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Apr 29, 2011

NT Intervention: the divide between opinion and evidence

The over-publicised tweet by Larissa Behrendt needs to be seen as part of a wider issue.

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Opposition leader Tony Abbott appeared on The 7.30 Report, interviewed by Chris Uhlmann against the backdrop of the NT:

CHRIS UHLMANN: I spoke with Opposition Leader Tony Abbott earlier today and asked if the intervention had achieved its primary aim, protecting children.

TONY ABBOTT, OPPOSITION LEADER: I think the intervention has made a difference. It hasn’t been perfect. Nothing is perfect, but it has made a difference and I think the challenge now is to build on that to try to see if we can extend the intervention to Alice Springs and the other major centres of the Territory, so that we ensure that everywhere in the Territory the kids go to school, the adults go to work and the ordinary law of the land is observed.

There is relatively little evidence of the benefits and/or harm of aspects of the Northern Territory Emergency Response (NTER) so we do not know how its components affected the targeted 73 communities and whether it met any of the vague aims set. There are some scattered but useful studies and serious doubts about the value of others. These questions of  evidence create considerable tensions between supporters of the intervention and those who doubt its value.

The over-publicised tweet by Larissa Behrendt needs to be seen as part of this debate and her expression of disgust and disagreement with Bess Price’s statements about the benefits of the intervention, not about her person.

It also highlights the discrepancy between the coverage an issue like the tweet story is given compared to the exposure that both Abbott and the media have given to opponents of the intervention — people like Barbara Shaw and the Intervention Rollback Action Group.

I was watching Q&A and I worried that the Price statements would be taken more seriously than the measured judgment of the Human Rights Commissioner Graeme Innes, who contradicted some of her assumptions. Evidence is very limited and often seriously flawed but should be debated. But as I show below, the government has failed to take seriously the evidence on offer and is making policy on its prejudices and some expressed opinions.

The income management part of the program is now extended to the whole NT, with the rest of Australia on the government’s agenda. I acknowledge my political views are anti much of the intervention (and I drink lattes) but I offer the evidence collected below, based on my strong professional ethos in research and evaluation. Despite many claims of success stated by the government, there is no statistical evidence that income management has in itself improved the health, child safety or family well-being in any of the designated areas.

I acknowledge that such data are hard to come by, as there was no baseline data that could be used to show change. Causality is always difficult to prove but where there are big and expensive program changes, there is a need to set up measures that can test the statistical differences of pre-, during and post-program behaviour. In this case there is no official baseline data or later measures, and there will be none in the big current evaluation of the NT wide program. In fact, although the extended new non- racial, but 94% indigenous, income management program, started last August, the evaluation is only now designed and not yet allocated by tender.

The government depends therefore on statements and opinions that support what it wants to do. This tendency showed up in the so-called redesign process, which took no advice from various consultations, submissions and reports. These offered repeated recommendations to replace population compulsory income management with a voluntary scheme except where people were proven to have problems. This advice came first in the Yu report that Jenny Macklin commissioned, and later in many submissions including from the Central Land Council and many Aboriginal groups. The Aboriginal Medical Service of the NT was quite clear in its submission:

AMSANT continues to oppose any form of compulsory income management for the reasons that follow…..

22. There is no compelling evidence that compulsory blanket income management is an effective tool for helping to improve the living conditions for children and families in Indigenous communities, or to support disengaged youth and vulnerable individuals in the broader community. In fact, the jury is still out on questions of its efficacy. The claims that quarantining welfare income under the NTER has significantly improved health and reduced alcohol consumption cannot be sustained on the evidence presented.

The careful Health Impact Assessment of the Northern Territory Emergency Response  from Australian Indigenous Doctors Association  (AIDA) recognised some immediate positives but also negatives that could have long-term effects stated in its income management section:

Rather than enabling Aboriginal families to better manage their money the process of compulsory quarantining was seen as reinforcing beliefs that Aboriginal people were not able to manage their lives. This loss of autonomy about where to shop and what to buy was seen as degrading and shameful. Importantly it did not focus on whether people received enough money to be able to budget appropriately or provide skills in budget management.

They conclude:

The positive and negative health impacts of compulsory income support are likely to cancel each other out.”

The carefully constructed store survey by the Menzies Health researchers found no statistical evidence of changes in purchasing that could be attributed specifically to income management. Better stores, nutrition programs and budget assistance were major factors in changing purchasing in many areas.

In the Senate report, this lack of evidence is described and summed up:

3.45 Many submitters and witnesses were critical of the evidence base used to support the extension of income management across the Northern Territory and Australia. Some of these criticisms were summarised by Professor Jon Altman, who stated: Unfortunately and sadly, no empirical evidence with any integrity has emerged to unequivocally support income management measures. That collected by the Australian Institute of Health and Welfare has been highly qualified and equivocal. That collected by the Australian government or its agents has been in-house, unreviewed and, frankly, a little amateurish. At best, it has been deeply conflicted by moral hazard. Agents of the state are asked by state employees or their paid consultants whether state measures are effective.

3.46 Several witnesses, including Anglicare Australia, the Australian Council of Social Services (ACOSS) and the St Vincent de Paul Society noted the small sample size used in studies such as the AIHW evaluation report and were of the opinion that the evidence base was not strong enough to support the expansion of income management.

Worryingly, the evidence might change over time. For example, there is forthcoming research from the Menzies School of Health Research, currently under peer review, that outcomes from income management might, at best, be ineffective and, and at worst, perverse.

Despite these views, the recommendation from the ALP majority was that the Bills should be passed without changes.

Since the Senate report was tabled, other evidence has emerged that the intervention hasn’t worked, including in child protection, its primary area of interest. The NT, in late 2009. commissioned a report on child protection Growing them strong, together to cover the past three years. This reported that child safety had deteriorated and, interestingly, failed to mention the NTER, either in its review of what had happened or income management as part of its future planning.

There are two other income management trials that are claimed to be showing good results. These are basically voluntary schemes with compulsion being used to punish/control non-compliers. Therefore, they are not comparable with the NT model but even then, the data does not show clear gains.  There is much more evidence  I could list, and it will come out as an issue of the Journal of Indigenous Policy.

The only clear support for maintaining the compulsory income management came from the NPY women’s group. Interestingly, they are the only group that the government quoted as a reason for continuing the program. It is this nexus of influence that shows the power of individual voices that agree with what the government proposes.  The Price comments, made on Q&A, can be seen as adding to the misinformation that has been used to justify this program.

There are many groups who are angry and puzzled that the mass of counter evidence is ignored. Opinions running counter to government views are also ignored even if they come from respected long-term residents. There are wide differences between the Bess Price and the NPY views and other elders from their own communities.  A few weeks ago at a forum in Melbourne, included the Reverend Djiniyini Gondarra, Rosalie Kunoth-Monks OAM, Miriam-Rose Ungunmerr-Baumann, Harry Jakamarra Nelson and George Gaymarani Pascoe, all of whom opposed much of what Bess supported.

Government ministers therefore seem equally able to discount opinions of locals and evidence from experts which do not support the views they hold. While evidence-based policy seems to have lost out in political debates, there is still the question of public opinion. The attack of Behrendt by News publications, which undermined the legitimacy of her professional judgment (and even Crikey’s) was obviously aimed at confusing uncommitted views of the voters. By playing the race in conflict cards and implying this was rural urban splits, The Australian made sure that the conservative views of its tame commentators would be unchallenged.

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