Market myths and the inclusion of people with disabilities

The National Disability Insurance Scheme, now to be known as DisabilityCare, has become a central theme of Australia’s national debate. This is a tribute to the many thousands of people who have campaigned tirelessly for better support for and inclusion of people with disabilities in society.

A lot of the detail has not yet been revealed, but DisabilityCare carries the hope for a system that will provide a level of much-needed — and long overdue — support to individuals with disability and their informal support networks. Australia's present system is a confusing, unjust and a woefully under-funded patchwork quilt of state, federal and charitable programs.

DisabiltyCare promises to double funding, treat people equally regardless of how they acquired their disability and allow portability of entitlements across state and territory borders, all of which are important steps that the Socialist Alliance welcomes.

However, the design of the scheme has been shaped by the Productivity Commission's unfounded insistence that the best way to allocate resources to disability services is via a market system of service providers competing for the disability “consumers’” individual funding allocation.

Many people in the disability sector have been suckered in to believing that a market system is best because they've repeatedly been told that this is the only way to give people with disabilities real choice and direction over their support services, in contrast to the impersonal and degrading one-size-fits-all institutions that many have endured.

But the problems with such a market-based system are many. Smaller community-established and run organisations will be squeezed out by larger profit-making organisations with bigger economies of scale. Those services still provided by government agencies will be privatised and skilled workers lost to the industry. This will reduce control and choice.

The state-based systems have already demonstrated that "marketisation" cannot provide the full range of necessary supports. For people living in remote and regional areas or with more specific needs, there is often no choice of service provider or no appropriate service available.

Under a market system, service users will generally try to extend their funding by seeking the lowest cost provider. This has the potential to see people with disabilities being used as a wedge to drive down the wages and conditions of workers in the sector.

This has already happened in Western Australia where people with disabilities (or their immediate support networks) have been advised by government and contracted agencies that they can raise the hours of support they receive by directly employing staff on lower wages, or even as “private and domestic” workers like nannies, who are completely exempt from the entitlements and protection of WA industrial law.

It should be obvious that treating disability support workers with contempt will produce sorry outcomes. Instead, all workers providing support services funded by government should receive the same wages and conditions as other public sector workers.

Several disability advocates have been dismayed by the choice of the name DisabilityCare, because it reflects outdated “medical model” thinking. The real challenge for society is the social and economic inclusion of people with disabilities, of which physical access and therapies are but one part.

There are serious fears that the system will put more emphasis on physical and medical supports, leaving people with intellectual disabilities and those on the Autism spectrum mostly abandoned.

The discussion about how to fund DisabilityCare has also been completely distorted. The Productivity Commission advised that an NDIS would have to be funded from general revenue by cutting other social programs. The federal government has partly followed this advice, proposing to fund DisabilityCare through general revenue and a 0.5% Medicare levy rise.

The widespread backlash over Myer CEO Bernie Brook's suggestion that an increased levy would hurt his company's profits because the extra $350 "is something they would have spent with us" is a credit to people's sense of community solidarity. However the fact remains that all of an improved disability scheme could be funded with a proper mining tax, increased corporate tax or by cutting handouts to the country's biggest polluters.

The Socialist Alliance welcomes more funding to disability services, but it is opposed to the extension and generalisation of the market service delivery model. People with disabilities are not “consumers”. They are citizens who have as much right to take part in society and enjoy a fulfilling life as anyone else.

Public funding should not go to private for-profit organisations, but only to services directly provided by government or to community not-for-profit service providers with democratic management structures that actively involve people with disabilities and their advocates in the decision-making processes.

The direct involvement of people with disabilities — or their supports and advocates where appropriate — and the democratic control of service provision is the best way to efficiently allocate funds where they are required.
[Sam Wainwright is a disability support worker, a councillor on Fremantle City Council and the Socialist Alliance candidate for the seat of Fremantle in the September federal election.]

From GLW issue 967