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Executive
Summary
This is the first Report of the Parliamentary Joint Standing
Committee
('the committee') on the National Disability Insurance Scheme (NDIS). The
report considers the evidence that the committee has gathered from public
hearings in the Barwon, Hunter, Tasmanian and South Australian trial sites in
April and May 2014. This evidence—from participants, carers, family members,
service providers, disability advocates, state and National Disability
Insurance Agency (NDIA) officials—has provided the committee with a range of
views on the Scheme's achievements and the challenges in its first nine months
of operation.
The committee has listened carefully to all stakeholders. The
report provides the committee's view on a range of complex matters and makes some
important recommendations. The committee hopes that in performing its key task of
reviewing the implementation and administration of the NDIS, it will contribute
constructively to the debate within government, the disability sector and the
wider community about the progress of the Scheme.
The need for change
The NDIS is an insurance scheme, paid for by taxpayers,
which, similar to the introduction of the Medicare healthcare reforms of the
1980's, recognises Australians' strong support for the principles of fairness
and equity. The National Disability Insurance Act 2013 stipulates the
requirement to ensure the financial sustainability of the Scheme.
The NDIS was designed and implemented following the landmark
report from the Productivity Commission, Disability Care and Support,
handed to the Federal Government in 2011.
The NDIS has the full support of the Australian Parliament. All
sides of politics recognise that the old grant-based model of disability
support was not working. It needed to be replaced with a unified system that
identified and prioritised the needs of the individual. The new system rightly
places emphasis on the goals and aspirations of the individual, their ability
to exercise choice and control, and to participate in the community. It
prioritises the needs of participants by establishing a fee-for-service model
for providers and developing a network of coordinated information and community
supports.
The social and economic benefits of
the NDIS
It is also acknowledged that the NDIS, successfully
implemented and delivered, will provide significant economic benefits not only
for the individual but the wider Australian economy. The committee highlights
research published by PricewaterhouseCoopers in 2011 that analysed the
disability system in Australia according to three scenarios. This research
found that by approximately 2025, the cost of doing nothing (i.e. continuing
with 'business as usual') would exceed the cost of the NDIS.[1]
Early intervention supports are a key element of the NDIS.
They are a crucial investment in the long-term well-being of a child. Incurring
expenditure on a particular intervention today not only creates the potential
to significantly improve a child's outcomes, but reduces the long-term need and
cost of permanent disability support.
Importantly, the NDIS is designed to complement, rather than
substitute, informal supports and existing community and mainstream services.
The ability of the NDIS to connect participants with mainstream services in
transport, health, education and housing will be crucial to its long-term
success. It is also important that the NDIS promotes workforce opportunities
for people with disability and their carers.
Success is not guaranteed, however. The challenges that face
moving from a system that is fragmented between states and reliant on ad hoc
funding streams, to a national scheme based on individual choice and
flexibility are substantial. Further, during the transition it will be crucial
that people do not 'fall between the cracks' of the old and the new. That is
why it is crucial that the Commonwealth and State Governments, and the NDIA,
adopt a ‘continuous improvement’ philosophy. The committee notes that this is
reflected in the NDIA's July 2014 Progress Report, which emphasises the 'learn,
build, learn, build' approach that underpins its 'ongoing growth and development
as an agency'.
Reasonable criticism should not be dismissed as an attack on
the goals of the NDIS itself but an opportunity to improve and deliver better
results for the disabled people that the scheme is designed for. The committee
has approached its task with this mindset.
By the time the NDIS is fully rolled out across Australia,
more than 460 000 Australians with disability will benefit. The NDIS plans
to provide Australians with disability, their families and carers with more
control over their lives, more certainty over the level of care they receive
and more opportunities to get involved in work, school and community life.
Australians know that this is what people with disability deserve.
A significant and complex reform
The NDIS is a massive and complex reform. More than 5400
people with disability have been provided with an NDIS plan in the first nine
months of the Scheme's operation. This is testament to the success of the
Scheme to date in terms of providing people with disability with 'reasonable
and necessary' supports that match their life goals. The committee heard many
of these positive stories from participants, family members and carers in the
trial sites. This report presents this evidence.
The NDIA is responsible for the implementation and
administration of the NDIS. The committee concurs with the findings of the
January 2014 Capability Review that 'it has been truly remarkable that the
Agency...was able to commence operating the NDIS Scheme on 1 July 2013'. This
report recognises the achievements of the Agency to date. In that time, the
Agency has relocated to Geelong, recruited staff, trained planners, established
the network of Local Area Coordinators, and set in place systems to receive
feedback and improve the Scheme's processes.
The committee agrees with the Chairman of the NDIS Board, Dr
Bruce Bonyhady, who noted that 'it was never going to be possible to just roll
out this scheme smoothly from day one'.[2]
The committee notes that the trial phase up until full scheme in
2018–19 will be important to test methods and processes and to get the Scheme
right. According to the last quarterly report available to the committee, the
Scheme is on budget and progress against performance benchmarks is improving.
Areas of committee focus
The evidence presented in this report identifies a number of
challenges that face the NDIA, and a wide range of NDIS stakeholders:
-
in terms of the culture of the NDIA, the committee
received evidence from a range of participants, carers and providers about the
need to ensure that communication with stakeholders is courteous, clear,
consistent and prompt. The committee is encouraged that the NDIA proposes a
'culture audit' later this year whereby it will ask participants, providers and
stakeholders whether the Agency is living by the values it espouses;
-
in terms of early intervention supports for children, the
committee took evidence from parents and service providers indicating concerns
about the current guidelines for funding these supports;
-
in terms of the role of planners and the planning process,
many witnesses emphasised the need to strengthen the involvement of prospective
and actual participants in developing plans. Many witnesses praised their
planner and the planning process. Others, however, expressed concern that draft
plans had not been provided, there had been unsolicited amendments to plans,
the planner's communication had been poor, there was no requirement to sign the
plan, and that the plan was too complex to understand;
-
in terms of advocacy, a number of participants, carers,
family members and service providers stressed the importance of the role of
advocates. They argued that it is critical to the Scheme's success that
prospective and actual participants are aware of the NDIS, what it has to
offer, how to navigate the planning process, and provided with forums for
feedback and discussion with other participants;
-
in terms of participants' plan management arrangements,
very few currently self-manage their plans (only three per cent). Most have their
plan managed through the NDIA. Some witnesses emphasised the importance of
helping people self-manage. The committee believes that for a mature and
innovative market to develop—one that prioritises participants' choice and
control—it is crucial to promote the self-management option;
-
in terms of service providers, there is a significant
challenge of transitioning from a block funded system to one based on a fee for
service. The committee received evidence from service providers across the
trial sites expressing their concern with the impact of this transition on
their financial viability. Some providers also expressed concern with the
non-activation of plans and the administrative errors in plans which led to
providers incurring extra costs; and
-
the availability of suitable housing for people
with disability was a significant theme in evidence from the trial sites.
Witnesses expressed a wide range of housing concerns including young people
living in residential aged-care homes and the deinstitutionalisation of
state-run large residential centres. It is important to note that suitable
housing for people with disability is a significant issue that pre-dates the
introduction of the NDIS. The introduction of the Scheme is an opportunity for
this issue to be addressed. These matters, and the broader problem of the
limited stock of housing for people with disability, require policy leadership
at the national level and should be the focus of the Council of Australian
Governments Disability Reform Council.
The committee wishes
to thank all the participants, family members, carers, advocates, service
providers and state and NDIA officials who gave evidence to the committee.
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