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The Politics of Disability

Dr George Taleporos watching Minister Bill Shorten on a computer screen

On Friday, takes a look back at the political week that was. The big event this week was, of course, NDIS Minister Bill Shorten's speech at the National Press Club. This was a huge event, but an announcement without any specifics or details. So how did the sector react?

One interesting early take came immediately after the speech from disability advocate and NDIS Advisory Council Member George Taleporos. He published the following on Linkedin:

"NDIS Minister National Press Club Address and what you might have missed (it's scary!)

At today's National Press Club Address Minister Bill Shorten made some important announcements and reminded me why I have such deep respect for this man and gratitude for his commitment to improving the lives of disabled people.

Then it ended with something really scary that freaked me out! Here is a summary of his announcements and my take on what he had to say. You'll have to read to the end for the scary bit.

  1. Increase the NDIA Workforce and its specialisation. Reduce the staff churn and improve the capability of the NDIA. Nice one Bill. Make sure there are specialisations focused on getting young people out of nursing homes, hospitals and other unsuitable institutional settings. Make the agency responsible for planning so that the Local Area Coordinators can focus on community development work and supporting people who aren’t eligible for the scheme. Remember Bill, that was what the Productivity Commission recommended back in the day. 2. Move to long term planning so that plans don't have to be reviewed every 6 to 12 months. Instead move to a multi-year plan system. That’s great Bill, but three-year plans have been a thing for the last couple of years. What’s new about this Bill? Also, it’s important that the agency does regular check-ins with participants. That could have avoided the tragic death of Anne-Marie Smith. And on that, we desperately need a National Community Visitor Program. 3. Prevent overcharging by providers. Yes please Bill! And here’s another way to save money, scrap the ridiculous 7 day cancellation notice requirements for service providers. If I reschedule my appointment within 7 days, my provider can easily do paperwork or see another client. They do not need to charge me and the government $200 for doing nothing to assist me. No other customer needs to provide 7 days notice to reschedule an appointment, so why should NDIS participants have to do so? 4. Review Supported Independent Living (SIL) in institutional settings Thank you Bill, this is long overdue. We know that institutional settings lead to bad outcomes so please give us choice and control over where we live, who we live with and how we are supported. 5. Target the misuse of NDIS funds to eliminate unethical practices. This is important and will require investment in capacity building for people with disabilities and families to make informed choices. I did a podcast to help people understand and avoid unethical providers, please share this video widely. 6. Increase mainstream supports and ensure they deliver on commitments. This will involve the states "stepping up". We need a whole-of-government approach Bill when it comes to addressing the needs of people with disability. If housing, education, health and all public services were more accessible and inclusive of our needs, there would be less reliance on the NDIS.

And now, the scary bit…

Before I go Bill, you said something today that scared me. Something about mandatory qualifications for people providing personal care. I fully support efforts to increase the skill and capability of the workforce, but mandatory qualifications are not the answer – they would devastate the sector and the lives of many disabled people.

There are thousands of incredibly capable, hard-working people who provide high-quality personal care every day who do not hold disability qualifications but who have the values, skills and attitudes that we desperately need in our sector. Many disabled people like myself depend on these people for our basic needs and it would be devastating and catastrophic if you prevented them from working with us.

Please go ahead and encourage more people to take on certificates in disability and ensure providers invest in training and development. But do not make qualifications mandatory and take away our rights to decide who provides our personal care. You promised us an NDIS where disabled people have choice and control over who provides our support, who comes into our homes and who touches our bodies.

That’s what we fought for Bill, and we won’t be giving that up. Please don’t make us fight all over again."

PWDA, People with Disability Australia were also quick out of the blocks with some solid analysis - and a warning - for the overhaul of the scheme . . .

"People with Disability Australia welcomes the news that the National Disability Insurance Scheme (NDIS) will ‘get a reboot’, as announced by Minister Bill Shorten at the National Press Club yesterday.

Mr Shorten’s six-point plan to overhaul the NDIS focuses on many of the key issues raised by disability advocacy groups, including PWDA, over the past decade.

PWDA President Nicole Lee said, “Minister Shorten’s address was a welcome change for people with disability, who for too long have had our lives limited, narrowed and capped by changes to the NDIS.

“The plan includes internal changes, including an increase in a number of staff working at the NDIS, a change to plan durations and making sure people don’t need to keep proving that they have disability,” said Ms Lee. External factors were incorporated including a crackdown on price gouging and unethical service provision as well as a ‘boost in community support from State Governments to free up NDIS budgets’.

“Whatever changes are made to the NDIS,” said Ms Lee, “these must first and foremost come from a position of the principles of choice and control of people with disability which was one of the main intentions of the NDIS from the beginning.”

At present, NDIS bilateral agreements exist between States and Territories, and the Federal Government to determine who will pay for the ongoing support of people with disability. Other support should be delivered through Australia’s Disability Strategy 2021-2031 and State and Territory initiatives where they exist.

“What we don’t want to see is a return to the early days of the NDIS, where the Federal and state and territory governments argued over who was responsible for paying for services and equipment which ultimately meant people with disability were left to languish without life-changing supports,” said Ms Lee.“ What we do want to see is all Governments at State, Territory and Local government levels work to ensure that all spaces, communities and services are accessible to people with disability.,” said PWDA Deputy CEO, Carolyn Hodge.

“For too long people with disability have been excluded or overly reliant on supports to do everyday activities like catch public transport, go to work, school or university because systems, spaces and buildings continue to be built that do not work for people with disability,” said Ms Hodge.

PWDA Vice-President Samantha Connor cautioned, “we hope that this measure does not herald a return to any version of block funding, or the fragmented circumstances that was the hallmark of the pre-NDIS State-based disability systems. It is important that the NDIS remains individualised, with people with disability at the heart of the scheme and in control of their funding and services,” said Ms Connor.

Journalists at the event asked about those missing from the NDIS included the low number of culturally and linguistically diverse participants and the estimated 60,000 Aboriginal Australians who have a disability and should be eligible for the NDIS. PWDA shares these concerns, and we are pleased to hear that they are on the radar of our government.

Lastly, the news that government is making a commitment to more in-home care for treatment outside of hospitals and care homes is welcome news for both people with disability and our families in the fight to end segregation.

We look forward to the outcomes of the NDIS Review and the Disability Royal Commission, as well as commitments to address public concerns about the use of algorithms in NDIS decision-making and action for those excluded from the scheme. We hope the 2023 Budget delivers on yesterday’s commitments."

The most important mainstream media commentary, however, was a piece by Queensland Political Reporter Matt Dennien in the Queensland Times. He looked at the internal Labor fight-to-come over money:

‘It's Not a state scheme’: Palaszczuk pushes back on NDIS cost-share lift

Photo Credit: Alex Ellinghausen, Matt Dennien, WA Today

Queensland has pushed back on federal government calls for the states to “step up” to help ease funding pressure on the National Disability Insurance Scheme. Outlining a plan to reboot the $34 billion program in a National Press Club speech on Tuesday, NDIS Minister Bill Shorten said states needed to honour commitments to people with disabilities. NDIS faces major reboot

Facing a multi-billion dollar cost blowout and allegations of rorting, the National Disability Insurance Scheme could have a major reboot. Budget pressures are staring down Labor state governments alongside the Commonwealth, with Victorian Premier Daniel Andrews unenthusiastic about lifting its contribution. The scheme was pitched to be funded 50:50 by the state and federal governments, with the latter promising to cover extra costs – expected to take the federal portion to 71 per cent by 2025-26. Queensland Premier Annastacia Palaszczuk, echoing Andrews, said it was “a national scheme ... not a state scheme” and offered criticism in response to a Labor backbencher during question time in state parliament on Wednesday. “We have concerns about the manner in which this proposal has been put to the states. There has been no consultation,” she said, to jeers from the LNP opposition. “We have concerns,” Annastacia Palaszczuk said on Wednesday in response to Bill Shorten’s speech.Credit: Alex Ellinghausen, Matt Dennien“The federal government needs to go back to the drawing board and look at how they are funding the National Disability Insurance Scheme. And I say today, to Bill Shorten, that we have concerns.” Palaszczuk said the state already funded a Minister of Disability Services with a budget of $2 billion, and was caring for long-stay patients with disabilities in state hospitals.

“We want the federal government to focus on moving them out,” she said.

The Palaszczuk state government had been highly critical of the former Morrison federal government on this, holding a parliamentary committee inquiry on the issue and others ahead of last year’s election. Data produced for that inquiry found that in the February 2022, 512 patients were medically ready for discharge from Queensland Health facilities but “awaiting appropriate supports to transition to the community”. The issue has been pointed to repeatedly by the state as one reason behind growing hospital pressures, and has continued to be mentioned even after the change of federal government. In Shorten’s Tuesday speech, he announced a new trial to probe whether early intervention for children with signs of autism could reduce the support they need later in life. He also said systemic reform of disability support was needed, with the scheme not delivering the outcomes Australians expected, while some improvements had already been made through a fraud taskforce and hospital discharge delays."

Dennien also reported on reaction to the speech from Aruma, one of the country's largest disability service providers, noting it had welcomed the scheme but flagged that the most crucial reforms would require state and territory support:

"This (fix) requires state and territory government-run hospitals, schools and community services to end cost-shifting to the NDIS," Aruma CEO Martin Laverty said.

"To get the NDIS back on track, we must build support for people with disability in the nation's health, education and community services to allow the NDIS to focus on those who need it most." Alliance20, representing many of Australia's largest disability providers, described Mr Shorten's speech as a "turning point" for the scheme and noted his commitment to stamp out dodgy practices by some providers."

All in all, not a bad week's work for Shorten (or, indeed, the disability sector as a whole).

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