A DEVELOPING NATION RESPONDS TO PROBLEM GAMBLING

1. A DEVELOPING NATION RESPONDS TO PROBLEM GAMBLING Presentation to the Portfolio Committee on Trade & Industry Cape Town 4 June 2003 by Mr Chris Fismer Deputy Chairperson South African Responsible Gambling Trust

2. The primary objective of the NRGP is to minimise the harm caused by excessive and compulsive gambling in South Africa. By providing education, treatment and research into problem gambling. But recognising that: people with self destructive behaviours cannot be forced to seek help, and Prohibition nearly drives the problem underground. INTRODUCTION

3. Pre-1994: A flourishing horseracing industry, 17 casinos in ex-homelands (four of the existing provinces); estimated 150 000 illegal slot machines, four lotteries with non-existent regulations, problem gambling not acknowledged; 2003: Rationalised horseracing industry, 31 casinos in nine provinces, dramatic decrease in illegal slot machines (less than 15 000?), a single national lottery, legislative mandate to address problem gambling. BACKGROUND

4. 2000: industry initiates a national responsible gambling programme through independent NGO (under NCSG at UCT); 2001: National Gambling Board convenes SAACREG, joint initiative of government, regulators and industry. Assumes oversight of NRGP; 2002: SARGT formed by SAACREG to supervise NRGP. Dr Vincent Maphai appointed chairperson. SARGT develops ‘social agenda’ and drives initiatives such as national self-exclusion policy, national advertising policy and code of conduct, etc. BACKGROUND (cont.)

5. The Structure of Responsible Gambling in South Africa South African Advisory Council on Responsible Gambling (SAACREG) Industry Public Sector Regulators Oversight South AfricanResponsible Gambling Trust (SARGT) Industry Public Sector Regulators Supervision National Responsible Gaming Programme (NRGP) National Centre for the Study of Gambling Management Public Education Research Training Treatment and Counselling

6. Reality of developing nation environment and circumstances, with other pressing public health priorities such as TB, Aids, severe primary health care needs, etc; Inadequate funds and infrastructure in public health system to provide the service; Operational independence, but control vested with a partnership of government regulators and industry; Integrated programme; Very cost efficient with low overhead structure; Able to source top professionals in the field; SA’s approach receives international endorsement (e.g. Budd Commission) and now being replicated in UK, Macau, and elsewhere. WHY THIS MODEL

7. Comprehensive budget developed according to the SAACREG formula (0.1% of GGR) and controlled by SARGT; Sector-by-sector contributions based on share of GGR (e.g. casino industry provides 50%); Public money has been forthcoming for specific initiatives e.g. pilot schools’ programme and seniors’ initiative. FUNDING

8. OVERVIEW OF THE NRGP: An Integrated Programme • THREE BASIC COMPONENTS: • Education & Training • gamblers and potential gamblers; • industry employees; • health and counselling professionals; • Treatment Network • Helpline • Outpatient • Inpatient; • Research • Quantitive • Qualitative

9. Collateral material in casinos, bookmakers’ premises etc. Brochures Posters Notices at all points-of-sale, cash desks and ATMs; Help line phone number and “warning message” on all gaming related advertisements. Nearly 9 000 trained to date by NRGP across the country; CONSUMER AND SUPPLIEREDUCATION

10. Awareness of problem gambling editorial and popular journals wide distribution of brochures and leaflets opinion and comment in various media advertorials, etc. in all major media statistical resources communication with government, regulators, medical community, NGOs and other stakeholders focus groups: seniors and schools programme Promotions, as with “Isidingo”, “Backstage”, SAPS roadshow in KZN, Mpumalanga Provincial Government awareness week etc. Over 50 media queries per quarter on average. PUBLIC EDUCATION

11. Pilots being undertaken in the Western Cape funded by the Dept. of Social Services, and with active co-operation of the Dept. of Education and its EMDC directors; Footprint: Grade 10 learners at schools in the vicinity of the province’s three casinos, but now expanded further; 10 350 learners have participated to date in 213 sessions at 43 schools, invitations to participate in the programme were sent to 180 schools in the Western Cape and southern Cape including private schools; 2 700 seniors in 52 clubs have received presentations to date. PILOT SCHOOLS’ AND SENIORS’ PROGRAMMES

12. NATIONAL HELPLINE • 24 hours per day, 7 days per week; • Multilingual service; • Toll-free in SA (0800 006 008)International (+27 21 797 0190); • Hosted at the Kenilworth Place Addiction Treatment Centre; • Callers assessed by trained helpline counsellors, over 43 000 calls to date; • Thereafter, referred for further (free) treatment to their nearest clinical psychologist in the NRGP network, all costs borne by the NRGP.

13. OUTPATIENT COUNSELLING • Multilingual clinical psychologists now in 27 major centres, including neighbouring states, and growing; • Psychologists are trained at the Kenilworth Place Addiction Treatment Centre; • Customised six-session treatment programme, paid by the NRGP, with appropriate follow-up and aftercare. More than 1953 patients (4.5% of all calls) referred for treatment to date, with another 416 (0.95% of all calls) assisted telephonically; • 70 former patients currently active in GA.

14. INPATIENT TREATMENT • Very serious cases only admitted eg potential suicides, multiple additions; • Four centres: • Cape Town • Johannesburg • Bloemfontein • Durban; • Costs • Covered by most health schemes • Subsidised by NRGP as is necessary; • Five patients have been hospitalised to • date.

15. MAIN CONCLUSIONS OF 2001 NATIONAL RESEARCH STUDY • Significant sample of 5 800 South Africans throughout the country “with access to gambling”.; • 3:1 approve the legislation and regulation of gambling, but an equal number concerned about problem gambling; • Gambling in South Africa predominantly a middle-class activity; • 0.38% of adults, and 0.5% of regular gamblers are deemed to be addictive gamblers. Problem gamblers constitute 5%; • Propensity to gamble highest among 30-50 age group, and among those with an education; • 68% of South Africans play the lottery at least once a month, 20% play slots, and 8% horse racing. 26% never gamble and 34% only gamble on the lottery; • Of those only playing the lottery, 1.74% demonstrate gambling problems, higher than comparable first world figures, eg 0.1% in UK.

16. SARGT and NRGP committed to nationally-acknowledged Targeted Access Programme (TAP) protocols; Year-by-year targets established in terms of procurement, outsourcing, recruitment etc; In 2001, the NRGP substantially exceeded its empowerment targets, e.g. 59% of NRGP procurement placed with PDIs and HDEs, nearly 100% more than the target. Empowerment and the NRGP

17. CONCLUSION • Government is successfully ensuring that the industry do as much as is reasonably possible to ensure : • that people understand how gambling works and what are its dangers; • That high quality help is available free of charge to those who develop problems The programme is a pioneering and highly successful exercise in public private sector partnership; The programme is providing a model which jurisdictions in the UK, North America and the Far East are seeking to emulate.

18. THANK YOU