NDIS review must set out reform

Even before Bruce Bonyhady and Lisa Paul hand their independent review of the National Disability Insurance Scheme to the Albanese government, some with a direct interest in the scheme have launched a backlash in anticipation of the report recommending cost-cutting. It needs to do so if the NDIS is to be sustainable for those who need it most, for whom it was designed to help – the severely disabled. The scheme currently has 610,000 participants, with the average annual plan payment more than $60,000. More than half of those supported by the scheme, 313,000 participants, are under 18 years of age. Of those, 75 per cent have a primary disability of autism or developmental delay. Without reform, the 2022-23 cost of $35bn a year has been projected to rise to $90bn in a decade.

As the states have largely withdrawn services for autism sufferers and their families, the issue of eligibility for the NDIS can no longer be avoided. But some disability advocates and occupational therapists are already putting the frighteners on, claiming a “quick and dirty” review will not address the scheme’s problems in time to meet national cabinet’s cost control targets, social affairs editor Stephen Lunn reports. Reasonable as it is, that 8 per cent cost growth target from 2026 needs to be met. It was agreed on in April after costs were found to be rising at the rate of 14 per cent a year.

People With Disability Australia president Nicole Lee claimed that children with autism were being “thrown under the bus” for the scheme’s financial sustainability problems. She feared they may be targeted for cuts to services. Occupational therapists say changes mooted by the review to how NDIS plans are devised would “reduce choice and control” for scheme participants. In the face of these and other emotive criticisms, the government will need to stand firm. Jim Chalmers has flagged the scheme as a major budgetary concern.

Children with autism and developmental delay are the scheme’s fast-growing cohort. But as the Actuaries Institute warned last week, the scheme has “medicalised” autism and given service providers incentives to ensure children remain dependent on therapeutic support. As Professor Bonyhady, the father of the NDIS and a longtime, passionate advocate for better services for the disabled, pointed out recently, the scheme is not a limitless “magic pudding’’.

The review will only fail if it does not come to grips with how to address soaring costs or the government fails to act on worthwhile reforms the review proposes.