Friday 8 December 2023

The government has a long road ahead to reform the NDIS — and there's the opportunity for plenty of pitfalls along the way.

Extract from ABC News 

ABC News Homepage

On some fronts for the Albanese government, it was a dismal final day of parliament for 2023.

The prime minister conceded standards had not been met by his attorney-general when he snapped at a Sky News journalist the previous day. Mark Dreyfus, who has apologised for his behaviour, watched on, chastened.

A fifth former immigration detainee, among the cohort released following last month's High Court ruling, was reportedly arrested, according to News Corp, causing more awkwardness for the immigration minister. The man is alleged to have had an outstanding warrant for his arrest, raising questions as to why he was released into the community at all.

The immigration detention fiasco has now been causing damage to the government for a month. The High Court's ruling was beyond the government's control, but at least some of the damage done has been self-inflicted.

Still, the final week of parliament hasn't been entirely dire for Labor.

In a wounded position politically, the government badly needed some policy victories to finish the year. A highly pragmatic approach was adopted to ensure it secured them.

The government agreed to demands from the Greens to remove offsets from its "nature repair" bill. It agreed to Senate crossbench demands to split its industrial relations reforms and pass what could be agreed on now, including the labour-hire changes which were most fiercely resisted by business groups.

And the big one, the government opened its chequebook to strike a deal with the states and territories to settle a raft of disputes over GST top-ups, hospital funding and the NDIS.

This was about more than "clearing the barnacles" as former prime minister John Howard used to call it. Particularly on the NDIS.

Advocate welcomes social model of disability from NDIS review

A big deal for two reasons

The agreement of the states and territories on the NDIS is a big deal, both in what it will mean for people with a disability and their families and the nation's finances.

The minister responsible, Bill Shorten, is confident the changes will achieve the target of reducing growth in spending on the scheme from 13 per cent to around 8 per cent a year. If he's right, that would mean a saving of nearly $60 billion over the decade, representing perhaps the government's biggest micro-economic reform to date.

The changes are based on a landmark review conducted by NDIS architect Bruce Bonyhady and former Education Department secretary Lisa Paul, in full and open consultation with the disability sector.

It's a blueprint Shorten fully supports and he isn't shy about the scale of what it involves. He calls it "NDIS Mark 2" — a necessary overhaul that will ensure the scheme doesn't entirely collapse under the weight of new entrants.

The states and territories have agreed to cover a greater share of the growth costs of the NDIS (8 per cent up from 4 per cent). This gives them far more skin in the game, and a much greater incentive to keep those costs down. This, along with the agreement between the Commonwealth and the states to fund a new system of "foundational supports" on a 50-50 basis outside the NDIS, are the game-changers.

YouTube NDIS Minister Bill Shorten's full address to the National Press Club.

A 'work in progress'

Precisely how these new "foundational supports" will work for those deemed ineligible for the NDIS isn't yet clear. Shorten is honest enough to admit this is a "work in progress".

For now, there's only a "vision" of what this new approach may look like. One idea is to screen all children at a young age (perhaps six months) for developmental delays. At the National Press Club, the minister likened this to universal immunisation or early hearing tests. This sort of universal early intervention would alone represent a huge transformation.

The foundational supports would involve a "lead practitioner" — ideally a speech pathologist, occupational therapist or similar — who can help coordinate wrap-around help at home, in childcare centres, or at school. Those with higher needs would end up on the NDIS, but only after a far more thorough assessment than currently exists of their needs, rather than a decision simply based on their diagnosis. "Navigators" would help both those on the NDIS and those on foundational supports find services and negotiate the complexity of the system.

The vision is a noble one, if somewhat blurry at this stage.

How precisely the new system of foundational support will work, how many people it will incorporate, how many will be moved off the NDIS, what the system will cost, and how future state governments will be convinced to stick with the deal, is unclear.

And while this might leave some people with a disability and their families nervously awaiting detail, it's unrealistic to expect a fully baked, highly detailed overhaul of this scale can be done quickly or without a long process of open consultation done in cooperation with the sector.

We're told that process will take five years to fully complete. It's a long journey ahead that may yet be derailed.

But despite its political difficulties at the end of 2023, the government has at least made a necessary start on fixing the NDIS — one of the toughest domestic policy challenges Australia confronts.

David Speers is National Political Lead and host of Insiders, which airs on ABC TV at 9am on Sunday or on iview.

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