Chapter 6Sustainability
Introduction
6.1Financial sustainability is essential for the viability and ongoing public acceptance of the NDIS. It is a requirement for the scheme under the NationalDisability Insurance Scheme Act 2013 (NDIS Act), and has been a key focus since its establishment. All stakeholders understand the need to ensure the scheme is financially sustainable, while delivering on its objectives.
6.2This issue has been considered in a number of previous inquiries and reviews, including the Productivity Commission's 2017 report on NDIS costs, reports of this committee, and the 2019 review of the NDIS Act (Tune Review). It was also front and centre in the recent independent NDIS Review, which outlined its serious concerns with the growth of the scheme. Reviewers noted that the scheme is not yet at 'maturity', but already supports 100000 more participants, and costs Australian taxpayers $8billion more than the Productivity Commission projected in 2017. Under existing settings, the NDIS has been 'projected to continue growing to be $92billion in 2032–33, significantly exceeding the 2017 [Productivity Commission] estimates'.
6.3Findings of the 2023 NDIS Review echo concerns raised by submitters and witnesses to committee inquiries over the last ten years. The reviewers concluded that many design aspects of the scheme negatively 'drive provider behaviours'. For instance, pricing does not generally reflect complexity, and current policies reward the 'volume of supports' over quality or outcomes for participants. Alack of transparency around transactions means 'fraud is difficult to identify'. Critically, the Review found that the scheme has become 'an oasis in the desert', when it needs to be part of a broader national 'ecosystem' of supports for people with disability.
6.4The Review identified a number of systemic issues that have the potential to undermine the long-term sustainability of the scheme, if not resolved. Factors putting pressure on the scheme, include:
a reduction in services for people with disabilities who are not eligible for the NDIS;
failure of state and territory governments to 'continue to reform mainstream services to make them more accessible and inclusive';
a growing 'inequality between participants and those who are not eligible for the NDIS';
a shift from supports being provided in 'natural settings', to an overemphasis on expensive, one-on-one clinical supports and therapies.
6.5In addition, there has been a failure of NDIS markets to work 'as expected'. There are chronic workforce and skills shortages, especially in regional and remote areas, and there is unmet need among underrepresented cohorts, such as First Nations, rural and regional, and culturally and linguistically diverse people.
6.6In April 2023, National Cabinet met to consider the sustainability of the scheme and agreed the NDIS Financial Sustainability Framework, which outlined 'an annual growth target in the total costs of the Scheme of 8 per cent by 1 July 2026, with further moderation of growth as the Scheme matures'. The Framework was accompanied by an investment of over $720 million over four years to 'lift the NDIA's capability, capacity and systems', including investments to better detect and prevent fraud.
6.7This chapter outlines these issues, and the actions being taken to address them. However, when considering sustainability, it is important to also understand the social and economic benefits of the scheme. The NDIS changes lives—increasing employment and social and economic participation for participants, family members and carers, and stimulating activity across the economy. In short, the NDIS has made Australia a 'stronger and fairer' country.
6.8Taking into account previous committee reports, external reviews, and recent evidence provided as part of the committee's ongoing General issues inquiry, this chapter discusses the following systemic issues:
the growth of the scheme;
economic and social benefits of the NDIS;
the role of state and territory governments, including mainstream services and Tier 2 supports;
NDIS market failures, and workforce issues;
the impacts of fraud; and
inappropriate appeals mechanisms leading to overuse of the Administrative Appeals Tribunal (AAT).
Growth of the scheme
6.9As at September 2023 there were 631529 participants in the scheme. Total payments increased from $10.5 billion in the year to 30 June 2019, to $35.2billion in the year to 30 June 2023. Payments in the quarter to 30September2023 were $10.1 billion. The increase in scheme payments was impacted by two factors—an increase in participants of around 15percent peryear since 2021, and an increase in average and median total payments perparticipant, of 6.2 per cent and 4.2 per cent respectively, over the last three years. Plan budgets continue to increase as well, at an average of 2.8per cent perannum for all participants (significantly higher for those in supported independent living (SIL)).
6.10Operating expenses for the scheme have increased from $1310 million in 2018–19 to $1830 million in 2022–23. However, this represents a decrease in operating expenses on a per participant basis, from 12.5 per cent in 2018–19 to 5.2 per cent in 2022–23. The NDIA notes that this compares favourably with the Productivity Commission's suggested benchmark of 7 to 10 per cent, as outlined in its 2017 study report.
6.11The committee considered the growth of the scheme in its 2022 report, CurrentScheme Implementation and Forecasting for the NDIS (Scheme implementation report), and recommended disability ministers commission independent research into:
the drivers underpinning growth in participant numbers;
the underlying causes of projected increases of the cost of plans;
the impact of National Disability Insurance Agency management approaches; and
the effectiveness of current capacity building supports.
6.12In its response to the committee's recommendations, the government pointed to the NDIS Review, which would later outline a series of proposed reforms designed to 'help secure the future of the scheme and … meet National Cabinet's NDIS Financial Sustainability target over the medium and long term'.
Economic and social benefits of the NDIS
We want a better balance between the NDIS and the rest of the disability ecosystem. We want a better balance between individualisation and complexity. We want a better balance between individualised, market-based delivery and approaches that build social capital. A better balanced system will be a more sustainable system.—NDIS Review, 2023, p. 33. |
6.13As an insurance scheme, the NDIS was designed to provide support to people with severe and permanent disability, while increasing social, economic and community participation, to ultimately benefit all Australians. Inquiry participants have cautioned against relying solely on metrics such as the number of participants or quantum of expenditure to judge the sustainability of the NDIS. For instance, Hireup argued that assessing sustainability means assessing the 'effectiveness' of the scheme, which can only be achieved through measuring outcomes.
6.14In its September 2023 Quarterly Report to disability ministers, the NDIA reported that the scheme 'continued to make a positive difference to participants, their families and carers'. Looking at outcome data for participants who have been in the Scheme for at least two years, the NDIA reported:
Participation in community and social activities has increased by 7percentage points from 35% to 42% for all Scheme participants aged 15years and older.
Participation in work (percentage in a paid job) has increased by 11percentage points from 10% to 22% for participants aged 15 to 24.
The percentage of parents and carers in a paid job has increased by 6percentage points from 46% to 51% for parents/carers of participants aged 0 to 14 years.
6.15As well as supporting increased economic and social participation for participants, their families and carers, the NDIS supports employment and stimulates economic activity nation-wide. According to the NDIS Review, there were around 325000 workers supporting NDIS participants, families and carers in 2021–22, and around '128000 more workers are likely to be needed by June2025 to fully meet demand'.
6.16The committee's Scheme implementation report referenced a 2021 Per Capita report which suggested the economic impact of the scheme is 'likely very large, even compared to other types of government spending':
A conservative estimate of the multiplier effect of the NDIS would be in the range of 2.25; and such a multiplier effect would mean that the economic contribution of the NDIS in 2020–2021 is around $52.4 billion.
6.17The Per Capita report argued the NDIS contributes to lower costs for other government services, an increase in direct employment and economic activity, and a 'secondary increase in economic activity stimulated by the NDIS spending'. While some of these impacts are difficult to quantify, Per Capita reported that, in 2021, the NDIS:
created employment for around 11550 people, including 4396 APS employees, 1692 labour hire contractors and consultants, and 5462 people employed by NDIA's partners;
supported an estimated 270000 workers across 20 occupations working in 11600 providers;
significantly increased participation in paid employment for participants, carers and family members, especially women, having a positive impact on workplace gender equality; and
increased the reliance of carers on wages by around 6 per cent since 2015, decreasing their reliance on other sources of income.
6.18The authors of the NDIS Review also highlighted the broader economic contribution of the NDIS. However, the Review noted 'current data and evaluation frameworks' make it 'very difficult' to evaluate individual and societal benefits flowing from supports provided, or to 'demonstrate what works, for whom, and why':
The current NDIS Outcomes Framework (the Framework) is limited in its coverage and does not include whole of system interactions between the NDIS, mainstream and other service systems. The outcomes it does measure are not directly linked to scheme costs. … The Framework relies on participant satisfaction surveys, draws on insufficient data to measure participant outcomes and scheme effectiveness adequately.
Analysis of the appropriateness of the current Framework found it has few objective measures, limited measurement of outcomes outside the Scheme and difficulty measuring progress when evaluating whether participant goals were met.
6.19The NDIA is aware of this gap and is working to better quantify the link between specific supports and participant outcomes. The NDIA has commenced the Investment Effectiveness Program (IEP), which aims to quantify 'the marginal effect of different types, levels and combinations of support payment for all NDIS participants', and guide development of an 'effectiveness modelling report and dashboard' to guide planning decisions.
An oasis in a desert—the role of state and territory governments
In trying to correct for the underfunded, inconsistent and unfair arrangements that existed prior to the NDIS, governments have come to rely on the NDIS as the dominant, and in some cases only, source of supports for people with disability—the oasis in the desert. This is to the detriment of all people with disability, particularly those outside the scheme, and is contributing to ongoing inequality between participants and those who are not eligible for the NDIS.—NDIS Review, 2023, p. 25. |
6.20Evidence to the committee over the last ten years supports the findings of the NDIS Review that the introduction of the scheme led to a significant reduction in services at the state and territory level. Instead of continuing to make mainstream services more accessible, and further investing in Tier 2 supports available to all Australians, state and territory governments have 'transferred the funding' from state-based programs to the Commonwealth for the NDIS. According to the South Australian Office of the Public Advocate (SA OPA):
… people now equate the NDIS only with Tier 3 i.e. you don't believe you are on the scheme unless you have a package of support. The NDIA effectively is the agency for Tier 3 supports. It is very difficult to keep people from trying to get into Tier 3 when Tier 2 offers so little.
6.21The committee has heard that the NDIS has significant positive economic impacts for both participants and the broader community. However, the extent of these positive impacts is not well understood. The last available research was conducted in 2021, which was commissioned by the peak body, National Disability Services (NDS) rather than the agency or the government.
6.22In the NDS-commissioned report, Per Capita concluded that NDIS funding decisions need to be 'based on sound, transparent and publicly-available analysis, not made behind closed doors based on secret modelling.'
6.23The NDIS Review Final Report 2023 also recognised that the 'data gaps and evidence limitations have most likely led to a significant underestimation of net social and economic benefits.' It made the point that addressing these 'limitations in data collection and quality is crucial to accurately measure the true impact of the scheme'.
6.24The NDIS Review highlighted the importance of comprehensive research to determine the positive economic impacts and flow-on effects of the NDIS. The Review noted that high-quality, open and independent research and evaluation activity, 'alongside knowledge translation of best-practice evidence into policy and provider actions, are critical to optimising outcomes, safeguarding participants, inspiring public trust, and supporting scheme sustainability'. To this end, it made recommendations regarding improved disability data, including in relation to the National Disability Data Asset (NDDA) noting that:
Australian Governments should build on and secure the long-term funding of the NDDA. A more comprehensive evidence-based picture of the disability support landscape would help the scheme demonstrate value for money to governments and taxpayers, and most importantly help participants improve outcomes and meet their goals in the most effective manner through innovative and evidence-based supports.
6.25The Applied Principles and Tables of Support (APTOS), agreed between the Commonwealth and state and territory governments in 2015, is a high-level document outlining areas of responsibility between governments. According to the NDIS Review, the APTOS 'has failed', leading to 'endless arguments about who does what and who pays for it'.
6.26SA OPA argued that the interface between government services is oversimplified in the APTOS, it is inconsistently interpreted, and that it provides no incentive for governments to work together. SA OPA said the Commonwealth government 'should have negotiated a more detailed agreement … with teeth', and recommended the APTOS be reviewed. In response to these and other concerns regarding the APTOS, the NDIS Review recommended it 'be replaced with a multilateral schedule … under [a] new Disability Intergovernmental Agreement.
Mainstream services and Tier 2 supports
6.27Chapter 3 of the committee's Scheme Implementation report discussed interfaces between the NDIS and mainstream and Tier 2 supports. It noted that the Information, Linkages and Capacity Building (ILC) program—established in July 2017 'to provide funding to organisations to deliver community-based projects' accessible to all Australians with disability—may be failing to meet its intended outcomes.
6.28According to Neurological Alliance Australia (NAA), the ILC program represented a 'significant funding boost' for many organisations. However, 'projects were time-limited and 'one-off' and did not provide any longer-term investment in those organisations'. NAA proposed a 'detailed revision of Tier 2 to fulfil its original objectives' and 'expansion of disability organisations' community development and capacity building programs'.
6.29JFA Purple Orange submitted that the focus of governments has been on establishing Tier 3—'personalised supports through individual NDIS plans'—and not enough work has been done to enable 'greater access and utilisation' of community supports and mainstream services under Tier 2.
6.30For the NDIS to be sustainable, mainstream services, such as health care, education, transport, and community groups need to become more accessible and inclusive, and Tier 2 (foundational) supports must be adequate and accessible. The NDIS Review set out a vision for a better integrated system of supports in which Tier2 is better resourced, better targeted and plays a much bigger role:
Figure 6.1Vision for an integrated, graduated model of supports for all people with disability
Source: NDIS Review, 2023, p. 25.
NDIS market
6.31The NDIS is a market-based system. The long-term success of the scheme relies on the availability and viability of disability service providers—a majority of which are small to medium sized enterprises. Evidence received by the committee over a number of years indicates concerns in this area. NationalDisability Services (NDS) submitted:
Financial viability remains a significant concern, driven by inadequate NDIS prices, compliance costs, and challenges in adapting to the new NDIA PACE system. The recent NDIA Annual Price Review failed to address the substantial gap between NDIS prices and the real costs of service delivery, posing immediate viability challenges for many providers.
6.32NDS's State of the Disability Sector Report 2023 outlines serious concerns about the sustainability of the disability services sector. According to the report, disability service providers 'reported their worst financial year yet' (in eight years of surveys). The proportion of providers reporting a loss in 2023 was 34 per cent—a significant increase on the last three surveys, in which between 19 and 23 per cent of providers reported a loss. Afurther 18 per cent 'broke even'. This is despite a continual rise in demand for services.
6.33In a recent submission to the committee's general issues inquiry, NDS argued that the viability of providers is threatened by 'significant gaps between NDIS prices and the real costs of service delivery'—from a 13 per cent gap across early childhood intervention supports (ECIS) to a 23 per cent gap in supported independent living (SIL) core supports.
6.34Another issue identified by NDS is the 'high cost of [insurance] premiums, the difficulty of getting approved for coverage, and the lack of understanding about the NDIS among insurers'. NDS recommended government works to 'help broker solutions to issues that are making it difficult for disability support organisations to access insurance products'.
6.35While many inquiry participants argued the benefits of encouraging service providers under the NDIS to be registered NDIS providers, the AustralianAssociation of Psychologists Inc. noted that its members are already registered with a regulatory body, and 'registering with another body is superfluous and will not amount to less risk to participants'. Removing this requirement for this profession, and other registered professions, would help boost workforce available to work within the scheme.
6.36These problems are compounded in regional areas, where 'thin markets' often make it unprofitable to operate.To address what provider groups call a 'trend towards market failure' in the disability services sector, NDS recommended measures including:
establishment of an independent pricing authority and 'pricing that reflects the real cost of support';
'minimum standards' for supports and 'greater oversight for greater risk'; and
development of a disability workforce strategy that 'pays providers for training, support and supervision'.
6.37National Legal Aid suggested the NDIA needs to 'improve oversight of the NDIS market and strengthen mechanisms to address gaps between the NDIS and mainstream services'.
6.38Issues impacting people with disability and the sector in regional and remote Australia, including the issue of thin markets, remain a major concern for the committee in the 47th Parliament. These matters will be further considered by the committee in its inquiry into the NDIS participant experience in rural, regional and remote Australia, initiated in late 2023.
Workforce issues
6.39Workforce shortages remain a significant concern. In its 2020 NDIS Workforce Interim Report, the committee explained:
Attracting and retaining a suitably skilled, qualified workforce is proving a challenging endeavour, as the sector is increasingly seen as overworked, underpaid, undervalued and poorly trained. … These issues are not new. They have been identified by this committee on several occasions, as well as via numerous other review and inquiry processes and through media commentary.
6.40The Health Services Union (HSU) noted that the NDIS will need an additional 3000 workers in 2025 to support the Scheme, but 'workers are leaving the sector in droves'. The McKell Institute similarly stated that the sector has the 'highest rate of attrition in the Australian economy, with up to one quarter of all NDIS workers leaving the sector, and over half wishing to within five years'. This attrition rate is up to double that of workers across the economy.
6.41Workforce shortages are seriously impacting most providers, with 78 per cent of respondents in the 2023 NDS survey reporting 'extreme to moderate difficulty' in securing support workers, and reporting a dire shortage of allied health professionals.
6.42Some of the key drivers of workforce shortages include: insecure employment, including the lack of portable entitlements across contracts; poor pay and career progression; and the increasing casualisation of disability support work.
6.43Volunteers provide significant support and care to people living with disability but operate outside the NDIS. Volunteering Australia reported that while volunteers 'add significant value' to care and support services, however, 'existing policy frameworks, funding models, and data collection efforts under the NDIS are poorly equipped to facilitate volunteer involvement in the sector'.
6.44The McKell Institute, HSU and Australian Services Union proposed the establishment of a Portable Entitlements Scheme, which would allow registered NDIS workers to accrue entitlements and benefits while working (such as long service leave), even if they are casual workers or independent contractors.
6.45The Centre for Future Work acknowledged that 'significant policy reform' is progressing through the development of the National Care and Support Economy Strategy development, and through the NDIS Review, but was concerned neither of these efforts would address the issue of poor‑quality jobs and informalisation of the NDIS workforce.
6.46However, the committee notes that the Draft National Strategy for the Care and Support Economy, released 28 May 2023, outlines objectives including the creation of 'decent jobs', through increasing professionalisation, better health and safety, and better pay and conditions. The NDIS Review also highlighted the need to improve jobs in the sector, including through:
introducing portable leave and training;
making better use of technology, including telehealth;
investing in innovative training and skill-development programs;
more strategic workforce planning;
targeted use of overseas migration; and
reforming pricing and payment arrangements under the scheme to support workforce capacity.
6.47These matters were also considered by the committee in its NDIS workforce final report, for which it looks forward to the government's response .
Fraud
6.48Fraud against the scheme threatens the sustainability of the NDIS. The NDIA's 2022–23 Annual Report estimated payment errors in 2022–23 (which may or may not indicate deliberate fraud) to have been:
$1174.3 million, or 4.0 per cent of total provider payments, compared to $606.1 million (2.6 per cent) in 2021–22; and
$228.2 million, or 5.4 per cent of total self-managed participant payments, compared to $244.9 million (7.0 per cent) in 2021–22.
6.49In media reporting participants described this wastage as 'heartbreaking' and decried the impact of fraud and error on the availability for funding for people with disability to access the supports they need. The NDIA was reported to have 'singled out' providers of supported independent living, who received 32percent—or $8.7 billion—of all NDIS funding in 2022.
6.50To address fraud in the NDIS, the government created the Fraud Fusion Taskforce in 2022. In its first year of operation the taskforce: received over 17000 'tip offs'; investigated over $356.5 million in suspect NDIS payments; launched 18 prosecutions with an alleged fraud value of $18.3 million; and led to 92compliance actions by the NDIS Quality and Safeguards Commission against providers and individuals, including the issuing of 43 banning orders.
6.51A further $48.3 million was invested in 2023 'to fight against fraud in the NDIS'. This will fund additional NDIA staff and the development of a business case for information and communications technology (ICT) systems to 'detect, prevent and reduce non-compliant payments'.
6.52The committee addressed the issue of fraud in its 2023 report on the capability and culture of the NDIA. The committee recommended the NDIA 'focus its compliance activities on the activities of service providers and subcontractors, to prevent systematic fraud and to ensure that people with disability do not experience further discrimination in the wider society'.
6.53NAA similarly commented that future fraud prevention measures will need to be carefully co-designed with participants and providers 'to ensure proposed improvements can be practically implemented and will not have a negative impact on quality services and participant safety'.
Over reliance on external review
Currently, the only avenue for applicants who are dissatisfied with the outcomes of a review is to appeal to the Administrative Appeals Tribunal (AAT). In our experience the complexity of this process and lengthy wait times deters applicants from undergoing this adversarial process regardless of the merits of their case. For those not deterred, they usually require the assistance of specialist disability advocates and/or lawyers to help them navigate these legal processes. This therefore places additional burdens on other services.—Eastern Access Community Health (EACH), Submission 37, [p. 3]. |
6.54The committee has heard evidence over the course of a number of inquiries which suggests that the NDIA's failure in recent years to effectively and efficiently resolve disputes through its own processes resulted in a surge of applications for review lodged at the AAT. The committee has previously recommended the NDIA improve the transparency and quality of its decision-making processes to avoid disputes ending up in litigation.
6.55There has been an increase in the number of NDIS cases being reviewed by the AAT over recent years, with 2021–22 seeing the number of AAT reviews morethan double compared with the previous year—from 2160 applications in 2020–21 to 5918 in 2021–22.
6.56National Legal Aid observed that the AAT appeals process is generally 'adversarial' and 'technical', can be 'intimidating', and often represents an uneven contest, as applicants are generally self-represented. It acknowledged that government is aware of this issue and is taking steps to address it. However, also suggested that, considering a large proportion of cases resolve in applicants' favour, the NDIA should focus on improving its decision-making to avoid litigation.
6.57NDIS participant, Mr Michael Curtis, noted the high costs connected to NDIA's engagement of external legal firms to represent the agency at the AAT, and suggested that this:
…could be avoided by establishing a cost- effective review panel. The panel, consisting of a GP, a NDIS participant, an experienced NDIS advocate, and a NDIA representative, could review decisions prior to involvement of the AAT. Legal advice for AAT cases, including the likelihood of a positive outcome, could be provided by an in-house NDIA legal department.
6.58One way to avoid AAT appeals would be to ensure all evidence is considered during the application phase. National Legal Aid noted that the NDIA is often 'unwilling to fund reports for people who are unable to pay for reports themselves' in the application phase. It may later require that information during review in the AAT, which 'imposes an increased burden, including an administrative burden, on the resources of other agencies, such as state health services, therapists, disability advocates, the AAT, and legal aid commissions'.
6.59Instead of refusing applications on the basis of insufficient evidence, NationalLegal Aid argued the NDIA should exercise its powers to request information, and should support participants in providing it.
6.60Disability Advocacy NSW was also concerned about the benefits and fairness of relying on the legal appeals process, saying:
Taking NDIS matters to the AAT can result in significant mental distress. The prolonged stress of going through an appeals process, combined with complex and litigious administrative systems deters many people from pursuing their NDIS matters. Put simply, it is a process that privileges those with the most cognitive and material resources given what is needed to engage in the appeals process. It disadvantages the most vulnerable in the disability community that are not equipped with knowledge, skills, finances, time, and energy to navigate what is increasingly becoming an overly legalistic process at the AAT.
6.61To reduce the need for legal appeals, Disability Advocacy NSW recommended:
better guidelines for practitioners and clinicians providing evidence;
greater transparency in the NDIA around 'how and why some evidence is deemed unsatisfactory, and other evidence is acceptable'; and
a willingness from the NDIA to fund requested evidence and be clear about what it needs to progress an application;
more consistent and transparent guidelines, developed through co-design;
the NDIA 'instate an independent panel of in-house clinicians/practitioners who have relevant experience and can provide oversight and independent advice to planners for complex matters' and
DSS invest in ILC programs that enhance the capacity of practitioners and participants to 'navigate the NDIS'.
6.62Exercise & Sports Science Australia argued for greater transparency around appeals, saying publishing 'de-identified summaries of themes arising' from cases would 'promote consistency in decision-making processes'.
This suggestion echoes a recommendation made by the committee in its NDIS Planning Final Report (tabled December 2020), which was 'noted' by the NDIA.
6.63Following the committee's report, the government implemented 'alternative dispute resolution processes', reducing the number of appeals in the AAT by around 27 per cent. The NDIA implemented an 'early resolution approach' to reduce the number of cases getting to the AAT in the first place, and established a trial for an Independent External Review (IER) process, where 'a disability expert independent of the NDIA reviews individual cases and gives a recommendation to the Agency'.
6.64The IER trial concluded in June 2023. The NDIA stated that it achieved its goal of 'resolving most of the legacy cases', and providing valuable 'learnings' to improve NDIA dispute resolution processes. However, the program's formal evaluation report notes that it 'had limited impact in helping clear the backlog of AAT cases, processing considerably fewer matters than first estimated'.
6.65The report suggested the IER model may not be 'scalable', and may be better implemented as a 'voluntary' step in the review process for appropriate cases. Other dispute resolution mechanisms, such as 'accelerated caseload and early assessment reviews' were proving successful, demonstrating the 'importance of giving participants the chance to discuss their matter in a non-legal environment'.
Role of the committee
6.66As the only ongoing oversight body for the NDIS, this committee is uniquely placed to monitor the evolution and performance of the scheme. As discussed in Chapter 4, the committee has scrutinised the NDIA, NDIS policies and guidelines, and the implementation of the scheme from the early trial phase through to scheme maturity, and will continue to do so.
6.67Many of the issues articulated in the NDIS Review echoed concerns raised by the committee in its earlier reports. Government responses have increasingly referred to the NDIS Review, saying the review would 'consider all available evidence and look at benefits as well as ways to address challenges'.
6.68Now that the NDIS Review is completed, it is clear that substantial reforms need to be progressed, both within and outside of the NDIS.
6.69The committee will have a key role to play going forward in examining proposed changes to the scheme, broader investments in foundational, mainstream and Tier 2 support structures, and agreements between the Commonwealth and states and territories.
6.70NDIS market and workforce issues will continue to be explored, including through the committee's current inquiry into rural and regional issues. The committee will also continue to explore options for preventing fraud against the scheme, and for improving the NDIA's internal dispute resolution process.
6.71Having collected a wealth of evidence, and established connections with stakeholders across the disability sector, the committee performs a vital independent oversight role and will continue to make recommendations to improve the scheme as the government embarks on this period of reform.