Tuesday, 20 October 2020
Appropriation Bill (No. 1) 2020-2021, Appropriation Bill (No. 2) 2020-2021, Appropriation (Parliamentary Departments) Bill (No. 1) 2020-2021; Second Reading
I acknowledge the member for New England's contribution. They're never boring! I'll move on. The budget funds the National Disability Insurance Scheme for another year. Mind you, it does so after ripping $4.6 billion out of the scheme last year and calling it an 'underspend'. Last year, the government ripped $4.6 billion out of the NDIS to prop up a budget surplus that never eventuated. In this year's budget, they've kindly returned only $1.5 billion of what they took. But I acknowledge the scheme is funded for another year, and this is a good thing for Australians with disability and those who love and care for them. That the NDIS is funded for the year is a small mercy that we have to celebrate, with a seven-year Liberal government. Despite what the Liberal government's comments are publicly, I think that, corporately, they are ambivalent about the national disability safety net and, at worst, many of them have a secret view that it is too expensive. You always have to wonder with the current government. When they seek to change something about the NDIS, you wonder: 'Who are they changing it for? What's really driving the agenda?'
This is why I want to talk about the government's most recent changes to the way that Australians with disability will now get onto the national scheme.
The Morrison government has recently moved to introduce a process called 'independent assessments' to the National Disability Insurance Scheme from 2021. This is a change from the system where a person with profound disability would seek to prove their eligibility for funding under the NDIS using expert reports from their treating doctors and the allied health professionals that they and their families have been dealing with. And where successful, based upon the evidence of treating medical experts and the people who work around them, the NDIA would approve their entry to the scheme. And there are 430,000 people now on this remarkable scheme. It would be a change though, this government's proposing, whereby they now seek to use a private national panel commissioned by the government that would see all existing participants and all applicants on the scheme and this independent panel would assess them.
According to the government, the basis for this change—moving from the participant providing reports and evidence to an independent assessment process—is that it is a response to the 2019 review into the operation of the NDIS by David Tune, the former secretary of Finance, a respected public servant. Mr Tune's review is now known as the Tune review. The Tune review made a single carefully qualified recommendation regarding independent assessments. It said that we should have independent assessments following the completion of pilot programs to be introduced through amendments to the NDIS legislation. However, of the two pilot programs which were scheduled, the first one was limited to a small number of people; it didn't consider all disability types; and it didn't sufficiently consider culturally and linguistically diverse people, people from Indigenous communities or people with highly complex needs. And this pilot program was discontinued halfway through this year. This is right. So the process upon which the move to independent assessments was to be justified hasn't been completed. We don't know one way or the other whether or not the two pilot programs in their entirety were a raging success, an unmitigated failure or, indeed, just insufficient. But the government in the meantime, even though it hasn't completed the two pilot programs, has announced the new direction. We presumed that when Mr Tune said there would be a pilot program before the full change was brought in nationally that was what was meant to be the case. We presumed that he meant it would be a completed pilot, not an abandoned one. The government's response to the Tune review cited independent assessments as a solution to no less than four of the Tune recommendations—he made several recommendations. It has announced that independent assessments become mandatory for all disability types at both access decisions and plan reviews.
The government has claimed that the original Productivity Commission report supports the introduction of this new system of independent assessments. However, they have been unable to adequately explain why the government has waited seven years from the Productivity Commission report or why assessments were not included back then. The absence of proper evidence to support the introduction of these significant changes to over 400,000 participants and their families on the NDIS is unacceptable. It has infuriated the Australian disability community.
Labor, over recent weeks and months, has heard from many people—many people with disabilities and their carers, and from service providers and their representative organisations—that the government hasn't adequately consulted them before it's decided to introduce the independent assessment process. We believe in Labor that this contravenes the principle of the NDIS Participant Service Guarantee that the NDIS be transparent, which the NDIA has said has been in place since July this year. You can't be transparent if you don't provide all the information or complete the pilot process.
Many NDIS participants are fearful that independent assessments are yet another standardisation scheme from the government that inflicted the unlawful robodebt program on more than 700,000 unsuspecting, innocent Australians. Labor shares concern that independent assessments are another way for the Liberals to simply take support away from disabled Australians by unfairly restricting access to the scheme and to limit plan funding. I say to the government, having spoken with people with disability, having spoken to their representatives and their carers, that the independent assessment process is causing more fear and more concern than should be the case if the government simply adhered to better implementation processes.
Labor supports the Tune review recommendations and agrees that there needs to be an approach that delivers more consistency and fairness in the NDIS. It is unfair that people who are unable to afford reports for an occupational therapist or an allied health professional should have to wait years on public waiting lists. We accept the principle that there needs to be equity in outcomes for NDIS participants. In other words, people with identical physical conditions shouldn't receive radically different funding packages without proper investigation. Consistency is a principle of equity. But the potential for the solution to these problems is being undermined by the way that the minister and the government are implementing independent assessments without proper process. We don't think that they shouldn't empanel a system of independent assessments, but they shouldn't do so until they've overcome the grave concerns of the disability community.
This is why Labor won't support the policy changes until the government has met at least the following conditions: (1) the government should listen to participants and immediately pause the rollout of the current independent assessments program. Do the process right the first time and you won't need to come back and keep doing it again and again and again. And it will not cause anxiety in the manner in which it's now doing. Two, there needs to be a genuine transparent consultation process to confirm what the issues are and trial different options. Not all people with disabilities come in the same size and shape. Three, they need to co-design a solution best supported by evidence with participants, families, carers and the sector. And (4) as a minimum they should make public all modelling, all actuarial advice and evaluation reports used to support the chosen process.
Unfortunately, the government have ignored the Tune recommendations to put the changes which they're introducing into legislation, so there's no opportunity for the parliament to properly scrutinise and, indeed, amend or improve the independent assessment process. This undermines the role of the parliament, and I know there are many individual Liberal and National MPs who are equally motivated to make sure that people with disability get a fair go, but I put them on notice: I spent 10 years working with people with disabilities on creating the NDIS and it would be far better to respect the role of government backbenches and the opposition as legislators as opposed to rubber stamps. The government won't put the changes through parliament, through legislation, so it becomes incumbent to have a public debate, denying the role of legislators of all political stripe to have their say and reflect the views of the community. I've written to the minister for the NDIS, Mr Stuart Robert, outlining Labor's opposition to the independent assessments in the current process. I will continue to draw attention to the matter.
The NDIS is a vital national scheme, but under this seven-year-old government it's been implemented in an ad hoc manner, which is jeopardising the scheme's aims of providing greater independence and quality of life for Australians with disability. There are many success stories with the NDIS, but there are many people complaining about the NDIS. We hear cases every day. I'll just share a couple. NDIS participant Wendy waited five years for home modifications that left her unsafe and tens of thousands of dollars out of pocket because the NDIS picked a dodgy builder, the lowest-cost builder. There's Indiana, who is eight. She's intellectually delayed, and she has aggressive epilepsy. Her single mum, Meghan, wants NDIS funding for an assistance animal, an animal that can help predict and work with Indi's seizures. It's a cheaper option than 24-hour, seven-days-a-week monitoring care and more accurate than any other available technology, according to the family, but the NDIA refuses to look at the assistance animal. Now, mum, Meghan, is forced to fight the decision at the AAT, while Indiana is in hospital for brain surgery. There is Kim, who, due to having shortfalls in her supported independent living funding, is having her insulin injected by a support worker, not a registered nurse, and who has ended up in hospital due to complications with her diabetes. There's Matthew, who's been waiting for over a year for custom-built specialist disability accommodation housing. At the last minute, the NDIA have withdrawn his approved supported independent living package and tried to force a lower care model on him, despite his high-support needs. If he doesn't accept, he won't be able to move in and he'll have nowhere to go.
I think we're at an important moment in this country for disability. I think there is political consensus about the role of the NDIS, which is a significant development in our social safety net. It's about empowering individuals living with profound or severe disability and giving them choice and control over their lives. It is a significant accomplishment. Without the outbreak of COVID related Keynesian of the born-again big government champions of social security, other Labor achievements are always at risk from our conservative governments. But the NDIS I think is one which doesn't need to be changed at an election. I think it is one that can be worked on with goodwill between the government and opposition now.
I genuinely believe that the government would be well advised to put a pause on the independent assessments process, not because the principle is all bad, because it's not. Equity and consistency in decision-making are important. But, when people with a disability have got a glimpse of home with an NDIS package, there's genuine fear and anxiety the independent assessment will override or trump the reports of treating allied health professionals. How in an hour or two can someone make an assessment about someone's adult child with autism and not as a starting point accept the reports of the treating allied health professionals and understand the family and the organisations providing care?
This is a situation where people are now nervous, people are scared, people are anxious. There are 430,000 participants. Many of them are asking themselves, as they become aware of the changes to the independent assessment process: 'Is this just an attempt to reduce my funding?' In the case of some people, their funding may go up. But there is no doubt that there will be losers out of this scheme. The government agency has said as much—there will be losers in this scheme. The point about it is that the government has already said that some people will go backwards. But, to go backwards on a process where people with disabilities voices haven't been heard, is an avoidable mistake.
Sometimes in politics there are some arguments that aren't avoidable. You can have arguments about industrial relations, you can have arguments about refugees and you can have arguments about the climate. But, on the NDIS, the government is making an avoidable decision to have an argument with participants in the scheme. There is nothing—there is no electoral stop clock—that says that independent assessments have to be resolved by a certain day and rolled out. Many other things in the NDIS have taken a lot longer. All I advise the government is hasten slowly. Put the evidence out there, complete the pilot programs and consult people with disability. Let the joint select committee, made up of Liberal, National and Labor MPs, do their job as legislators. It is time to say to the executive of government: respect the legislators, respect the everyday experience of MPs from all sides of the people they see in their office. Let's put people with disabilities, their carers and the people who support them every day first. Let's put them first and let's not cause needless anxiety.