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Ms Karryn Goode, CEO, Rights Information & Advocacy Centre, Proof Committee Hansard, 4 May 2021, p. 21
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'We often talk about the cost of medical reports. Not all of our participants but the majority are on some form of government subsidy or payment. An average cost could be between $1,000 and $2,000 for a report. For somebody who's on a disability support pension, that is out of the question and would impact on their plan.'
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Coalition of Disability Advocacy Organisations, Submission 194, p. 8
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'The same individuals who have not been able to source evidence for an access request under current arrangements will experience the same issue under the proposed process including:
Individuals with no treating doctor, and minimal or out-dated medical history;
Individuals who have relied solely on the closest bulk billing clinic for urgent issues, and their records are spread across multiple clinics, none of which relate to the underlying disability
Individuals who are, or have been homeless, escaping from domestic violence, in prison or other custodial detention
Individuals who experience other forms of intersectional disadvantage, such as lower socioeconomic status
In these circumstances it is hard to meet the evidentiary requirements set out by the NDIA, including requiring the treating health professional who provides evidence of the disability to have treated the person for a significant period of time (e.g., at least 6 months). For example, people in rural and remote areas may only have access to visiting treating health professionals who travel to their region every few months and already have long waitlists…We have supported many people with disability who have had to pay to access information which provides evidence of their diagnosis and treatment. This includes obtaining reports from specialists, having reports supplemented to provide additional evidence, and payment for accessing private records under the Privacy Act. Additionally, people located in rural and regional areas have had to travel to metro areas to attend both public and private appointments. This comes with the added cost of transport and accommodation. These are upfront costs that will not be alleviated by the introduction of mandatory Independent Assessments. Cost will continue to be a barrier for many people who are yet to test their eligibility, and a reason why many people have not even considered attempting access to the scheme.'
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Royal Australian and NZ College of Psychiatrists, Submission 65—Supplementary submission, pp. 3–4
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'The creation of Medicare Benefit Schedule-style items for health and medical professionals could be a better way to create equitable access for people with disability seeking to access the NDIS and allow people with disability more choice in decisions which impact their NDIS journey. Alternatively, a multidisciplinary meeting could be undertaken instead of independent assessments. This would encourage a more holistic approach, involving a variety of allied, medical and support staff as well as family and carers to support the person with disability in presenting their case for consideration as the functional capacity and supports required. Professionals could then be remunerated for their attendance and input. This would be beneficial to people with disability and their families as those in attendance would be allied health and medical professionals who are familiar with their history, strengths and functioning.'
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Australian Medical Association, Submission 200, p. 2
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'The AMA recommends instead better engagement with general practice through clarifying appropriate MBS items for completing application forms. The NDIS could develop continuing professional development (CPD) training for GPs to accompany this. Mechanisms to ensure GPs have oversight of the care their patients are receiving through the NDIS would also improve the overall level of care received. GPs report that their patients who are participants in the NDIS expect their GPs to know what care they are receiving.'
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Mrs Claire Hewat, Allied Health Professions Australia, Proof Committee Hansard, 23 April 2021, p. 28
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'The suggestion is that independent assessments will introduce equity into the system, because currently people who can afford to pay for potentially quite expensive assessments now are getting an advantage and that this will actually change that. But we contend that this will actually simply move the inequity somewhere else, that simply bringing in independent assessments is not going to change the inequity because people who can afford to get a lot of assessments are still going to get them. It is not unreasonable for a person with disability to seek the best advice and the best assessment that they can get. It's just that, at the moment, those who can afford to do it can get a lot and those who can't afford to do it will get very little and will have to wait in long queues in the public system.'
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Ms Jaimee Witcombe, Proof Committee Hansard, 4 May 2021, p. 36
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'As the sole carer of two children with disabilities and medical conditions, the toll on my health, wellbeing and quality of life in the context of my own disabilities has been substantial… I also have a psychosocial disability, for which I am unable to afford the formal diagnosis that would enhance my funding and supports. The local public waiting lists were closed last time I called with my referral.'
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Ms Luana Martin, Proof Committee Hansard, 30 April 2021, p. 22
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'I want my child to succeed in life. I want him to make a difference in this world. For him to be able to do that with a disability, to thrive and fit into a society that is not set up for him, he needs to get as much support as he can. I believe in my child. So for me, if that stranger comes on a day when things are going great and makes judgments accordingly, then my child is not going to get the funding that his therapists have recommended, and it is going to be on my shoulders. Financially I cannot afford to get it elsewhere, but also he is going to miss out on things that could make a real difference to his chances in life to grow up to be an amazing person in society.'
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Ms Mary Sayers, Children and Young People with Disability Australia, Proof Committee Hansard, 23 April 2021, p. 19
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'When we heard that the Tune review was implementing assessments, we didn't know what type of assessments they were. We thought, "Great, that means people who can't afford to get the diagnostic assessments might get access to the scheme." But people still have to pay all the money to get all the diagnostic assessments and then they have to go through an independent assessment. So it's not actually introducing the equity into the scheme that, when we first read the Tune review, we thought it might. As the previous speaker said, people will still have to spend thousands and thousands of dollars getting psychological assessments to prove diagnosis. So the very fix that these independent assessments are trying to do to make the scheme more equitable are not going to work because many people already have barriers to accessing the health system...'
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Ms Jacqui Pierce, Chair, Corangamite NDIS Reference Group, Proof Committee Hansard, 4 May 2021, pp. 28, 30
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'I'm not saying I agree with the current proposal around independent assessments for access, but one of the biggest challenges that I find people face is them trying to self-fund. If you've got a plan you're not self-funding those assessments anymore, generally. You're paying for a lot of those assessments out of your NDIS plan. You're getting your OT to come in and do another full functional assessment of you. You're getting your speech pathology to do a mealtime assistance review. The NDIS is paying for those out of your plan. But if you're a new person trying to get into the scheme you trying to produce those reports is where the high cost comes in and many vulnerable, disadvantaged people cannot afford those. So I think there's a whole different question there about how the NDIS potentially funds independent assessments to really ascertain and assist with access to the scheme to make that a fairer process, because at the moment it's a completely uneven playing field… I think that what we could do for people who are attempting to access the scheme is, if they've got a current treating therapy team, we could pay that team for their time to write a report, rather than the person having to self-fund that.'
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Ms Catherine McAlpine, CEO, Inclusion Australia, Proof Committee Hansard, 18 May 2021, pp. 51–52
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'Also, we said from the beginning that this was about cost, not about equity. If you were really trying to resolve equity, there would be two things you would do. Basically, you would make reports free for people, and you can do that through a Medicare item or through vouchers for people or through free independent assessments.'
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Hutt St Centre, Submission 14, p. 7
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'Recommendation 1: Functional assessment/ occupational therapy assessments are incorporated into the Medicare schedule and are bulk billed so that they are accessed when a person needs them to supply additional evidence of their disability, not as a mandatory process for determining access.'
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Ms Shauna Gaebler, CEO, Consumers of Mental Health WA, Proof Committee Hansard, 27 April 2021, p. 44
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'In the past, some NGOs have provided support for people to access NDIS. This has dwindled and many people have to do it alone. This can be particularly difficult, in feedback we've received, for people from Aboriginal and CALD backgrounds and for people who rely on bulk-billing support to gather their evidence.'
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