Our CEO, David Clarke shares his thoughts on the NDIS and its potential to become a tool for social change.
The NDIS as a tool for social change
The way we view disability in our society and the way we support individuals is undergoing a positive, yet radical social reform. It is not that far in the past when prosthetic limbs would be coloured some off-pink that approximated no one’s skin tones. Yet in a few short years, such assistance devices are made of exotic metals, perform incredibly and are on display. The para-games are intermingled on the agenda with events for able-bodied athletes – and so they should be. It is a measure of how far this has come that Dylan Alcott is more recognisable to the majority of Australians than many of his able-bodied tennis-playing colleagues (with some exceptions).
There is a quiet societal revolution going on – and the NDIS has been an incredible force for change. Do not for a moment think that I am implying that the NDIS is a perfect system, nor that it is easy to navigate. But the principles on which the NDIS is founded are filtering into our social structures. And that is also how it should be.
The future of the NDIS
The NDIS at current projections supports some 530,000 participants across Australia. At its height, it will cost some $34bn per year to service. Depending on which figures and time periods you source this is around the same size, or larger, than Medicare. The number of people supported in the community by NDIS dwarfs the number of people who live in the other key area of social-support, that is Aged Care. The vision of extending support to people living in the community with a disability is being realised.
Along with the shift in place and manner of support, the way in which the NDIS targets and delivers support has also delivered a seismic shift in social policy. The former top-down model of funding distribution where government administrations provided funds to organisations on not-entirely-clear bases led to a patriarchal or top-down mentality of service delivery. The recipient was seen at the bottom of the distribution system. It can be argued that this also instilled a sense of self-justification and control within the services that distributed the funds that was potentially counter to the needs of the recipients.
Updating the system
The NDIS has set out to deliberately up-end this top-down model. It is one of the fundamental principles of the scheme as it seeks to place individual participants at the top of the cascade of supports and services. The inviolate principles are to deliver choice and control of service and support delivery to each individual participant.
But in this level of individualism is where the entire system becomes hugely complicated. The issue is that no two people even with a “similar” disability have the same needs. There is no convenient “Medicare item number” for the dispensation of disability services. And that means every one of the 530,000 people receiving support under the NDIS need to be individually assessed, have an individualised plan for their needs developed (and approved) and receive funding that allows them to achieve their goals. It is an unbelievably massive and ambitious undertaking. Yet in, the vast majority of cases, it might just be working.
The administrative burden to realise and manage the scheme is mind-numbing. A cascade of plan managers working with support coordinators, garnering specific expert advice on equipment, products or services is required just to define each participant’s plan. Socially, Australians expect government administrators to put checks and balances in place to ensure the funds go to the right person in the right amount at the right time. That calls for an oversight and approval system. If by this stage you aren’t considering that something this large will get it wrong from time to time, you haven’t been following the thread here.
So while disputes around levels of funding and appropriate provision of equipment or services will continue to appear in the newsfeeds, the principle remains that Australia has undergone a social transformation at least as big as universal suffrage or the social safety net of unemployment benefits or as healthcare-liberating as Medicare. There is an old saying that states that the only health system that is worse than the Australian system is every other one around the world. Similarly, it can be argued that Australia has been uniquely innovative and brave in putting a system in place that is as far-reaching and socially directed as the NDIS.
The debates and questions will remain over the long-term sustainability of the NDIS for the Australian economy. There is no doubt within the context of economic challenges arising from COVID and the Russian-Ukraine conflict the NDIS will place pressures on deficits. Additionally, the need for some rationalisation on the level of supports previously committed to will be an ongoing debate. Economic forecasters and actuaries will have ongoing roles advising on modifications to policy settings. The underlying truth is that the NDIS is here to stay, and we now need to make sure it re-focuses on serving its original purpose. The principle of almost universal support for people living with a disability in the community on their own terms constitutes precisely that.
At the same time the visibility and social roles for those living with disability is undergoing a similar transformation. As Dylan Alcott said in his Australian of the Year acceptance speech, the problem isn’t with us, the people living with a disability, it’s with you, the able-bodied Australians who have difficulty accepting us. Let’s work towards changing us.
Forward Ability Support congratulates Paralympian Kurt Fearnley as the newest Chairperson of the National Disability Insurance Agency (NDIA). It is the first time a person with lived experience has held the role of Chair of the NDIA since its inception in 2013.