Draft Strategy to Prevent and Minimise Gambling Harm 2025/26 to 2027/28

Kia ora koutou everyone. Welcome along to this session to discuss the Strategy to Prevent and Minimize Gambling Harm between 2025-2026 to 2027-2028, to inform the Public Consultation phase. I'll just share my screen, and we'll get into the presentation.

Hopefully, you all see that. So yeah, kia ora koutou. Ko Michael Woodside toku ingoa.

I'm Mike Woodside. I'm the group manager of Mental Health and Addiction Strategy and Policy at Manatu Hauora, the Ministry of Health. And this session is to provide an update on the proposals that are currently being consulted on and the Strategy to Prevent and Minimize Gambling Harm.

So, this information session will roughly take around about half an hour, and all the information is pulled from the consultation materials that are on the Ministry's website, at that Consultation Hub link. So we'll move into the session now.

So the purpose of this session is to support engagement on the strategy. It also enables-- gives a bit of guidance on how you can make a submission and outlines the process and next steps. A lot of the information provided is relatively complex, so I appreciate this will be a refresher for some and new for others, but we'll basically step through the different elements of the strategy.

So here's a brief outline of the presentation itself. We'll start off with a bit of context, in terms of the Gambling Act, requirements and roles. Talk about the gambling harm needs assessment, key findings, and just gambling harm context in New Zealand as we know it currently.

We'll then go into the consultation document materials and walk you through the Draft Strategic Plan proposals, which is what we want to achieve, then the Draft Service Plan and indicative costs for the three-year period, so that's how we plan to do it-- the services we intend to provide and the related costs.

And then finally, the draft problem gambling levy rates and options for the period, which is how we will fund the activities. And then, as I mentioned earlier, I'll cover off how to make a submission, next steps and timing, and then any opportunity for any questions at the end.

So in terms of that broader context, the definition of gambling harm that we take from the Gambling Act of 2003 is harm or distress of any kind arising from or caused or exacerbated by a person's gambling. This includes personal, social, or economic harm suffered by the person themselves, by the person's spouse, civil union partner, family, wider community, in the workplace, or by society at large.

So that definition informs what is in the strategy. And the Gambling Act requires an integrated problem gambling strategy focused on public health. And it specifies this must include measures to promote public health, services to treat and assist problem gamblers and their families, whānau, independent scientific research, and evaluation.

So the Ministry of Health is the responsible department for developing the strategy every three years. And we also manage the research component. Health New Zealand, Te Whatu Ora, they implement the public health and intervention services and evaluation components of those. And that's involved in the last strategy, when Health New Zealand has now been established.

Then, the Crown recovers the costs of developing and implementing the strategy in full. It's full cost recovery model using the problem gambling levy. And the process for this consultation is all set out in the Gambling Act.

And it also requires a needs assessment, which we'll talk about shortly.

The Gambling Commission also has a role as stipulated in the Act. They consult on the revised proposals and report to the responsible ministers with a view of funding-- with their view of funding in the levy proposed. And the responsible ministers are the minister of Internal Affairs Brooke van Velden and the Minister for Mental Health, Honorable Matt Doocey.

So this time around, the 2024 Needs Assessment key findings are outlined on this page. So this is an 80-page report that's available on the Ministry's website.

As mentioned, there's a requirement to undertake this needs assessment to inform the development of the strategy. And this needs assessment identifies the demand for services and the needs of those who use them.

This time around, the report was completed by Ballard Test International and Superior, and that was earlier this year. It comprised of an independent review of available literature and research, interviews with a cross-section of stakeholders, and a survey of service providers.

And the key findings there are most people continue to gamble for leisure and recreation. Whilst the overall percentage of adults gambling has been relatively steady in recent years, the total number of people affected by gambling harm has increased in line with population growth.

The needs assessment also found that whilst a reduction in the number of pokies, class IV or non-casino gaming machines, they remain disproportionately more common in high deprivation areas. And expenditure has continued to increase.

Online gambling was also a focus from the needs assessment, particularly with unregulated providers based overseas, the continued growth. This is revealing inconsistencies with the current levy funding process because offshore providers do not contribute.

And further finding was that the gambling harm minimization sector is under pressure, and has found the health reforms challenging. It is seeking stronger government leadership and coordination and more sustainability of funding.

Finally, further key finding was there is a need to grow and support the gambling harm workforce, both clinical and peer led.

So we have a look at what we know about harm. This slide gives a few key findings, and then I'll outline more in the following slides.

So, it's estimated that each person who experiences harm from gambling harms another six people in return, with over one in five New Zealand adults affected at some time in their life for their own or somebody else's gambling.

The harm is not evenly felt. Maori, Pacific, Asian, and youth, both individuals and communities, are over-represented amongst groups who experience harm.

And then the impact of gambling harm on health quality-- health-related quality of life is significant for those who gamble and their families and communities. And just on that last point, for those who gamble, the impact of gambling on their health-related quality of life is considered greater than diabetes and arthritis, and approaching the same level as anxiety and depression. And that's at the individual level.

So as mentioned, harm is not evenly experienced. I will pause here to reflect that the Healthy Lifestyle Survey 2020 is the latest prevalence survey we have available. There is a current gambling survey that has been completed and is in the process of being finalized that will be available later this year, but these are the figures that we're working off.

As you can see, Maori 3.13 times more likely to be moderate risk or problem gamblers than non-Maori and non-Pacific peoples. Pacific peoples then 2.56 times more likely to be moderate risk or problem gamblers than non-Maori and non-Pacific peoples.

And whilst fewer Asian peoples gamble compared to other population groups, they are more likely to experience gambling harm compared to their European and other population groups.

Then finally, youth are also over-represented in harm statistics. 45.7% had gambled in the previous year, and they made up 14% of moderate and high-risk gamblers.

And if we look at that age breakdown a bit more detail, you'll see in the pie graph here that those that experienced the most harm are the age groups of 25 to 44 and 45 to 64. But you can see, the 16 to 24 age group is also represented. And although there was a decrease in youth gambling from 2018 to 2020, prevalence rates have fluctuated over the last decade.

Now, we'll look at the service picture. So this is utilization of gambling harm services, but it does exclude brief interventions.

So you can see that top line there is the total clients. And this graph goes back to 2004, so you can see a level of fluctuation there over the last 20 or so years, with a sort of a flat lining in the last few years.

And then you can see the existing clients and total-- and new clients, the two lines below.

And if we move on to discussing presentations by ethnicity, again, excluding brief interventions, you'll see there that the top level is the other components. And then we've got Maori, Pacific, and East Asian represented there, in terms of their trend lines. Again, a level of fluctuation, but sort of a flat lining for most groups over recent years.

I mentioned online gambling earlier, and that came up as a theme in the needs assessment so just digging into that a bit further. There's been a steady increase in online gambling, spending, participation, and harm. $342.5 million in the '22-23 year.

But I would note, that's GST registered online gambling providers, so it is an underestimate, in terms of the total amount of online gambling New Zealanders will be taking part in. And given offshore providers, many of which will not be paying GST

Participation online doubled to 27% between 2018 and 2020. And in 2018, 13% of New Zealanders gambled online locally, 2% offshore. Those gambling online are more likely to experience harm compared to other forms of gambling. Young people are particularly vulnerable.

But the government has recently announced that they will be regulating online casinos, and this will be through a licensing system. Expected to come into effect in 2026. This will be designed to minimize harm, support tax collection, provide consumer protections to New Zealanders.

So the Ministry of Health is working with the Department of Internal Affairs. We're leading the policy work. And as part of that work, there'll be considerations for the implications on the gambling levy.

So that's the overarching context and sort of harm snapshot, and that's all informed the development of the draft strategic plan that we are consulting on.

So the draft strategic plan, it describes what we want to achieve, our goals and outcomes, it sets out priority areas and actions to focus on over the next three years, and it reflects the government's mental health and addiction priorities. So in this context, those priorities are increasing access to gambling home support, growing the gambling harm workforce, strengthening the focus on prevention of and early intervention in gambling harm, and improving the effectiveness of gambling harm support.

Now, this slide shows the broad strategic framework for preventing and minimizing gambling harm that's included in this strategy. So you'll see on the left-hand side there, the Mental Health and Addiction System Priorities that are just covered off. And then you've got a series of actions across those priorities, which taken together are designed to describe a well-functioning gambling harm prevention and minimization system.

And then delivery of these-- delivery of these actions in totality, as it then-- it then feeds into achieving the strategic outcomes referenced at the top. So there's a full spectrum of services and support to prevent and minimize gambling harm. It's all the way from prevention to specialist support, social and cultural norms, prevent and minimize gambling harm-- minimize harm from gambling-- sorry-- strong leadership and accountability of the gambling harm prevention system with decision-making as close to communities as possible, and then, finally, there is a system focus on those who are most at risk from gambling.

And this all feeds into an overarching goal of where New Zealand's quality of life and mental health outcomes are not affected by gambling harm. We'll dig into these actions further as part of the next section.

OK, so now, we're on to the draft service plan. So this is, basically, the delivery components that ensure the strategy is achieved. And this time around, this has been developed by Health New Zealand, Te Whatu Ora.

So as mentioned, the plan-- the draft service plan describes how we will achieve the strategic goal and outcomes, and it's guided by the strategic framework. It sets out the proposed activities and services that the levy will fund for the next three years. And it's organized by the strategic priorities, with research and evaluation and agency operating costs also itemized.

And then, it's got a series of appendices, which provide a summary of funding by the service areas. You can see, there's public health services, clinical intervention and support services, research and evaluation, and new services.

So some of the headlines in the service plan are maintains investment in high quality public health and clinical services, but has a focus on the government's priorities for mental health addiction, with proposals to increase access by expanding clinical service provision, growing the workforce by supporting new entrants, preventing harm and intervening early, and delivering a range of community health focused-- community-focused health promotion activities, and improving effectiveness by commissioning a suite of research and evaluation projects. And I'll dig into all of these areas a bit further as we go through the presentation.

So in terms of priority one and some examples of areas of proposed investment, this is around increasing access to gambling harm support. So, there's investment in ongoing delivery and improvement of clinical intervention services, and a focus on including filling regional gaps. Some of those services include dedicated hauora Maori intervention services, services based on Pacific and Asian worldviews and expertise-- noting that all those groups are over-represented in the gambling harm statistics-- and expansion of the intensive support coordination service.

And priority two, growing the gambling harm workforce. Some of the examples of proposed areas of investment-- expanding the peer workforce to improve access to broad spectrum of effective services, further embed lived experience into gambling harm service provision, and planning.

We've also got proposals to develop gambling harm content from NZQA Level Seven qualification, as well as investments in clinical internships and ongoing professional development for the existing workforce.

Priority three, strengthening prevention of and early intervention gambling harm. Good proposals to refresh national public health promotion and destigmatisation initiatives. New local regional public health services to empower communities, build awareness, resilience, reduce stigma and barriers to help seeking. Proposals to ensure services are informed by lived experience.

There's also a recommendation to explore a system to enable individuals to block themselves from online or mobile gambling outlets, noting this is subject to the online casino regulation that I mentioned earlier.

Continuing to develop public health approach in schools to support young people as a higher risk group. Investing in service promotion and support in primary health care. And then finally, enhance work to support self-exclusion for the multi-venue exclusion system, MVE.

Finally, for priority four, improving the effectiveness of gambling help support. There's ongoing investment in lived experience advisory group. Proposal to develop and roll out a modern client data management system. Investing in research and evaluation to inform policies and service improvement, and then research and evaluation will be informed by communities-- affected communities, service providers, and those with lived experience.

So just pausing to dig into research and evaluating a bit more detail. The priorities are committing to tracking gambling harm prevalence. I mentioned the survey that has results due out later this year. So there's proposal to have another gambling harm prevalence survey in the next strategic cycle.

Growing the evidence base that supports all our work. Informing policy and operational decisions to prevent and minimize gambling harm. Evaluating gambling harm services and initiatives. That's Health New Zealand evaluating delivery. And then better disseminating research to strengthen capacity and capability.

This time around, there's also a proposal that the Ministry commission an impact evaluation of the strategy itself, including the services commissioned.

So there's a bit of an insight into the service plan, and that brings us to the costs for delivery. So the estimated total costs for the three-year period are $87.718 million, and that's an increase of $11.595 million, roughly 15%, compared with the current strategic cycle.

This does comprise the forecast $3.412 million underspend for the current period. So that's new funding that would be of $84.306 million for the three years.

The underspend is forecast for the current year, 30 June 2025, due to delays in commissioning as a result of the health reforms and sector restructuring. So as a result, some work from the current levy period will continue and be completed in the next levy period.

In terms of the increase, about half of the new funding is for new services and interventions. For example, service promotion and workforce development and the online gambling exclusion system. And the other half is to address cost and volume pressures in the system, so relating to service expansion and wage pressures.

So just cutting this in terms of proposed additional investments. In terms of the new initiatives, promotion of clinical services, expanding the gambling workforce, NZQA Level Seven qualification, clinical internships, and the online self-exclusion system, they all represent new areas of spend. Whereas, there's also a number of areas where further reinvestment is proposed. So workforce development to support clinical and public health, more funding for MVE, expanding health promotion education and supportive environments, and then data and information management solutions.

So I've got a couple of tables here, which is cutting these figures in slightly different ways. This way is by-- against the four priorities, as well as separating out agency operating costs.

And you can see for the three years, roughly $28 or $29 million per year, and that gets you to the total of $87.7 million. So the two biggest categories of spend are against priority one, increased access to gambling help support, $35 million over the three years, and strengthening the focus on prevention of and early intervention in gambling harm, $30 million.

This next table shows the budget cut by service activity area, which is probably more familiar for many, and relates to the way the current strategy allocates cost. So you can see, we've also included this time around, a comparison with the current levy rates for each of these categories.

So you'll see, for example, in the top line there, over the three-year period currently for primary prevention public health was $24.84 million and proposed new strategy, that is rising to $29 million. Whereas, in terms of research and evaluation, currently that's at $7.94 million, and the proposal is for that to $5.658 million and proposals for that to drop to $4.999 million.

So that brings us on to the problem gambling levy. So there's a few more technical slides here, but they are all outlined in the consultation document in more detail, and you can also refer to the legislation itself.

So, what is the problem gambling levy? So the purpose of the levy is to recover the Ministry and Health New Zealand's costs for developing, managing, and delivering the integrated problem gambling strategy. So as I mentioned earlier, it's a full cost recovery model.

The act prescribes a levy formula, which takes into account forecast and actual expenditure over time, any overrun payments by each sector, and changes in each sector share of expenditure and presentations, which are used as two proxy indicators of harm. And this is all outlined in Sections 319 and 320 of the Gambling Act 2003.

And under the draft levy rates, the levies are set by a formula in the legislation to recover the costs of providing the strategy. And that formula consists of gambling industry sector share of expenditure and share of presentations, as I mentioned earlier, as proxies for gambling harm.

It compares actuals to forecasts, and adjusts for any overall underpayment of levy compared with costs. It also adjusts for changes in sector share of presentations and forecast expenditure.

So four levy options are presented. Currently, the government has chosen a 30/70 split for the current levy period, so that's a 30% weight to expenditure, and 70% to presentations.

I would note that the levy calculations will be updated with the most recent data a couple of times through this process. So for the revised proposals that go to the Gambling Commission, and probably in late October, and then, again, in early 2025 before final decisions are made by Cabinet.

So I won't go into this in detail, but this is the problem gambling levy formula that is outlined in the legislation Section 320. And you can see there, W1 and W2 are the weights for expenditure and presentation. This presentation is the sum of which is 1. And I'll move on to talk about what the current picture is looking like for each of those.

So the share of presentations expenditure by sector for the latest data we have available. Updated expenditure figures for year June 30-- June 2023, where presentations are for calendar year 2023.

So you see here, the blue color on the left here is the non-casino gaming machines or pokies, and you can see that they have 39% of all expenditure, whereas 54% of presentations to gambling harm services.

The next one, the orange, that's casinos. 22% share of expenditure, and 20% of presentations. The third there is TAB New Zealand, 14% expenditure and 10% presentations. And then, finally, the yellow there, that's Lotto. 26% of expenditure, and 15% of presentations.

So a couple of tables now that look at the expected levy payment per sector by expenditure presentation weighting options. So you can see there, the top line is the current levy. So that's currently non-casino gaming machines, $34 million, casino $15 million, TAB, $8 million, Lotto, $11 million.

And then you can see the fluctuation there as the options adjust. So if you've got a 95, 90, 80, 70 presentation weighting, you can see how the figures change.

You'll see for the Casino column there, not a lot of change as you move through the different weighting options. And that's because, as you recall on the previous slide, the proportion of expenditure and presentations was fairly even. Whereas, you'll see for some of those other categories, there is a bit of a shift in terms of the figures.

And this table shows the competitive levy rates calculated as a percentage per sector, with the data we have to date. So the proposed levy rates are higher than for the period to 30 June, 2025 for Lotto NZ and class IV and lower for TAB NZ. The levy rate for casinos is about the same.

And then, basically, this is putting all these calculations and information onto one graph. So we see that the higher the weighting on the presentations, you will see that the higher the share to be paid by the class IV sector. So that's that non-casino gaming machines top line. And the lower the share to be paid by Lotto NZ

And then, obviously, the opposite is true as you go down the other end, where Lotto's amount of funding increases the more you have a focus on expenditure. Whereas, the Casino line, the orange line, is fairly steady across the whole spectrum.

So, that's a bit of a summary of the consultation materials. Now, I'll briefly touch on submissions and next steps.

So in terms of how to make a submission, there's a submission form at the back of the consultation document, and that includes a series of questions.

You can make a submission by completing the online submission form at that web address there, or by completing the "making submission form" at the back of the consultation document and sending it as a Word document or a PDF to our [email protected] address.

You also don't have to use either of those. You can just email your own thoughts through to that gambling harm email address. And then there's, also, the opportunity to attend in person one of the consultation meetings that are occurring, And the details are available at that consult.health.govt.nz.

All submissions must be received by Sunday-- by 5:00 PM on Sunday, 6, October 2024, for consideration.

In terms of the process after that, independent of analysis of submissions will be undertaken by Allen + Clark. And then the Ministry and Health New Zealand will work together to make any revisions to the draft strategy and the service plan. The levy calculations will also be updated with the latest data available at that stage.

Then, in November, it's intended that those revised proposals provided to the responsible ministers-- so again, that's minister of Internal Affairs and minister for Mental Health-- and the Gambling Commission. And then the Gambling Commission has a requirement to hold a meeting and report to ministers. Then the updates to levy calculations and further potential revision of the strategy happens after that phase.

Then in March 2025, Cabinet decides on the final shape of the strategy and the levy. And then late May 2025-- which is approximate because it relates to budget '25 date, which isn't confirmed until next year-- the strategy and the levy are made public. And this is all in order for the new strategy and levy to go live from 1 July, 2025.

So that's all I have for you today. Thanks for your attention. We do hope you engage with the materials and also, submit. And you're welcome to join a consultation session. Thank you, again.