The AFR View
The $92b disability services question is still unanswered
The NDIS minister failed to drive home the real political message: as harsh as it may sound, expectations of what the NDIS can do, and for whom, have to be wound back.
The review of the National Disability Insurance Scheme had two basic tasks. The first was to explain how a scheme that began with the generous intention of delivering personalised, life-changing support for a relatively small pool of people with a permanent and severe disability has grown into a budget monster that Prime Minister Anthony Albanese now says has to be saved from collapse.
The second task was to provide a set of credible recommendations to deliver on NDIS Minister Bill Shorten’s plan to reduce annual growth in the cost to taxpayers to 8 per cent, down from the current 14 per cent that, unless checked, would lift its annual cost to $92 billion within a decade.
As with the royal commission on robo-debt, taxpayers deserve to be reassured that the political class has learned the lesson from the morphing of the NDIS into perhaps the most out-of-control social services program ever.
Bill Shorten’s political focus at Thursday’s National Press Club appearance was on cracking down on waste and fraud. James Brickwood
Yet the reviewers, NDIS architect Professor Bruce Bonyhady – who once claimed the scheme would largely pay for itself by helping the disabled find work – and former public servant Lisa Paul, have failed to tackle the fundamental question directly. Why did a scheme which was supposedly focused on those with severe disabilities become a much broader and open-ended social entitlement program for those with less severe conditions?
How did nearly one in eight boys aged between five and seven come to receive funding from a scheme designed for severe and permanent disability?
Nevertheless, the basic story of what has happened can be pieced together from the proposed reset and redesign of the NDIS rules to better police who is eligible for how much funding.
‘Buying’ NDIS reform
The review recommends that eligibility for NDIS funding be based on a clearer and more robust definition of “substantially reduced functional capacity”. That would abolish the automatic access to the scheme based on a medical diagnosis by doctors, which apparently explains the unbudgeted explosion in the number of children with mild autism and other early developmental disorders accessing the scheme.
The review also recommends legislating a clearer and more consistent definition of the “reasonable and necessary” supports that the NDIS will fund, backed up by new individualised plans in consultation with an expert employee of the National Disability Insurance Agency. This appears to be the in-house version of the proposed independent assessments that the Morrison government was forced to abandon after Mr Shorten launched a Mediscare-style political campaign against them.
The $92 billion question is whether the proposed changes will actually rein in the spending in line with what is already plugged into the budget’s medium-term projections. That calculation needs to factor in the additional costs of politically “buying” NDIS reform as the Albanese government takes back with one hand and gives out again with the other.
The one in five Australian children reportedly suffering mild autism and other “foundational” conditions, who are to be excluded from the NDIS from now, are instead to be cared for by a new $10 billion joint federal-state funded scheme announced by the national cabinet on Wednesday. That is on top of the $25 billion extended GST top-up payments and increased public hospital funding that state governments extracted from the federal government to get them to agree to sign off on changes to the NDIS.
The GST top-up entrenches the dog’s breakfast of federal-state financial relations just as personal income tax eats up a record high amount of Australians’ household income.
The NDIS was established a decade ago amid the China-based resources boom that over-inflated political expectations of what governments could provide, especially for worthy causes such as severe disability and children’s education.
Mr Shorten’s political focus at yesterday’s National Press Club appearance was on cracking down on waste, fraud, and business models of “millionaire” NDIS service providers. The minister in charge of reining in the NDIS failed to drive home what needed to be the real political message. As harsh as it may sound, expectations of what the NDIS can do, and for whom, have to be wound back.
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