Coalition must pre-commit to addressing problem gambling

It’s hardly surprising the Coalition would baulk at costly regulation in the gambling industry. Flickr/Marionzetta

The future of Australia’s pokies pre-commitment scheme – which enables players to set a limit on how much they’re prepared to lose – is in doubt, with Labor likely to support the Coalition’s move to repeal key elements of the former government’s pokies reforms.

The Coalition has vowed to pursue a voluntary pre-commitment scheme. But few details have been released about how this will work. It will be designed following wide-ranging consultations required by the draft legislation.

Whether pre-commitment is mandatory or voluntary, what matters most is that it’s effective and targeted.

‘Nanny state’ regulation

There is nothing unique about government regulation and legislation in public health matters. Governments regulate the use of alcohol, tobacco products and illicit drugs with varying degrees of success. Indeed, many of these addictions also occur frequently in combination with problem gambling.

In the illicit drug context, prohibition has been the most common regulatory response but this approach has been spectacularly unsuccessful.

In the alcohol context, the purchase of alcohol in liquor stores, provided the person is not intoxicated, is unconstrained. But in most jurisdictions, it is illegal to serve people alcohol when they are impaired. Responsible serving of gambling provisions also involve similar arrangements.

In the tobacco context, aside from the statutory age limits there are no major constraints on the purchase of the products. But, through pricing and other regulation and public education campaigns, government has very successfully driven down Australian smoking rates.

It is hardly surprising that the Coalition – as philosophical champions of individual liberties, states rights, reduction of regulation and a pro-business stance – would baulk at a brave new world of costly regulation in the gambling industry.

Voluntary vs mandatory

The big issue for the advocates of a universal mandatory system is targeting: should pre-commitment be mandatory and should it extend to all gamblers?

After all, a lot of effort and expense could be incurred in regulating the gambling of people who do not have a problem. Problem gambling prevalence rates vary from study to study but are likely to be close to 1% in the general Australian community. Measures that capture the entire population to target a much smaller percentage of the population are potentially costly and inefficient.

The government and opposition now both seem to support some form of pre-commitment but now it seems it will be a voluntary “opt-in” scheme. The Coalition bill states:

The Commonwealth will work with governments of the states and territories, the gaming industry, academics and the community sector … to develop and implement a voluntary pre-commitment scheme on gaming machines in venues nationally.

Consultation is usually a positive but it would be regrettable if the process delivered widely different results in the different jurisdictions. Australia is too small to afford or warrant boutique approaches to key matters of national social policy. Consistency in regulation is more efficient.

Around 1% of the Australian population are problem gamblers. Panchenks

Another concern is that the exact design parameters of such a pre-commitment intervention are still unclear. We have slogan-based debate without the technical detail required to rationally assess the merit of the proposed measures.

The Productivity Commission’s 2010 problem gambling report outlines the current international and Australian experience in pre-commitment trials. Workable options include breaks in play and spending limits that may be set over particular time frames, such as daily or overall spending limits.

But the Commission concludes the success of pre-commitment depends on what specifically is being proposed; a poorly designed universal “mandatory” system could be much less effective than a well-designed and targeted “voluntary one”.

Problem gambling researchers and advocates are concerned that the currently low uptake in treatment may be matched by a similarly low uptake in pre-commitment by people who really need it.

The majority of problem gamblers never receive treatment for their condition and an even larger percentage of current problem gamblers are not in treatment. An ineffective voluntary pre-commitment scheme may also receive poor uptake and that opportunity to capture people who require support may be lost.

While there’s certainly a strong political dimension of this debate, we need to focus on the evidence available and use the established principles of behaviour change program design to implement a system that is going to work.

Just one piece of the puzzle

Pre-commitment is not a substitute for funding and marketing credible treatment systems for problem gamblers; it’s one of many responses needed to reduce the harms from problem gambling.

An appropriate level of resourcing for high-quality treatment services should be a mandatory policy pre-commitment. While some argue prevention and government regulation should be the priority, formal treatment remains the most effective way we currently have of dealing with problem gamblers.

The National Health and Medical Research Council guideline on the screening, assessment and treatment of problem gambling, which we developed, concludes that gambling behaviour can be successfully changed with appropriate interventions. Well-trained practitioners can deliver sustained reductions in gambling spend, debt, frequency and associated negative consequences using structured programs, while noting that treatment uptake is a challenge.

Pre-commitment is one tool among many that may help people control problem gambling. This is not the whole farm, it’s just the front gate.