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Joint Standing Committee on the National Disability Insurance Scheme
Independent assessments

McRAE, Ms Kim, Tjungu Team Manager, Ngaanyatjarra Pitjantjatjara Yankunytjatjara Women's Council [by audio link]

SMITH, Mrs Margaret, Vice-Chairperson and Director, Ngaanyatjarra Pitjantjatjara Yankunytjatjara Women's Council [by audio link]


CHAIR: We will now move to the NPY Women's Council. Do we have online either Mrs Smith or Ms McRae?

Ms McRae : Yes, we're both here.

CHAIR: Just for the information of my colleagues, you're appearing by teleconference. I welcome you both. Would either of you like to make some opening comments?

Ms McRae : I will make some brief opening comments about the concerns that we have about independent assessments. In the remote Aboriginal communities that we service, for a range of reasons we believe that the independent assessments will disadvantage Aboriginal people living in remote communities. We think that the proposal is not culturally appropriate. Many of our clients and families do not have English as a first language and do not like to talk to strangers. These are very remote areas. It takes a long time to get out there. Often you get out there and you find that our clients or families aren't there when you get there because there are other cultural priorities, like funerals or business. It can be difficult to get out to those communities if the weather is unsuitable. The roads flood regularly. As we stated in our submission, there are a whole range of reasons why we think independent assessments are not an appropriate tool for Aboriginal people in remote communities to access the NDIS.

CHAIR: Thank you, Ms McRae. I'll go to Senator Brown.

Senator CAROL BROWN: Thank you for your submission and for your evidence today. Given your opening statement, how did people in the NPY region hear about the planned changes to the NDIS?

Ms McRae : It's mainly been through information through various websites. It's been my job as the manager of the disability team to let our families know about the proposal. In terms of Aboriginal people living in remote areas, I don't think they would know about it unless they had workers who have had access to the information through email and websites; otherwise I don't think my families would know about it at all.

Senator CAROL BROWN: Have particular concerns been raised and do people feel that they've had an outlet to raise those concerns once they find out? Do you feel you've had the outlet on their behalf to raise those concerns?

Ms McRae : We have raised the concerns. The NDIA did their own consultation about the independent assessment proposal. We were able to respond to that. It was very discouraging that, before any outcome had been announced from the consultations, suddenly we were being told that a number of organisations had been appointed to do the independent assessments. It felt like it was a complete waste of time responding to that consultation.

Senator CAROL BROWN: We've had that evidence to the inquiry from other organisations as well. Touching on the companies that have been awarded the tender, do you know if the companies have cultural awareness?

Ms McRae : No, I don't. I haven't heard. We've had no contact with any of those companies previously. I've been here for 17 years, and to the best of my knowledge those companies have not been active in the remote NPY region previously.

Senator CAROL BROWN: What practical impact do you see independent assessments having on the NPY community?

Ms McRae : I think it will further disadvantage people because talking to strangers about personal-care needs and the impact of disability is something that Aboriginal people from our region would be very reluctant to do. Of course, there will be huge barriers in terms of language and culture because most of our clients and families have English as a second, third or fourth language. People have very low literacy skills, so reading and writing in English is also something that people struggle with. What will happen is that people will not get the sort of NDIS plan that they need because they're not going to feel comfortable to adequately describe the impact of their disability on their function.

People get embarrassed and ashamed to talk about things like personal care—showering and toileting—so they're certainly not going to feel comfortable at all to talk to someone they don't know about these sorts of matters. We also have highly mobile, transient families. It can often be very difficult to find people. We tend to chase people around to deliver services. It's going to be a real struggle for an independent assessor who doesn't know the participants and families to even find them to do the assessment.

Senator CAROL BROWN: We've heard evidence here today that raised concerns about the tools being inappropriate, and that's exactly what you've just been saying. Do you see that this proposed independent assessment process just entrenches many of the problems that already exist?

Ms McRae : Absolutely. It's going to add more disadvantage. It's another barrier to people in remote areas getting the sorts of supports that they really need.

Senator CAROL BROWN: Thank you. I appreciate your time here today.

Mr WALLACE: Thank you very much for your evidence today. We heard evidence earlier today from another organisation that provides services in remote Western Australia that the services that were provided under the old state-funded disability scheme were better then than they are now under the NDIS. Would you agree with that or disagree with that? What are your thoughts?

Ms McRae : Potentially, with the NDIS, in terms of the budgets attached to people's plans, there's more money available. In theory, that should mean people have access to better services or to more services. But, in reality, you're right; the previous state government funding was adequate so that people could get the kinds of services and supports that they needed in a basic way. I feel that there are people with plans that have very high budgets but they're not receiving services because the services aren't actually out there and available in those remote communities. In reality, there are many people that have great big plans that are totally underutilised because those services are not available out in those communities.

Mr WALLACE: What you've said there is not inconsistent with what we've heard previously. What I'm struggling with is that, with the tyranny of distance, I accept that it is difficult for private service providers to be able to provide those services in some parts of such a large country. But were they getting those same services under the old model?

Ms McRae : No. We work on the Ngaanyatjarra lands in remote Western Australia. With respect to the only disability services available, the state government was funding case management and requestable respite. Under the NDIS there is the potential for far more services to be provided, and people's plans and their budgets actually reflect that they have potential access to a lot more supports than they were getting previously.

Mr WALLACE: If I understand you correctly, in your experience, under the old model they weren't getting the services that they needed. Under the new model they're still not getting the services that they need but they've got the budget to provide those services and then some?

Ms McRae : Yes.

Mr WALLACE: What's the answer? How do we provide services to remote Western Australia that are culturally sensitive? How do we do it? How do we bridge that tyranny of distance?

Ms McRae : My view is that the NDIA has relied on an idea that the market would suddenly appear, so there would be all of these services available because there are all of these people with big, generous plans, and that would entice all of these private service providers out there. But any of us who have worked out there for a while realise how challenging it is to provide services out there. As a result of that there's a whole pile of reasons why. There is the tyranny of distance. That's a huge barrier. There's very little housing available for staff, for organisations. There are a whole lot of safety issues about sending staff out to remote communities to work.

You have to have relationships with Aboriginal people in communities in order for them to feel comfortable working with you. You can't go out there as a stranger and expect that everybody's going to want you to work with them. You've got to build those relationships, and they take a long time. I'm speaking as someone who's worked in an Aboriginal organisation for almost 17 years. Those relationships take years to build—those trusting relationships.

I think we need to focus on building the capacity of existing organisations in remote communities to be able to take on more of the service provision and provide more of the supports for Aboriginal people.

Senator STEELE-JOHN: Can I take you back to something you said a little bit earlier in your evidence? Confirm this for me: as far as you know, with the eight organisations that have been awarded tenders to provide independent assessments, which are mandatory under the government's proposal, none of those organisations have previously worked or have a presence in the NPY lands?

Ms McRae : Not that I'm aware of. I have not had any contact previously with those organisations out on the lands.

Senator STEELE-JOHN: Do you know whether any of them have previous experience working with disabled First Nations folks at all?

Ms McRae : No, I haven't heard anything about that. They may have done in some of the urban areas or in the cities, but I'm unsure about remote areas. I haven't heard anything.

Senator STEELE-JOHN: That's very concerning. Lauren Rice gave evidence earlier in the inquiry that they hold serious concerns around the cultural appropriateness of some of the tools that are being used as part of this process. There's been a lot of focus on the concerns that have been created by the consultation process or lack thereof in relation to the implementation of independent assessments. What we are now hearing as a committee is that the nuts and bolts, the tools that are being proposed to be used in the assessments themselves, are not fit for purpose. That's the concern that's been put to us. Do you hold those same concerns about the tools that will be used?

Ms McRae : Absolutely, yes. We are not aware that they are culturally appropriate tools. Again, with the whole business of a long assessment, people often don't want to sit for hours and hours being asked questions. It's considered very confronting and, in fact, quite rude to ask direct questions about people's capacity. There are a whole lot of real issues and barriers that are going to disadvantage our families because those assessment tools are not proven in the context of remote Aboriginal communities.

Senator STEELE-JOHN: If we step back from this for a moment, a lot of the questions that are contained within these tools for anybody would be confronting, distressing and embarrassing to answer, whether they be about your connection to community, whether they be about sex and sexuality or whether they be about your ability to pick up a glass of water. What you seem to be saying to us is that when they then move into the First Nations context there are additional—it is not just awkwardness—actual hard and fast cultural barriers that make it not only inappropriate to ask these questions but almost impossible to ascertain that information through those methods.

Ms McRae : That's correct. People will not respond to questions that they think are rude or inappropriate or make people feel ashamed or embarrassed, particularly when it's a stranger asking those questions. There's a whole lot of men's business and women's business as well. There are areas like sexuality or toileting that a man cannot ask a lady about. That's completely and entirely inappropriate. It is very rude and confronting, and vice versa. All of those issues would need to be addressed by any sort of independent assessment.

Senator STEELE-JOHN: That was going to be my next question. If the model goes ahead as proposed and a situation takes place where a stranger enters the home, asks these questions and attempts to undertake an independent assessment, do you think that that will cause harm to the participant? As it is currently taking place as part of the trial, do you think that that would currently be causing harm or distress to First Nations participants?

Ms McRae : Yes, absolutely I do. I think it would be very traumatising for people.

Senator STEELE-JOHN: On the basis of that view, the trauma that you have just told us about, is it your view that the trials currently underway should cease?

Ms McRae : Yes, absolutely.

Senator STEELE-JOHN: Is it your view also that the attempt to utilise these tools in this way through the structure proposed could have the net result of perpetuating systemic racism?

Ms McRae : Yes, it absolutely is my view.

Senator STEELE-JOHN: Thank you very much.

CHAIR: Ms McRae and Mrs Smith, thank you very much for your submission and thank you very much for coming online and discussing it with us today. We greatly appreciate it.

Mrs Smith : Thank you.

Ms McRae : Thank you very much.