Monday, September 28, 2015

A Fair Trial for the NDIS


The recent opinion pieces published in the West Australian by David Gilchrist, Gordon Trewern and other stakeholders in the disability sector are of great concern to Western Australians and their families.

The views expressed are not the views of people with disability and their families themselves, who want a fair trial for the National Disability Insurance Scheme and the State based scheme, My Way.

The West Australian Government and disability service sector have been vocal in decrying the Federal scheme, stating that 'My Way is the best way.'

But who should get to decide what the 'best way' is? Those who will be directly affected by the scheme, or those 'stakeholders' who have vested interests?



In his latest opinion piece, Gilchrist not only fails to disclose his own vested interests, but tells West Australians that the scheme is destined for failure because the 'amounts being paid for services being paid for services by the NDIA will not sustain the disability services sector'. Ultimately, he says, the risk associated with this concern will be 'borne by people in our community living with disability'.

Gilchrist has strong links to government - as a former Assistant Auditor General and employee who relies on government funding - and is currently the chairman of Nulsen, one of WA's biggest service providers. He asserts that there has been 'no real research into the NDIS' - despite hundreds of thousands of dollars having been sunk into the national scheme's design, primarily on consultancy and actuarial work in assessing the scheme's costs - and says that the scheme is now 'bound by a funding envelope that is artificial.'

Self reinforcing rhetoric is not uncommon at present when it comes to Western Australian disability services. At a public hearing in April, the Disability Services Commission's Dr Ron Chalmers was asked to explain why funding packages in the My Way trial were routinely, on average, over $10,000 cheaper than the national average. He replied that people in the lower South West were encouraged to rely on 'friendship networks' and informal supports. When questioned about lack of access to therapy services, he told the Standing Committee that although people were not being supported to access therapy, it was a 'transition issue'. According to the DG, people with disability prefer to have less money for their funded supports, and would prefer to ask their friends for assistance.

Dr Chalmers : I draw again on 20 years worth of experience to say that, firstly, there are many people who would prefer that type of arrangement to be in place than having to rely on the fellow yesterday who did not have the support worker turn up on the second day in his plan. Those informal networks are very attractive to people and they would prefer to be supported it that way, a more natural way, than just saying, 'I am totally dependent on a funded service.'

A petition signed by hundreds people with disability and their families recently asked decision makers to give Western Australians with disability a fair trial under the NDIS, but their voices and public protests at the Canning election sites went all but unnoticed by mainstream media outlets.



It is a shame that allegedly bipartisan-supported reforms like the National Disability Insurance Scheme have been tainted by divisive politics which are informed by potentially the wrong stakeholders. Disability reform requires a nuanced and complex understanding of social policy, and this can only be directly informed by people with disability themselves.

There is one thing that is certain. Unless we are in possession of all of the facts - the facts about which scheme will work best for West Australians with disability themselves - we will be doing them a disservice by cutting the trial and evaluation short.

What do we need to happen in the NDIS/My Way trial?

- People with disability, their families and consumer representative groups in Western Australia must be directly involved in decision making around the future of the State scheme for people with disability and people with psychosocial disability. It is not acceptable for politicians, service providers and government departments to be making decisions which will directly affect our lives and futures.

- The NDIS/My Way trial must be allowed to run its full course, and people with disability must be directly involved in the design and implementation of the evaluation to ensure that it is fairly and equitably conducted.

- Key issues for different population groups, including the Aboriginal population in Western Australia, the CaLD community, the LGBTIQ communities, people with psychosocial disability, people with acquired injuries (including those who are compensable), regional and remote Western Australia and people who are exceptionally disadvantaged (including people who are living in institutionalised care and people with very high support needs) must be thoroughly examined to ensure the workability and appropriateness of any implemented scheme. There will also need to be close thought and examination of workforce and sector capacity issues and an understanding of how a state based scheme may interact with a national scheme (different residency requirements, portability of funding, safeguarding) and the NDIS legislation.

- A citizen’s jury should be considered as part of any evaluation to ensure that people with disability are independently and fairly judging the merits and pitfalls of each scheme. This jury should be funded by government (either State or Federal) and conducted by disabled person’s organisations.

- People with disability and their families should be given equal voice by media outlets, in political arenas, and in governance and decision making processes around the two schemes.

- There must be specific attention given to choice and control for people with disability, which under the State based scheme is allegedly more limited than the NDIS, to transport in regional and remote areas, to portability of funding and ownership of information. There must be robust analysis about the contention that My Way is able to be delivered for $10,000 cheaper than NDIS, despite higher costs for providers and regional locations, and the assumption that people will be forced to rely on 'friendship networks'. There should also be close examination about the apparent failure to fund therapy services because of 'transitional issues'.

- The bilateral agreement should be closely examined in relation to the impact upon choice and control for people with disability, as should the My Way emphasis on service provision.

- People with disability need to have roles as critical questioners in some of the key differences between the schemes. For example, it takes much longer from time of consent to time of plan approval in the My Way scheme. In the NDIS trial, more people are found ineligible. There is a vast and unexplained discrepancy in package sizes (ten thousand dollars more in NDIS) and My Way claims to have 34% self management, with no breakdown regarding shared management costs. Alarmingly, there is no available data from the My Way trials about complaints, internal reviews, AAT applications, safeguarding or satisfaction ratings.

- Modeling should be carried out about how a person will not be worse off if they move from Geelong to Perth, or vice versa. Portability was one of the key components of a national scheme, as was certainty - will certainty of funding be guaranteed under a state based scheme that sits separately from the NDIS?

- We need to ask and address key questions about certainty and change in the future. Will improvements/legislative amends are made in national scheme - will My Way just get left behind or will it seek to provide parallel level of benefits? How will they guarantee "not worse off" into the future?



Image description 1:

Three vests sit on stands. One is an Argyle sweater, the second is a standard vest and the third is a life jacket.

The Vested Interest Exhibition
The WA Government and Public Service has a vested interest in a successful My Way trial. They care about their jobs, power and control and will do anything to make sure they retain that, at any cost.

The big service providers have a vested interest in a successful My Way trial. They are in corporate survival mode, and will do anything to survive, no matter what the cost.

But what does a vested interest look like for people with disability and their families?
You think you're stakeholders, but this is about OUR LIVES. We want a FAIR TRIAL for the NDIS.


Image description 2:

A group of protesters holding signs speak to a politician about the NDIS My Way trial. One of the signs reads, 'A Fair Trial for the NDIS'.





3 comments:

  1. Sam,

    Firstly, I have to say that I am not employed by government and my role as Assistant Auditor General had nothing to do with Disability Services or their funding. Further, I do not rely on government funding for my employment.

    Secondly, I think it is important for you to separate the issues that are being raised. I have never spoken against the ideas that you have raised regarding care services or suggested in any way that people living with disability should not get a say. Indeed, one of the themes I have spoken on is the glaring need for people with disability to get a say. Rather, I am talking about funding and sustainability. The NDIS cannot survive if there are insufficient funds to support service providers. All of those things you discussed in your blog are different to the issues I was canvassing.

    As chairman of Nulsen I have seen first hand the financial pressure that service providers are placed under and this is surely an important perspective in terms of the objectives you have for the NDIS.

    Further, it is widely acknowledged that there was insufficient research undertaken prior to the scheme's commencement and new information is coming out of the trial sites all of the time. Again, I am not against the scheme, but, how can you get what you describe above if there is no planning or understanding of the costs and demand?

    Political will is critical but it is not enough and we need to understand the true cost of service delivery in order to understand the true funding problem so that it can be resolved and we can move toward providing the things you have spoken about.

    I am a great supporter of the NDIS but it cannot deliver if funding is inadequate. That is my sole point.

    David Gilchrist

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  2. This comment has been removed by the author.

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  3. Hi Samantha,

    The Wire current affairs radio program is working on a series about the NDIS, from our Sydney studio. Would you be interested in talking to us about your thoughts on the scheme?

    If so, we can arrange a pre-recorded phone interview. You can send an email to thewireradiooz@gmail.com and then I'll give you my contact details.

    Or feel free to call our newsroom and ask for Melissa: (02) 9514 9563

    We broadcast to community radio stations across Australia. Our website is www.thewire.org.au

    Thanks,

    Melissa

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