more awareness and a commitment by government and agencies. This is a real problem because the people who suffer are vulnerable—initially, those unborn and then those who are born suffering with, as I said at the start, significant physical deformities, often cognitive impairment, and a whole range of disabilities and factors which will disadvantage them throughout life. I am not raising this to be judgemental. I am not looking for a heavy-handed approach. What I am looking for is some action, particularly in the area of education and awareness, to make women, in particular—and men as well because they have a responsibility in this—aware that when it comes to the unborn and then the child, we are dealing with the lives of those who cannot defend themselves and who are completely at the mercy of, obviously, their mother, their parents and the rest of the community. I commend this motion, and I bring it, as I say, in the spirit of trying to advance the way in which we deal with this issue so that we can, hopefully, spare children the serious consequences that currently flow from foetal alcohol syndrome. Ms BEDFORD House of Assembly Florey Ms BEDFORD (Florey) (12:21): I support the motion that the state government and federal government intensify their efforts to reduce the incidence of foetal alcohol syndrome. Foetal alcohol syndrome is a pattern of mental and physical defects that can develop in a foetus in association with high levels of alcohol consumption during pregnancy. Foetal alcohol spectrum disorder is the term used to describe a range of cognitive, physical, mental, behavioural, learning and developmental disorders that result from foetal exposure to alcohol. This term describes a continuum of permanent birth defects caused by maternal consumption of alcohol during pregnancy, including foetal alcohol syndrome as well as other disorders. There are a number of babies born with foetal alcohol spectrum disorder at the Flinders Medical Centre and the Lyell McEwin Health Service, given the high rates of substance use/social disadvantage and other risk factors in their areas. There is currently no specific diagnostic laboratory test to detect the adverse effects of alcohol consumption on the foetus nor a specific diagnostic laboratory test for detecting foetal alcohol spectrum disorder in babies. Foetal alcohol spectrum disorder is diagnosed by clinical assessment to determine whether a child's features meet defined international criteria for this disorder. The diagnostic process undertaken involves screening and referral by health professionals, physical examination and differential diagnostics, investigations such as an MRI brain scan, neuro-behavioural assessment, and exclusion of alternative diagnoses by appropriate clinical assessment and laboratory tests. People with foetal alcohol spectrum disorder require a range of treatments and services comparable to those required by people with psychiatric disability, acquired brain injury and/or substance abuse issues. A number of cross-agency services are provided for people with co-morbid mental health and disability or substance abuse issues by specialist mental health services, Disability SA, the Exceptional Needs Unit, the Brain Injury Rehabilitation Unit, and the Office for Disability and Client Services. These cross-agency services include assessment, intervention, individual and developmental support, assistance to access community services, as well as access to more intensive services where behavioural difficulties are extreme. Support is provided to pregnant women with alcohol problems through a variety of programs, including: case management to pregnant women through the Women's and Children's Hospital's Strengthening Links Program and the Flinders Medical Centre Early Links Program; provision of maternity care to women in the Flinders Medical Centre Medical Complications of Pregnancy clinics—a multidisciplinary clinic with consultant obstetrician, medical physician, anaesthetists and neonatologists; the Drug and Alcohol Services South Australia Obstetric Program, which provides consultation, liaison, client advocacy, education, clinical assessment and treatment for substance abuse for women prior to and during pregnancy; and the Metropolitan Aboriginal Family Birthing Program, a free service in metropolitan Adelaide, which cares for Aboriginal women who are pregnant. Care is provided by a group of midwives and one Aboriginal and maternal infant care worker throughout the pregnancy, labour, birth and after the baby is born. The midwife and Aboriginal and maternal infant care workers support women to have a positive pregnancy and birthing experience and support and advocate for the reduction of alcohol consumption. Information on foetal alcohol spectrum disorder is also available in the form of patient information booklets and pamphlets, which clearly state the danger of alcohol consumption during pregnancy, and also on the Child and Youth Health internet site: www.cyh.com.au. There are strategies to increase awareness and reduce the incidence of foetal alcohol spectrum disorder in South Australia. In 2005 and again in 2007, the Women's and Children's Health Network (formerly the Children, Youth and Women's Health Services), in conjunction with the Department for Health and the National Organisation for Foetal Alcohol Syndrome and Related Disorders Incorporated, developed and ran the Pregnancy and Alcohol Don't Mix campaign. This campaign raised community awareness about the amount of alcohol considered safe for pregnant women to drink from 68 per cent recognition within the community in 2002 to 83 per cent in 2006. The South Australian government is currently implementing a range of strategies in response to risky alcohol consumption, guided by the South Australian Alcohol and Other Drug Strategy 2011-2016 and the Primary Prevention Plan 2011-2016, including: the implementation of comprehensive social marketing campaigns; trialling a new brief intervention and screening approach within selected primary health care settings to determine its effectiveness and ongoing viability; working with non-government organisations to address alcohol use and its links to long-term health issues such as cancers; and through the Healthy Workers—Healthy Futures initiative, encouraging South Australian workers to not drink in excess of National Health and Medical Research Centre guidelines. SA Health has also led the development of a nationally developed monograph titled 'Fetal Alcohol Spectrum Disorders in Australia: An update (URL, National Drug Strategy—Fetal Alcohol Spectrum Disorders in Australia: An update). Drug and Alcohol Services chaired the working group that coordinated the development of the monograph. The monograph was developed on behalf of the Intergovernmental Committee on Drugs (the national senior officers' committee that provides advice to ministers on tobacco, alcohol and other drug-related matters). The monograph was endorsed by the Standing Council on Health in February 2012 and released to the public. The monograph provides an overview of the current research, policy and practice in relation to alcohol consumption during pregnancy, particularly in terms of FASD. The findings identify areas where additional attention is required and enhancements to existing practices that might improve the current situation with regard to prevention, early intervention and long-term management of this preventable condition. There are national strategies to increase awareness and reduce the incidence of foetal alcohol spectrum disorder. With regard to the appropriate labelling of alcohol to raise awareness of the potential effects that alcohol can have during pregnancy, the Council of Australian Governments and the Australia and New Zealand Food Regulation Ministerial Council in 2009 initiated a review of food labelling law and policy in Australia (the review). Alcohol was in scope for the review as it is considered a food, regulated under the Australia New Zealand Food Standards Code. The South Australian government provided a submission as part of the review, which highlighted the merit in informing consumers of potential harms associated with alcohol, thereby enabling the consumer to make an informed choice. It was recommended that the review consider labelling of alcohol products with health warnings as a relatively low cost way of raising awareness and reminding the public of the possible harms associated with drinking. In 2011, the review panel released its report 'Labelling Logic—Review of Food Labelling Law and Policy 2011'. Recommendation 25 of the report outlines that a suitably worded warning message about the risks of consuming alcohol while pregnant be mandated on individual containers of alcoholic beverages and at the point of sale for unpackaged alcoholic beverages, as support for ongoing broader community education. On 9 December 2011, the Legislative and Governance Forum on Food Regulation, convening as the Australia and New Zealand Food Regulation Ministerial Council, concluded that: The Standing Council on Health has advised that pursuing warnings about the risks of consuming alcohol while pregnant is prudent but, noting the voluntary steps industry has already taken in this area, has suggested that industry should be allowed a period of two years to adopt voluntary initiatives before regulating for this change. On 21 August 2012, the federal Minister for Mental Health and Ageing announced the following funding for projects aimed at reducing alcohol-related harm in the community: More that $750,000 over three years for the National Organisation for Foetal Alcohol Syndrome and Related Disorders to support its work as the peak body. More than $1 million for projects that raise awareness of the risks of harmful drinking, particularly during pregnancy. Funding will also be provided to the Foundation of Alcohol Research and Education to work with health professionals in raising awareness with patients about the risks of harmful drinking, particularly to pregnancies. To optimise the impact of the alcohol industry warning labels, funding will also be provided to DrinkWise Australia to work with industry to develop point-of-sale information for consumers at liquor retailers, clubs, pubs and hotels. The projects to build on the $103.5 million national binge drinking strategy and on specific government investments made for better prevention and understanding of foetal alcohol syndrome. The House of Representatives' Standing Committee on Social Policy and Legal Affairs is currently inquiring into and reporting on developing a national approach to the prevention, intervention and management of foetal alcohol spectrum disorder in Australia, with particular reference to prevention strategies, intervention needs and management issues. The anticipated outcome of the inquiry is a commitment by federal parliament to develop a national strategy for intervention and the prevention and management of foetal alcohol spectrum disorder. Whilst there have been significant efforts, both within South Australia and nationally, to increase awareness of the risks of consuming alcohol whilst pregnant and to prevent the incidence of foetal alcohol spectrum disorder, I would like to express my support for continuing efforts and collaboration in this important area. Mr PEGLER House of Assembly Mount Gambier Mr PEGLER (Mount Gambier) (12:31): I rise to support this motion. I have some constituents who were born with foetal alcohol syndrome. I think it is one of the saddest things you will ever see in the aspect that there are enough children born who do have problems, but this is a problem that has been caused by their parents rather than by their genetics, etc. It is something that can be alleviated if only the pregnant mothers were more responsible in their alcohol consumption. I certainly feel that we must do everything we can as a society to reduce the number of children who are born with foetal alcohol syndrome. The Hon. R.B. SUCH House of Assembly Fisher The Hon. R.B. SUCH (Fisher) (12:32): I thank members for their contribution and their support. As is my wont, I do not bring this in as an attack on people or to condemn the government or whatever. I want to see greater effort put in and greater awareness of what, in particular, excessive alcohol consumption can do to the unborn. I am sure that the Minister for Health in this place is committed to it, and I am sure federally likewise. I think that the message needs to get out that particularly drinking large amounts of alcohol during pregnancy can have serious and long-term consequences for the most vulnerable in our community. Motion carried.