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NDIS: What the doctor ordered?

The National Disability Insurance Scheme (NDIS) seems to be a step in the right direction for Australians with a disability. It aims to provide flexible, person-centered support to allow those with disabilities to lead normal lives, so what could possibly be wrong with this? You can start reading about the misgivings some in the community have with NDIS here.

So the NDIS aims to introduce a quasi-market model to disability service provision. This aims to turn people living with disabilities into empowered consumers. Empowered is a wonderful word, isn’t it?

There’s a troubling implication in all of this that many seem to have missed. It seems like the NDIS is putting the onus on the individual with disability to source their treatment or service and get it approved from a marketplace, and no clarification has been provided in certain key areas.

We live in a country where Public Hospitals are a thing. One does not need to go from hospital to hospital shopping for the best deal for them, nor does one have to consider whether they should employ a doctor directly. Here too, there has been no clarity provided. What exactly does employ directly mean?

Here’s an abstract from a study that brings into question the efficacy of a quasi-market model of service provision:

A qualitative study involving semi-structured interviews with 31 people with disabilities and 32 carers in the state of Queensland, Australia, found that their experience of supportive service delivery had not improved despite reforms of the service delivery system driven by a version of the quasi-market model. Instead of delivering increased consumer choice and improved efficiency in service delivery, service users experienced inadequate service supply, service cutbacks, and an increased emphasis on cost subsidisation and assessment processes. Additionally, few consumers felt that individualised funding arrangements had personally delivered the benefits which the quasi-market model and associated policy paradigm had indicated that they should receive. For many consumers, the notion of consumer ‘choice’ around service provision was fictitious and they felt that any efficiency gains were at the agency level, largely at the consumers’ cost. It is concluded that there appears to be no particular benefit to service users of quasi-market reforms, particularly in policy contexts where service delivery systems are historically under-funded.

The Opposition were absent from last week’s introduction of the draft NDIS legislation. This does not speak well of their concern for the disabled population of Australia.

The NDIS could be a step forward for equitable treatment of people with disability in Australia, however at the moment it seems murky and designed by individuals that do not understand what social and structural barriers are faced by individuals with disabilities. Even the quasi-market system, one that hides behind the banner of being flexible and person-centred, does not seem to consider the difficulties faced by those with intelectual disabilities, acquired brain injury, or their carers.

The cynic in me could see the push for the NDIS as the machinations of a government trying desperately to gain approval from an increasingly disenfranchised public.

Queensland was quite opposed to running NDIS trials, continuously calling foul and claiming to be broke. It could not afford to support disabled Queenslanders, what with the giant deficit left by the previous government, the devastating flooding, and the fact their financials put them close to being “the Spain of Australian States”. So then…

Whatever the merits of the current round of public service cuts, no-one can seriously argue that Queensland can’t afford a trial of the NDIS. As former Democrats senator Andrew Bartlett pointed out last week, the state is spending $80 million on the racing industry, including funding for a new greyhound racing track.

You can see how the remaining claims stack up and read the rest of the article here.

I believe strongly in disability support, and reform that will make life more liveable for those with disability is good in my books. I’ve spent two years working in the capacity of a Disability Employment Consultant, I have trained in Psychology and believe strongly in promoting ability rather than disability. I hope the NDIS will be what this country needs. However, I would be remis to say that the lack of clarity in the current draft and the seemingly indifferent attitudes of Australian politicians towards the plight of the people they represent hasn’t been cause for concern.

Have a bit more to chew on over here.

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