Chapter 7Committee views and conclusions
Overview
7.1The establishment of the National Disability Insurance Scheme (NDIS, or the scheme) over ten years ago was a world-leading reform. The scheme has changed thousands of lives for the better, and increased economic, social and community participation for people with disability, their families and carers.
7.2Since the scheme was first envisaged in 2008, Australia has had six different Prime Ministers and two changes of government. All governments support the scheme and have worked hard to ensure its success and sustainability.
7.3As the scheme progressed from the early trial stage, through the national rollout, and into scheme maturity, the Joint Standing Committee on the NationalDisability Insurance Scheme (the committee) has independently overseen the process. The committee has provided an important mechanism for participants, families and carers, and the disability sector to communicate their experiences, concerns and views with the Parliament and parliamentarians. Through its general and specific inquiries, the committee has worked to hold government, and National Disability Insurance Agency (NDIA) to account.
7.4The committee has heard, throughout many inquiries, that when the scheme works well, it is lifesaving and life changing. However, in many cases, the committee has heard that scheme does not always live up to participants' expectations.
7.5The committee's many recommendations made over its 10 years of inquiry reflect the lived experience of participants, families and carers, of providers, and the broader disability sector. Collecting and presenting a wide variety of evidence, the committee's reports have helped inform discussion and provided recommendations to reform the scheme as it has matured.
7.6However, as an innovative, world-first model of disability support, the NDIS is still evolving. Governments continue to test, evaluate, and refine aspects of the scheme, recording a number of successes and shortcomings along the way.
7.7In this report, the committee has looked back through the last ten years. Acknowledging the remarkable achievements of the scheme and of the NDIA, we also identified a number of areas where there is still work to be done.
7.8This chapter concludes our report, providing the committee's views in relation to three critical pillars of the scheme, which also represent the three key areas for improvements to the NDIS:
co-design
choice and control, and
sustainability.
Co-design
7.9Co-design principles draw on the lived experience of people with disability to inform the development of the NDIS at all levels, from the overall scheme to the delivery of individual plans and supports.
7.10The NDIA is committed to working collaboratively with the disability community to design and implement improvements and changes to the scheme. It also promises to work with individual participants to design their individual plans and supports.
7.11The NDIS Review includes a recommendation that co-design principles be embedded in the design, funding and implementation of the FoundationalSupports Strategy.
7.12The committee welcomes the government's recent commencement of work on the strategy, and is committed to monitoring its development through future inquiries.
Choice and control
7.13The NDIS was created with the express purpose to increase the level of choice and control that people with disability are able to exercise. The committee has heard that there are some areas where work is needed to ensure choice and control is embedded in the scheme and the experience of every participant.
7.14The NDIS Review also found that the rhetoric of choice and control is not supported by the experiences of people with disability, with poor availability of services and the complexities of navigating the system having a profound impact.
7.15The Review made several recommendations targeted at supporting participants to exercise genuine choice and control and to be able to make decisions about their supports and how they live their lives. (Recommendations 4, 5 and 8).
The committee supports these recommendations and will be closely monitoring their implementation.
7.16The committee understands the additional barriers and challenges to exercising choice and control that are faced by First Nations people, people from culturally and linguistically diverse backgrounds, and people living in rural, regional and remote areas. The committee will continue to investigate these issues through its inquiries, including its current inquiry into the NDIS participant experience in rural, regional and remote areas.
Reasonable and necessary supports
7.17Over its ten-year history, the committee had heard time and time again, about the critical importance of providing participants with the reasonable and necessary supports they are entitled to with respect to the principles of the scheme as embedded in the NDIS Act. We have also heard from participants and their nominees on multiple occasions that the determination of a participant’s reasonable and necessary supports must be based upon the participant’s (or their nominees') lived experience and their expertise of their own disability and life; along with their goals and evidence provided by their health professionals.
7.18The committee has repeatedly heard that great distress has often been caused to participants and families when supports applied for or previously funded that have been applied for or previously funded are not provided in the participant’s plan. The committee has long held the view that this distress and consequent difficulties for participants in securing such supports could be avoided if they were provided with a draft of their plan. To this end, recommendation one of the JSC NDIS Report on the 2020 NDIS Planning Inquiry stated that:
The committee recommends that the National Disability Insurance Agency provide fully costed, detailed draft plans to participants and their nominees at least one week prior to their meeting with an official with the authority to approve the plan.
7.19The committee continues to uphold the view, in line with its 2020 recommendation, that fully costed, detailed draft plans should be provided to participants and their nominees at least one week prior to meeting with an NDIA official with who has the authority to approve a plan.
Sustainability
7.20Australians believe in a fair go. This is why most Australians support the NDIS.
7.21The NDIS is not simply a cost, it is an investment. Providing reasonable and necessary supports to people with disability increases social and economic participation, reduces hospital admissions and medical costs, frees up informal carers and family members to work and participate in the community, and improves health and wellbeing for the long-term.
7.22Some data is available which demonstrate these outcomes. Similarly, research into economic benefits flowing from the scheme indicates that the NDIS stimulates a large quantum of economic activity and supports many thousands of jobs.
7.23However, mechanisms to measure the impact of specific supports and interventions must be developed, so that funding can be better targeted and provided in a more consistent, evidence-based manner.
NDIS markets and workforce
7.24The issue of 'thin markets' in regional and remote locations is a wicked problem. The committee is acutely aware of how this failure reduces access to the scheme for people in those areas and limits their choice and control.
7.25Also concerning is the increase in financial distress among providers reported by National Disability Services and others. Government and the NDIA must work to understand the drivers of this distress, and adjust policy and pricing as needed to reverse the trend.
7.26Workforce shortages remain a significant challenge for the sector, despite high and growing demand for services. The committee is encouraged by objectives outlined in the Draft National Strategy for the Care and Support Economy, and recommendations made in the NDIS Review which aim to improve jobs in the sector.
7.27It is critical that urgent action is taken to make jobs in disability support and care more attractive, and that governments invest in growing the skilled occupations needed under the NDIS, such as Occupational Therapy and Speech Therapy.
NDIS policies and practices and obligations under the UN Convention
7.28Australia is a signatory to the United Nations Convention on the Rights of Persons with Disabilities (UNCRPD) and the NDIS Act gives effect to the UNCRPD along with other Commonwealth legislation.
7.29The committee has heard consistent calls across its ten years over NDIS oversight about the importance of aligning all government programs and services with the UNCRPD. This point has been repeatedly raised across multiple inquiries and in many submissions. As a signatory to the UNCRPD, Australian government departments and agencies have an important role in ensuring that any changes to NDIS policy and programs, rules and regulations must be consistent with the UNCRPD, and thereby remain inclusive and accessible.
Conclusions
7.30This report has detailed ten years of the committee's oversight of the NDIS. Over this period, the committee has played a significant role in reviewing the scheme and making constructive recommendations for improvement and reform. The report also draws on contemporary evidence received during this inquiry, from participants and others regarding current challenges with the scheme.
7.31These challenges, many of which were recognised by the Independent Review, relate to the implementation of the three fundamental principles of the NDIS, namely co-design, choice and control, and sustainability. The committee recognises that it is these foundational principles that establish a framework for the scheme, inform its culture, and make it world leading.
7.32In this report, the committee has drawn on evidence from NDIS participants and others to reveal the ways in which the implementation of these fundamental principles, and lack thereof, impacts the quality of life for participants as well as the quality of services and supports provided to them. The committee will continue to oversee these challenges and efforts to address them, including through implementation of the Independent Review's recommendations.
7.33Finally, the committee would like to recognise the remarkable work and tireless efforts of participants, their families, carers and the disability sector over the last ten years to provide their views and concerns about the NDIS to the committee. Their engagement as submitters and witnesses has contributed to a significant volume of evidence over numerous inquiries, including through submissions, public hearings and in response to committee correspondence, and has shaped the committee's work and informed its findings and recommendations.
7.34The committee would like to remind all those submitters and witnesses that their efforts do matter, and their evidence does count, and continues to contribute to improvements to the NDIS.
Ms Libby Coker MPSenator Hollie Hughes
ChairDeputy Chair
Joint Standing Committee on the NDIS of the 47th Parliament
Source: AUSPIC
Back row (from left to right): Ms Alicia Payne MP, Senator Anne Urquhart, Senator Jana Stewart, Ms Jenny Ware MP, Dr Mike Freelander MP
Front row (left to right): Ms Libby Coker MP (Chair), Senator Hollie Hughes MP (Deputy Chair), Senator Jordon Steele‑John
Absent: Dr Monique Ryan MP, Senator Dave Sharma
Former members: Senator Kerrynne Liddle (from 1 August 2022 until 13 June 2023), Senator Linda Reynolds CSC (from 13 June 2023 until 4 December 2023)