Monday, 21 November 2011
Social Security and Other Legislation Amendment Bill 2011; Second Reading
While the Greens support some schedules in the Social Security and Other Legislation Amendment Bill 2011, we do not support schedule 3. Schedule 3 allows for the implementation of the new disability impairment tables, which we believe are inadequate. We are deeply concerned that they will have unjust outcomes for people living with disability, particularly when it is added to the process around access to the disability support pension, which the government has already put through this place.
While we support the move to a functional model of disability, as opposed to a purely medical one, we believe that the process by which the tables were drafted and tested should have been much better. We are deeply concerned that the more stringent nature of the assessment will have unacceptable impacts on some people living with a disability. We believe that the process by which the tables were drafted showed a lack of adequate consultation. We do not believe that the tables were adequately tested. They do not properly address the needs of some people living with disability, particularly those in regional and remote Australia, and they show considerable gaps in coverage of certain conditions. We believe they will cause increasingly large numbers of people living with a disability to go onto Newstart in a deeply inhospitable labour market where there are still not good outcomes for people living with a disability trying to find sustained employment. That came out not only in the inquiry into this particular bill, but also in the previous inquiry into the process for accessing the disability support pension. It is also coming out in the inquiry into disability and employment services.
If you look at the consultation and testing process, we are deeply concerned that there were a limited number of consultations with people living with a disability and with the disability sector, both before and after the drafting. We are concerned that there has also been inadequate testing of the new impairment tables. There was a small sample size of 215 people who were tested through the process. We do not believe this is statistically sound, despite the government's claim that it is. Moreover, when those people are divided over the 15 tables, there are 10 tables where the number of people tested is six individuals or less. This is far too small a sample size. The trial was conducted entirely in Victoria. Not that I am being state-centric, but there is a vast difference between Victoria and my home state of Western Australia, for example. We do not believe that has provided adequate coverage of the rest of Australia, particularly of regional and remote communities. It is also unclear whether people with a disability from non-English speaking backgrounds or those who are Aboriginal and Torres Strait Islanders were consulted or included in that process.
Furthermore, the trials revealed that in some cases where an inter-rater comparison was completed there was a 35 per cent conflict between primary and secondary assessors. This brings into question the validity of the assessments, which cannot be applied consistently. It is extremely troubling that these tables, which have the potential to impact on thousands of vulnerable Australians, have not been subject to more rigorous examination. I have no confidence that the tables will adequately assess a person's disability or functionality. It is unfortunate that, yet again, the people who are going to be the most affected by this—those with a disability—are going to be subject, in essence, to what will become just one big trial of these new impairment tables.
During the committee inquiry into this bill, the impact on people living with disabilities in regional and remote areas was discussed quite a bit. I am particularly concerned that the adverse consequences of the new tables will be felt very strongly in regional and remote areas. The new tables rely heavily on applied health practitioners such as occupational therapists to provide information for diagnosis. In many regional and remote areas these specialists may not be available or may be recent graduates with not sufficient experience. That is not having a go at recent graduates, but the point is we often have the most inexperienced graduates in some of these areas who are not used to this type of assessment. We are quite concerned about these particular issues.
Furthermore, the tables clearly prohibit the consideration of environmental concerns when determining DSP eligibility, creating serious questions of equity for people living with a disability in remote and regional Australia. For example, this group is subject to the same requirement to look for work within 60 minutes commuting time of their residence. In some areas with minimum public transport this is a deeply unreasonable expectation, even with the mobility allowance. The tables are unable to consider issues such as access to public transport and taxis, distance required to travel to work, attitudes of employers and availability of jobs. Sue Egan of Physical Disability Australia says:
We believe that, for people with a physical disability, an accessible worksite and being able to get to and from work are crucial, particularly for people who work in rural areas where there is no accessible public transport. I live in a rural area myself and I work from home, but if I did not work from home there would be no accessible transport for me to get to work, as I have a disability as well. So I think that those factors need to be taken into account when considering whether a person should qualify for a DSP.
Almost 50 per cent of people living with a disability on DSP in Australia live in regional and remote areas. It is extremely concerning that the needs of this large group have not been adequately taken into account. I am very concerned that many conditions are not properly captured by the impairment tables—in particular, co-morbidity, chronic or persistent pain, and intellectual disability. Senator Fifield has touched on the issues around chronic and persistent pain and around intellectual disabilities.
There are concerns that individuals who have co-morbid conditions, scoring 15 points across the tables, are likely to face major difficulties in the employment services system but will no longer be eligible for DSP. The tables compound difficulties already experienced by people with co-morbid conditions and, as I was saying earlier, when you look at the changes that were brought in under the 3 September changes to the Family Assistance and Other Legislation Amendment Act 2011, the interaction of these two pieces of legislation will have significant impacts on people living with a disability. Under this new legislation, only those who are assessed to have a severe impairment will be exempt from completing a program of support. However, the method for determining severe impairment does not adequately take account of co-morbidity, as there is a requirement for 20 points in a single table. People with co-morbid conditions who are not judged to have a severe impairment will not be put straight on to DSP. They will most likely be placed on Newstart and yet be unable to, in some cases, meet the requirements of participation in a program of support. I know I have traversed these issues previously in this chamber, but it remains a very serious concern.
Chronic pain is another condition, coverage of which by these tables has also been significantly questioned, and it was raised during the committee inquiry. The tables consider paying a symptom only and not a condition. It appears that chronic pain will not be assessable as an impairment even though it may have major function impacts on daily activities and preclude the sufferers from maintaining 15 or more hours work per week in the labour market without the need for ongoing support. I understand some of these issues are being addressed, but it yet again highlights the way the changes to these tables have had inadequate consultation and were brought forward before these issues had been adequately dealt with.
The other issue that was raised, which Senator Fifield also touched on, is intellectual disability, particularly for people with an IQ score of 70 to 79, who would fail to qualify under the revised tables. Some 24,000 people fall into this group, which is already over-represented in homelessness statistics, in hostels and, unfortunately, in our prison incarceration statistics. Again, while I understand that there has been some ongoing dialogue about this issue, it is symptomatic of the fact that these impairment tables have been rushed through without adequate consultation or thought about what they mean for these people with significant disabilities.
I must question the motivation for some of these changes. While ideally the move to functionality is supported, as I have already articulated, I am very deeply concerned about what the underlying motivation is for some of these changes, when you also take into account the changes that have already been made in the Family Assistance and Other Legislation Amendment Bill. I believe these changes are focused on trying to save money by keeping people off disability support and on Newstart, not on improving their ability to find long-term, sustainable employment.
When you look at some of the issues around the labour market, one of the most critical issues I want to raise is the endemic and widespread inability of people with disabilities to secure sustainable employment. This is not just about cycling people in and out of short-term employment. It is extremely concerning that about 38 per cent of new DSP applicants in the trials at the moment have been rejected under the new tables. It is clear many people will be placed on Newstart who are unlikely to find long-term, sustainable employment, which is what this measure is said to try to achieve.
According to the National Council on Intellectual Disability, the current outcomes for disability employment service programs reveal a 26-week employment outcome rate of 16 per cent. This means 84 per cent of people with disabilities entering the disability employment service will not get a sustainable job. Anglicare and ACOSS believe this is largely due to the job market, which is currently not able to meet the employment needs of job seekers with a disability. The concern here is that, if we are cycling people in and out of short-term jobs, this is not achieving what we are trying to achieve, which is sustainable employment. It can also act as a disincentive to people who are continually cycling in and out of jobs and, through no fault of their own, are not able to maintain these positions. We will just be adding more people to this group, of which there are already 13,000. I am not convinced (a) that the employment services are prepared to handle this number of people and (b) that we can guarantee we will be able to find sustainable employment for these people.
I know the minister will address the issue by saying that there was money allocated in the budget for work placements. Again, there are not enough resources allocated to adequately support the number of people on the disability support pension who are seeking employment or the number on Newstart who are seeking employment. I will quote from ACOSS's submission to the inquiry:
… the DSP assessment process as a whole does not take account of the labour market response to disability, for example whether work of the kind a person is capable of performing is available where they live and whether employers discriminate against people with a particular disability … it is important to acknowledge that the labour market is still hostile to disability. The overall employment rate of people with significant functional impairments in 2009 was 42% compared with 70% for the wider community.
We are deeply concerned that the government is pursuing measures that will reject more people from DSP, given the inability of the present job market to absorb people living with a disability.
We are also concerned that people who are unable to get sustained employment and unable to qualify for the DSP will be living on Newstart, on $34 a day. Newstart is $128 a week less than the pension—and that has changed—and has a much harsher income test and taper withdrawal rate. It is inferior to the DSP in many ways. For example, there is no eligibility for the pensioner education supplement and a liquid assets waiting period applies. People living with a disability accrue extra costs on top of ordinary living expenses—for medication, equipment, transport and even electricity. We are not saying that people who do not qualify through the impairment tables are not living with a disability, so we are talking about people on Newstart trying to find sustained employment while living with a disability. We believe many, many people will find it difficult to meet the activity requirements and will be confronted by a complex and punitive compliance regime.
I am very concerned at what will happen to people currently on DSP when they are subject to review with the new tables. According to FaHCSIA, under the old tables 2.2 per cent, or 18,100 people, were required to undertake a medical review in 2010-11, and 1.6 per cent of those, or 298 individuals, lost eligibility. It is not possible to tell with certainty how many people would lose eligibility when assessed using the new tables, but if the results of the trial are any indication around 38 per cent of those 18,000, or 4,500 people, may no longer qualify for DSP and be placed on Newstart. This is exceptionally problematic, considering many of these people will have been on DSP for years, if not decades, and have little prospect of securing sustainable employment. This impact has to be examined in light of other changes to DSP taking place. As I have already said, we are extremely concerned that we are going to have a growing cohort of people living with a disability on Newstart who will be permanently stuck on Newstart. I do not think this is a way of helping people—entrenching poverty, particularly when they have a disability.
We are very concerned about monitoring these changes, given all these concerns, and about how soon this massive trial, which is essentially what this amounts to, will be adequately reviewed. Although we know an 18-month review is planned, we do not believe this is soon enough. We believe it should occur within 12 months, because, as I said, this is essentially a giant trial. The longer it goes on before it is assessed, the greater the impact of its negative effects on those living with a disability. We cannot support the changes proposed in schedule 3 at this time, because we do not believe the new impairment tables will lead to better outcomes for those living with a disability. So we will be opposing schedule 3 of this bill, and I have circulated amendments to that effect.
Finally, I would like to touch on schedule 4. While I support the introduction of an independent certification system for disability advocacy services, and the creation of the new standards, it is imperative that we get these standards right. I have received concerned calls from disability advocacy organisations stressing the importance of including independence from disability employment services in these standards and the provision of other support. I have circulated a second reading amendment going to a specific issue to do with independence. While we appreciate that, particularly in regional areas, it is very hard to ensure complete independence of organisations from the provision of other support services and employment services from advocacy services, we do believe that there must be as much care as possible and services should as much as possible be free from conflicts of interest or the perception of conflicts of interest.
So, although I understand that these issues are intended to be addressed in the standards, we believe that there should be a second reading amendment to the legislation to actually state that fact very clearly upfront. I have to say that the evidence I have heard so far through the hearing into employment services reinforces for me the need to make sure that advocacy services are, as much as possible, independent from the other services that organisations may provide. I do understand the argument, particularly for regional and remote services, that it is very difficult to have completely separate services in these small centres, so I have amended my position on this. But I still believe there is a need for a recognition by this chamber with respect to this legislation that in fact, for the purpose of certification of advocacy services under amendments made by schedule 4 of the bill, advocacy services must be as free as possible from conflicts of interest or the perception of conflicts of interest with disability service providers. I believe that is essential. I understand that is the government's intention. We believe it needs to be permanently on record that this is what the parliament of Australia expects: that these services are as independent as possible. I therefore move the Australian Greens amendment on sheet 7152:
At the end of the motion, add:
but that for the purposes of certification of advocacy services under amendments made by Schedule 4 of the bill, advocacy services must be as free as possible from conflicts of interest, or the perception of conflicts of interest, with disability service providers.