2.1
This chapter provides background on the National Disability Insurance Scheme (NDIS) and briefly examines the state of the NDIS workforce and its future growth needs.
2.2
This chapter also provides an overview of relevant work conducted by this committee, as well as various Senate committees. Finally, it briefly examines the publications and work of other relevant bodies and initiatives, including the Royal Commission into Violence, Abuse, Neglect and Exploitation of People with Disability; Disability Reform Ministers’ Meetings; Australia’s Disability Strategy 2021‑2031; and Employ My Ability, the Disability Employment Strategy.
National Disability Insurance Scheme
2.3
The NDIS is an insurance-based model for funding and supports for people with disability, families and carers. It replaces the previous state-based system of block funding with a 'fee-for-service', market-based approach.
2.4
The main component of the NDIS is individualised packages of supports for eligible people with disability. The scheme is based on the premise that people with disability each have different support needs and should be able to exercise choice and control in relation to their supports.
National Disability Insurance Scheme Act 2013
2.5
The NDIS is established under the National Disability Insurance Scheme Act 2013 (NDIS Act). The Act sets out the objectives of the NDIS, which include:
supporting the independence and social and economic participation of people with disability
providing reasonable and necessary supports, including early intervention supports, for NDIS participants
enabling people with disability to exercise choice and control in the pursuit of their goals and in the planning and delivery of their supports
facilitating the development of a nationally consistent approach to accessing, planning and funding of supports for people with disability; and
promoting the provision of high quality and innovative supports.
2.6
The NDIS Act further provides for how a person may become a participant in the NDIS; how plans are prepared and reviewed; how the NDIS approves funding; how an entity can become a registered provider of supports; and the process for reviewing decisions.
National Disability Insurance Agency
2.7
The National Disability Insurance Agency (NDIA) is the independent statutory agency responsible for the governance and administration of the NDIS. Its core functions include delivering the NDIS in a way that maximises choice and control for participants and promotes access to high quality supports, and managing, advising and reporting on the financial sustainability of the NDIS.
National rollout of the NDIS
2.8
The NDIS became operational on 1 July 2013 with the commencement of trial sites. National rollout of the scheme began on a geographic and age basis from July 2014, with the majority of jurisdictions beginning transition on 1 July 2016. The transition to full scheme was guided by bilateral agreements between Commonwealth, state and territory governments.
2.9
National geographical rollout of the NDIS was completed on 1 July 2020, with Christmas Island and the Cocos (Keeling) Islands joining the scheme. As at 30 September 2021, the NDIS was providing services to 484 700 participants across Australia.
The NDIS workforce and its future growth needs
2.10
A workforce of sufficient size to meet demand, and that has the appropriate skills, qualifications, and expertise is critical to the sustainability of the NDIS and the delivery of safe, quality supports.
2.11
As set out in the committee's interim report, attracting and retaining a suitably skilled, qualified workforce is proving challenging for the NDIS, as the sector is increasingly seen as overworked, underpaid, undervalued, and poorly trained.
2.12
Analysis from the Department of Social Services (DSS) indicated that in 2020, there were around 270 000 workers in the NDIS workforce. This comprised approximately 178 000 home-based support workers, 63 000 community-based support workers, 19 900 allied health professionals and 8 000 workers in other occupations.
2.13
It is estimated that the workforce will need to grow by 31 per cent (an additional 83 000 full time equivalent staff) to support 500 000 NDIS participants by June 2024, when full transition to the scheme is projected to be complete.
2.14
This analysis suggests the NDIS workforce is required to grow to a total of 353 000 workers, which would include:
60 900 additional home-based support workers;
10 000 additional community-based supported workers; and
8 000 additional allied health workers.
Relevant parliamentary inquiries
Work of this committee
NDIS Workforce Interim Report
2.15
On 9 December 2020, the Joint Standing Committee on the NDIS (the committee) tabled an interim report for its inquiry into the NDIS Workforce. The interim report is available on the committee’s webpage, and is discussed further in Chapter 3.
Inquiry into General issues around the implementation and performance of the NDIS
2.16
On 30 November 2021, the committee tabled its 2021 General Issues report, its second progress report in the 46th Parliament, considering the general implementation and performance of the NDIS. The report is available on the committee’s webpage.
2.17
The 2021 General Issues report covered the period of December 2020 to November 2021 and discusses a number of issues relevant to this inquiry, including:
the qualifications of NDIS planners
thin markets in rural, regional and remote areas
the complementary workforce, namely, how nurses could contribute to and support the NDIS workforce; and
Inquiry into NDIS Quality and Safeguards Commission
2.18
On 30 November 2021, the committee tabled its NDIS Quality and Safeguards Commission report. The report contained 30 recommendations in relation to the NDIS Quality and Safeguards Commission’s (the Commission’s) approach to quality and safeguarding for NDIS participants, as well as other quality and safeguarding matters.
2.19
The NDIS Quality and Safeguards Commission report considered a range of matters relevant to this inquiry, including the Commission’s:
registration and worker screening processes;
staffing and resources; and
data collection and reporting on workforce matters.
Inquiry into market readiness for provision of services under the NDIS
2.20
From December 2017 to September 2018, the committee undertook an inquiry into market readiness for provision of services under the NDIS (Market Readiness inquiry). Among other matters, the inquiry considered workforce demand and shortage; policies and initiatives to grow the workforce; and barriers to workforce growth. The full report was tabled on 20 September 2018 and is available on the committee’s webpage.
2.21
More detail on the Market Readiness inquiry, including issues raised, recommendations and government responses that are relevant to the present inquiry, is also discussed in the NDIS Workforce interim report.
Work of other committees
Senate inquiry into the current capability of the Australian Public Service
2.22
On 1 December 2020, the Senate referred an inquiry on the current capability of the Australian Public Service (APS) (APS inquiry) to the Senate Finance and Public Administration References Committee. The inquiry reported on 25 November 2021.
2.23
Relevantly, the APS inquiry heard concerns about labour hire within the NDIA and the NDIS Quality and Safeguards Commission, including: ongoing reliance on labour hire for core, ongoing work; diminished quality of services; stressful and insecure conditions for staff; and a lack of information on expenditure, particularly in regard to the wages paid to workers.
2.24
The majority report proposed a series of recommendations to address these concerns. Government senators on the committee provided a dissenting report that argued the majority report did not give weight to the evidence provided by APS agencies. The report (including the Coalition Senators’ dissenting report and additional comments from the Australian Greens) is available on the Senate Finance and Public Administration References Committee’s webpage.
Senate Select Committee on Job Security – First Interim Report
2.25
The Senate Select Committee on Job Security (Job Security Committee) tabled its first interim report into on-demand platform work in June 2021. The majority report considered at a number of matters in relation to the prevalence and operation of on-demand platform work.
2.26
The report explored the emergence of on-demand platform providers in the disability and care sector and highlighted the demographics and workforce models of the main platforms operating in the disability and care services space. The report considered the projected growth of contracting arrangements in the disability sector, as well as the associated risks this could present to the sector for both workers and NDIS participants who are seeking disability and care services including:
lack of entitlements for workers employed through on-demand platform providers; and
attribution of liability and other Work Health and Safety implications.
2.27
The Job Security Committee in that report made a recommendation that the Joint Standing Committee for the National Disability Insurance Scheme, as part of the current inquiry into the NDIS Workforce, give consideration to a number of matters relating to the provision and operation of platform-based work within the disability sector.
2.28
The Job Security Committee has since tabled second and third interim reports, and is expected to table a final report in February 2022.
Senate inquiry into violence, abuse and neglect of people with disability
2.29
In February 2015, the Senate referred an inquiry into violence, abuse and neglect of people with disability (2015 inquiry) to the Senate Community Affairs References Committee. The inquiry reported on 25 November 2015.
2.30
Relevantly, the 2015 inquiry identified several systematic and workforce-related issues that may cause or exacerbate violence, abuse or neglect towards people with disability and recommended that a Royal Commission into violence, abuse and neglect of people with disability be called. Issues identified by the inquiry included:
the institutional nature of disability service provision
low pay rates, contributing to high levels of staff turnover
high rates of casualisation
lack of career development and training
lack of appropriate pre-employment and ongoing worker regulation
poor workplace culture; and
lack of appropriate risk management and reporting processes.
Work of other relevant bodies
Royal Commission into Violence, Abuse, Neglect and Exploitation of People with Disability
2.31
The Royal Commission into Violence, Abuse, Neglect and Exploitation of People with Disability (the Royal Commission) was established on 4 April 2019, to inquire into all forms of violence against, and abuse, neglect and exploitation of, people with disability in all settings and contexts.
2.32
Evidence before the Royal Commission routinely touches on issues affecting the NDIS workforce and the capacity of the workforce to deliver safe, quality supports. Several key issues related to this inquiry have been raised at recent public hearings of the Royal Commission, namely:
Public hearing 9: Pathways and barriers to open employment for people with disability.
Public hearing 10: Education and training of health professionals in relation to people with cognitive disability.
Public hearing 19: Measures taken by employers and regulators to respond to the systemic barriers to open employment for people with disability.
Royal Commission into Aged Care Quality and Safety
2.33
The Royal Commission into Aged Care, Quality and Safety (Aged Care Royal Commission) was established on 8 October 2018 to deal with matters relating to the provision, quality and delivery of aged care services in Australia. Among other factors, the work of the Aged Care Royal Commission is relevant to this inquiry, due to similar structural workforce challenges identified both the aged care and NDIS sectors, and young people with disability living in residential aged care homes.
2.34
The Aged Care Royal Commission tabled its final report, titled ‘Care, Dignity and Respect’, on 1 March 2021. The report included a number of recommendations, several of which related to the aged care workforce, including:
changes to education, training and labour conditions to professionalise the aged care workforce
registration of personal care workers
ensuring independence, accountability and transparency through strengthening provider governance arrangements
enabling a stronger quality regulator; and
development of a plan to ‘deliver, measure and report on high quality aged care’ that will place a general duty on aged care providers to ensure quality and safety of care.
2.35
In the government response to the final report, the government accepted or accepted in-principle, a number of recommendations relating to the aged care workforce. Other responses to recommendations relating to the aged care workforce included that:
Recommendation 78 relating to establishing a mandatory minimum qualification for personal care workers was subject to further consideration.
Recommendation 84, would be noted (that there be an increase in award wages for aged care employees); and
Recommendations 101 and 102 relating to penalties for breaches of legislation were subject to further consideration.
Disability Reform Ministers’ Meetings
2.36
Disability Reform Minister’s Meetings are held several times a year, to provide a forum for all Commonwealth, state and territory Ministers responsible for disability policy to drive national reform, including through the National Disability Strategy and the NDIS.
2.37
Since the NDIS Workforce interim report was tabled on 9 December 2020, five Disability Reform Minister’s Meetings have been held. Matters raised in these meetings that relate to this inquiry include:
the NDIS National Workforce Plan 2021-25
the Australian Government’s the A Life Changing Life campaign
work underway to align regulation to improve quality and safety and reduce red tape across the care and support sectors; and
the COVID-19 vaccination roll-out to people with disability and disability support workers.
Australia’s Disability Strategy 2021–2031
2.38
On 3 December 2021, marking the International Day of People with Disability, the Australian Government launched Australia’s Disability Strategy 2021–2031 (the Strategy), Australia’s national disability policy framework for all people with disability (not just NDIS participants).
2.39
The new Strategy builds on its predecessor (the National Disability Strategy 2010–2021) and sets out a plan for continuing to improve the lives of people with disability in Australia over the next 10 years. The Strategy was signed and agreed to by all jurisdictions and levels of government, and was developed in close consultation with the disability community.
2.40
Relevant to this inquiry, the committee particularly notes the Strategy’s following policy priorities:
Increase employment of people with disability.
Improve the transition of young people with disability from education to employment.
Improve pathways and accessibility to further education and training for people with disability.
People with disability have increased opportunities to participate in accessible and inclusive lifelong learning.
Employers value the contribution people with disability make to the workforce, and recognise the benefits of employing people with disability.
Employ My Ability: Disability Employment Strategy
2.41
The Australian Government’s new Disability Employment Strategy, 'Employ My Ability' was launched alongside the National Disability Strategy 2010–2021 on 3 December 2021. It provides a 10–year guiding framework for improving employment opportunities for people with disability, with a vision to create ‘inclusive workplace cultures where people with disability thrive in their careers’.