NATIONAL DISABILITY INSURANCE SCHEME — IMPLEMENTATION

Motion

HON PETER COLLIER (North Metropolitan — Leader of the Opposition) [2.06 pm]: I move —

That this house —

(a)  recognises the potential benefits of the National Disability Insurance Scheme for people with a disability throughout Australia; and

(b)  expresses its concern with elements of the implementation of the NDIS, particularly in Western Australia, and the effect that these problems are having on a significant number of people living with a disability.

Comments and speeches from various members

HON ALISON XAMON (North Metropolitan) [2.47 pm]: I rise on behalf of the Greens to indicate my support for this motion. This is a really important issue that this Parliament keeps revisiting. I note the bipartisan commitment to the National Disability Insurance Scheme and to wanting to make sure that we are monitoring what is happening with the rollout. I also recognise that when bringing these sorts of issues back to this chamber—we have discussed this issue multiple times—we could always have a motion that focused simply on one particular area of need. I note the minister has already talked, for example, about the particular issues facing people who have complex needs. I could spend two hours talking about what is happening for prisoners. There are issues with access to the NDIS by Aboriginal Australians, particularly those in remote communities. We know that culturally and linguistically diverse communities have particular issues that we could be talking about. Of course, a whole bunch of issues have arisen for the service providers themselves. That is before we even start talking about the impact on carers and families. We need to remember that while we are unpicking the complexities that have emerged around the rollout of the NDIS, the NDIS remains not only one of the biggest reforms this country has seen, but also one of the hardest-fought-for reforms with the most noble of motivations—that is, equity of access and equity of outcome for people with disability. I am really concerned to make sure that when we are legitimately talking about the issues that are arising, as we are now, we keep our eye on the prize of ensuring that this particular program succeeds at all costs. I think every person in this place wants to ensure that that is the case.

We know that people who acquired a disability as a result of an accident were potentially eligible to receive insurance payouts, which meant that they were better placed to ensure they had the level of services they required to be able to live a decent life, as opposed to people who were either born with a disability, had a progressive medical condition or, for legal reasons, were unable to access a payout. Of course, this was patently unfair and needed to be addressed. However, at the same time, we have to recognise that to date the implementation of the National Disability Insurance Scheme has been challenging. In fact, I would say that in WA we have, arguably, experienced, if not the bumpiest, at least the longest road to get to this point.

Members will recall that I introduced a motion at the beginning of this fortieth Parliament that was debated in October 2017, calling for certainty as Western Australians had been waiting a long time for an outcome. However, we have come a long way since then, even though I am recognising absolutely that we have so much more to do. As at 31 March this year, 13 478 Western Australians have an approved NDIS plan and, as we know, projections are for a total of 39 000 people to be in the scheme within just over 12 months. Although implementation challenges are always to be expected, it seems that the scale of difficulties experienced in the implementation phase have been so fraught that I think there are genuine concerns that the viability of the scheme may be at threat unless the National Disability Insurance Agency responds to what the sector and people with disability and their carers are saying to it. Given this, it is fundamentally important that we ensure that mechanisms are in place that allow people with disability to express their ideas and their solutions for the issues that affect them. On that note, I acknowledge and thank the minister for the investment into individual and systemic advocacy. It is something I have been calling for over the last two years simply because this is what people with disability have been calling for. That has been heard and been acted on, and it is really important. I also suggest that it is something that needs to remain on an ongoing basis. It was very, very welcome.

Although on many fronts the problems with the transition to the NDIS within our state are common to those experienced elsewhere, it is apparent that the lengthy delay in WA joining the scheme has created some additional difficulties for Western Australians. We can see this because, very simply, there are still some parts of WA in which the scheme has not yet been rolled out. As a result, some people who are working in the sector are concerned that WA is less likely to be considered for trial sites for innovative solutions to some of the problems because other states are much further along the rollout process.

Conversely, I hope that, in theory, the delay should be able to bring some benefits because we are in a position to take some of the learnings from mistakes that have occurred in other states. I hope that will at least be the silver lining to that. We know, for example, that in New South Wales there is a six to nine-month waiting list for early childhood and early intervention and prevention services, which, particularly in the context of a young child’s life and child development, is unacceptably long. We should be able to work with our New South Wales counterparts to make sure that we avoid the same sort of thing happening here.

I made this point also when the minister announced funding for systemic disability advocacy in the transition to the NDIS. There is no doubt that the NDIS is representing enormous change and it makes sense that additional funding is directed towards it to highlight the systemic issues that will inevitably arise during the implementation of what is, as has already been said, such a significant reform—the biggest reform since Medicare. However, it does not detract from the need for ongoing funding for systemic advocacy as the core service. Similarly, for the NDIS to be effective, other core services such as the provision of housing, justice and advocacy for people with disability will all need to be in place and operating well on an ongoing basis. This is a huge challenge and a huge investment. In Victoria and New South Wales, the withdrawal of systemic advocacy funding at the end of their NDIS transition period resulted in understandable outrage only for the governments there to step in and provide ongoing funding. It is really important that we maintain that.

I want to comment about people with complex needs. This has already been raised but it is a particular issue. The transition to the NDIS is requiring applicants to complete a number of administrative requirements to meet the eligibility criteria. As such, we are finding that people with complex needs who have very little resources available to them are at the greatest risk of having their level of support disrupted.

I am also the Greens spokesperson for disability as well as for mental health, so I am hearing directly a lot of the concerns that other members have talked about. I have heard some pretty heartbreaking stories about the NDIA’s failings in this space. One in particular comes to mind—namely, that of a father with a severely autistic teenage son with incredibly challenging behaviours. Recently, the son’s supported accommodation arrangement broke down and the father subsequently became suicidal, yet in this time of absolute crisis, the father was unable to access any timely support from the NDIA and a service provider had to step in without any assurance they would receive funding from the NDIA to do so. I commend that service provider for stepping up and doing what was clearly needed, but this way of operating will not be a sustainable way for the agency to operate and cannot be relied on in the future. It is also apparent that one of the key barriers to access to the NDIS in WA is the centralised decision-making model, which has been by employed by the NDIA, and everyone has already spoken about that. Remote decision-making is impacting on not only the timeliness but also the quality of the service. Advocates are finding that when previously they were dealing with local review team issues, they were resolved fairly quickly, whereas now that decisions are being made at the national level, unfortunately, things are moving far more slowly. It is particularly hard for a person who is living and working over east to grasp what is and is not applicable within a Western Australian context, especially while trying to fully appreciate the implications of an individual’s disability. This centralised model of decision-making is having a disproportionate effect on the people who I think need the greatest level of support. I was very pleased to hear in the minister’s remarks that there is hope and there might be an opportunity to talk about changing the level of authority that might be given to the state manager over here. That would certainly help to alleviate some of the problems, because the disconnect between Bendigo and people here on the ground has been a huge issue.

I want to comment about the previous local area coordinator process. It is the case that for a lot of people, the previous LACs were wonderful. They had terrific relationships with people at the local level and had a very familiar understanding of the appropriate service delivery within our local communities and were very easily able to connect them. However, I would be remiss if I did not acknowledge that for some people the previous LAC process was not ideal and it seemed to be heavily reliant on how good the relationship was with their particular local area coordinator, so it was a bit of a mixed bag. Having said that, I think there must be middle ground here so that people who have a good understanding of the local community within which people with disability are living can coordinate these services and assist with plans and eligibility, and at the same time ensure that there are avenues available to enable people with a disability to go to other people if they are not having much joy with the person to whom they have been allocated. I have to recognise that, as always, these issues are amplified for people living in the regions, particularly when options for face-to-face planning in the first place are so much fewer than for those who live in the metropolitan region. For example, currently, if someone who lives in the wheatbelt wants to complete their plan face to face, they have to travel to either Midland or Northam to do so. At the moment, the system is struggling to cope with producing draft plans so that the applicant can be clear about what is and is not included in the plan before it can be signed off. This means that there is a reasonable likelihood that the plans will need to be reviewed through the centralised system.

I want to make some specific comments about the NDIS and psychosocial disability. The NDIS, in theory, presents an opportunity for people who are living with psychosocial disabilities to access support that may not previously have been available. It is fundamental that the particular characteristics of what constitutes a psychosocial disability are well understood and that the system is flexible enough to be able to respond appropriately. We know that psychosocial support needs are very often episodic; sometimes people may require a huge amount of support, and then find that within a couple of months they require very, very little support.

I refer to a report that was commissioned by the University of Sydney and Community Mental Health Australia— of which I used to be vice-chair—and was released last month. It shows that people who are currently being supported under other mental health programs are at risk of being left without any supports at all after these programs are rolled into the NDIS. The three commonwealth-funded programs for people living with serious mental illness are Partners in Recovery; Personal Helpers and Mentors—or PHaMs, as it is referred to; and Support for Day to Day Living in the Community. The intention was that all current recipients of these funding streams would transition to the NDIS before June 2019, at which time these programs were to be terminated.

The authors of the report have, however, found that 50 per cent of the more than 8 000 people currently accessing these programs have not yet transitioned over, which is forcing the commonwealth government to fund these programs for an additional 12 months, until June 2020. The report suggests that without major changes to the processes of application and assessment, there will still be a large cohort of these people who will not be NDIS participants, even by that date. It is not all smooth sailing, even for the 50 per cent of people who had managed to apply to the NDIS. Of that 50 per cent, half were assessed as eligible; a quarter were found to be ineligible; and a quarter were still waiting to hear, or their outcome was unknown. Ultimately, this means that out of all the people accessing the three programs I mentioned, only 25 per cent are supported through the NDIS. Unfortunately, this also means that 75 per cent are not.

The research project also sought staff perspectives on the barriers that people with psychosocial disability face when applying for the NDIS. They included GP’s and specialist’s lack of understanding of the NDIS, the client, or of psychosocial disability; a limited amount or lack of evidence available, due to limited service engagement by clients; clients’ fluctuating mental health and thus fluctuating ability to even manage the application process; and the cost of gaining expert advice. Unless some of the problems identified in this report are resolved, I am afraid there is the very real possibility that many people will lose access to their existing supports.

Although this is a national issue, it is particularly concerning for Western Australians because of the delays in the rollout of the NDIS here. Fewer than 50 per cent of Western Australians receiving Partners in Recovery funding have applied to the NDIS, compared with 84 per cent of clients who have applied nationally. This is a clear example of a known and, I think, well-articulated risk, and one that we must take steps to address or there will, inevitably, be a crisis. Again, I want to remind members that we are talking about large numbers of people who are among the most vulnerable within our community and we must, at all costs, ensure that those currently receiving support do not end up losing it. It will cost us more in the long run if that happens. About 3 500 to 4 000 Western Australians currently receive funding from one of these programs. As things currently stand, the majority of them will not transition successfully to the NDIS and will be left with less than they currently have. This is not the outcome we want.

More broadly, beyond those currently accessing commonwealth funding, we know that people in WA who should be eligible for support are not receiving it. So far, of the people in WA accessing the NDIS, only seven per cent have a psychosocial disability, whereas modelling shows the figure should be sitting at around 14 per cent. I note that in this year’s budget papers, the Mental Health Commission has advised that it is aware that this is a problem and that it is committed to ensuring that people with psychosocial disability who are not eligible for the NDIS continue to have access to the services they require in the future, because it is going to be a problem. I am pleased to see that the government is acknowledging this issue, and I will be paying very close attention to see that this happens and that no-one is left with less support than they had prior to the introduction of the NDIS; clearly, that would be completely counter to the principles of the program.

In my remaining time, I want to make some comments on the issue of carers. Of course, the transition to the NDIS has broader impacts than those on individuals with a disability applying for assistance; it also has implications for existing supports for families and carers. I quote from a statement from a National Disability Insurance Agency spokesperson that was reported in an ABC online news article only a couple of days ago —

The size and scale of the NDIS means that it will not be without challenges, but ultimately it is a significantly better way of providing support for Australians with a disability, their families and carers.

That is what was said by the NDIA, but the problem with this statement is that carers cannot apply for funding through the NDIS because it operates as an insurance model for the person with a disability. The difficulty with that is that a large chunk of existing funding for carers under the National Respite for Carers Program is now being rolled into the NDIS, only to be replaced by a newer carer support program called the Integrated Carer Support Service, which has a much smaller bucket of money. This means that the people who are often the most instrumental in caring for their loved ones will potentially have less capacity to do so because they will no longer have access to the same level of carer support that they had prior to the changes. We need to ensure that we have complementary services for carers that sit outside the NDIS.

There is no question that the NDIS represents an enormous opportunity for people with disability right across Australia, and we are all committed to the principles that underpin it. It is also equally clear that implementing change on this scale is proving enormously difficult and that there is a very real risk that a number of people will fall through the cracks. We need to do everything we can to ensure that this does not happen.

Comments and speeches from various members

Question put and passed.

 

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