The eternal trial

BY PAM WALKER
Sydney’s only injecting centre will remain on trial despite the very public exit of its medical director.

Dr Ingrid van Beek has been guiding the centre since it was set up in 2001 as a four-year trial but resigned last month expressing her frustration that almost eight years later, the centre is still on trial.
 

She said it had been a heart wrenching decision: ‘I decided it was time to pull up stumps. But it was a decision driven by disappointment rather than anger. If I was staying I’d have to stay another three years fighting the same fight and the same people.’

Speaking from Mexico where she will address the International AIDS Conference in the first week of August, Dr van Beek said the centre had left her with a great sense of achievement and its fate was now less unpredictable. She is on leave until the New Year but will return then to the Kirkton Road Centre, and said her preference would be for the injecting centre to be incorporated as a unit of that facility. ‘It’s doable for both services,’ Dr van Beek said.
In the meantime she will pursue her academic work overseas.

Internationally the Sydney medically supervised injecting centre (MSIC) is considered the ‘jewel in the crown’ in harm minimisation programs, but it is still a political issue in Australia, locked into a four-year electoral cycle.

The injecting centre is one of about 76 established over the past 22 years in eight countries including Switzerland, the Netherlands, Germany, Spain, Canada, Norway and Luxembourg.

The Australian experience has much in common with that of the Vancouver ‘Insite’ project in Canada, Both centres are seen as world-class well-resourced and well-evaluated services seeing large numbers of drug users. And both are under attack, unlike the other 74 facilities operating in other parts of the world.

Charlie Lloyd of the UK’s Joseph Rowntree Foundation suggests the injecting centres in Australia and Canada remain politically vulnerable, despite positive evaluation results, because they are couched as ‘trials’.

One argument for keeping the centres as  ‘scientific trials’ has been that it exempts them from the United Nations Office of Drugs and Crime (UNODC) covenants in relation to illicit drugs.

But other countries that operate injecting centres are also signatories to these UN covenants and have given their centres permanent status.

Last June, the State Government extended the MSIC trial until October 2011.

The licensing operator, the executive director of Uniting Care, Reverend Harry Herbert, wants the government to stop calling it a trial and to amend the legislation for longer than four years to remove it from the parliamentary cycle.

‘By making it a permanent trial, it seems to be saying we’re not sure you’ve done a good job or achieved what you set out to do so we’ll keep evaluating you,’ Rev Herbert said.

Its trial status has caused several operational problems including difficulties with securing the lease for the Darlinghurst Rd site.
‘The timing of the lease and the legislation was difficult. Now we’ve bought the building that issue is solved but the problem of recruiting staff remains,’ Rev Herbert said. ‘When you get into the last six to nine months, you can’t guarantee employment so people are less than wildly enthusiastic to work somewhere if they don’t know what will happen. And while other people face job insecurity, the fact it has to go to Parliament gives it greater significance.’

The reverend said he was not hopeful the government would change the arrangements under the current climate. ‘We’ve made our point as strongly as we can, and now publicly, and they don’t agree with it. I don’t see anything changing quickly.’
 
But he is determined to put the case again when the legislation is reviewed before the next state election, and is hopeful that at the very least the current arrangements would continue if the Liberals win office.

Dr Marianne Jauncey has been appointed as the new medical director.

‘We’re confident that will work well,’ Rev Herbert said. ‘Ingrid’s personal commitment to the centre was very valuable and it was wonderful to have her in charge. But it’s a sign of how successful she has been that it can now continue successfully without her. Any project should not be centred around one person. Ingrid has taken the centre to where it needs to be and she’s now free to pursue other things.’