The National Disability Insurance Scheme (NDIS) is one of Australia's most ambitious public policy initiatives. At 30 September 2020, the NDIS was supporting over 410 000 people with permanent disability to access services and supports. The number of participants is expected to grow, with the Minister for the NDIS estimating that the scheme will ultimately support more than 500 000 Australians.
Critical to the sustainability of the NDIS and the delivery of safe, quality supports is a workforce of sufficient size to meet demand, and with the appropriate skills, qualifications and expertise. It is estimated that the workforce will need to grow by approximately 90 000 full time equivalent staff over the next four to five years.
However, attracting and retaining a suitably skilled, qualified workforce is proving a challenging endeavour, as the sector is increasingly seen as overworked, underpaid, undervalued and poorly trained. Evidence indicates that:
the sector is highly casualised, and work is often insecure;
pay rates may not reflect the complex, sensitive nature of disability support work;
workers often receive limited if any training from their employers, and there are limited opportunities for career advancement; and
workers may not be adequately supervised, and are often left to make complex decisions about care needs.
These issues are not new. They have been identified by this committee on several occasions, as well as via numerous other review and inquiry processes and through media commentary.
Comprehensive, targeted action is required to address barriers to attracting and retaining a skilled and qualified workforce. Otherwise, workforce supply issues and skills gaps will likely worsen, with significant adverse consequences for participants.
The issues raised in this report are not intended as a criticism of individual workers or providers, who are working under increasingly trying circumstances to deliver safe, quality supports. Rather, the committee has endeavoured to address systemic issues which are creating barriers to workforce development.
The need for an interim report
Evidence received during the inquiry indicated that more time is needed to present a fully considered report on the NDIS workforce, noting the scope of relevant issues and the need to consider matters affecting multiple jurisdictions and service sectors. Additional engagement with stakeholders—including NDIS participants, workers and representative organisations—is also required.
In addition, the committee understands that the Australian Government proposes to release a national workforce plan for the NDIS in the coming months. Further time is needed to assess the extent to which this plan addresses issues raised in evidence during this inquiry, including through consultation with key stakeholders.
The committee has therefore decided to present an interim report, to draw attention to key issues facing the NDIS workforce. The report also makes 14 recommendations to address the identified issues, focussed on NDIS pricing; training and professional development; growing the lived experience workforce; and addressing thin markets for supports and services. In addition, the committee has highlighted matters that should be addressed in the national workforce plan, and which the committee will consider in more detail after the plan is released.
The COVID-19 pandemic
The COVID-19 pandemic has had an unprecedented impact on all Australians, and has created particular challenges for people with disability and the workforce which delivers disability supports and services. This report does not consider issues associated with the COVID-19 pandemic in any detail, focusing instead on more general issues affecting the NDIS workforce. Issues associated with COVID-19 are considered as part of the committee's inquiry into general issues relating to the implementation and performance of the NDIS.
The NDIS funding model and price settings
Evidence indicates that current price settings, implemented in the context of the consumer-directed funding arrangements which underpin the NDIS, may be driving poor workforce conditions within the sector. The Australian Government should therefore facilitate a review of the funding model for the scheme—including current and future pricing arrangements—as soon as practicable. This is to understand the impact of NDIS price controls on work in the NDIS, the workforce, and the quality of care for participants. The committee will also consider price settings and the NDIS funding model in its final report for this inquiry.
Training and professional development
Disability support work is complex, sensitive, and highly skilled, and it is imperative that the workforce possesses the qualifications, skills and expertise to deliver safe, quality supports. The workforce requires a keen understanding of disability and its manifestations, and critical intangible skills such as the capacity to treat people with dignity, respect and compassion. Specific skills are also needed to support people with particular disability types, and people from particular demographic cohorts.
The Australian Government should undertake a thorough analysis of the skills and qualifications required in the disability sector, informed by extensive consultation with people with disability, support workers, peak bodies and tertiary education providers. Thereafter, the Government should facilitate a review of current vocational education and training (VET) and university programs in disability and allied health, to ensure that the training needs of the NDIS workforce are captured.
Evidence also suggests that the lack of nationally recognised competency standards for the NDIS workforce may lead to considerable variation in the quality of supports for participants and to increased costs for providers. The Government should review options to develop a national registration and accreditation scheme. This should include competency standards reflecting the diversity of people with disability, co‑designed with people with disability, support workers and representative bodies.
Employment opportunities for people with disability
More should be done to increase the representation of people with disability in the NDIS workforce. This is not only to improve employment outcomes for people with disability, but also to grow and enhance the quality of the NDIS workforce by harnessing the untapped potential of lived experience. While some initiatives exist to support the employment of people with disability, there does not appear to be a strategy with a specific focus on the lived experience workforce within the NDIS.
The NDIA should therefore develop, publish and implement a strategy to grow the lived experience workforce, co-designed by people with disability and peak bodies. The strategy should include measures to match opportunities to the capabilities of prospective employees, and should encourage people with disability to aspire to roles at all levels—including managerial, technical and leadership roles.
In addition, the NDIA should implement an education strategy for participants, co‑designed by people with disability, peak bodies and training providers. This should include measures to clarify the training requirements of particular roles, encourage academic success, and support the transition from education to employment.
Thin markets
Evidence indicates that thin markets for supports and services continue to present challenges for the NDIS workforce, as well as for participants and providers. Much of this evidence reflects concerns raised during previous inquiries of this committee, and through other review and inquiry processes, suggesting that limited progress has been made to address identified issues. Thin markets require targeted action by government, and should be a focus of any national workforce plan for the NDIS.
Maldistribution of allied health services
A particular concern for stakeholders is the maldistribution of allied health services, leading to reduced service access and to difficulties attracting and retaining suitably qualified staff. The Commonwealth, states and territories should, via the appropriate intergovernmental forum, consider the matter of allied health maldistribution and implications for access to services, and develop strategies to enable workforce distribution, sustainability and growth.
Supporting Aboriginal and Torres Strait Islander communities
Aboriginal and Torres Strait Islander peoples continue to be underserved by the NDIS, due to acute shortages of affordable, culturally safe and appropriate services and the lack of investment in capacity-building. A targeted strategy is needed to grow the Aboriginal and Torres Strait Islander workforce, co-designed by Aboriginal and Torres Strait Islander peoples and Community Controlled organisations. The strategy must recognise the need for access to supports on country and the paramount importance of cultural competency.
Workforce planning
The committee understands that the Australian Government proposes to release a national workforce plan for the NDIS, after consultation with the disability, aged care and community sectors. The committee looks forward to the release of this workforce plan, and considers that it should include—at a minimum—measures to:
improve workforce conditions via stable employment; investment in training, supervision and professional development; and pay reflecting the complex, sensitive nature of disability support work;
enhance and—where appropriate—harmonise the skills, qualifications and expertise of the workforce;
support the employment of people with lived experience of disability; and
address thin markets for services—particularly for Aboriginal and Torres Strait Islander peoples and for people living in regional, rural and remote areas.
In addition, a national plan should deliver national consistency, and address gaps at the interface of Commonwealth, state and territory schemes and service sectors. It should provide for clear national leadership, and clarify responsibilities at the Commonwealth level for market stewardship within the NDIS.
Workforce data
The Australian Government should develop and implement a strategy to collect, refine and publish data on the NDIS workforce, including development of a national minimum dataset. This should allow stakeholders to properly understand the size and composition of the NDIS workforce, anticipate demand, and build solutions.
Marketing the NDIS
The Australian Government should develop and implement a strategy to 'market' the NDIS as an employer of choice. This may include public campaigns to highlight the value of the scheme, and measures to promote the sector via secondary and tertiary education settings.
Conclusion
The committee thanks everyone who participated in the inquiry by lodging submissions, providing testimony or expressing views via correspondence.
The committee will give further consideration to issues associated with the NDIS workforce in coming months, including consideration of any national workforce plan. This will include conducting further public hearings. The committee proposes to present a final report to Parliament in 2021.