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National Disability Insurance Scheme Bill 2013
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McKenzie, Sen Bridget
National Disability Insurance Scheme Bill 2013
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Tuesday, 19 March 2013
Senator McKENZIE (Victoria) (13:43): I rise to comment and contribute to the debate on the National Disability Insurance Scheme Bill 2013—a bill whose time has come and an issue that has been a blight right across our society, in how we as a community, as a nation, care for those within our communities with a disability.
The bill establishes the framework for the National Disability Insurance Scheme—the NDIS—a new program for funding care and support for people with a disability, which is intended to commence in full right across Australia from 2018. The coalition very, very proudly supports and encourages this important reform across the disability sector and we have been a full and active participant in the inquiry process. Both Senator Boyce and our shadow minister in this area, Senator Fifield, in conjunction with other coalition senators, such as Senator Smith and me, have been examining this legislation in detail as part of the Senate Community Affairs Legislation Committee inquiry into the bill, which I will tell you about a little bit later.
I also welcome the launch of the NDIS transition agency and the first stage of the scheme in five sites across Australia. I particularly welcome its launch in Victoria in July and commend the coalition government in Victoria for staying at the table and ensuring that the 4,000 people, their families and carers, in the Barwon region, including the local government areas—the city of Greater Geelong, Colac Otway Shire, the Borough of Queenscliffe and the Surf Coast Shire—will benefit under the launch in July. The first stage will cost the Commonwealth government $1 billion over four years from 2012-13 and $342 million over three years from July 2013 to provide up to 10,000 individually funded personalised care packages for people with significant and permanent disability in 2013-14 and for up to 20,000 people from 2014-15.
The introduction of the NDIS is a positive move, and these reforms are a continuation of the reform process that began under the Howard government in 2005. Providing help and support for people who have a disability should be the core business of government. And while I welcome the support of the not-for-profit organisations, it should not be the sole responsibility of the private sector and of organisations like Windara, near Bendigo, or BrainLink in the Latrobe Valley, or the many thousands of carers to coordinate an attempt to support disabled people and their families and carers across our nation.
The NDIS will be a complex scheme that will transform the disability care sector in Australia and has broad support through the disability sector, although concerns were raised throughout the inquiry about the lack of detail in the bill—some would say this is an endemic issue, nevertheless we will save that for another day—and the impact on small service providers. Further questions raised included how the full version of the NDIS will be financed, whether there will be sufficient monitoring and other protections in place for participants, who specifically will receive the support and what specific support they will be able to access under the framework, and whether people aged over 65 should be able to become participants in the NDIS. It will take an insurance approach that shares the cost of disability service and support right across the community, it will fund reasonable and necessary services and support directly related to an eligible person's individual ongoing disability support needs and it will enable people with disability to exercise more choice and control in their lives through a person-centred, self-directed approach with individual funding.
Most Australians have assumed that because Australia is an advanced, wealthy nation that adequate support has been provided for people with disabilities. It is a reasonable assumption, but it has been somewhat misguided. Governments have struggled to find a solution for how to support those with a disability and their families. People with a disability have experienced significant barriers to full participation in both the economic and the social lives of the Australian community. A person with a disability has a poverty risk around 2.7 times higher than a person without a disability, putting Australia twenty-seventh—or last—out of the 27 OECD countries on this measure.
The support for Australians with a disability has been a frayed patchwork characterised by piecemeal programs, inconsistent eligibility criteria and a lack of coordination, so it is definitely time to invest in the needs of people with a disability, their families and their carers and work to ensure they are supported to meet their goals, objectives and aspirations over a lifetime. The current system of support for people with disability has been broken, and until recently we have not adequately addressed the need to support those people. Finally people will be able to decide for themselves how to manage their care and support. I remember hearing from particular witnesses during the hearing how important it was for them to be able to decide how and what services they needed to assist them to live with their disability, and the range is wide. Obviously they will need to be able to access assistance from local coordinators should they wish.
I commend the community affairs secretariat also on the mammoth task to produce this report. As usual, it is a comprehensive piece of work. Obviously, I again commend the shadow minister, Senator Fifield, for his leadership in this area. And particularly I commend all of those on both sides of the Senate chamber for their strong bipartisan support for the NDIS.
My involvement in the Senate inquiry, though brief, centred around the Geelong and Melbourne hearings and it shaped my concerns relating to the specific needs of people who live outside metropolitan areas. I would like to particularly acknowledge the thousands of Victorians living with a disability outside metropolitan Melbourne, and their families, who have suffered for so long and have waited so patiently for this major national reform. There are 161,000 people in Victoria with a disability. Given that 28 per cent of Victorians live in rural and regional areas and that disability crosses all socioeconomic groups, there are around 46,000 people living with a disability outside Melbourne. That is 46,000 people with a disability and at least another 46,000 regional Victorian families and carers—enough to fill the MCG on grand final day, if only they could all get there.
The NDIS Productivity Commission report confirmed what these people already know and what many of us know—that is, there is significant regional disparity between the city and the country when it comes to disability service provision. There has been less regional support for those people with a disability in regional Australia, and I quote directly from the Productivity Commission's report:
… rural and remote areas face poorer provisions of support than would be available to cities and metropolitan areas.
The current system is fundamentally flawed, the availability of support has been limited by location, and many families in regional and rural Victoria have not been able to get access to funding or assistance as the system currently operates. Everyone has to compete for a limited pool of resources, and for many families it is a situation of crisis. As the Nationals senator for Victoria, I have met disabled people and their families from across my state, and they have all challenged my notion of hard work and sacrifice. These people have been so desperately in need of our support. To the families who have been required to sell the family farm and move to Melbourne because that is the only way they can get support for their child, to the elderly dairy farmers who are worried about how to care for their 55-year-old intellectually disabled son once they are gone, to the families whose children attending Windara near Bendigo are looking to set up a residential facility, to the people who are worried about their children having to leave home in order to receive the care they need, I say: this National Disability Insurance Scheme is long overdue. It is an idea whose time has come. Again, to the Productivity Commission report: Australia's disability support system is inequitable, fractured, underresourced and slowly collapsing under the weight of its own inadequacies while suboptimally consuming billions of dollars of taxpayers' money each year.
So I welcome a number of amendments to the legislation that have been proposed throughout our inquiry. Specifically, I would like to draw the Senate's attention to the coalition's additional comments. In these comments we reiterate our strong support for the National Disability Insurance Scheme. Australia needs a new system of support, based on need rather than rationing. If we are going to do something, let us do it well and ensure that the role of government is for those in our communities least able to support themselves. We need to state once and for all on the record that this is an issue beyond partisanship. This is about empowering the individual, removing government from people's lives and reducing red tape. It is fantastic that both sides of the chamber are supportive of those types of measures, particularly around issues of disability.
But I have a number of concerns. One is the need to ensure that whilst this is a framework that outlines our intent and aspiration, we ensure that we monitor how this once-in-a-generation reform in the disability sector rolls out, because it is a bipartisan reform. We are proposing some amendments to assist parliament in ensuring that the rollout of the NDIS does fulfil the needs and the expectations of the community. The expectations are great. There are expectations to ensure service provision and to ensure adequate financial restraint so that money goes where it is needed rather than being rationed.
Other amendments are to subclause 35(4) that provides for rules to be made to deal with compensation payments when determining what is reasonable and necessary support that will be funded or provided and how to take this into account. The vast majority of people with disability have only ever received informal care, usually from family members. Nationally this is 66 per cent, but in regional centres, where less formal public support exists, we have heard anecdotal evidence that this figure is much higher. It is more likely that community support is strong in regional centres and smaller towns simply because it needs to be. Informal care is vital to the care needs of people with disability. This will continue to be the case in the future, regardless of improvements in the provision of NDIS support. Currently, the formal support provided by informal care is insufficient. This is most visible in the unmet need for supported accommodation and respite, particularly in regional centres. The need for more support care has been made strongly.
Similarly, I raise amendments to subclause 26(2) and (3). The proposed legislation has been adjusted so that a CEO is allowed to make requests for an extension of longer than 28 days for a person to meet the access criteria. This is particularly relevant for people in regional and remote areas of Australia, as a result of the availability of relevant and experienced medical professionals. Someone in regional Victoria, for example, might need more than 28 days to make the necessary medical appointments, drive to Melbourne or Adelaide to see a specialist, attend and have the report provided to the CEO in the previously required time frame. This is a sensible amendment; fantastic work again by the Community Affairs Legislation Committee.
Similarly under subclause 24(1) and (2) the NDIS will be a needs based rather than diagnosis or aged based scheme. Funding will be provided not because a person has a diagnosis but because they cannot function physically, intellectually or socially and need particular assistance. If they meet one or more of the intellectual, cognitive, neurological, sensory or physical impairments or psychiatric conditions, and the impairments are or are likely to be permanent then they will meet the criteria and be eligible. Given these changes, if the impairments result in substantially reduced functional capacity, including psychosocial functions, and they cannot communicate or interact socially, or if they have trouble learning with mobility, with self-care or self-management then they are eligible for NDIS support. This supports a key recommendation of the Productivity Commission inquiry report that assessments move from medical diagnosis to an assessment based on the capacity of the individual to work or undertake training.
Firstly, I have a number of concerns. Can we be sure that participant families who have actively supported their disabled adult or child will not be disadvantaged financially by the NDIS? How will the NDIS encourage, recognise and reward family participation? Secondly, some regional towns in Victoria have developed specific areas of expertise and have great specialists working specifically with the needs of people in their communities. While some disabilities might be better supported than others, providing for the specific needs of people in the regional areas is a particular concern of mine. The legislation is not perfect, and introducing an NDIS is complex, but whatever it looks like we need to make sure we capture existing services and add to them, not start from scratch. Some conditions might be better supported than others, and this is local knowledge in all country towns.
Finally, I have concerns about the capacity of this government to effectively implement this costly and complex reform. It is instructive that the unmet support needs of people with disability cost roughly $6.5 billion each year, roughly equivalent to the annual interest bill on the government debt the Gillard government has run up. While the coalition and other parties supported the NDIS and the broad architecture outlined by the Productivity Commission, the detailed design of the scheme, the legislative drafting and launch site implementation are the responsibility of the Gillard government. We wish them every success in ensuring that the high community expectation and the particular needs of our disabled communities are met through this legislation as outlined in the government's response. We wish them success, but we recognise that the implementation of the NDIS is solely in their court.
The coalition has offered to be partners with the government in the design of the scheme and the drafting of legislation through the establishment of a joint parliamentary committee to oversee the implementation of the NDIS. Unfortunately, the government has not accepted our offer. Therefore the coalition has not had the benefit of the information and the opportunities such a committee would have provided to work with the government on this truly bipartisan, once-in-a-generation reform before us.