NDIS delayed is NDIS denied

| September 4, 2015

Some suggest to stop or slow down the roll-out of the National Disability Insurance Scheme (NDIS). Craig Wallace says this would spark an unprecedented outrage as people with disability, families and carers have already waited 40 years for help.

The National Disability Insurance Scheme (NDIS) is once again in the opinion cycle with speculation about its timing, most recently in The baby and the bathwater: let’s keep the NDIS but slow down its roll-out published recently in The Conversation by David Gilchrist as well as reporting of calls for a localised NDIS by WA Disability Minister Helen Morton.

While the social arguments for the NDIS have been well canvassed there has been less debate about where the NDIS sits in the wider landscape of gridlocked national reform.

The recent National Reform Summit hosted by The Australian, The Australian Financial Review and KPMG generated a lot of commentary about reform amidst the structural problems facing the Budget. I was at the Summit, and the headwinds coming out of the end of the China mining boom are sobering. We will need to lift productivity to maintain our living standards.

Business, community and unions shared a surprising level of frustration about the inability to tackle issues and pull off complex reform in a fickle political culture with a 140 character attention span.

It’s interesting to note that while Former Treasury secretary Martin Parkinson expressed doubts about financial viability on the event’s sidelines, not one serious leader from the combined ranks of business, community, think tankers, government and union leaders actually questioned the funding priority given to the Scheme during the Summit. If there were serious doubts, this was the place to voice them.

Perhaps this is because the national interest case for the Scheme is so strong and accords with virtually all the reform themes identified during the Summit.

In a message broadcast at the start of the summit, the Prime Minister highlighted the fact that “today’s prosperity can be traced to yesterday’s reforms”.

We may well say that about the NDIS by the time the nation faces the full economic headwinds predicted to arrive by 2020.

Taxpayers are already “buying” disability care and this is closer to a zero sum game than we realise.  At the moment what we are buying is inferior product. Hand me down supports scattered across levels of government that periodically leak costs into the health, justice and acute care systems.

This has downstream costs as families break down, people get into trouble and supports run out half way through the financial year. People get put into nursing homes or institutions that expose them to neglect, abuse and violence, bought into stark relief by the Senate Inquiry and the Royal Commission.

We cannot look to informal supports for help. The number of carers is declining as fewer women take up traditional caring roles that have masked the lack of a decent care and support system. Estimates by credible bodies like NATSEM suggest that at the same time the numbers of older persons with a severe or profound disability in Australia are projected to grow from 539,000 in 2001 to 1,390,000 in 2031, an increase of about 160%[1].

A lack of early intervention means children with disabilities use non-prescription wheelchairs and grow up with curved spines needing costly corrective surgery. Parents struggle for autism therapy despite evidence that getting in early can make a difference. Australia has the lowest combined level of participation and the highest level of poverty for people with disability in the OECD.

The Summit also heard from Reserve Bank Governor Glenn Stevens that competition spurs innovation. Well, disability supports have been sadly lacking competition for decades. Block funding and a lack of consumer power has created wild distortions, such as a soup spoon with a bent handle for people with arthritis costing anywhere from $10-$60. Roll on the innovation.

Critics offer no alternatives to the NDIS, and the piece by David Gilchrist, while it raises legitimate issues in the transition, punches no holes in the underlying rationale for reform. It doesn’t tell us what a proper planning process for the whole rollout would look like or how we could arrive at one.  Instead it suggests a vague process of withdrawal, regrouping and introspection.

Stopping? Slowing? Localising? The alternatives are all a bit unclear.

Meanwhile in the real world, an NDIS is past ponderous examination. A Federal Government which delays will face a tsunami of united outrage from people with disability, families and carers. People with disability, some on the cusp of the age cut off for the scheme, have waited 40 years for help.  They won’t wait any longer for someone to replace patched up callipers and wheelchairs from the last century. Ageing parents in their 80s and 90s will not put up with knocking at death’s door for basic supports and peace of mind either. The fury would be unprecedented.

Politics aside there is another reason for seeing the NDIS to fruition, and that is about good policy.

If we “stop” the NDIS rollout we will be saying goodbye to the only really big intergovernmental reform to get over the line in any national policy area since the introduction of the GST and virtually the only big bipartisan one since the gun buyback in the early days of the Howard Government.

Have no doubt, once a halt is called the proceeds of the NDIS levy will be siphoned away by revenue hungry States as Governments resume their merry game of cost-shifting for disability services. The unheralded bipartisan support for the scheme will vanish like smoke in the wake of the following COAG meeting while the underpinning cost drivers get worse, left for the grandkids to fix.

Slowing down the NDIS will not mean Australians stop paying for disability services nor seal the leaks on a sinking system. But we may lose far more than we realise – our capacity to propose and deliver complex systemic reform in modern Australia.

[1] Who’s going to care? Informal care and an ageing population, Report prepared for Carers Australia by the National Centre for Social and Economic Modelling, Page 27