Kate Chaney (Curtin, Independent) Share this | Hansard source

It seems appropriate that the new rule-making power requires the say of the states, given the system requires cooperation and buy-in from the states so people don't fall between the cracks. I'll support an amendment to embed the need for co-design and consultation in the development of this delegated legislation, and I'll also review this delegated legislation when it's made, consulting with disability organisations and supporting a disallowance if adequate consultation or co-design has not occurred.

A second concern relates to foundational supports. When we have 10 per cent of Australian boys between five and seven on the NDIS we need to look at different ways to address the issue. I have personal experience with my own kids. With an individualised approach it's on parents to access the NDIS, find the appropriate specialists, make appointments and get their kids to those appointments. If schools adequately catered for neurodiversity, our kids' ability to live up to their potential would be less dependent on parents. Building schools' capacity to deal with neurodiversity is no small matter. Over the last 10 years many block funded state support services have been withdrawn, leaving the NDIS as the only lifeboat in the harbour, as the minister puts it.

I can understand the concern that this bill is being passed without those foundational supports being in place. Rebuilding that capability will take time. People cannot be allowed to fall through the cracks. The minister assures me that the implementation schedule will reflect the preparedness of the states to step up in different areas. It will be important that there's transparency on the implementation progress of those foundational supports and that these supports are co-designed with people who have lived experience of disability—another thing the minister assures me will happen.

A third concern that's come up is the new needs assessment mechanism. The bill introduces mandatory functional assessments for all participants. As the scheme currently operates, there is a huge discrepancy in how support is provided to people. In some cases numerous individuals with similar needs are being provided with vastly different packages. Currently the size of your support plan can depend a lot on your ability to advocate. If you or your family or your support coordinator or plan manager are able to argue your case, you may get a better plan. Using a common functional assessment tool should ideally apply a consistent, commonsense approach. There is no one assessment tool for every disability. The minister has said there will be multiple assessment tools focused on the whole of the person, not just their diagnosis, and these will be developed in consultation with disability experts and advocates. These assessments will need to be based on the medical advice provided by experts and will need to be driven by clinical and functional need, not financial KPIs. It's not clear what qualifications these needs assessors will have or where they'll come from. It's also not yet clear what relationship the assessors will have with medical experts or how families will be involved in this assessment process, but these consent will be vital. This will be a significant challenge in implementation, and it's crucial the government builds trust in the new system by ensuring the workforce is well equipped to doing this role.

A fourth concern I have heard repeatedly that there's no merits-based review pathway with the new assessment process. The minister has told me that this bill has no impact on the review pathway available. The ability to challenge a reviewable decision based on its substance will still exist under section 100 of the NDIS act. A needs assessment will be an input to the statement of participant supports, which remains a reviewable decision. You will be able to see your support needs assessment and the budget outcome, including a draft; hopefully, this will mean that any concerns can be addressed at the draft stage rather than having to wait for the formal statement of participant supports and go through a formal challenge. I will be supporting amendments to require participants sign off on the draft plan and statement of supports to ensure that this is developed with the participant. But if you don't think the assessor has made the right call on the assessment that informed your statement of participant supports, you can seek internal and external review. In other words, you can still challenge your package through the Administrative Review Tribunal.

The fifth concern I've heard is that only limited types of supports will be available. Under this bill there was going to be a limited list of types of supports that could be funded. In response to evidence given at the Senate inquiry, the government has removed this with section 10 amendments, so now the same range of supports should be available as are currently available.

The sixth concern I've heard is that people want to be able to use unregistered providers to provide NDIS services because it gives them choice and control. Currently, NDIS recipients who self-manage their plans are usually not required to use registered providers. In fact, only nine per cent of providers receiving payments last year were registered. But there are growing concerns about the quality of care they provide patients. The government has absolutely no oversight on unregistered providers. Given that we're talking about some of the most vulnerable people in our community, it seems reasonable that providers should meet some minimum standards as long as the registration process, which is currently being reviewed, is not too onerous.

A seventh concern I've heard is in relation to accommodation. People who have been living alone in supported accommodation for a long time are now concerned that they'll no longer be eligible for that level of support, and may be forced to move into group accommodation. Some assurances have been given that this is not the intention. If delegated legislation is passed that's contrary to this, I'll be supporting its disallowance.

The final key concern I've heard is in relation to change-of-circumstance top-ups. There will always be a need to top-up plans when circumstances have changed, but at the moment we're spending $3.4 billion a year on top-ups when plans have already been fully spent before the end of the year. This is not a sustainable situation, and there is evidence that the system is being abused. The department tells me that there are currently twice as many of these applications as last year, and about three-quarters of these participants don't even know that a change has been lodged on their behalf. Communication with participants has broken down. There seem to be plan managers working the system at the moment, with anecdotal evidence of people being told to spend all their money because they can apply for a top-up. We cannot run the NDIS like this. There will always be a need for a top-up when there are legitimate changes in circumstances, but this should be proven. The department is currently working through what the appropriate evidentiary burden should be for a change in circumstances. This will also require adding more specialisation in the agency so the people assessing the changes in circumstances have an understanding of the relevant disability.

I take all these concerns from constituents very seriously and have passed them on to the minister. I thank him for his genuine engagement on this legislation and his willingness to make some amendments to address constituent concerns and provide greater comfort on how this reform will be implemented. In conclusion, the NDIS is a good thing, but it needs to be sustainable. It is currently in need of reform both to make it sustainable and to put people with disabilities at the centre of decisions and to ensure common sense prevails. I appreciate the amendments agreed to and the assurances provided by the minister, and I will be watching implementation very carefully. If there are issues in implementation—and I suspect there will be, as with any reform of this size—I will continue to bring issues to the attention of the minister so that they can be addressed, and will support disallowance of delegated legislation if needed. The NDIS should be something that Australia is proud of, and I believe that it can be.

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