Wednesday, 9 December 2020
National Disability Insurance Scheme Joint Committee; Report
On behalf of the Joint Standing Committee on the National Disability Insurance Scheme, I present the following reports: General issues and the NDIS workforce interim report.
Reports made parliamentary papers in accordance with standing order 39(e).
by leave—I will make a statement on each of the reports. I am pleased to present the General issues report of the Joint Standing Committee on the National Disability Insurance Scheme, a report pertaining to the committee's ongoing inquiry into general issues relating to the implementation and performance of the NDIS. This inquiry provides an opportunity for the public to present important evidence to the committee about the NDIS and how it could be improved. In particular, the inquiry is a chance for people with disability to share their experiences of the scheme. This is the committee's first report of the 46th Parliament for the general issues inquiry. It reviews issues raised during the inquiry and provides an update on the committee's recent activities. The committee makes 10 recommendations to improve the NDIS for participants, providers and other key stakeholders.
A key focus of the report is the National Disability Insurance Agency's proposal to introduce independent assessments as part of the NDIS access and planning processes. According to the agency, the introduction of independent assessments will enhance equity and consistency in access and planning decisions.
The policy intent of independent assessments is to be commended, as is the decision to offer assessments free of charge. However, a substantial number of submitters advanced that independent assessments may create challenges for people with disability, may not be an accurate means of measuring functional capacity and may not reflect adequate consultation with the disability and allied health sectors.
Independent assessments have not yet been implemented and the committee does not make any recommendations about these assessments in this report. However, the committee appreciates that the introduction of independent assessments represents a major change to the NDIS, and is cognisant that there are significant concerns that have been expressed about this matter. The committee therefore proposes to conduct a dedicated inquiry into independent assessments. This will include seeking further evidence about this matter through submissions and public hearings next year.
The report also examines the impact of the COVID-19 pandemic, which has had extraordinary and destructive effects on Australian society. As all here would be aware, the effects of COVID-19 have been particularly acute for people with disability, their families and friends. The pandemic has also presented serious difficulties for NDIS providers, disability support workers and others in the disability sector.
Of course, the effects of the pandemic are ongoing and likely to be with us for some time. The report examines evidence about the stress and anxiety felt by people with disability during the initial phase of the pandemic, difficulties in accessing personal protective equipment and challenges for providers continuing to offer disability supports. It also considers the government's planning and preparation for a pandemic, as well as how the NDIA and the NDIS Quality and Safeguards Commission have responded to COVID-19.
The committee makes two recommendations on these matters. The first aims to ensure that we learn lessons from the COVID-19 pandemic and are better prepared to support people with disability in future emergencies. The second proposes that the NDIA and the commission maintain beyond the COVID-19 pandemic beneficial changes that were implemented in response to the pandemic.
The report also gives voice to a number of other key issues related to the NDIS raised by participants, providers and other stakeholders. These include financial matters relating to the implementation and performance of the NDIS and issues affecting particular cohorts of people with disability. The committee makes eight recommendations intended to improve the operation of the NDIS in light of the issues raised, focused on the following matters: systemic engagement with people with psychosocial disability; ensuring cultural competency and investing in capacity building for Aboriginal and Torres Strait Islander communities; supporting people with disability who are experiencing homelessness; improving the way in which the NDIA communicates with participants; and managing the circumstances associated with a participant's death.
Some of the issues reviewed in this report have been more thoroughly examined by the committee in its other inquiries, or have been considered in inquiries conducted by other bodies. Consequently, in a number of instances the committee proposes to maintain a watching brief and encourages the government to give close consideration to the matters raised in this report.
The committee thanks everyone who has contributed to this inquiry by making submissions, expressing views through correspondence or providing testimony in public hearings. In particular, the committee thanks the NDIS participants who shared their experiences. The testimony of people with lived experience is crucial to identifying issues with the NDIS and improving the operation of the scheme. With these remarks I commend the general issues inquiry to the House.
I'll now turn to the NDIS workforce interim report. The NDIS is one of Australia's most ambitious public policy initiatives. It is currently supporting over 410,000 people with disability to access services and supports. The number of participants in the NDIS is expected to grow, with the minister for the NDIS estimating that the scheme will ultimately support over 500,000 Australians.
Critical to the sustainability of the NDIS and the delivery of safe, quality disability supports is a workforce of sufficient size to meet demand with appropriate skills, qualifications and expertise. To meet growing demand for disability supports it is estimated that the NDIS workforce will need to increase by around 90,000 full-time equivalent staff over the next four to five years. However, attracting and retaining a skilled, qualified workforce is proving to be a challenging endeavour, as the sector is increasingly seen as overworked, underpaid, undervalued and poorly trained. Evidence indicates that the sector is highly casualised and work is often insecure. Remuneration may not reflect the complex and sensitive nature of disability support, workers often receive limited, if any, training from employers and there are limited opportunities for career advancement. Workers may not be adequately supervised and are often left to make complex decisions about care needs. Evidence to the committee also indicates that Aboriginal and Torres Strait Islander peoples continue to be significantly underserved by the NDIS due to acute shortages of affordable, culturally appropriate services and a lack of investment in capacity building.
More must be done to increase the representation of people with disability in the NDIS workforce, including in the leadership, managerial and technical roles. This is not only to improve employment outcomes for people with disability but to grow and enhance the quality of the NDIS workforce by harnessing the untapped potential of lived experience.
The issues identified in this report are not new. They've been identified on several occasions by this committee, as well as via numerous other review and inquiry processes and in media commentary. Many of these issues have also come into sharp focus during the COVID-19 pandemic and have created challenges for various stakeholders seeking to manage the impact of the virus on the Australian community. Comprehensive, targeted action is required to address barriers to attracting and retaining a skilled and qualified workforce that reflects the diversity of people with a disability. Otherwise, workforce supply issues and skill gaps will likely worsen, with significant adverse consequences for participants.
This interim report makes 14 recommendations to address some of these issues, focused on addressing concerns with funding arrangements, enhancing training, growing a workforce with lived experience of disability and addressing thin markets for supports and services. The committee acknowledges actions that have been taken by the NDIA and by the Australian government more broadly to address some of the workforce issues facing the NDIS and the disability sector. However, evidence before the committee indicates that these have not been sufficient to date to address the workforce issues facing the NDIS into the future.
The committee also appreciates that the Australian government has a number of initiatives in train, including, significantly, the development of a national workforce plan. However, as many of these initiatives have not yet taken effect, it is not possible yet to determine whether they'll address the issues identified in the inquiry. The committee therefore proposes to give further consideration to the issues identified in this inquiry in the coming months, including through additional public hearings, before presenting a final report to the parliament in 2021.
In conclusion, the committee thanks all those who have participated in this inquiry so far by lodging submissions, giving testimony at public hearings or expressing their views through correspondence. I thank the other members of the committee, including the deputy chair, Senator Carol Brown. I particularly thank the secretariat, led by Bonnie Allan, for their wonderful efforts. With these comments, I commend this report to the House.
by leave—I rise to speak on the Joint Standing Committee on the National Disability Insurance Scheme's interim report on the NDIS workforce and the same committee's report on general issues. I would like to thank the joint standing committee for its work—the chair, the member for Menzies, Kevin Andrews; the deputy chair, Senator Carol Brown; Senators Askew, Chisholm, Hughes and Steele-John; the members for Corangamite, Adelaide, Reid and Fisher; and the committee secretariat.
I would urge the government, as a matter of priority, to respond to the recommendations of both these reports in a timely manner that reflects the hard work and the importance of their content. The report on general issues in the NDIS makes several important recommendations, including that the NDIA and the watchdog, the NDIS Quality and Safeguards Commission:
This is an important recommendation that recognises the reality of people with disabilities being forgotten in the early stages of the pandemic. The royal commission recently noted how the government had even omitted people with disability entirely from its pandemic emergency response plan.
There are recommendations about better engagement by the National Disability Insurance Agency with Indigenous Australians, with homeless people and with people who have psychosocial disorders. The final two recommendations are about better communication with NDIS participants about matters relating to the scheme and better management of circumstances around the death of participants. These are a response to the sorts of shortfalls highlighted by the tragic deaths by neglect, such as that of Ann-Marie Smith in Adelaide. Following her death and following calls by Labor, the government initiated the independent Robertson review. Alan Robertson, Senior Counsel, made a series of recommendations, some of which are now mirrored in these joint standing committee recommendations. I hope that the Minister for the NDIS now takes more notice of these important calls. He has so far refused to respond to the Robertson review recommendations. It's now 95 days since the Robertson review into the death of Ann-Marie Smith was handed down, and we've heard nothing from the government.
The committee's interim report on the NDIS workforce also shows that remaining work needs to be done. I think some of the noteworthy recommendations here are the need for the NDIA to ensure all pricing reviews are conducted in full consultation with people with disability, support workers and representative organisations.
A review of options for a national registration and accreditation scheme for disability support workers is an analysis of the skills and qualifications required by the disability workforce and a look at the vocational education and training programs and university courses to ensure they capture the real training needs for the sector and for the workforce of the future. Further, it's removing barriers of entry for people with disability to apply for positions at the National Disability Insurance Agency. There is a need for a strategy to address distribution shortfalls and thin markets in the allied health workforce in many parts of Australia.
A lot of this talks to what Labor has been saying for some time now and what we have been hearing from unions representing workers in this sector—the ASU, HSU, the United Workers Union and Australian Workers Union. There's a real need for career ladders, plans for job security and meaningful qualifications so that Australia cannot just do the right thing by the workforce and people with disability domestically but we can become a world leader in standards of care—a key remaining part of our service-leaning care economy.
It is excellent this bipartisan committee is speaking such sense on the issues. However, it does go against the trend of accelerating the gig economy. There remains a danger for government, such as the current one, falling for the lure of app based mechanisms that undermine the importance of a quality non-casualised workforce. Some government MPs may be attracted to the of uberisation of disability services—a digital marketplace—but I urge them to carefully listen to the well-researched and sensible conclusions of the report, which the member for Menzies has been speaking to. It is the right path for workers, the industry and people with disability.
One final matter, which would be remiss of me not to raise, is in response to the member for Menzies' comments on the report and the proposed introduction of independent assessments. I wish, in particular at this point, to draw attention to the views of the Australian Association of Psychologists. They have written to me and said, 'The proposed changes have caused a great deal of distress in the disability and psychology communities, with many of our members, the psychologists, sharing grave concerns for the wellbeing of their clients, if it is implemented. A key concern is that allied health professionals who are known to participants will have little input, if any, into the participant's eligibility to determination, plan development and reviews.'
The psychologists go on to say, 'The NDIA-appointed independent assessors will not have the depth or breadth of knowledge about a range of disabilities, particularly uncommon disabilities, to be able to adequately understand the complexity of various participant needs. Simplistic assessment by unfamiliar assessors will likely be traumatic for participants and their families. The use of one-size-fits-all assessment tools will most likely result in people with complex disabilities not being assessed properly. Poor assessments are likely to lead to people being denied access to this scheme, and, for those deemed eligible, they're likely to be granted inadequate funding. For people with social, cultural and language barriers, as well as those with complex communication or sensory needs, unfamiliar, independent assessors are unlikely to be able to understand or indeed assess their needs.'
The psychologists go on to say—and I agree with their proposition—'The participants should be given the right to choose to either undergo the independent assessment process or use reports from their trusted and qualified allied health providers. People living with disabilities are often subject to prejudices and quick judgement of others as well as the loss of choice and control. The independent assessment changes proposed by the current minister cements that experience for the participant. It takes away the participant's right to have a tailored assessment and a treatment program to improve their function and achieve goals for their choice. Experienced allied health professionals who are familiar with the most evidence based interventions available are best placed to recommend the type and frequency of treatment required to meet the participants' needs. If there are additional assessment measures that the NDIA requires, these need to be communicated clearly to providers so they can be included in reports, removing the need for independent assessors.'
All of us, I believe, have the view that the NDIS should protect the most vulnerable in our community. What we need to do is make sure that we honour our beliefs in the actions which we take in this place. I commend the report, to which the member of Menzies has spoken.