Reforming disability services
Over a thousand people attended the National Disability and Carer Congress in Melbourne last week. The huge attendance demonstrated how much interest there is in reforming the disability care and support system.
The Federal Government asked the Productivity Commission last year to look at the disability care and support system in Australia. The government asked the commission to make recommendations about what disability services should look like in the future. The Productivity Commission went around the country asking people about their views and experiences. It then released a draft report on February 28 this year. The report detailed many of the problems with the current system. It recommended that the government establish a National Disability Insurance Scheme (NDIS). It also recommended a National Injury Insurance Scheme (NIIS).
DiVine attended last week's congress. We spoke to many people with a disability, community leaders and advocates. Today we present some of their feedback about the Productivity Commission's draft report.
The Productivity Commission's draft report has been welcomed by many people with a disability. There is strong support for change. The recommendations most strongly supported are:
- A doubling of funding. The Productivity Commission calculated that an additional $6.3 billion was needed to provide people with the support they need. This is roughly equal to the current funding. The total cost of the NDIS would be around $12.6 billion every year. The commission says this could be funded through spending cuts and tax increases. Not everybody is convinced this will be enough money. But most agree that doubling funding will make a big difference to people with a disability who need support and equipment.
- Self-directed funding and individualised support packages. Central to the proposal for an NDIS is the allocation of individualised funding or support packages. This means the person with a disability can choose how they want to spend their money. They can purchase services and equipment with the funding they receive. People will also be able to directly employ support workers. The commission says there will be flexibility and choice so that people can use their support package to best suit their needs. People will have the option to receive their support package as a direct payment into their bank account. They could also have an organisation assist them to purchase services on their behalf. This level of flexibility and control has been widely recognised as a very important step. People with a disability should be able to receive better services designed to meet their unique needs.
Aspects of concern
Some aspects of the Productivity Commission's draft report have been indentified as needing more work. Concerns include:
- Two schemes have been proposed. Some people are concerned that two schemes will result in inequity. It might also be inefficient. The Productivity Commission says there are already some good injury insurance schemes around the country that work well. It wants the injury scheme to be separate from the NDIS for the first five years.
- Psychiatric disability and chronic illness might not be covered under the NDIS. Mental health and chronic illness advocacy groups say it is unfair not to include psychiatric disability and chronic illness. The Productivity Commission says the health sector should be responsible for services for people with psychiatric disabilities and chronic illnesses. But it says the NDIS could play a role for those needing daily support.
- Use of labels rather than individual assessments. People with an intellectual disability would be automatically eligible for the NDIS. But people with other disabilities will need to prove they need support. This concerns some people because it focuses on diagnosis or labels rather than an individual's support needs. The commission says they made this decision to reduce the amount of assessments people need to undertake.
- People with a disability will be assessed by the National Disability Insurance Agency. Some people believe it is a conflict of interest to be both the funder of supports and to make decisions about who will get these supports and how much support they will receive. Some people think it should be people with a disability doing the assessments.
- People with a disability will not be strongly represented on the board of governance. The board will mainly consist of experts in insurance and finance. Views of people with a disability will come through an advisory group who will not have control over the decisions of the NDIS. The Productivity Commission says this arrangement is necessary because the main priority of the board will be to make sure that the NDIS operates efficiently and spends taxpayer funds wisely.
- The NDIS will not have an external complaint mechanism. The commission says complaints will be handled by an internal department within the National Disability Insurance Agency. In Victoria, people can complain about disability services to an independent Disability Services Commissioner. An internal complaints system is seen as a step backwards by some people.
The Productivity Commission is now considering feedback it received following the draft report. It will present its final report to the Federal Government in July. The government needs to respond by the end of the year.