'Existential period' for NDIS, as Albanese-Taylor inch toward deal | Insiders On Background

ABC News In-depth

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Video Summary

The National Disability Insurance Scheme (NDIS) faces an "existential period" as the Australian government seeks to drastically curb its unsustainable growth. Originally projected to support 500,000 participants at a cost of $28 billion annually, the NDIS now serves nearly twice that number with double the intended expenditure. Proposed reforms, aiming to reduce the annual growth rate from 11% to 2% over four years, are nearing bipartisan support in Parliament. These changes include shifting eligibility from diagnosis to functional capacity and requiring participants to exhaust all other treatment options before accessing the NDIS, a move intended to clearly delineate disability support from healthcare funding. However, concerns linger regarding the development of assessment tools, the potential disruption to existing participants, and the readiness of foundational support programs for those who may no longer qualify for the NDIS.

Short Highlights

NDIS Faces Existential Threat: The scheme's rapid growth and cost are deemed unsustainable, risking public backlash and potential termination.
Growth Rate Targets: The government aims to slash the NDIS's annual growth from 11% to as low as 2% over the next four years.
Eligibility Shift: Future NDIS access will be based on functional capacity rather than diagnosis, a return to original Productivity Commission intent.
Exhaust All Options Rule: Participants must prove they've tried all other treatments, aiming to separate NDIS funding from healthcare needs.
Foundational Support Concerns: States, particularly Queensland, are lagging in delivering promised foundational support programs for those not on the NDIS.
Social Participation Cuts: Proposed reductions in funding for social and community participation programs raise fears of increased isolation and abuse.
Inspector-General Proposal: An independent Inspector-General is suggested to provide oversight and advise on systemic improvements.

Key Details

NDIS Facing Existential Period [00:00:00]

The NDIS is at a critical juncture, with its rapid growth and escalating costs posing an "existential" threat.
The original commitment was to a specific cohort of people with permanent and significant disabilities, not all individuals with disabilities.
If Parliament fails to pass upcoming legislation, the scheme's growth curve will continue unchecked.

"But this is almost an existential period for the NDIS."

Restoring Original Intent [00:01:30]

The Productivity Commission's 2011 outline projected 500,000 participants and a $28 billion annual cost by now.
The reality is nearly double the participants and twice the projected cost.
The government aims to reduce the annual growth rate from 11% to 2% over the next four years, a target crucial for the budget.

"The reality is that there's almost twice that number in the scheme today, and the cost, not surprisingly, is twice that which was originally intended."

Bipartisan Deal Nears [00:02:45]

Reforms are expected to pass Parliament with bipartisan support following negotiations between the Prime Minister and the Opposition.
While many in the disability sector are concerned, there's a general agreement that changes are needed for sustainability.
Martin Laverty, an original architect of the NDIS, supports the need to curb growth but has specific suggestions.

"And after several meetings through the week between Anthony Albanese and Angus Taylor, it looks like a bipartisan deal will be reached early next week to pass these reforms into law."

Eligibility Shift: Functional Capacity [00:04:15]

Proposed changes will base NDIS eligibility on functional capacity rather than diagnosis.
This aligns with the Productivity Commission's original intent, as a diagnostic approach was a trade-off due to the lack of a suitable assessment tool at the scheme's inception.
Concerns exist because the specific assessment tool has not yet been developed or revealed.

"It would be based under these changes on functional capacity rather than diagnosis."

Concerns Over Reassessment [00:05:30]

Reassessing participants, particularly those in supported independent living, is seen as potentially unnecessary, disruptive, and costly.
Laverty suggests that approximately 30,000-40,000 participants in supported independent living might not require reassessment.
The World Health Organization Disability Assessment Schedule is the model for the proposed Australian assessment tool.

"You're saying they don't need to be reassessed all the time?"

Exhaust All Other Options Test [00:07:00]

A new requirement mandates participants to prove they have exhausted all possible treatments before NDIS access.
This aims to clearly distinguish between NDIS-funded disability supports and healthcare needs funded by the health system.
Concerns were raised that this could push people towards riskier treatments or disadvantage those in regional areas.

"The NDIS should not be funding health needs."

Foundational Supports and State Responsibility [00:08:45]

State and Territory Ministers have expressed concerns about the readiness of foundational support programs for those not eligible for the NDIS.
Historically, state governments reduced their own disability support programs after the NDIS was established.
A $10 billion commitment for foundational supports is planned, but delivery commencement in October is uncertain, with Queensland notably holding out.

"State and Territory Ministers did make a submission to the inquiry that basically said they weren't ready with the foundational supports for those who aren't going to be on the NDIS."

Social Participation and Inspector-General [00:11:30]

Proposed cuts to social and community participation programs risk increasing social isolation and abuse.
Laverty advocates for carve-outs for supported independent living residents and employment support.
He proposes a statutory Inspector-General to provide independent oversight, similar to the aged care sector, to improve system navigation and transparency.

"Why is an Inspector-General needed? It's a check and balance, if you like."