Shortcuts / 12 December 2023

Your guide to the NDIS

Let’s wind it way back: why was the NDIS created in the first place?
To understand why the NDIS was created we need to look at what existed before, which was a patchwork of support systems administered by states and territories. The old system meant that, for the 4.3 million Aussies living with a disability, it was a bit of a lottery of what support you might get.

So… not the best system?
At one point the old system was labelled “underfunded, unfair, fragmented, and inefficient”. Cue years of discussions about the problems, the need for reform, and proposals for new models of disability support. And like many things in our federal politics, 2007 was a pivotal year… in his election campaign, Labor’s Kevin Rudd promised to look into how to fund, finance, and deliver disability services in the future.

And Rudd won that 2007 election, right?
He sure did. Work began on figuring out a new disability support system, and pretty quickly, the idea of a disability insurance scheme became the focus. Shifting to an insurance model was a big change for how disability support worked in this country…

What was different about it?
To paraphrase one of the architects of the new scheme, Professor Bruce Bonyhady, the difference was that the previous system was based on welfare and responding to immediate needs, while an insurance-based system plans for the long-term. Shifting to an insurance framework meant that the government had an incentive to help people early, including with early interventions to help kids who might otherwise need greater support later in life. 

What else were people saying about this insurance-based proposal?
In 2011, there was a report from the Productivity Commission which found that this approach would actually boost Australia’s economy. The government would, of course, have to spend money in the short-term, but in the long-term that support would save money and grow the economy because people with a disability would have more options to participate in work and the community more broadly. 

Sounds promising… any other differences?
Yeah, another biggie was that the shift to an insurance model would mean that people with disabilities would be directly consulted on their needs and goals, and that money would flow directly to them… rather than being given to disability support organisations, as in the previous state-based system. 

Okay, so what happens to all this thinking and planning?
The new plan is named the National Disability Insurance Scheme, or NDIS, and is written into legislation. Julia Gillard was the Prime Minister at the time, and she gets emotional when passing the legislation, saying that Aussies with a disability would now have “the security and dignity that every Australian deserves”. 

When does the scheme actually start?
Trial locations of the NDIS begin on 1 July 2013, and those trials work towards a national rollout on 1 July 2016. But some problems soon emerged…

Uh oh. What goes wrong?
Far and away the biggest issue that’s had a lot of attention in the past couple of years is the cost. To wind it back a step, the initial idea was that the cost would be split 50-50 between the federal government and the states/territories, and if any extra money was needed, it would be stumped up by the federal government… but it turns out that a lot of extra money has been needed.

How much extra money?
Let’s get into some numbers… In 2011 the cost of the NDIS was estimated at $13.6 billion a year… but the cost for this year actually turned out to be closer to $42 billion, according to the Australian Financial Review (paywall). 

Why the difference in the estimated and actual cost?
It’s because there are many more people accessing the NDIS than was originally projected…

How many more?
The number of participants in the NDIS was originally projected to be 411,000… But there are currently more than 600,000 participants. So the big political question that comes up around the NDIS is now; how do you make the scheme “sustainable” into the future… 

Right, and… how do you?
This brings us to the review that was handed down this week. It was led by the original architects of the NDIS, including Professor Bruce Bonyhady, who we mentioned before… and that review made 26 recommendations

What are some of the main ones?
The main recommendations were changes in how the NDIS is accessed. For example, rather than Aussies getting NDIS access based on a medical diagnosis, instead people with a disability would be assessed for eligibility based on “functional impairment”…

What does that mean?
The gist is that NDIS access would depend on how much a person’s disability affects their ability to participate in daily activities.

Does that mean that fewer people would be participating in the NDIS?
Well, yeah, but the review also has a plan to make sure that people who need support aren’t missing out. The review recommends additional services be set up around the NDIS, called “foundational supports”… these would be support services for people with less severe disabilities, like mild autism and developmental delays. 

What do they mean by “foundational supports”?
Let’s take the example of a child with developmental delays. The idea is these children go back to being the responsibility of the states and territories – they will access the help they need through schools and other services.

What’s the thinking behind this shift back to states and territories providing support?
The authors of the review say that their view is “that you can’t fix the NDIS without fixing everything around it”. We should also say that the review also recommends that all of these changes be phased in slowly, over 5 years, so nobody is losing access to the NDIS without these other supports in place.

How have people responded to this review and its recommendations?
One response was from Nicole Lee, the president of People with Disability Australia. She said, “I’m hoping that those foundational supports will actually be able to help people when they actually need it”. Labor’s Bill Shorten is the minister in charge of the NDIS, and he welcomed the review. He said he’s committed to making the NDIS work. And from the Coalition, the shadow minister for the NDIS is Michael Sukkar, and he said that he wants to know exactly how the changes would keep the costs of the NDIS from ballooning out further…

What happens from here?
Bill Shorten said that the government’s full response to the review would come next year.

Squiz recommends:

Read: the work of Nas Campanella, the ABC’s disability affairs reporter.

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