Shoring up NDIS for long term

The long-awaited review of the National Disability Insurance Scheme reminds us that it is a world first, “one of the pillars on which the decency and fairness of Australian society stands”. And now, after a decade, the review calls for ways to widen service delivery for the 2.5 million Australians with a disability aged under 65 by making their support a truly national responsibility.

The Australian has long supported the intent of the NDIS. However, after 10 years the scheme must change to ensure its sustainability and to address operational failings and protect clients and carers from a bewildering bureaucracy.

As the scheme’s minister, Bill Shorten, puts it, “confusion is a fairness issue”. But so, for taxpayers, is responsible funding.

In his anxiety to get an agreement with the states on reform, Anthony Albanese has already given away much of the savings that could flow from focusing spending on greatest need.

This makes it imperative to reduce costs – notably by tackling outlays on young people medically diagnosed into the NDIS with autism and developmental delay who may not need it. They account for three-quarters of NDIS clients under 18 and make up 20 per cent of the scheme’s total costs.

In November, Mr Shorten told ABC Radio in Adelaide that “one thing which we have to have a conversation about is rather than just saying ‘I have got autism too, therefore I am on the scheme’ is ‘How does my autism affect my learning?’ … We just want to move away from diagnosis writing you into the scheme because what happens is everyone gets the diagnosis then”.

The intent of the review, to expand services outside the NDIS, gives Mr Shorten the opportunity to stop talking and start acting.

The NDIS certainly needs updating so that it makes the most effective use of all available state and commonwealth resources. It cannot continue to be the funding agency of first and last resort simply because it offers uncapped resources.

These are all complex and controversial tasks but they are essential if the NDIS is to deliver on its mission to be a truly national service that the community continues to be proud of. And that means facing funding challenges – the review warns that on present projections the NDIS will cost $92bn in 2032-33, up from $35bn now. Dealing with this is as inevitable as it is essential. As the review warns, spending that appears exponentially out of control will cost the scheme credibility with taxpayers that “a human right which cannot be sustained is a human right denied”.

Inevitably, reforming the NDIS involves the eternally unedifying sight of the Prime Minister and premiers haggling over money – which Mr Albanese and the premiers did prior to the review’s release.

Mr Albanese delivered the states GST top-ups and increased health funding this week in exchange for their agreeing to an 8 per cent increase in annual contributions to the NDIS.

Mr Shorten says “this responsibility we share is bigger than the eternal tug of war of commonwealth-state relations”, but the political reality is that a new NDIS system cannot be created without the states and territories, and their support comes at a cost to the national budget’s bottom line.

The question to come will be whether it is a hit worth taking. As the review puts it, “all governments are accountable for the sustainability of the disability ecosystem”, which means a big role for foundation supports outside the NDIS and making mainstream services more accessible and inclusive. That “this is the most important way to improve scheme sustainability and reduce pressure for NDIS support” is a core message.

Inevitably, and appropriately, there is a focus in the review’s 26 recommendations and 139 proposed actions on putting people with disability at the centre of the scheme. It is less alarming than appalling that the review warns of “significant data gaps that limit the ability to measure what matters for people with a disability across the entire disability support ecosystem”.

That after a decade, a $40bn scheme, meant to support disabled Australians does not know what matters to the people it exists to serve demonstrates it has strayed from its original purpose, funding “eligible people with disability to gain more time with family and friends, greater independence, access to new skills, jobs, or volunteering in their community, and an improved quality of life”.

It’s the first thing Mr Shorten must have fixed – and fast.