Bill Shorten’s NDIS reforms aim to make it sustainable

NDIS Minister Bill Shorten has extricated himself, for now, from a tight spot between a policy rock and a very hard political place as he struggles to bring the National Disability Insurance Scheme under some semblance of financial control. He has worked for months with premiers and the federal opposition to secure support for NDIS savings. And with the states now on board, legislation is imminent. Much of what Mr Shorten was celebrating on Wednesday was reaching agreement on terms with state and territory governments. What matters most about his legislation is whether it is sufficient to make the NDIS efficient, effective and affordable.

Mr Shorten says it will help create such a structure for meeting needs through new assessment and budget tools. He is clear that the NDIS needs to change to be sustainable. As he said: “This will always be a work in progress but … we are committed to making sure the scheme is here for the future.” That was a point service providers needed to hear given Mr Shorten’s objective is not to cut total costs but to reduce the rate of annual growth from 15 per cent to 8 per cent.

The scheme costs $40bn a year now and last December’s NDIS review warned it could explode to $92bn in a decade. Should the present trajectory continue, the question inevitably will arise: What other public services would need to be cut to fund NDIS growth? As Mr Shorten has acknowledged previously, the scheme must be better managed to contain profligacy, poor management and flat-out fraud. He grasps the fact that the NDIS needs community support to continue.

Mr Shorten’s plan to control cost growth includes replacing some NDIS services, notably personal support packages, with state and territory-delivered targeted assistance. While there would be more federal funding to assist with this, his package will take pressure off the NDIS budget, which increasingly is consumed by assistance for children diagnosed with autism and development delay. That group now accounts for 20 per cent of the scheme’s total costs. In return, Mr Shorten has responded to premiers’ complaints that he wanted to move away from the original co-governance model. But demonstrating that governments recognise changes must be made, instead of unanimous support for significant variations to NDIS rules there will now be majority agreement.

While the political deal looks done, Mr Shorten still faces opposition to both the details and the spirit of what he intends. As Sarah Ison has reported, the peak NDIS consultation collective, the Disability Representative Organisations, rejects proposed changes and calls for more support to provide services as they are. The group argues that what Mr Shorten wants is “completely out of step with the spirit and intent” of the scheme.

But demands on the NDIS have grown as community expectations have changed. Accordingly, it must adapt its resources most effectively. The days when people with a disability were ignored or, way worse, shamed are gone and that is good. Difference is now celebrated – there is an ABC television series featuring young aspiring journalists who are autistic. However, the NDIS is not always the most cost-effective way to help them. As Mr Shorten told ABC radio in November, it is important to ask whether all young people with autism need the scheme. “We just want to move away from diagnosis writing you into the scheme because what happens is everyone gets the diagnosis then.” It is the sort of question that must be asked to ensure Australia can continue to afford the scheme. Reaching an agreement with the states is a useful step, but the main challenge is still to come. That is, making hard decisions to achieve the necessary savings by reforming the NDIS, what it offers and to whom.