As of this week Australia has its first Minister for the National Disability Insurance Scheme (NDIS), Stuart Robert. And if today’s Age is anything to go by, Bill Shorten could take on the shadow ministry after exiting the Labor leadership.
It’s been three years since the NDIS was rolled out, and just over a year since Flinders University researchers found roughly half of participants either had support cut or experienced no change under the scheme. So, what are the main issues that need their attention?
Remove the staffing cap
When the National Disability Insurance Agency was first envisioned and legislated under the Gillard government in 2013, the Productivity Commission found that it would require 10,000 direct employees by 2019 in order to manage funding and eligibility for the roughly 500,000 people in Australia living with disabilities.
Australia soon got the Abbott government and, in what Greens spokesperson Jordon Steele-John calls “one of the great mysteries of the NDIS”, then-social services minister Mitch Fifield created a cap of 3000 employees, with up to 7000 spots to be outsourced by full roll-out in 2020.
The Productivity Commission conducted another review in 2017 finding that the cap led directly “to poorer outcomes” for clients and, following similar calls from the Community and Public Sector Union, Labor last year committed to removing the cap as an election promise. Subsequent complaints, difficulties maintaining internal capability and expertise across contractors, and an exodus of “burnt out” direct employees have seen that number budge slightly to roughly 3,230 across 2019-20. However, Steele-John maintains the cap needs to be removed entirely and the full 10,000 positions brought in-house in order to avoid a repeat of existing problems.
“They manifest themselves in ridiculous conversations, like people with Down Syndrome being asked whether they still have Down Syndrome, or amputees being asked if their adaptations are permanent,” Steele-John says. “They manifest themselves in the form of First Nations people across this country who are being so profoundly failed by this scheme that does not work nor has been designed to work, really, for them in their community.”
The Greens Senator says he has witnessed these kind of bureaucratic problems first-hand, including a child with Duchenne muscular dystrophy who missed out on six months of therapies and funding because of an administrative problem his office was able to resolve in one week. Steele-John argues that the lack of consistent and experienced in-house staffing has resulted in extraordinarily long wait times, costly appealed decisions at the Administrative Appeals Tribunal, and poor decision-making from staff “trying to do too much with too little”.
“All of these things can be fixed. We do know how to do it. But at the end of the day we need people to help make that work, and that’s what the staffing cap stops us from being able to provide.”
Reform the IT system and draft plans
One of the most consistent complaints from participants is that, after having their needs assessed, they do not have an opportunity to view draft service plans before approval by the NDIA; they can only restart the planning process if they discover errors.
“You wouldn’t buy a garden shed before you were able to actually see it, yet they expect you to sign up to an NDIS plan that would cover a year or more, with all your complex support and community engagement in there, without actually seeing the plan. And that’s driven, partly, by the IT system not being able to function,” Steele-John says.
This briefly changed after a parliamentary committee recommended giving participants the right to review drafts in 2014, but the NDIA reverted to the old system in June 2016. Last year the NDIS Joint Standing Committee held an inquiry into the ICT systems, and the NDIA moved to a website in January this year. But Steele-John maintains the scheme requires a new user portal, claiming the existing MyPlace Portal is “jerryrigged” from Centrelink.
Fund and plan the thing
Labor, however, is not exactly blameless for the implementation of its flagship scheme. While the ALP maintains the $22 billion NDIS was fully funded and delivered when signed off, the Flinders University study found that accompanying legislation was too broad and in “hindsight suggests that the speed of the implementation was too fast”.
Bill Shorten since refused to match the Coalition’s proposed Medicare levy from opposition, and the funding issue has become something of a political football escalating in Shorten’s promise for a “locked box funding” in May.
Yet with Robert also heading the new agency Services Australia to focus on delivering “bureaucratic efficiencies” and the Coalition looking to deliver on its “big tax cuts, no delivery cuts” election promise by slashing the public service, it’s unlikely the Coalition will either top up or stop outsourcing. Robert has not returned requests from Crikey for comment.
Going forward, Steele-John recommends the NDIA appoint a chair with a lived disability experience (especially after the 2017 corporate makeover), and hopes that Robert “sits down with disabled people, and that he listens to us”.
“We have been fighting for this scheme for decades, we know how it works because we use it every day,” he says. “The minister has the opportunity to press the reset button, and to begin to deliver the NDIS people need, rather than the one that bureaucrats have been trying to ram down our throats for six years. And he should take that opportunity because people’s lives depend on it.”