National Disability Insurance Scheme
In August 2011 the Council of Australian Governments agreed on the need for major reform of disability services after extensive lobbying by people with disability and their advocates. The proposal for a National Disability Insurance Scheme (NDIS) was an outcome of the Productivity Commission's inquiry into disability care and support. From 1 July 2016 the NDIS was rolled out nationally following three years of trials at specific locations. From the outset, the scheme revealed itself as not being as positive as many had hoped.
On 1 July 2014 the Medicare levy was increased from 1.5 to 2% in order to provide a stable funding base for NDIS. The Medicare levy is a flat impost on taxable income; not a progressive tax which would require those on larger incomes to pay a proportionally larger share.
From the outset, the NDIS has been something of a political football for the federal Coalition government. In February 2017, on the failure of the Senate to pass a bill intended to cut government spending[i], then Prime Minister Malcolm Turnbull, claimed that the NDIS was left unfunded byLabor and threatened to increase taxation to fund the $22 billion scheme.
In its 2017 budget, the Coalition government pledged to increase the Medicare levy again to 2.5% in order to fund the NDIS shortfall. In April 2018, however, then federal treasurer Scott Morrison announced that the government had abandoned its plan to increase the Medicare levy, claiming that funding would be secured in perpetuity from increased tax receipts resulting from growing the economy.
In order to provide for a reasonable standard of life for the 460,000[ii] people who will access NDIS when it is fully rolled out, NDIS funding must be guaranteed in the short term, through increased taxation on wealth and big business if necessary. While Socialist Alliance maintains that the NDIS should be replaced with a genuine needs based support system, funding for the NDIS must be guaranteed in the meantime.
Who is eligible?
Socialist Alliance believes that all people with disabilities should have access to the NDIS on the basis of self-assessment, regardless of the severity, their age, employment or visa status. Unfortunately, it is proving to be a struggle for many people with disabilities to even access the scheme. This been doubly difficult for those with cognitive disability.[iii]
Those aged over 65, unless already “participants” in the scheme, are ineligible for NDIS funding, leaving older disabled people stranded, particularly as state governments wind back their schemes with the rollout of NDIS.
What’s the plan?
NDIS participants are provided with an annualised “plan”, which details the funding they are to receive in any of a range of line items, such as assistance with personal care, funding for transport, or improved health and well-being. Participants must then take the plan to the disability services provider market and negotiate a service agreement with a provider (or a number of providers for different types of support) to begin receiving NDIS funded support.
The plan is delivered to the participant by the NDIS planner. While a “planning meeting” is held, the final decision about the level and purposes of the funding rests with the bureaucrat. The only means that a participant has to challenge the amount of funding they receive and what it can be spent on is to request a full review of their plan, a lengthy, time-consuming and stressful process, with no guarantee of success. At the end of the year’s funding (sometimes less than a year), the NDIS participant must once again go through the whole process of applying for funding for the next year.
Funding for disability services must be provided on a needs basis. Socialist Alliance believes that people with disabilities should not be forced to justify why they need ongoing funding.
People with a disability should be central to all decision-making. As a first step, a person with disabilities, or their representative, must be able to negotiate directly with the NDIS planner in an open and transparent process to ensure that their needs are properly met, eliminating the need for time consuming reviews.
Participants and providers
People with a disability who receive funding (a plan) from NDIS are described as “participants”. NDIS encourages participants to seek to maximise the amount of service they receive within their plan funding by negotiating payment rates with their support providers (“providers”). In essence, this turns the interests of participants against those of the providers, and their (generally low-paid) staff[iv].
Socialist Alliance believes that the interests of people with disabilities and those who are paid to care for them are aligned, and rejects the attempt of NDIS to turn them against each other. It is in the interest of people with a disability that those who work in the disability sector are properly paid and not forced to work additional hours, or additional jobs, just to make ends meet. Equally, it is in the interests of disability workers to ensure that the people they provide services for are given the best possible support to maximise their ability to engage as full citizens in society.
The NDIS has paved the way for NDIS entrepreneurs, who are investing millions on the expectation of guaranteed revenue (and profits) from the NDIS over the years to come[v]. Socialist Alliance believes that the disability care sector should be community-based and democratically run. The lives of people with a disability are not-for-profit.
Socialist Alliance believes that provision of disability support should be based on the person with a disability’s needs as self-assessed by the individual, where possible (we are all experts in our own body’s needs).
Socialist Alliance believes in democratic governance of all disability funding-support bodies, including the current NDIS. The NDIS should be fundamentally reorganised, with governance provided by a board with the majority of people with a disability. The board should be elected on an annual basis by participants. The board should organise an annual policy conference, open to all people with a disability and their advocates, to set binding policy for the NDIS.
The future of disability care
In the long term, the framework for disability care provision must be the decision of people with disabilities themselves. Socialist Alliance supports empowering people with a disability to make decisions about their future, including the form and content of a national disability support scheme. In that context, Socialist Alliance wishes to be part of a discussion of the future of disability support in Australia, and offers the following policy points as a contribution to that discussion:
While Socialist Alliance welcomes increased funding to disability services and supports the principle of self-directed and individually tailored supports, we oppose the market service delivery model enshrined in the NDIS in which service providers compete for the disability “consumers’” funding allocation.
The problems of providing disability services with a market-based funding system include:
The support to and inclusion of people with disability is a fundamental human right
The Socialist Alliance supports a national disability system that will genuinely enable the human rights of people with disability. We support a national system that: