Blog Archives

DisabilityCare, Geelong and the Decentralisation of Public Services

Planning for the NDIS, now DisabilityCare is coming along quite well. The only state yet to sign up to the full roll-out of the Gillard Government’s new plan for disability services is Western Australia. And just a few short weeks ago, the legislation for the funding of the disability scheme was introduced into the parliament and swiftly passed through both the upper and lower houses of parliament.

And on Monday this week the government announced that the headquarters for the government program will be in the Victorian city of Geelong. The move to base the head office of the scheme in Geelong came less than two weeks after the city took a big hit with Ford announcing it plans to cease production of automobiles in the country, a decision which will cost over 1000 jobs.

As a result of the government’s announcement, three hundred jobs will be on offer in Geelong, in what is being pushed as assistance to a town which will be beginning the transition away from large-scale manufacturing, at least as far as cars go, over the next three years.

But here we reach the first question. Is it really of great assistance to Geelong, and in particular, workers who will be leaving Ford Australia? Potentially. Some may be picked up over time by the DisabilityCare agency as they try to seek work locally. Some will inevitably retrain in another area, perhaps in public administration or disability services. But others will need to look elsewhere in Geelong, or perhaps much further afield.

What the announcement really is, in the way it was framed, is a symbolic gesture by the Labor Government, meant to appeal to the heartstrings.

Another claim put forth by the government is that it is an example of a commitment to the decentralisation of the public service. And it is decentralisation, in the sense that  the top brass in the DisabilityCare bureaucracy will not be based in the traditional heartland of the commonwealth public service in Canberra. Having a number of staff in the states and territories is also an example of decentralisation.

What this policy needs however, is a more deeply decentralised structure. Rather than simply saying that the top end of the bureaucracy should be based in one city or town or another, we should be spreading it around Australia more, on the basis of the population of each state and territory respectively. We ought to have decision-makers much closer to “the action”.

This reform is about delivering the best we can to the most vulnerable in our community. This means throwing as much as possible into a number of local areas, including major players.

Of course the CEO and some staff are going to have to be placed in one location. That is not a problem, but more senior staff should be spread around.

There are still other issues to be teased out in terms of making sure that the funding commitments aside from the levy are maintained, regardless of who is in government. And we must make sure that Western Australia joins in with the disability insurance scheme, or worst case scenario, offers a policy almost identical to the national one, save for possible improvements on how to administer it.

There is a lot still to be discussed, but the die has been cast and Geelong has secured some employment opportunities. But all care needs to be taken and in particular, lessons need to be learned, during and after the trial phase which commences in just a number of weeks.

Hopefully there will be no hard lessons in the coming years.

We Must Remain Vigilant

The National Disability Insurance Scheme, now renamed DisabilityCare is a step closer to becoming reality after the Queensland Premier Campbell Newman signed an agreement with Prime Minister Julia Gillard in Brisbane. The agreement confirms the funding commitment of both levels of government to the disability scheme.

The deal will see Queensland contribute $1.9 billion dollars over the next decade and see the disability reform starting to emerge in 2016, before it is fully operational in 2019-20. In signing up, Queensland now joins New South Wales, Tasmania, Victoria, South Australia and the Australian Capital Territory as signatories to the funding arrangements. That leaves Western Australia and the Northern Territory as the only governments still to put ink on the page.

Understandably, excitement is growing about the future of disability care in Australia and that has accelerated with each individual agreement reached between the state and territory governments and the commonwealth. People with a disability around Australia, their carers and families, are slowly rediscovering a long lost hope, that their needs might be sufficiently met by government. Of course there is going to be palpable excitement. Of course there will be some celebration.

But we need to be very careful about how we view recent events. As advocates and supporters of this much-needed reform we must not allow ourselves to get too swept up in the emotion of important days like yesterday. There is no doubt that commitments like that agreed to by Julia Gillard and Campbell Newman are a big step forward, but a lot can still go wrong between now and 2018-19. In fact, there is a need to continue to be cautious until well after the scheme is fully operational across the country. Things can still go a bit pear-shaped.

The first, but most surmountable roadblock is getting the recalcitrant state of Western Australia and the Northern Territory to agree to a funding commitment for the rollout with the commonwealth.

Western Australia wants to sign up but wants more decentralised control of the scheme in the state and that is fair enough, because service delivery should be based on a largely decentralised bureaucracy. Negotiations between WA and the federal government will continue and a resolution of some sort appears inevitable. But caution is still the order of the day here and both the state and the commonwealth must continue negotiations with an open mind and a desire for compromise on the specific issues WA has with the policy.

The Northern Territory will also need to get the pen out and sign a deal with Canberra for the full rollout of DisabilityCare. The NT Government just recently penned a deal to have their own launch site in the Barkly Region. In light of this, realisation of the funding for the full commitment surely cannot be too far away. But again, all possible eventualities must be taken into account, including the negative ones. even though 6 of the 8 states and territories have agreed to terms with the Gillard Government.

Bilateral agreements aside, there is still the issue of where the commonwealth, even the states, will get the rest of the money for the disability insurance scheme, despite the commitments to fund the scheme. At present the agreements are simply words between two parties and in the interest of making sure DisabilityCare happens, the positive developments must be viewed with the utmost wariness until the full policy has actually commenced.

The Opposition too, who will almost certainly be in government come September, will need to be pursued just as relentlessly over its commitment to the NDIS. There is bipartisan support but it means nothing until we actually see the policy up and running.

Finally, we must continue to run a critical eye over the policy even when it is operational. There may be shortfalls in standards of delivery and even funding and we should not be particularly surprised if either of these possibilities arises. In fact, it is completely within reason to expect that both problems may exist, though hopefully the  launch sites will allow enough time to remedy most, if not all potential issues.

With the agreements signed to date between commonwealth and state and territory governments, about 90% of Australians with severe and permanent disability and those that look after them can now have a little more hope.

We need to make sure over the coming years that the agreements are transformed from words on a page to deeds.

Gap Between NDIS Idea and Reality Narrowing

A not insignificant breakthrough has been achieved in the journey toward a fully-funded National Disability Insurance Scheme. The Gillard Government and New South Wales have reached an agreement on joint funding of the full NDIS, due by 2018-19. The deal brings the full scheme closer to fruition. However, there are still challenges which will need to be overcome before people with a disability can say with absolute certainty that the National Disability Insurance Scheme is going to happen.

Under the agreement the federal government has agreed to fund 51.4% of the cost of the scheme to NSW, with the state government set to fund the remaining 48.6%. Under the deal, in dollar terms, both the state and federal government will contribute over $3 billion to the scheme, with the commonwealth providing $3.319 billion and New South Wales $3.133 billion.

From financial year 2018-19, the major disability reform, under the Commonwealth-NSW agreement, would see 120,000 disabled people in the state have their needs met by the NDIS.

To have the biggest state by population being the first of the states and territories to sign up to the full disability scheme is a sizable coup. What the deal means is that 120,000 of the over 400,000 set to be covered by the full disability insurance scheme now have their future assured, at least on paper.

The announcement does not assure that the NDIS will go ahead, but it does provide a level of hope that has not yet been experienced by people with a disability, their carers, families and advocates.

There are another 5 states and two territories which will need to sign onto the scheme for the national project to go ahead.

The NSW deal could provide a catalyst for other states getting onboard with the disability reform, either when they meet with the Prime Minister at the Council of Australian Governments meeting tomorrow, or at some stage in the future after tomorrow’s COAG.

Today Queensland Premier Campbell Newman appeared to have changed his political tune about the reform, saying that he and his government are “very interested” in a deal like the one Barry O’Farrell and Julia Gillard reached today and that it is “very attractive”. He did however say that at this stage his government did not have the funds for the implementation of the policy.

Western Australia are at present looking at their own trial of a similar scheme to the NDIS, but they too could change their tune tomorrow when the Premiers and Chief Ministers meet at the COAG table.

And Victoria, a state closely aligned with New South Wales in terms of political allegiances could easily agree to follow the lead of the O’Farrell Government when the Council of Australian Governments meets.

It would appear likely that the state Labor Governments which have signed up to the trial will be prepared to sign on the dotted line, providing their formal support for a fully established National Disability Insurance Scheme.

An argument raised today, as it inevitably is when there are major reforms announced, is just how believable and enduring the agreement between the Australian Government and NSW will be.

It is true that the agreement lacks detail at this stage and that it might fall victim to politics. Six years is a long time away and governments, state and federal may fall in the meantime.

The agreement however is a commitment from the O’Farrell Government of New South Wales, that it can and will find over $3 billion dollars to fund a fully operational NDIS. Some of that will come from the approximately $17,000 per person that is spent at present by the biggest Australian state. The rest, the NSW Government has today agreed, will be found elsewhere in the state budget.

Even less of a worry is the prospect of a change of government at the state level.

In the event of a Labor administration taking power in New South Wales by fiscal year 2018-19, it would be unlikely that you would see them walk away from the O’Farrell commitment to help fund disability services. Indeed, it would be a politically stupid government that would choose to walk away from a commitment set to benefit so many people.

The prospect of more states agreeing to deals like the one between New South Wales and the ALP Government too might actually help the deal endure.

It is true that the commonwealth government will likely be a different one in 2018-19 and that in itself could provide problems even though the NDIS is the subject of bipartisanship.

Whichever side of politics is in power during the year 2018-19 will need to act on the NDIS and by then will well and truly be in a position to do so.

The next move or set of moves may come tomorrow, or some time in the near future.

The pressure from the disability lobby must remain strong. There are still five states and two territories which need to commit funds and the advocacy work cannot cease, even after the scheme is operational.

A Response to an NDIS Opinion Piece

Today Prime Minister Julia Gillard introduced the legislation for the National Disability Insurance Scheme. This Medicare-like scheme is a very important reform, a long time coming for people with a disability, who have suffered under inadequate and differing support regimes from state-to-state. The NDIS will create a national framework under which the needs of those with a severe and permanent disability will be met.

The introduction of the legislation in the House of Representatives is just the first step. NDIS trial sites will be launched next year, but there is still a need to keep the pressure on, to ensure that the fully-fledged system will be realised.

Up until recently, most of the negative debate around the policy has been about the cost. It is significant, requiring approximately $15 billion a year from the first full year of implementation in financial year. That time comes at the end of this decade. But the scheme can and must be funded. There are numerous ways to ensure that it is fully funded.

This week, in an opinion piece in The Australian written by Doron Samuell from SR2 Healthy, relatively new arguments came to light.

In the first instance, Mr Samuell argued that, “lured by the promise of taxpayer dollars, it is inevitable that disability services will come to be dominated by large, corporate players in the post-NDIS world.”

Later in his op-ed, Doron Samuell provides an argument which says that this is already occurring. So really, what we will have is the status quo. It is hard to envisage that smaller providers could be crowded out even more than they already are.

For equipment, like wheelchairs and other mobility aids, disabled people will most likely choose to use bigger organisations that might have the capacity to carry a broader range of stock and therefore, more cost-competitive products.

For services, users will probably choose to use a mixture of smaller, community-based organisations and larger “corporatised” ones. This will, again, at least maintain the status quo. There is also a strong chance that smaller organisations able to adapt to client needs under the NDIS will be able to grow if they can prove they provide good services.

The idea of the insurance scheme, as it will apply to many applicants, is to give users, capable of decision-making, the choice to pursue services from providers that they perhaps already identify with.

Also on the question of choice, Samuell made what amount to some pretty offensive, not to mention inaccurate comments about the capacity of people to choose wisely under the disability scheme. He actually claimed that the disabled were “often unsophisticated” purchasers and asked “these consumers going to make the right decisions?”.

Well, of course those who have a capacity to make decisions for themselves are overwhelmingly going to make the right decisions according to their needs. People with a disability are no less rational than ‘able-bods’ and nobody else knows their personal requirements better than people with a disability themselves. No doctor, no healthcare professional, no bureaucrat understands disability better.

Mr Samuell also appears to have forgotten a provision in the bill, which allows for funds to be provided to a carer or directly to a service provider in the event that someone eligible for NDIS funds is unable to make or communicate decisions for themselves on their own care needs. The latter is a worry because, again, bureaucrats should not be making these kinds of decisions.

Samuell also states that “the NDIS will need to ensure that buying decisions are scrutinised, audited and reviewed”. The legislation actually provides for this.

Doron Samuell does go to the question of funding. He does this from the position that Medicare, the system that the National Disability Insurance Scheme is based on, is under-funded and has a bloated bureaucracy.

There is a danger that the NDIS will be under-funded. There is always that danger when government embark upon significant reforms, that costs might be under-estimated. But what is clear is that the claim about Medicare only coping “by progressively lowering the standard of care to maintain its universality”, will almost certainly not apply to the NDIS.

A bloated bureaucracy is of some concern. There will need to be a significant number of  jobs created or filled across the states  and territories to oversee the agency. However, the bigger concern should be too much centralisation of the increased bureaucracy.

Finally, Samuell’s contention about the NDIS not being based on insurance principles is neither here nor there. What is important is that this landmark reform provides adequate support for those it is targetted at.Getting bogged down in definitions is pointless.

The biggest concern should be making sure the introduction of the full scheme occurs in 2018-19.

An Open Letter to State and Federal Politicians Regarding the NDIS

Dear state and federal governments,

I do not believe that all of you, despite protestations to the contrary, are actually one hundred percent serious about pursuing the implementation of a National Disability Insurance Scheme. Furthermore, I am concerned that the bipartisanship at the federal level may well be in name only.

Labor: You announced, with great fanfare as a result of work precipitated largely by Bill Shorten as Parliamentary Secretary for Disabilities through the Productivity Commission, that a NDIS was needed. That report identified that the disability services sector is fragmented and under-funded. You pledged to work towards implementing such a scheme.

The Coalition: You announced swiftly, despite a perceived disposition towards opposing major reforms, that you wholeheartedly supported the idea to assist some of the most vulnerable Australians.

Since that wonderful day when you, our federal politicians gave a feeling of hope that many people with a disability and their carers have never experienced before, things have changed.

The future of the much-needed reform looks far less certain than it did this time last year and that worries me. I have no doubt it also worries many others with a connection to disability. We are used to disappointment and people with a disability are used to being largely left out of government calculations.

I acknowledge that the problem is not wholly because of you, the federal government. Blame for the uncertainty must also be laid squarely at the feet of some of our state governments. Yes, you did ignore, as governments generally do an important recommendation. This recommendation from the Productivity Commission said that you, the commonwealth should be the sole funding government of this important initiative.

To Tasmania, South Australia, the Australian Capital Territory and later New South Wales and Victoria: Thank to all of you for getting past the Gillard Government’s refusal to be the sole contributor to the National Disability Insurance Scheme. Your contribution is much appreciated, even yours NSW and Victoria. At least you were willing to remain at the negotiating table even if your government’s played it trickily for a while.

Queensland: Despite the dumping of the key recommendation from the report into the insurance scheme, you could have contributed a modest amount of funds toward a launch site.

You should have been able to get past that point and negotiate with the federal government from the viewpoint that they must be responsible still for the bulk of money contributed towards the establishment of a NDIS. We know and acknowledge that your revenue streams, as with all states, are limited. However, giving something was entirely possible.

To all the states: Please now operate on the assumption that the commonwealth government should provide the vast majority of the funds toward the NDIS. That includes you Queensland.

But back to you, the federal government: A half thanks for the $1 billion over 4 years in the May budget. You contributed something. But in the scheme of things it falls remarkably short of the mark. The meagre sum of $250 million a year for four years for a project that will cost over $13 billion in the first full year is a bit of a joke, especially considering how much more you like to waste in other areas.

To the federal Opposition: Thanks for what appeared, at least initially, to be earnest support for an essential new way of catering to the unmet needs of people with a disability.

Since that initial endorsement though, there have been mixed messages which make me and many others concerned that your professed interest in pursuing this in government might actually be a little on the fake side.

If this is a false assumption then please stop people like Joe Hockey from appearing to question the ability to fully fund the scheme years into the future. Please stop the Shadow Treasurer from referring to it in a negative light.

Contribution to the scheme will be more than possible by the time of implementation put forward by the Productivity Commission. Even the timetable of the ALP Government is within reason. It is only one year earlier.

Again to Labor: I hope you did not think that my concern over your actions, or lack thereof was limited to that already mentioned. It is not.

I am very concerned at your ability to appear to be doing something while actually doing little at all, other than mostly talking. You now say you will introduce legislation to establish aspects of the NDIS, including the transitional agency. That is great, but it is useless without money being funneled towards it.

You have said, or at least hinted over the past couple of days at more money being directed toward the policy, but only next year. If your hilariously small contribution in the May budget is anything to go by, then a contribution next year, keeping in mind the state of the budget and the fact that it is an election year, will either be inadequate or potentially peeled back upon change of government.

The disability community would appreciate it if all of you would address our concerns. Some of you are doing very well, some okay and one state, that’s you Queensland, doing terribly.

There are a lot of people now more cautious, some cynical and some even scared about the prospects of not having the NDIS going ahead. We need reassurance that our concerns are not based in reality. That can only be achieved through strong actions, not strong rhetoric.

Yours Sincerely,

A NDIS fan

Another Hurdle for the NDIS

It seems a bit odd speaking of yet more potential woes surrounding the National Disability Insurance Scheme on an otherwise very happy day for people with a disability around the world with the London 2012 Paralympics beginning. But unfortunately that has to be done. A new report has placed serious doubts on the price tag for a fully-funded NDIS . Therefore the future of the scheme is put into question even more before the launch sites in New South Wales, Victoria, Tasmania, South Australia and the Australian Capital Territory have commenced operation. This would no doubt be a scary prospect for those with severe and permanent disabilities around Australia, their carers and families.

A report by the Australian Government Actuary shows that the initial figures put out by the Productivity Commission in its report into the establishment of a National Disability Insurance Scheme could well be wrong to the tune of billions of dollars. The Commission said in its report that a fully-funded NDIS in the first year of operation would cost upwards of $13 billion. The report by the actuary however, shows that the eventual cost in the first full year of the Medicare-like policy would be closer to $22 billion, that’s almost $9 billion more than the Productivity Commission determined the cost to be in their report to the Gillard Government.

That’s a horrifying extra hurdle that needs to be overcome in providing much needed, essential and coordinated services to a cohort that is all too often overlooked when calling for extra funds just to be able to do simple things like getting out of bed of a morning and out of the house to engage in the community.

Such a scary proposition requires a rethink of how to proceed with funding such an important initiative. Previously, the state governments, barring a few exceptions, with different degrees of vigour, have asserted that the commonwealth must do as the Productivity Commission recommended in their recommendations. That advice was that the federal government, to avoid a COAG bunfight with the states, be the sole-funder of the insurance scheme.

Particularly the Liberal state governments, but also the Liberal and National Party Coalition in Canberra toed the Productivity Commission line from very early on, saying that the feds have to be the sole contributors to the NDIS. Back when the figure was nearly $14 billion dollars, this wasn’t such a silly thing to pursue the government on, given what the Productivity Commission thought possible. But it would still have been a  difficult proposition given that the initial figure was not exactly small change.

Now two Liberal states agreed, after the conclusion of a Council of Australian Governments meeting, with much pressure applied by federal Labor, the press and lobby groups, to contribute some not insignificant funds in order to host launch sites in their jurisdictions.

The state and territory Labor Governments of South Australia, Tasmania and the ACT got onboard with the discussions from the very beginning, willing to put money toward such an important and necessary idea. They were rewarded at COAG, being named the hosts of the first three sites to see the National Disability Insurance Scheme in working order.

Then there was Queensland, the only state or territory, other than the Northern Territory, which was nearing an election and Western Australia, trialing a similar policy of their own, that wasn’t willing to stump up a single cent in order to be chosen to host another commencement location for the scheme.

Regardless of the recommendations, it could have easily been said back at the time of the COAG meeting of the Premiers, that the policy really needed agreement and an ability for all the states and territories and the commonwealth to work together on achieving this policy outcome.

Now, with the newly inflated figure being bandied about, it is absolutely essential that all the states and territories, in conjunction with the commonwealth government, are willing to put all the money needed toward a properly funded disability scheme.

All states and territories, as well as the national government must now work towards agreeing to put all of the money they currently contribute to disability services into the funding pool.

Then, the state Premiers and Chief Ministers along with the federal government must discuss and agree to contribute their fair share of the extra funds necessary to realise the benefits of an NDIS.

There is the possibility of instituting a levy to make up any short fall, but this should only be considered if both levels of government cannot agree to contribute all the funds necessary for the full operation of the proposed disability services framework.

It’s also politically risky for the incumbent government, with people generally not liking new taxes. But if all or at least a majority of states and territories can agree that a levy is a good way ahead, then that could go some way to ameliorating the concerns of the public in having to pay a new tax.

Particularly in light of the very contradictory statements coming from the federal Opposition over the NDIS, it is important that their suggestion of a multi-party committee to work together advancing the insurance scheme is instituted. This would give the Coalition no wriggle room to back away from a commitment to funding their part of the National Disability Insurance Scheme if, as many believe likely, they take the government benches in 2013.

Were such a joint committee to be established, it would also take the politics out of the equation which has infested debate over the scheme and ramped up in recent months. We all know who ‘owns’ this policy prescription, but it is so important that it should not be seen as something that the government and the opposition cannot work together on to achieve.

There are murky days, weeks, months and years ahead for the National Disability Insurance Scheme. The future of the not yet rolled out scheme looks tenuous. What we need now, more than ever, is for our politicians to shine, to rise above politics or the very worst fears of people with a disability, so often let down by government, will again be realised.

%d bloggers like this: