9.1
The committee welcomes the announcement by the new Minister for the NDIS, Senator the Hon Linda Reynolds CSC, that the Government will not be proceeding with independent assessments in their proposed form, and will be taking time to consult in a meaningful way. In particular, the committee wishes to acknowledge the Minister's receptiveness to feedback from the sector. Her decision following consultation to abandon independent assessments as proposed indicated that she did not merely listen to the sector, but also heard and took action on the basis of expert advice. The committee expects that the Minister will continue to consult in this manner.
Preliminary comments
9.2
The committee notes the Productivity Commission's recommendation in its 2011 report that future changes to the key features of the scheme occur 'only by explicit changes to the Act itself, be subject to the usual processes of community and Parliamentary scrutiny, and require consultation with all state and territory governments'.
9.3
The committee also notes that the Tune Review argued that the introduction of independent assessments would 'require extensive consultation with participants, the disability sector, service providers and the NDIA workforce', and that the success of independent assessments would largely depend on:
The willingness of prospective participants and participants to work with NDIA-approved functional assessors; and
Those assessors providing truly independent functional capacity assessments, so they would not be perceived as agents of the NDIA or a tool designed to cut supports from participants.
9.4
Looking at the recommendations of these two key inquiries in the context of evidence presented to the committee indicates that the NDIA did not follow what was recommended, despite frequently referring to both reports in its reasons for introducing independent assessments. For example, the Tune Review considered that independent functional assessments could be an option for people with disabilities 'who would like to test their access for the NDIS or who require further evidence to support decision-making' in their plans. In considering the broader question of best practice approaches to policy development, the failure to follow these recommendations, particularly in relation to the consultation process, is especially concerning.
9.5
As both of those inquiries identified, genuine consultation and co-design were key steps to ensuring that people with disability and their families were open to independent assessments being introduced, in an appropriate form. While the committee is not suggesting that the sector would have welcomed independent assessments if co-design and genuine consultation had taken place (indeed, the end result of such a hypothetical process should have resulted in a very changed model to what the Government proposed, given the concerns raised about the reliability and validity of the tools), any future major changes to the scheme should involve both of these processes. As such, the committee strongly encourages the Government to adopt appropriate co‑design processes and welcomes the recent announcement from the Chief Executive Officer that the NDIA will be focusing on a new co-design process. The committee has more to say on this matter below.
9.6
The committee commends the new Minister's recent efforts to consult with state and territory ministers and her commitment to continue doing so through the Disability Reform Ministers' meetings. The committee further welcomes the Minister's announcement that proposed amendments to the National Disability Insurance Scheme Act 2013 would be released publicly and subject to consultation. These approaches are in line with what both the Productivity Commission and the Tune Review proposed should occur before major changes to the NDIS are implemented. The committee will have more to say about proposed amendments in future inquiries; for now, the committee acknowledges these first positive steps taken by the Minister, which will help to put any proposed reforms on a solid foundation moving forward. However, the committee reminds the Government of the importance of listening to people with disability and placing equal importance on their views alongside best practice and feedback from experts. Further, evidence-based best practice should never be used to discount the lived experience or views of people with disability.
The financial sustainability of the NDIS
9.7
The committee notes that a key reason given by the Government for introducing independent assessments as proposed was to address the financial sustainability of the NDIS. If the NDIS is on an unsustainable financial trajectory, there appear to be five possible solutions:
(1)
Reduce the number of participants in the NDIS;
(2)
Reduce the types of supports available;
(3)
Reduce the dollar figure of supports available;
(4)
Source additional Commonwealth funding; or
(5)
Renegotiate bilateral agreements with the states and territories
9.8
This committee does not take the position that access or ongoing eligibility for a world-first scheme, which has brought life-changing transformation to hundreds of thousands of participants and their families, should ever be denied to people with disability who meet the criteria for accessing the scheme under the Act. The committee also does not agree that overall plan funding should be reduced so long as those plans have been determined to be reasonable and necessary. After seeing the progress and positive benefits achieved under the scheme, it is crucial to avoid returning to a system that would leave people with disability without the supports that they need. This is not a controversial position; support for the NDIS is bipartisan, spread across ideological divides and shared across Australian society, because the benefits the NDIS brings to Australia as a whole are substantial and meaningful.
9.9
The focus of this inquiry was not the financial sustainability of the NDIS, and as such, the committee received only limited evidence on alternatives to independent assessments that could put the scheme on a better financial trajectory. However, the committee did ask the Minister and the NDIA, in questions on notice, to respond to the following:
What other options, besides independent assessments, did the Government consider to help ensure the financial sustainability of the scheme?
Has the Government established an NDIS Reserve Fund, as indicated in Commonwealth/state/territory bilateral agreements that underpin the establishment of the scheme?
Please provide the relevant actuarial data, risk assessment profiles and short and long-term modelling that led the Government to conclude that the NDIS is on an unstainable growth trajectory, and all other relevant information that indicates that the cost of the scheme will differ from the Productivity Commission’s original projections.
Please provide in full (not summary form) all Financial Sustainability Reports since 2015.
9.10
Eight days after these questions were sent to the Minister, the NDIA publicly released a substantive interim update to its Annual Financial Sustainability Report Summary. On the matter of its request for full Annual Financial Sustainability Reports, the committee notes the Minister’s advice that previous reports were 'prepared solely for consideration by the Board'. While the committee looks forward to the NDIA Board releasing the 2021 report in full when it is available later in the year, the committee remains concerned that the Government has to date not provided the more detailed information contained in previous reports. Without this information, it is difficult for the committee to analyse key information contained in these reports.
9.11
The Government's answers to the other questions posed to the Minister have been canvassed elsewhere in this report, and the committee thanks the Minister for her commitment to transparency, evidenced by the comprehensive responses to many questions the committee has put to her. The committee also thanks the NDIA for the time that it has taken to respond to the committee's recent requests for detailed data. The committee also welcomes the announcement by the Disability Reform Ministers Council that 'further work will be undertaken… to understand cost drivers and underpinning assumptions in the Annual Financial Sustainability Report (AFSR)… informed by data and modelling underpinning historical and future AFSRs' and that representatives of people with disability should be actively engaged in this work. The committee nevertheless notes that full actuarial data and long-term modelling about the financial sustainability of the scheme were not provided to the committee during this inquiry.
9.12
The committee further wishes to focus on an area of particular concern arising from the Minister and the NDIA's response to the question on the NDIS Reserve Fund. The committee is surprised and concerned that the NDIS Reserve Fund does not yet exist, particularly in light of the Government's commitment to establish the Fund in multiple bilateral agreements that are already several years old. The Productivity Commission in its 2011 report explicitly emphasised the importance of a reserve to act as a buffer against the unpredictability of 'claims and their costs' and to avoid a 'situation in which the Australian Government would need to inject additional funds from general revenue when there were higher than expected claim costs in any given period'. The Productivity Commission's 2017 report further emphasised the importance of establishing a reserve fund which could help cover long-term costs of the Scheme. The committee recognises that the Government may have reasons for not implementing the NDIS Reserve Fund, but if these reasons exist they have not been shared with the committee. The committee therefore considers that the Commonwealth Government should commit to implementing the Fund as soon as practicably possible.
9.13
The committee recommends that the Commonwealth Government implement the National Disability Insurance Scheme Reserve Fund as soon as practicably possible.
9.14
The committee takes the view that no discussion that even suggests the removal of people's access to the NDIS, or reducing participant numbers or supports, should take place until sufficient Tier 2 supports are in place—that is, community supports for people with disability who are not eligible for the NDIS. However, beyond this point, without access to more complete data, it is difficult for the committee to propose solutions to the long-term financial problems that the Government has flagged are an issue. The committee hopes that more data will be released with the next Financial Sustainability Report, enabling the committee to consider these broader questions in its next General Issues report.
Appropriateness of proposed tools
9.15
On the question of the appropriateness of the specific assessment tools proposed for independent assessments, the committee makes the following points. Any allied health tool that the Government intends to make compulsory for NDIS participants should be subject to rigorous reliability and validity testing before a decision is made that those tools will be implemented. This should occur, as a matter of best practice, by:
Consulting widely with external experts—that is, allied health professionals, peak bodies, practitioners and academics outside the NDIA;
Conducting rigorous literature reviews, not 'pick-and-choose' literature reviews, and adhering to best practice according to accepted consensus on what the literature says; and
Carrying out trials that do not merely evaluate participants' views but also are designed appropriately, with experts, to determine whether the tools proposed are reliable and valid for the purposes for which they are intended.
9.16
On this final point, the committee wonders whether the NDIA tested the reliability and validity of tools between family members with similar disabilities (for example, siblings and twins) and examined whether the results of these assessments of different family members aligned. The committee has flagged in previous reports inconsistencies in plan funding between family members who have the same disability. The Final Evaluation Report of the Second Independent Assessment Pilot does not appear to indicate that this occurred.
9.17
Whether the NDIA did this or not is largely irrelevant if, in fact, as the allied health sector warned in hundreds of submissions to the inquiry, the tools were not designed for the purposes for which the Government proposed they be used. Particularly worrying is the evidence indicating that the Pedi-CAT is not psychometrically sound—that is, that it does not measure what it was intended to measure, even in settings unrelated to independent assessments. Of further concern is the assertion that the NDIA had examined the WHODAS and the Pedi-CAT in the early years of the scheme and determined that they did not 'give the information that was needed to draw a link between that information and reasonable and necessary supports'. The committee acknowledges the possibility that this previous finding was based on an unclear link between assessment results and individual, line-by-line supports—not an overall 'reasonable and necessary' funding package, as was proposed in the Personalised Budgets Paper.
9.18
The committee affirms the Productivity Commission's statement in its 2011 report that tools should be valid, reliable, rigorous and cost-effective, and the NDIA should only use a tool to assess the needs of particular groups where its reliability and validity have been established for that group. The concerns outlined in evidence by experts indicated that some of the selected tools were never designed for functional assessments; no evidence exists that any of the tools, individually or combined, are 'disability neutral'; the tools should not be implemented without sufficient assessor expertise and accompanying, contextual data; the tools were never validated to assist in making decisions on funding amounts; and some tools have never been validated for use with people with particular disability types.
9.19
Of particular note were concerns about the reliability and validity of the tools for episodic, fluctuating and degenerative disabilities, and the absence of information about how assessors would take into account the circumstances of those whose results would indicate high functioning because of their existing NDIS supports, without which their functioning would likely decrease. This highlighted the importance of both assessor expertise and contextual information—a point that the committee considers in further detail below.
9.20
The evidence and the research that the committee examined during the course of this inquiry attested to the need for any assessments of eligibility or capacity relevant to a participant’s funding to be holistic and take into account a range of evidence. The committee acknowledges that the NDIA had stated that participants could still provide reports from medical professionals to supplement their assessments; however, it is clear that this should not be an optional part of any proposed assessment model but rather, wherever possible, a standard inclusion—without which assessments would not be reliable or valid.
9.21
A key rationale for introducing independent assessments was to ensure more consistent decision-making, thereby reducing inequities in the scheme. In the form proposed, however, it is evident that reliable and valid results of the proposed tools still depend on contextual and supplementary information in expert reports, the ability of participants to understand questions and provide appropriate responses, and the presence of a supportive family member or supporter to undertake the Vineland test. As a result, those with limited insight, impaired cognitive ability and limited support networks would still be disadvantaged. The committee has more to say on this issue, and on the importance of recognising the individual circumstances of people with disability, later in this chapter.
Policy development, consultation and co-design
9.22
If some of the tools were never designed for functional assessments, the committee questions why their selection occurred in the absence of widespread consultation with external experts and a broad, open consultation process involving practitioners. Good policy processes should ensure that extensive consultation, trials and pilots iron out the flaws in a policy proposal, but in this instance the committee notes that the policy process appears to have taken place in reverse to how it should have occurred. Figure 9.1 sets out how, in hindsight, the committee considers the policy process, from design to roll-out, of independent assessments should have been implemented. The committee acknowledges that it does not have full insight into internal workings in NDIA branches, including any closed consultation processes with external experts.
9.23
The March 2018 Quarterly Report indicated that the NDIA was working with stakeholders to verify and validate assessment tools before conducting the initial pilot program. However, evidence from experts and organisational peak bodies hinted that this process was limited. Indeed, some academic experts wrote to the committee specifically to flag that, while they had been asked to advise on the NDIA's Functional Capacity Assessment Framework, they did not support the NDIA's tools paper or further policy decisions. One highlighted that an assessment 'must combine quantifiable information obtained using scientific standards with the expert knowledge of people living with disability and the families and professionals who know them', while the other argued that the independent assessments framework should be tailored 'to the characteristics of each individual'.
9.24
Crucially, the committee considers that extensive consultation should have come much earlier in the NDIA's policy development, and calls on the NDIA to commit to more extensive consultation in future policy initiatives to ensure that funds are not expended on policies that experts and people with disability contend are not sound or evidence-based. The committee considers that such extensive consultation, including with people with disability and allied health practitioners, should be carried out by the NDIA before future policy decisions are announced.
9.25
The committee acknowledges that the NDIA has 'a range of policies and procedures to ensure compliance with, and maintenance of, ethical standards as prescribed by National Health and Medical Research Council guidelines'. However, the committee considers that the independent assessments trials and pilots should have been subject to an independent ethics assessment. The committee encourages the Government, in its commitment to transparency and consultation, to implement this option should it carry out further trials and pilots of future policy initiatives.
Co-design
9.26
Media reports in March 2021 suggested that the Government was considering removing all references to 'co-design', though it was unclear from these reports in what context. The committee notes that the three NDIS Corporate Plans before the recently released 2021–2025 Plan did not use the term 'co-design'. Further, these Corporate Plans, including the most recent plan, have not referenced the previous NDIS Co-Design Framework paper from 2015, which appears to no longer be available on the NDIS website.
9.27
In light of this, the committee welcomes the CEO's announcement in July 2021 that the NDIA would be 'co-designing' a new model of co-design. This news is particularly heartening given concerns the committee had about the NDIA's commitment to co-design, especially, as noted above, because people with disability appear to have been consulted after decisions were made concerning them in the policy development process.
9.28
Co-design should be a fundamental feature of any major changes to the NDIS. The committee points the NDIA to its preliminary research outlined in Chapter 8 on the basic principles of co-design, and looks forward to hearing more about what the 'co-design of co-design' will involve. To ensure that this principle is enshrined in the basic foundations of the NDIS and never disappears again, the committee considers that the NDIS Act should be amended to include a specific commitment to and definition of co-design, once this consultation process has ended.
9.29
The committee recommends that the Commonwealth Government amend the National Disability Insurance Scheme Act 2013 to include a specific commitment to and definition of co-design, following extensive consultation on what 'co-design' should be.
Learning from other schemes
9.30
The committee points the Government and the NDIA to its discussion on how other schemes are using independent assessments as a starting point for what has been implemented effectively. Features from these other schemes that the committee highlights include assessment review rights, extensive training and experience requirements for assessors and, in the case of veterans, the ability of a claimant to choose their own professional to provide medical records concerning their condition, paid for by the Department of Veterans Affairs. In the latter case, reports from treating specialists are preferred even where medical records are not provided or not considered sufficient for a diagnosis. Indeed, the Productivity Commission in a 2019 report on supporting veterans recommended that external assessors ‘should only be called upon when strictly necessary and staff should be provided with clear guidance to that effect’.
The future of assessments
9.31
The committee is heartened to learn, through answers to questions on notice provided by the Minister and the NDIA in early August, that the NDIA has been looking to improve equitable outcomes arising from its decision-making processes. The committee commends the NDIA for taking this long-overdue action, and recognises that building of the NDIS has taken place concurrent with the scheme commencing and continuing to operate, leading to a number of challenges that are still being worked through. However, the committee also emphasises that consistency does not necessarily mean equity, and that people with disability continue to need supports that reflect their individual circumstances.
9.32
The committee also acknowledges the Minister's commitment to developing a new person-centred approach with state and territory ministers, in consultation with people with disability.
9.33
The committee notes that research provided by the NDIA suggests that some people with disability may feel a sense of 'guilt' that they are asking for too much, taking funding away from someone else or burdening the system. In addition, it should be recognised that some people with disability may have been traumatised by their experiences interacting with service systems and other health professionals in the past. It is clear to the committee that, for people with this background, assessments by a stranger have the potential to cause considerable harm. Further, in many cases, for those with rare and degenerative diseases and episodic disabilities, the only appropriate person who would fulfil the requirements outlined above would be one of their own treating professionals, given the shortage of allied health professionals with experience in certain disability types.
9.34
At the hearing on 5 August 2021, the Minister informed the committee that the Disability Reform Ministers Meeting in July had agreed that, while independent assessments are dead', ministers 'also agreed we do need some form of assessment'.
9.35
Under the NDIS Act as it currently stands, the CEO of the NDIA (or their delegate) may ask a prospective participant or current participant to do either or both of the following:
Undergo an assessment and provide to the CEO the report, in the approved form, of the person who conducts the assessment;
Undergo, whether or not at a particular place, a medical, psychiatric, psychological or other examination, conducted by an appropriately qualified person, and provide to the CEO the report, in the approved form, of the person who conducts the examination.
9.36
Indeed, evidence indicated that the NDIA has required some participants and prospective participants to undergo independent assessments for years, often with occupational therapists. The committee recently discovered, through evidence presented to its inquiry into General issues around the implementation and performance of the NDIS, that the sector was not aware that this was happening for planning purposes:
It now transpires that long before the controversy around Independent Assessments, the National Disability Insurance Agency (NDIA) was utilising clinically flawed assessment tools to determine participant plan budgets and, because of the agency’s culture of secrecy, allied health professionals were unable to alert the agency to this problem.
9.37
It appears that in practice, this requirement has often, though not always, been applied in circumstances where the participant or prospective participant does not have the money to obtain their own specialist reports to support access or funding requests, or does not have an existing network of health and allied health practitioners. The committee expects that this would be particularly the case for people from low socio-economic backgrounds, people who are homeless, people who are leaving criminal justice settings, people who have very few informal supports, people from culturally and linguistically diverse backgrounds and people in rural and remote areas. As a result, many of the people who need the NDIS the most may have been denied access to the scheme. Further, those from the most disadvantaged cohorts who were granted access may have ended up, on average, with fewer supports and less funding than those able to obtain assessments from their own health professionals—and not had the resources or the knowledge to appeal decisions based on these independent assessments.
Bulk-billed consultations with nominated professionals
9.38
The NDIA has acknowledged that inconsistent planning and access decisions are an issue affecting equity. The mechanism proposed to address the problem of a system that worked better for those able to provide specialist reports was to require all prospective and current participants to undergo independent assessments similar to what the Agency has required of some individuals for years. The committee, for reasons outlined at length throughout this report, does not agree with this approach, but it is clear that the current system as it stands cannot continue—not so long as inconsistent assessments remain unfair for some of the most disadvantaged people, and not so long as these people are unable to afford consultations with professionals who would take the time to understand their disabilities and provide a holistic assessment. Further, any approach involving any form of assessment should recognise the individual circumstances of people with disability, and not equate equity with consistency, nor consistency in decision-making processes with fair outcomes. As such, the committee considers that the Government should consider providing people with disability access to bulk-billed consultations with specialists and allied health professionals for the purposes of NDIS access and plan requests. The committee proposes that these consultations be funded under a new Medicare Benefits Schedule item. The committee takes this position in light of the considerable evidence outlining the equity issues that may exist for participants and prospective participants unable to afford the cost of consultations and reports to support their access and planning requests (see Appendix 3 for further detail about this evidence).
9.39
Here the committee outlines several options for the Government to consider, should the Government proceed with bulk-billed consultations in some form. The committee is not seeking to pre-empt any co-design process between the NDIA, the disability sector and the allied health sector that may consider what form any future assessments and reports should take as part of these bulk-billed consultations. However, in the first instance, the committee takes the view that to ensure valid and reliable results, all assessments should be:
Holistic, taking into account medical reports and other contextual information as appropriate; and
Multidisciplinary, involving consultation with multiple experts who treat and have treated the person.
9.40
The evidence strongly supports the need for practitioners who provide evidence to support access and planning applications to have sufficient expertise in disability types in order to be able to apply their own clinical judgement. However, in addition to this evidence, there is the matter of the individual rights and dignity of people with disability. Just like veterans, who are able to use their own professionals under veterans' compensation schemes, people with disability have the right to dignity, and they should not be punished for having a broad network of professionals to support their applications for the NDIS and for inclusions in their plans. People with disability are not passive players in their own NDIS journeys; many have spent years (often with their families) building up support networks with key professionals to ensure that they are able to obtain reasonable and necessary supports.
9.41
All medical practitioners are expected to act in the interests of their patients. The evidence suggests that this may in fact lead to better health outcomes, and not necessarily transfer into sympathy bias as alleged. Further, professional bodies have existing procedures in place to remind practitioners of their obligations, including strict codes. While the committee notes the argument of 'sympathy bias' put forward by the NDIA, the committee found no evidence suggesting that any sympathy bias would affect the judgement of medical professionals known to individuals for the purposes of NDIS reports, given the existing codes of conduct and ethical guidelines that registered practitioners are expected to adhere to. The committee expects as a matter of course that medical and allied health professionals will continue to adhere to these guidelines.
9.42
The committee recommends that consultations with medical and allied health professionals for the purposes of access to the National Disability Insurance Scheme and to support requests for items in NDIS plans be:
carried out by health professionals nominated by participants and/or their nominees, where appropriate and available;
holistic, taking into account medical reports and other contextual information as appropriate; and
multidisciplinary, involving consultation with multiple experts who treat and have treated the person.
Bulk-billed consultations with a professional who is a stranger
9.43
The committee recognises that not all people with disability have access to a medical professional with whom they have an existing relationship, particularly those who are disadvantaged or have complex support needs through a history of involvement with other service systems (e.g. out-of-home care and the justice system). In such instances, the committee proposes that the NDIA implement an accreditation system for health professionals who could be called upon to provide evidence to support a person's application for access to the scheme and for planning purposes. The committee further proposes that the NDIA proactively reach out to allied health professionals and specialists around the country to ensure that there is a broad range of professionals who could come together to provide holistic evidence for those who do not have existing networks of health professionals for planning purposes. The NDIA should provide training and incentives for these health professionals, and the NDIA should develop specific, targeted strategies to ensure that particular cohorts are not disadvantaged in the process.
9.44
The NDIA should consult extensively on these strategies, the proposed accreditation system, options for people with disability to seek reviews or alternative reports, and any further relevant points that would ensure people with disability without existing supports are equipped to receive the assessments and the supports that they need.
9.45
Further, any proposals that would be expected to impact the allied health workforce should be accompanied by comprehensive modelling outlining the impacts, along with proposed mitigation to ensure that allied health services remain available to people with disability.
9.46
The committee recommends that, where consultations with medical and allied health professionals for the purposes of access to the National Disability Insurance Scheme or to support requests for items in NDIS plans cannot be carried out by appropriate professionals nominated by a participant and/or their nominee:
The National Disability Insurance Agency implement an accreditation process for appropriate professionals to carry out consultations for those in the circumstances described above;
The National Disability Insurance Agency ensure that these assessments are holistic and multidisciplinary; and
The National Disability Insurance Agency implement specific, targeted strategies to ensure that particular cohorts are not disadvantaged by such a process.
9.47
The committee recommends that the Australian Government consider funding bulk-billed consultations with medical and allied health professionals for the purposes described in Recommendation 3 and Recommendation 4.
Assessment tools
9.48
As discussed above, the committee considers that any new proposed forms of assessment should be developed through extensive and genuine co-design processes, which include people with disabilities, the disability sector and the allied health sector, to ensure that the experience is consistent with the intent of the assessment, and is safe and appropriate for the person undergoing assessment. Assessments tools should be accompanied by rigorous evaluation processes that include people with disabilities to ensure fitness-for-purpose, accessibility and safety.
9.49
Further, all assessment tools the NDIA proposes should be subject to rigorous consultation with the allied health sector. None should stand alone; rather, they should supplement reports by treating professionals and be part of a holistic, multidisciplinary process, as the committee has recommended above. Rigorous and genuine consultation and co-design also should also be carried out, as a matter of priority, with people with disability and Disability Representative Organisations, with their views reflected in any decisions made.
9.50
The committee recommends that all assessment tools that the National Disability Insurance Agency proposes, for the purposes of funded assessments to access the National Disability Insurance Scheme and to help inform funding decisions, should be subject to rigorous consultation with people with disability, Disability Representative Organisations, and relevant health and allied health practitioners before the National Disability Insurance Agency decides to implement them.
Concluding remarks
9.51
This report does not mark the end of the committee's oversight of the Government's independent assessment proposal or the broader questions concerning the financial sustainability of the scheme. The committee will continue monitoring these issues through its ongoing General Issues inquiry. The committee may also initiate new, separate inquiries into the Government's management of the NDIS.
9.52
The committee will be keeping an eye in particular on the NDIA's planned co-design consultation process, the forthcoming amendments to the NDIS Act, and any further proposals the Government puts forward to address the challenges facing the scheme, including its financial sustainability and the person-centred approach flagged by the Minister.
9.53
This committee plays a key role in hearing from participants and their families who sometimes do not feel comfortable raising their concerns directly with the NDIA because of the worry that their plans will be affected, or because of previous negative experiences engaging with the Agency. This includes those who gave confidential submissions to the inquiry that the committee has chosen not to publish. The committee reiterates the advice of the Independent Advisory Council and encourages the NDIA to turn its mind to how it can rebuild trust with people with disability and the disability sector so that they feel comfortable reporting their concerns directly to the NDIA.
9.54
However, the committee also took a significant amount of expert advice from the allied health sector, which largely came away from the NDIA's independent assessment consultation process feeling sidelined and ignored. The NDIA should consider what processes it needs to put in place to ensure that it properly consults with and takes into account the advice of experts outside the NDIA, including, crucially, practitioners. The committee will leave it to the NDIA to decide how to ensure this takes place in the future.
9.55
As noted in the preliminary comments to this chapter, the committee welcomes the Minister’s advice that the government has committed to extensive consultation and co-design to develop a new person-centred assessment process. The committee also takes this opportunity to reiterate that changes to key features of the NDIS should only be approached through undertaking a development process that centres consultation and co-design on people with lived experience of disability, their families and the networks of practitioners, carers, and others providing them support. In the current context, it is crucial that this consultation includes the wider disability sector, including the allied health sector. Such an approach is consistent with the findings and recommendations in the Tune Review and the Productivity Commission reports.
9.56
The committee is confident that a genuine commitment by the Government to such an approach will go a considerable way to ensuring that future changes to the scheme are appropriately designed and implemented, and will therefore ensure that the NDIS can continue to serve the needs of people with disability and assist them to reach their goals.
Hon Kevin Andrews MPSenator Carol Brown
ChairDeputy Chair