Sometimes governments need to make tough decisions because circumstances allow no alternative.
Budget emergencies. Fiscal crises. National interest.
And then sometimes governments make tough decisions – so unfettered by logic, so without justification – that you’re left wondering about their motives.
The Turnbull government’s plan to prevent some people who are severely impaired from drug and alcohol misuse from accessing the disability support pension (DSP) surely fits into the latter camp.
If the government’s proposed changes go through the parliament this week, then from 1 July people with severe impairments caused by alcohol or drug dependence applying for the DSP will be diverted on to income support and required to meet all the necessary job search obligations.
This is despite most not being able to look after themselves, even in the most basic ways.
How did we end up here?
A person’s access to the DSP is administered by a set of impairment tables covering areas as diverse as intellectual, mental health, visual and limb function. The tables are used to assess how an individual’s disability or chronic illness affects their capacity to work and their appropriateness for receiving the pension.
The Turnbull government plans to abolish impairment table 6, which is used to assess a person’s permanent impairment due to excessive use of alcohol, drugs or other harmful substances.
Charitably, I can only assume the idea behind this change is to shut the door on recreational drug users trying to access the DSP?
Yet the people who will actually be affected are seriously impaired by alcohol and drug misuse, both physically and mentally. They struggle to manage day-to-day, let alone apply for, or hold down, a job.
People like Sharon.*
Sharon is in her 40s. She has two teenage daughters and has just escaped from a three-year violent relationship.
Sharon also has a long-standing dependence on opioids, alcohol and benzodiazepines.
A victim of early childhood sexual abuse and trauma, Sharon has used drugs to help manage her psychological pain. Yet Sharon’s years of heavy drug and alcohol misuse have left her with an attention deficit disorder and constant anxiety.
As is common with many people with severe drug and alcohol dependence, time and time again Sharon has voluntarily accessed treatment for her addictions. She’s also tried to find work and support her family, but each time her drug use, anxiety and social disorganisation have sabotaged her efforts.
It is naïve and unrealistic to think a person like Sharon – with a severe substance use disorder – will simply stop using alcohol and drugs and start looking for a job because they can’t apply for the DSP. Things are too far gone to make such a big step.
As part of the clinical definition, people with severe substance use disorder are unable to modify their behaviour, even in the face of known negative consequences.
This measure will not improve Sharon’s job prospects. On the contrary, it’s likely to thrust her already difficult life into even greater turmoil: people who are unable to comply with their job search requirements will be at risk of having their income support payments cut off.
What’s really concerning is that the government has made this decision without any medical advice or input.
The DSP impairment tables were updated in 2012 after a long and consultative review that was led by clinicians, allied health and rehabilitation experts, people living with disabilities, mental health advocates, and relevant government agencies. The proposed new tables were then independently tested before being implemented.
However, in this case, none of this consultation has occurred.
Nor can the government characterise this as a savings measure. Its own budget papers say the policy will affect 450 people each year – so why are they pursuing it when addiction medicine experts are telling them how dangerous and unfair it is?
This is not about giving social security handouts to recreational drug or alcohol users. The threshold for someone who is severely impaired to access the DSP is extremely high.
As CEO of Mission Australia – then the largest provider of employment services under contract to the commonwealth – for eight years, I often advocated for sensible and sensitive reforms to the disability support pension. Work – where possible and with the right support – can make a remarkable difference to a person’s health and self-esteem.
But this measure fails to pass even the most basic logic test and must be rejected by the parliament.
*Name changed for privacy reasons