Bottom line: Sydney’s “lockout laws” reduce assaults

LOVE them or hate them, early last drink laws appear to have hit the target as a strategy to reduce serious injuries from alcohol-fuelled violence, with new research from Sydney adding to the existing evidence base in support of the regulations.

Under Sydney’s controversial “lockout laws” introduced in February 2014, licensed venues in Central Sydney and Kings Cross were prohibited from admitting patrons after 1.30 am or serving alcohol after 3 am – although the times have since been relaxed by half an hour.

The laws have been strongly opposed by many councillors, publicans and members of the community for strangling the city’s night life, and have been blamed for the closure of several iconic bars and clubs.

However, emergency doctors and the Police Association of NSW are among the laws’ strongest supporters and point to the substantial reduction in assaults.

This week, doctors at St Vincent’s Hospital in Sydney published the first before and after analysis of the incidence of orbital fractures around the time of the introduction of the lockout laws, noting that assault is the main mechanism of this kind of injury.

There were 41 fewer orbital fractures in the first 2 years of the lockout period compared with the 2 years before the laws came into effect (155 cases v 196 cases), the authors reported in the MJA.

There was a 10% reduction in the number of violence-related fractures and a 7% reduction in the number of drug- or alcohol-related orbital fractures.

Twenty-seven fewer fractures required surgical management after the introduction of the lockout laws – saving an estimated $391 286 in hospital costs and $4946 in ambulance costs. Additionally, there were 13 fewer cases of orbital fracture requiring conservative management.

Altogether, the authors estimated the laws had saved $463 692 in 2 years.

In an accompanying editorial, Dr Diana Egerton-Warburton, an emergency medicine physician and leading public health campaigner, called for early last drinks laws to become part of a national strategy to reduce harm from alcohol. She also applauded the Queensland Government for recently introducing the measures statewide.

Dr Egerton-Warburton said that there was evidence from multiple sites, including Sydney and Newcastle in NSW, and Norway, showing that early cessation of alcohol service reduces alcohol-related violence.

Dr Egerton-Warburton said in an MJA podcast: “Emergency clinicians really are so sick of those tragic anecdotes where we have to talk to families about their children being brain dead after one-punch injuries … those serious assaults and injuries have reduced after these lockout laws”.

She added: “There is nothing cosmopolitan happening on the streets of Sydney after 3 am”.

Greens MP Jenny Leong has been a consistent critic of the Central Sydney and Kings Cross lockouts as the Member for Newtown, which borders the lockout zone.

She told MJA InSight: “It’s evident from the reports from St Vincent’s Hospital that the desperate situation there has improved since the lockout laws were introduced, and it’s no surprise given … the amount of people going out late at night in the city and Kings Cross has dramatically reduced.

“If we took the same approach to driving and the road toll, we could stop serious injury and death from accidents by banning driving; however, we wouldn’t consider it reasonable to do this.”

Ms Leong said that she was confident that strategies other than early last drinks could curb alcohol-related violence.

In Newtown, for instance, the Greens have helped coordinate a community engagement process involving police, publicans, politicians and community members which has led to initiatives to reduce troublesome queuing at popular night-spots and to improve transport home. Some venues have also agreed to voluntary curfews as part of the process.

Even though the number of late-night revellers in Newtown has swelled since the lockout laws were introduced in bordering precincts, there’s been no corresponding increase in assaults in the area according to local police and doctors at the nearby Royal Prince Alfred Hospital (RPA).

Ms Leong cites this as evidence that the community engagement process in Newtown is working, adding: “Lockout laws are not the only way to stop drunken idiots punching people after 3 am”.

Professor Gordian Fulde, a founder of the Australasian College for Emergency Medicine and a co-author of the MJA research letter, said that early last drinks laws had been very effective in King’s Cross, but added “one size doesn’t fit all”.

“We really need good evidence and good data of things like the time and venue where assaults take place and bottle sales to see where this kind of approach might be appropriate,” he said. “A shotgun at every door isn’t appropriate.”

Associate Professor Michael Dinh, Co-Director of Trauma Services at RPA told MJA InSight: “There is strong evidence in the case of Kings Cross and surrounding areas that [the lockout laws] worked and that there hasn’t been a transfer of violence to neighbouring areas.

“This supports my view and the view of the trauma community in NSW that current restrictions must be maintained and evaluated and implemented in areas where there is evidence of ongoing alcohol fuelled violence.”

Professor Dinh has previously written on the topic, demonstrating that there was no increase in assault-related emergency department presentations at RPA in the wake of the city’s lockout laws.

To find a doctor, or a job, to use GP Desktop and Doctors Health, book and track your CPD, and buy textbooks and guidelines, visit doctorportal.