The of the current National Disability Insurance Scheme聽(NDIS) begins in 2007聽when the聽 sought to address the chronic funding shortfalls and ongoing service failures suffered by disabled Australians, their families and carers.
Australia signed the聽聽that year听补苍诲 Labor committed to a National Disability Strategy during its 2007 campaign.
After decades of representations by advocates and the disability community, the聽futuristic 聽recommended in 2008 that a national disability scheme be set up. It was to be based on insurance principles to ensure future funding of the 鈥渇ully funded, needs based鈥 scheme.
Everybody wanted it, especially the long-suffering聽聽disability community who had been ignored for so long, their neglect laid out in shocking detail at the .
found the benefits of the NDIS would outweigh the costs of servicing the nearly half a million it was designed to help.听However, it noted the structural needs of the NDIS itself would outweigh the available workforce, skills and market infrastructure for some time.
By the time the by the Julia Gillard Labor government in 2013聽it had been through so many inquiries, commissions and committees and generated countless submissions, reports, agreements and funding models, it should at least have had a smooth implementation.
But, if the roll-out proved the one thing the disability community has been saying for decades, it is that, while the NDIS and its funding was welcome and desperately needed, managing disability in a profit-driven framework would take a whole lot more than money.
NDIS budget
The NDIS鈥 multi-billion dollar budget has been criticised as inadequate, both in terms of state and Commonwealth services听补苍诲 the funding allocated to individual participants.听
The NDIS is currently the third largest program, as measured by total general government sector expenses, with an of $41.9 billion in 2023鈥24.听
Projections from the聽聽suggest that the scheme could cost as much as $89.4 billion by 2031鈥32 (not including operating costs) 鈥 an estimated 2.55% of gross domestic product.听聽financially to the NDIS based on bilateral agreements with the Commonwealth.
So why then does it keep coming up short on delivery?
Underestimated need
Despite this, the level of need and the complexity of providing disability services was still significantly underestimated.听
In addition, the inconsistencies in (NDIA) assessments听补苍诲 the application of evidentiary requirements led to disabled people being rejected.
Had the NDIA board, management and employees been primarily disabled people (similar to ATSI-related jobs prioritising Indigenous applicants) this could have been avoided.
However, after a lifetime of hearing that disabled people 鈥渃an do anything鈥 and it鈥檚 鈥渁ll about motivation鈥, they were suddenly under qualified for the high paid, perk-heavy NDIA jobs managing the NDIS鈥 pot of gold.
This has been partially addressed by Labor disability minister Bill Shorten appointing , but the structural damage is largely irreversible.
Like the previous Disability Support Pension, it too often came down to whether an able bodied, under qualified intake officer thought they were disabled enough to deserve it.
Need was particularly underestimated among young children, the diagnostic required confusing to everyone,聽a situation the interim report suggests NDIA is still struggling to address.
Profit before functionality
NDIS has repeatedly failed on its mandate of 鈥渃ontrol and choice鈥 service delivery, because it is based on combative market competition between providers.
This pushed out traditionally under-funded local community services, replaced by increasingly greedy corporatised providers.
Instead of 鈥渢he market鈥 providing better quality care, privatisation and the NDIS price structure virtually guaranteed the bulk of a participant鈥檚 funding would go to a corporatised provider, not towards the promised 鈥減eace of mind鈥, 鈥渃hoice and control鈥 or even hours of direct care and support.听
This remains particularly true for people who are unable to self-manage their NDIS packages.听With even many have nowhere else to go.
Some high-need NDIS users found themselves at the Administrative Appeals Tribunal seeking more funding after inadequate NDIA allocations increasingly locked in a 鈥渞ace to the bottom鈥 forever cheaper care hire.
Others had the opposite problem.听One participant told聽91自拍论坛聽they had sufficient funding but were unable to use most of it.听鈥淲e鈥檙e in a regional area鈥 she told us. 鈥淢any of the services and workers we are funded for simply don鈥檛 exist here,鈥 stating 鈥渢oo many are only in it for the money鈥.
Inclusion?
A key element of the NDIS is to fund programs that support inclusion.
Despite living with a disability,聽governments remain adept at ignoring disabled people because there is no real consequences for doing so.
They have long ignored disabled public transport users听补苍诲 Disability Support Pensioners remains a popular sport.
Selfish, in disabled spaces, and transportation听补苍诲 .
Unfair and 聽remain rife with few prosecutions.
If access discrimination attracted a $22,000 fine and 2 year鈥檚 jail, like climate protesting does, the blatant access discrimination against disabled people might finally be addressed.
Full circle
By the time the then Coalition government had finished with it, the NDIS was on the brink, with Labor promising the current review during the last election campaign.
Minister for Disability and Government Services , one of the NDIS鈥檚 original architects, released the NDIS Review interim report on June 30.
identified the following five key issues that need to be addressed.
1. 鈥榃hy is the NDIS an oasis in a desert?鈥
After underfunding community-based services and privatising disability care under a market driven model, the government is now asking disabled people to 鈥済ive feedback鈥 on why it鈥檚 still not working.听
The report notes: 鈥淐ommunity supports for all people with disability 鈥 have not been delivered 鈥 having significant impact on the cost of the scheme.鈥澛
2.听聽鈥榃hat does 鈥榬easonable and necessary鈥 mean?鈥
Staggeringly, there is still not an agreed NDIS-wide, definition of what constitutes 鈥渞easonable and necessary support鈥.听聽
The report notes: 鈥淭his unresolved issue is the cause of many of the scheme鈥檚 challenge鈥 including poor planning, inequitable funding decisions and disputes with the NDIA.
3.听聽鈥榃hy are there many more children in the NDIS than expected?鈥
The report notes this under estimation reflects overall 鈥渉igher than previously identified rates of disability amongst young children鈥 and identifies the 鈥渓ack of supports outside the NDIS鈥 and a 鈥渇ocus on diagnosis rather than support needs鈥 is undermining sustainability.
4.听聽鈥榃hy aren鈥檛 NDIS markets working?鈥
It says 鈥渘ot only do we not know whether participants are getting good outcomes such as employment and a good life; but we also don鈥檛 know the relative quality of the supports they receive鈥.听
It concedes the market approach has not produced improved outcomes, particularly in remote areas.
5.听聽鈥楬ow do we ensure that the NDIS is sustainable?鈥
The final key issue listed begins with this: 鈥淭he NDIS is an uncapped, needs-based scheme鈥 immediately followed by, 鈥淗owever, the NDIS must also be sustainable and its costs predictable for governments and the public鈥. Then, finally, it must 鈥減rovide certainty鈥 for participants and their families, balancing benefits and costs, and balance the core ideals of choice and control against sustainability.
The interim report is calling for final submissions on its five identified key issues, as it tries to get the NDIS back on track.
It remains to be seen if the primary focus really will be the sustainability of disabled people鈥檚 everyday lives, or the sustainability of the government鈥檚 precious budget.
[Suzanne James has a background in writing policy, governance, risk management and regulatory compliance frameworks and in legislative compliance application.]