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The benefit in doubt


aug 2011 benefit in doubt

Welfare beneficiaries who use alcohol and drugs are likely to be targeted under a new, tougher regime if recommendations by the Welfare Working Group are introduced. The government-appointed group has found the current system is too permissive and proposes benefit cuts and stand-downs as penalties for those who fail drug and alcohol tests and refuse treatment. Critics argue the suggested measures are draconian and could lead to an increase in social harm and criminal offending that would impact on all New Zealanders.

When New Zealand’s welfare system was first established more than 70 years ago, it was designed as a safety net for the most vulnerable. There are now fears among beneficiary advocates that, if reforms proposed by the Welfare Working Group (WWG) are implemented, this net could turn into one that captures and penalises more than it rescues.

That concern could be particularly relevant for people who drink alcohol or take drugs while receiving a benefit. Critics, including the New Zealand Drug Foundation, are worried beneficiaries with addictions – already one of the most powerless groups in society – will be at greater risk if the WWG’s proposals are introduced.

The group’s hefty February report Reducing Long-Term Dependency details 43 recommendations, including proposals targeting substance abuse.

It says at present there are insufficient consequences if recreational drug use prevents people from finding a job.

“People on a benefit using illegal drugs do not have to look for jobs in industries with pre-employment drug testing. There is also no requirement to engage in drug or alcohol treatment as part of meeting a job search obligation.”

These policies are described as “generally permissive of alcohol and drug dependence that is a barrier to employment”, and in the WWG’s view, the taxpayer should not be required to support someone who is unable to get a job because of drug or alcohol use and is not prepared to take steps to address those issues.

The group notes overseas evidence that suggests considerable benefits from a strategy targeting chronic drug use, with returns as high as $2.50 for every dollar spent.

It recommends a stronger set of rules and obligations regarding alcohol and drug use where beneficiaries would face a regime of graduated sanctions, such as benefit reductions and stand-down periods without a payment, if they refuse to apply for a job because the employer uses pre-employment drug testing or they fail a work-related drug or alcohol test. Refusing to take part in a treatment programme offered to them would also be seen as a failure to meet job search obligations.

Where the wellbeing of the individual or children is deemed to be at risk because of drug or alcohol dependence, the group recommends consideration be given to placing management of their welfare payment into the hands of a responsible third party.

The WWG accepts the new system of stronger rules and obligations it proposes would need to be underpinned by personal advice and rapid access to free rehabilitation, which would require a “significant expansion” of publicly funded drug and alcohol treatment programmes.

A ministerial working group is currently considering the WWG report before deciding which of the recommendations will become part of National Party policy in the lead-up to the election in November. Social Development Minister Paula Bennett, who is convening the ministerial group, says announcements will be made “within weeks”.

While many taxpayers and potential voters might support moves to motivate long-term beneficiaries with drug problems into seeking treatment and employment, the Drug Foundation has raised serious concerns about the impact of the punitive methods proposed by the WWG.

In the policy briefing Welfare Reform and Substance Abuse, written by the Drug Foundation in response to the WWG report and presented to the government, it strongly supports the recommendation for more accessible drug and alcohol treatment services, but says the other measures suggested are based on fundamentally misguided assumptions about substance use, addiction and welfare dependency.

The report’s author, Drug Foundation senior adviser Sanji Gunasekara, says the WWG’s proposal of using economic sanctions as a punishment would not help people with addictions to change their behaviour.

“If you have problematic drug use and addiction, many of the people in this situation aren’t going to be able to make a rational decision and change their behaviour, so the notion of having to meet obligations or face penalties is unrealistic for this group. Even people with the best social supports and from the best socio-economic positions tend to have trouble undergoing treatment successfully on their first attempt, so people on benefits who are some of the most vulnerable in our society are unlikely to be any different.”

Julian Buchanan, an associate professor at Victoria University’s Institute of Criminology, agrees with the Drug Foundation’s stance and is concerned by the overall tone and direction of the WWG report.

“I think, in respect of alcohol and other drugs, it’s pretty draconian. It’s ill-conceived, ill-informed, and I think it’s really quite flawed as a way forward. If it’s designed to reduce drug use, it’s not going to do that, and if it’s designed to try and encourage people with drug problems to get jobs, it’s not going to do that either. The problems with it are that it’s promoting health change with a whole set of coercive sanctions and punishments. Generally speaking, that’s not a sensible way to bring about changes in habitual behaviours.”

As a probation officer in Britain in the 1980s, Buchanan specialised in work with drug users before moving into the academic field 15 years ago. He believes the WWG’s recommendation to impose sanctions on beneficiaries who fail to meet certain obligations would be counter-productive and could potentially increase criminal behaviour. Beneficiaries penalised with stand-downs would be left without any legitimate income to support themselves or their families and would be likely to turn to criminal behaviour, such as drug dealing and theft, which would have a negative impact on families, communities and wider society.

“If you take away their benefit for several weeks and that’s their only source of legal income, they’re going to end up borrowing or committing crime or getting into more trouble and more of a mess as they try and find an alternative way of generating income. It’s not rocket science. And if that happens, we’ll end up spending more state money rather than less.”

People with addictions need to have high personal motivation to change their behaviour and quality programmes tailored to them as individuals for treatment to work, he says. Neither of these conditions is likely to be met when treatment is forced upon someone because they’ve failed to meet their obligations.

He argues penalising people who are often low-skilled or have limited qualifications will further stigmatise them and make it even more difficult for them to find work. This is not a positive way of addressing welfare dependency and will push them further away from social integration.

“Often their labour isn’t in demand. We have to recognise their position in New Zealand society – these people don’t need punishing, they need help and encouragement and incentives. There are some people who are skiving and cheating, but I don’t think they represent the majority of people on benefits. I think they represent a tiny proportion.”

Gunasekara says international evidence suggests punitive measures could have the opposite effect to what the WWG intends. Cutting benefits to those who fail to attend or complete addiction treatment is an approach that has been considered overseas and has either failed or been abandoned. In Britain, the previous government had planned to introduce benefit sanctions for problematic drug users but the idea was scrapped by the new government in May 2010, partly because of concerns about coerced health treatment and fears it would impoverish people who use drugs. In the US, drug testing combined with sanctions on people receiving welfare assistance proved costly and ineffective in the states where it was tried.

Rather than encouraging drug users into treatment, a regime of sanctions has the potential to exacerbate poverty, increase crime and harden drug dependency in a group that is already marginalised, the Drug Foundation report says.

“Were such a recommendation implemented, we would fully expect to see an increase in theft, drug dealing, begging, homelessness and possibly domestic violence.”

Gunasekara argues this doom-filled forecast is not overly pessimistic.

“The Welfare Working Group report doesn’t consider what the outcome of stand-downs could be for the individuals concerned, their families and our communities. Based on what’s happened in the US and on feedback we’ve had here from the treatment and criminal justice sectors, it’s likely that many people with severe addiction who face a total loss of income will turn to crime and other illicit activities.”

Māori (who are twice as likely as other ethnic groups in New Zealand to have a substance abuse problem in their lifetime), Pacific peoples and the most socio-economically deprived groups of society would be most likely to suffer as a result of the WWG proposals, he says.

The Drug Foundation also believes the WWG has overstated the extent of problematic drug use in people receiving benefits.

The WWG report says alcohol and recreational drug use is becoming a barrier to employment for an increasing number of people and quotes a Ministry of Health survey carried out in 2007/2008 that found 32 percent of beneficiaries reported using a drug (excluding alcohol, tobacco and BZP party pills) recreationally in the past 12 months, compared to 18 percent of non-beneficiaries.

But in notes on its unpublished survey results, the Ministry cautions against using the figures to show causality. It also says the results do not show the frequency of drug use or give any indication of the impact of that use, and it’s possible some of the differences in drug use are explained by beneficiaries being more likely to live in poorer neighbourhoods.

Gunasekara says US research shows only about 3.3 percent of those on benefits meet the criteria for being diagnosed with a serious drug use disorder, and it seems unlikely the numbers would be significantly different in New Zealand.

Buchanan and the Drug Foundation are concerned the WWG recommendations do not differentiate between recreational drug users who are able to lead normal lives and heavy drug users who are causing problems for themselves, their families and society.

“We know more than half of all young people aged between 16 and 28 use illicit drugs, and those figures are likely to be even higher for people on benefits, but I would say only about 6 percent of people who use illicit drugs actually have a drug problem,” says Buchanan.

He believes widening the net to capture young, recreational drug users and putting them in the same category as drug addicts would be a dangerous step and one that wasted resources that would be better spent targeting people with real drug problems.

Buchanan is an outspoken critic of workplace drug testing, which he describes as a growing business internationally. He says it’s a blunt instrument that can have unwanted consequences. A positive test for alcohol, for example, doesn’t identify whether a person is a recreational, social drinker or someone with a drinking problem. Although alcohol is a potentially dangerous drug, a positive result could be completely irrelevant to that person’s work performance, ruling them out of getting a job without any justification.

“Drug testing is flawed because it makes all sorts of assumptions, but it doesn’t really tell you anything. You can also get false positives where someone who has taken a legal substance, such as a prescription painkiller that contains codeine, can show up as using an illegal drug. It doesn’t give you a definitive, black and white answer.”

He believes testing should be reserved for high-risk workplaces – such as machinery operators, commercial pilots or drivers – where intoxication from alcohol or other drugs is manifestly unsafe.

Reading the WWG report gave him a sense of unease about where this country could be heading with regard to the use of drug testing and its consequences.

“I felt some disquiet when I read the draconian tone of the report in terms of human rights. Within that punitive tone, you can imagine drug testing for all people on benefits would be the next step – it wouldn’t have surprised me to read that.”

The Drug Foundation agrees that putting workplace drug testing at the heart of the WWG’s proposed new sanction regime presents a host of practical, legal and ethical fish hooks. In his report, Gunasekara writes: “By placing undue reliance on the role of employment-related drug testing, the WWG’s proposals have the potential to create a new barrier for a group of people whose drug use doesn’t compromise their workplace safety or productivity but are erroneously categorised as having a drug issue, subsequently labelled as such and subject to sanctions."

He believes, for the majority of beneficiaries, factors such as psychiatric illness, poor physical health, childcare concerns or language barriers are more likely to present a barrier to employment than drug use.

“We already have a treatment sector that is over burdened and under resourced. If you’re going to catch a greater number of people – some of whom may only be using drugs very occasionally and with very little impact on their lives – and pressure them into treatment programmes, it’s going to completely swamp those treatment agencies.”

In 2008, the National Committee for Addiction Treatment estimated the capacity of addiction services needed to at least double to allow the most severely affected to get timely access to treatment.

The Salvation Army is one of the largest providers of addiction treatment programmes in New Zealand, with centres from Kaitaia to Invercargill. Its National Manager for Addiction Services, Gerry Walker, says it already has waiting lists in many areas and would be unable to cope with a big increase in referrals from Work and Income New Zealand.

“If there’s not a corresponding increase in capacity and funding, then we’ve got a major problem,” he says. “It could open a veritable floodgate, potentially. We’ve got significant demand for our services. In some of our areas, we’ve got waiting lists for people wanting our service, so we’ve got to be mindful of that or we could end up with longer waiting times.”

Any changes to the way beneficiaries with drug problems are dealt with would have to be carried out in a very planned and co-ordinated way so that infrastructure, facilities and experienced clinicians were available in the workforce to meet higher numbers of people needing treatment.

That is more complicated than simply boosting funding, Walker emphasises.

“Clinicians and staff experienced in treatment of people with drug addictions aren’t plentiful. We’ve got to make sure there’s a strategy that addresses all of those points rather than just an immediate response.”

However, he says the Salvation Army already accepts numerous referrals of clients through the Court system and the Probation Service, and making drug treatment non-negotiable for people does not mean it will be unsuccessful.

“We’re used to dealing with people who are not there by choice initially. But part of our model is to try and work with them and get them to a point of acknowledging they do have a problem and that it’s a good thing they’re having treatment. If people present voluntarily, that’s better, but that’s not the real world.”

He says addiction is extremely powerful for many people, and having on-going support available for those going through treatment is one of the major indicators of success.

Beneficiary advocate Sue Bradford, a member of the Alternative Welfare Working Group set up last year, says her deepest fear is that the government will not properly implement the much-needed expansion of addiction treatment programmes but will instead use the WWG’s recommendations as a way to punish beneficiaries with drug and alcohol problems.

“I think it’s hugely invasive of people’s privacy, including people who don’t actually have an addiction but use alcohol and drugs in a reasonably safe way. They will be impacted by this as well. It’s another layer of abuse and harassment of beneficiaries.”

It is extremely difficult for people to access addiction treatment in a timely way in most parts of the country at present, and it will take a huge investment to bridge that gap, Ms Bradford says.

“The whole thrust is to try and get people out of the benefit system, not to try and help them, and I think it’s very unlikely that health services necessary to really help people who do have drug and alcohol problems will be provided.”

Sanctions such as benefit cuts and stand-downs could have a devastating effect on the children of people receiving welfare payments, and she foresees a frightening social cost if the reforms are introduced.

“Addictions are likely to get worse, mental and physical health, crime, homelessness and a terrible impact on children. Ultimately I think there could be suicides as well. The welfare system is supposed to be a safety net for the most vulnerable and their children. That original safety net has been eroded hugely already, and if these measures go through, there won’t be much of a net left at all.”

Social Development Minister Paula Bennett says it’s too soon to respond in detail about what changes are likely to be made regarding welfare reform, but she could comment on some issues raised by the Drug Foundation in response to the WWG report. She says the Foundation’s submission contains some “strong and well made arguments” and the ministerial group would definitely take into consideration the issue it had raised about the importance of distinguishing between those who are addicted to alcohol or drugs and those who use substances recreationally.

Regarding concerns about the use of penalties such as stand-downs, she says the sanction process as it stands gives people full and clear warnings with several opportunities to comply with their obligations before any changes are made to their benefit. Those with children face lesser penalties.

“Final decisions on welfare reform have not been made, so it is too soon to say how the sanction process may look in the future.”

But a harder line seems likely given Bennett’s dissatisfaction with the lack of teeth in the current system.

"If people can work, they should, and if they’re sick, they should be doing what they can to get well so they can get back to work. I don’t think it’s unreasonable to expect those on a benefit due to drug or alcohol addiction to be taking steps to be well, because it is designed to be temporary assistance.

“I'm concerned the system currently lacks a requirement for those receiving welfare because of drug and alcohol addictions to be making every effort to get well. I am concerned both that more than 5,400 New Zealanders are currently on either the sickness or invalid’s benefit because they have an addiction problem to drugs and or alcohol. Currently, if someone on a sickness benefit doesn't wish to seek medical treatment, including rehabilitation for an addiction, there is nothing we can do.”

She says New Zealanders need to decide if they want changes to the system to incorporate a greater emphasis on people getting well so they can get back to work. That may require more resources and support for beneficiaries to get them back to work faster.

The Minister also appears to strongly support the use of employment-related drug testing, saying she has real concerns about young people being work-ready “which means being drug-free and able to take up a job when the opportunity arises”.

“Recently, 17 percent of the young people at a Work and Income seminar said they wouldn't pass a drug test. Forestry industry leaders tell me they simply will not hire young people who can't pass a drug test, and they find a large number don't. This is unacceptable."

Gunasekara says the key finding of his investigations is that the government needs to be guided by scientific evidence and not ‘flawed populist assumptions’ about drug users needing to be punished or coerced into treatment. He calls on decision makers to enlist the advice of treatment and mental health specialists and use empirical evidence when acting on the WWG’s recommendations on how to tackle substance abuse.

But Bennett says the WWG’s review of the welfare system began in April 2010, and there was a 9-month consultation period where experts and specialists in a range of fields were approached to provide evidence and opinion, “so there has been every opportunity for groups like the Drug Foundation to have a say on this”.

Despite this, the Drug Foundation is not convinced the WWG’s recommendations will achieve its worthy objective of “ensuring drug and alcohol dependence issues are addressed so that people can sustain employment and provide a safe environment for their children”.

Kelly Andrew
Christchurch-based writer

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