Labor’s chief NDIS campaigner John Della Bosca reflects on what went wrong
John Della Bosca led the NDIS campaign but now admits backing a deal ‘quite biased against the commonwealth’ that led to a $46bn program becoming seen as a ‘cure all’ for every disability.
The Labor powerbroker who led the campaign for the National Disability Insurance Scheme says he has to take “some of the blame” for the $46bn program becoming seen as a “cure all” for every disability, while raising the spectre of Medicare being used to cover programs for autistic children no longer on the NDIS.
In his first comments on the Albanese government’s NDIS reform agenda, John Della Bosca, former campaign director of Every Australian Counts, said Labor had given itself a “tough timeframe” to divert children on to a new system of supports outside the NDIS from 2027.
“One of the big problems that (NDIS ministers) Mark Butler and Jenny McAllister face … is making sure the states have got some operational capacity to support all this cohort that are basically going to lose their NDIS support,” said the former NSW health minister.
“Because I think if you can’t do that, that’s a real problem.”
As premiers declared they would not sign any “blank cheques” after Mr Butler unveiled a $2bn commonwealth investment to set up services for autistic children outside the NDIS, Mr Della Bosca said the government needed to consider making early-intervention services for developmentally delayed kids totally covered by the national Medicare scheme.
“Back when I was a health minister in NSW, one of the things we did was … introduce universal hearing tests for infants, for babies when they were first born,” he said. “This was a big thing, it wasn’t that complicated, and when hearing (issues) were picked up very early, they could be treated or dealt with. I would say the same argument, although it’s obviously a more complicated condition, applies to the various kinds of developmental delay.
“The earlier you find out that a child has mild autism or various kinds of things, the more likely you’ll be able to give them very early intervention, and they’ll get better outcomes. So there’s an opportunity … to do a universal kind of examination and work out who needs extra support.”
The Albanese government has already committed more than $8bn to reforming Medicare and making nine out of 10 GP visits free by the end of the decade through a new incentive payment scheme for doctors and their practices. While providing $2bn to start the work on developing the Thriving Kids program aimed at helping children with mild to moderate autism, the Albanese government has not yet made clear how that money will be utilised.
Mr Butler said in a National Press Club address that “existing networks” should be used and expanded, such as supported playgroups, childcare and maternal health systems. Who would fund these expanded services beyond the forward estimates remains a concern for states, which have criticised Mr Butler for not consulting them about his Thriving Kids announcement or giving them detail on the future reforms.
Concern around the financial burden that would be shifted to states was also exacerbated by Mr Butler revealing eligibility for the NDIS would change from mid-2027, after which children with mild to moderate autism would no longer be able to access to the scheme. Instead, they would be covered through the Thriving Kids initiative.
Mr Della Bosca said support for autistic children should be focused in the education sector. “I think that is a truism, that they would be able to be better supported and assisted and developed through the states, but predominantly through the education system,” he said.
Mr Della Bosca said excitement around the scheme’s creation in 2013 was so high that the Gillard government signed on to a deal “quite biased against the commonwealth” and which revoked states’ responsibility in disability service provision.
“Some of the states got really cheeky. Not only did they shut down the specialist disability support, they shut down the ancillary disability supporting in schools and things like that, which meant, you know, that literally, people had nowhere to go except the NDIS,” he said. “States sort of got away with getting rid of a politically controversial and a fiscally risky area of policy.”
The explosion in the scheme’s growth over recent years was in large part due to the huge number of autistic children joining the program, which Mr Della Bosca said no one had expected back in 2013. “Maybe I have to take some of the blame for this, or most of blame for it: the NDIS became a bit of an icon or a sort a ‘cure all’ for every disability problem, and that was the way people saw it,” he said.
“The original intent of the scheme was to look after the chronically and severely disabled Australians, maybe 350,000 of them at the peak of the scheme. And obviously we know it’s got to a lot more than that.”
As of June, there were 739,414 people receiving support from the NDIS.
Mr Della Bosca said the NDIS was also clearly not designed for Australians with psychosocial disabilities or complex mental issues that were episodic in nature.
“Obviously, they need access to some sort of psychiatric support or some as something in the kind of health, the health field,” he said. “But whether or not they need other (NDIS-funded) services like permanent accommodation or supported independent living, that’s the question.”
The Australian reported this month that the government was intending to address other cohorts on the NDIS after bedding down its reforms for children with developmental delay. Mr Butler in his NPC address invoked the recommendations of the NDIS Review, which called for “major changes” to support people with psychosocial disability, focusing on personal recovery, early-intervention pathways, improved co-ordination with the broader mental health system and enhanced “foundational supports”.
Commonwealth and state governments agreed at national cabinet in 2023 to co-fund foundational supports, with the Albanese government to invest $5bn while the states would jointly fund another $5bn.
The $2bn commuted to Thriving Kids is part of the commonwealth’s $5bn commitment, leaving $3bn to expand services for autistic children further or else begin work on diverting others, such as those with psychosocial disabilities off the NDIS.
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