The New South Wales Inebriates Act: Going,Going,Gone?

In August 2004, the Standing Committee on Social Issues of the New South Wales Legislative Council published a report on the Inebriates Act 1912.[1],[2] It recommended, inter alia, that the existing Act be repealed and replaced with new legislation. Under the new legislation, the only type of involuntary care that would be authorized would be short-term care for the purpose of protecting the health and safety of a person with substance abuse who had experienced or was at risk of serious harm.

In the second chapter of the report there is a brief summary of the early history of the Act, which notes that while it was originally intended that special purpose-built facilities for voluntary inebriates who could not be managed any other way be developed, this, in fact, never happened. In 1929, as a ‘temporary “default” measure’1 only, the existing hospitals for the insane were gazetted to take inebriates instead. Those hospitals that exist today are still gazetted as inebriate institutions and are still being used, albeit only occasionally, for this purpose. The background to this is a fascinating slice of history.

As Lewis points out, in the 19th century in Australia, society's approach to people who used alcohol to excess went through a number of overlapping ideological shifts.[3] The first approach was punishment, with those who could afford it paying a fine. The fine established in New South Wales under the Drunkard's Punishment Act of 1866 was up to 20 shillings for simple drunkenness in a public place and up to 40 shillings for anyone who was ‘drunk and disorderly’.[4] Those who could not afford to pay such a fine (which would have been the majority of those arrested) could be placed in gaol for up to 7 days.

A second approach was to promote restrictions on the use and availability of alcohol. The well-organized, religion-based Temperance Movement was especially active in this.[3]

A third approach was the medicalization of the problem, with alcoholism being seen as a treatable medical condition. This came to have a significant effect on political thinking, leading to the passage of the first Inebriates Act in New South Wales in 1900,5 an amending Act in 19096 and a consolidating Act in 1912.

In 1868, Dr Norton Manning, later to become the first Inspector General of the Insane in New South Wales, in his report on lunatic asylums throughout the world, had noted that inebriates were ‘objected to by almost all asylum superintendents’, ‘ordinary asylums are not fit residences for them’ and ‘the American plan of separate institutions… is far preferable’. 7 In 1872, a Report from the Select Committee on Habitual Drunkards appointed by the House of Commons in England had stated, quite firmly, ‘placing inebriates in lunatic asylums… is improper, and should not be allowed’.[8]

In spite of such weighty authority, the first version of the Inebriates Bill, introduced to the Legislative Council in October 1898, included ‘receiving houses’ and ‘hospitals for the insane’ as places where inebriates could be sent, along with ‘the house of the inebriate’, ‘the house of a friend of the inebriate’, ‘a public or private hospital’ and ‘some gaol’.

The originator of the Bill was the Hon J. M. Creed, a medical practitioner with a long interest in the treatment of chronic inebriety and a member of parliament since 1872. He firmly believed that alcoholism was an illness and that the core of the treatment programme was total abstinence.[9] For poorer people this would ideally be achieved through lengthy incarceration in a state institution designed for this purpose, preferably on an island with a farm settlement. Richer people could be confined in their own homes with a personal attendant. Creed also believed in the efficacy of hypnosis for inebriety, but mainly where the inebriates were ‘men and women of social or business standing’.[10]

In introducing the Bill at the Second Reading, Creed explained that he had included hospitals for the insane because it would take some time to develop separate inebriate institutions but that the inebriate ‘would go there under different conditions, and would not be stamped as a lunatic’.[11] During the parliamentary debate, several members opposed the inclusion of hospitals for the insane, some on the grounds of marked inconsistencies between the Inebriates Act and the Lunacy Act (which would disadvantage the inebriate), others on the grounds that the hospitals for the insane were already overcrowded and that stigmatization would be a problem. As a result, the words ‘hospitals for the insane’ were omitted from the Bill. Creed stated that he had decided to omit them on the advice of the Inspector- General of the Insane, Dr Eric Sinclair, who ‘thought that it would complicate matters in the beginning to retain these words’.[12] This was a considerable understatement of the problem.

Alcoholics were already taking up a number of beds in the Reception House and the overcrowded hospitals for the insane and would continue to do so even after the Inebriates Act was passed. An amendment to the Lunacy Act in 1882 had permitted magistrates to send, under remand, cases of acute alcoholism to the Reception House for care and treatment, where they formed ‘the large majority of recurrent cases’. Those whose symptoms justified the signature of lunacy certificates had gone on to hospitals for the insane.[13] In 1899, for example, of the 796 admissions to hospitals for the insane, 58 had their cause of insanity listed as ‘intemperance in drink’.[14]

In 1918, the corresponding figures were 1458 and 171, respectively.[15]

With the exclusion of inebriates from the hospitals for the insane, the voluntary agencies – mainly the Salvation Army and the Central Methodist Mission – stepped in to provide the institutional services required.[16] The Prisons Department also developed services for inebriates but these were only for convicted inebriates, at least until 1915. Convicted inebriates were those who had been convicted of an offence of which drunkenness was an ingredient and subsequently placed in certain prisons gazetted under the Inebriates Act for this purpose. In 1915, there was a change in policy and the Department made available one of its facilities – the Shaftesbury Institute at South Head in Vaucluse, which had previously only been used for convicted inebriates – for ordinary inebriates, which helped to fill the gap in services for this group for the next 14 years. In 1929, however, the Prisons Department decided to close the Institute. Various reasons were given for this, including the suggestion that it was not adequately staffed, that it had not altered re-offence rates, that it was too costly to run, that the land was too valuable to be used for this purpose,16 and that there had been pressure from the liquor trade, which had been prevented from obtaining ‘a wine licence or a publican's licence in Vaucluse’ because of the presence of the Institute.[17]

Whatever the reason, the imminent closure of the Institute raised, once again, the need for some alternative form of institutional care for ordinary inebriates and the government was faced with the expensive prospect of developing special institutions for this purpose. The Under Secretary of the Department of Public Health came to the rescue and suggested that, until the alternative institutions could be developed:

In spite of the fact that these hospitals were already severely overcrowded, the government seized on the suggestion with alacrity and the named hospitals were duly proclaimed as institutions for inebriates on 17 April 1929.[19] The Reception House at Newcastle and North Ryde Psychiatric Centre were proclaimed later in 193820 and 1959,21 respectively.

As it happened, the 1929 proclamations were not done properly. Section 9(c) of the Inebriates Act required that technical descriptions of the boundaries of the land be given. The Lands Department could not provide the necessary information and suggested that the hospitals be surveyed. The Under-Secretary of the Department of Public Health vetoed this on the grounds that it would be too costly, too time-consuming and, given the fact that the gazettals were a ‘purely temporary measure’, unnecessary.[22] So, only the names of the hospitals were gazetted.

This matter had to be revisited in 1947 when two attendants at Morisset Hospital were charged with unlawful behaviour under Section 10 of the Inebriates Act. Part of their defence was that Morissetwas not proclaimed properly as an institution under the Act, a point with which the Crown Solicitor was forced to agree. The Department of Lands began the survey that should have been done many years earlier but, in the post-World War II era, resources were scarce and it was not until 1954 that the surveys were complete and the hospitals gazetted properly.[23]

Over a century has passed since the first Inebriates Act was proclaimed and 75 years have passed since the psychiatric hospitals in New South Wales were proclaimed as places for the reception and treatment of inebriates under that Act. Should the recommendations of the report of the Standing Committee on Social Issues of the Legislative Council be implemented, the involvement of psychiatric hospitals in the social control of people with alcohol- and drug-dependency problems might finally come to an end in New South Wales, 136 years after Manning's strong warning that it was something to be avoided in the first place.