Allegra Spender (Wentworth, Independent) Share this | Hansard source

The NDIS is one of the most important supports in Australia and is currently helping almost 660,000 people to live fuller, richer lives as a result. Over 1,000 of these people live in my electorate of Wentworth, and they and their families regularly tell me about the difference the NDIS has made to their lives. One woman I met recently, who has lived with quadriplegia for the last 28 years, spoke to me about being able to move out of care and into independent living, manage chronic pain, return to work, volunteer and participate in her local community and be more active in her son's life as a result of the NDIS support she receives.

The choice and flexibility that the NDIS provides gives people living with a disability true agency over their lives and allows them to address the specific nature of their disability through the ways best suited to them. It is critical that any changes to the NDIS maintain the focus on choice, control and dignity. At the same time, I acknowledge the critical growth rates that have become a feature of the system. We're seeing alarming trends that threaten the financial stability of the scheme to serve future recipients. For example, one in 10 boys between the ages of five and seven are now on the NDIS and annual expenditure is growing at 15 per cent a year—roughly three times faster than aged care.

The head of fraud and integrity of the NDIS has also identified issues with the system such as overcharging from providers. Even worse, reports have now emerged of criminals exploiting participants and having them purchase unnecessary or illicit products or withdraw funds directly. It seems these are not isolated. The NDIA estimates up to five per cent of the scheme could be being spent in error. These types of revelations undermine not only the financial stability of the system but also the integrity of the scheme and the public's faith in the NDIS to deliver on its objectives. This sort of bad faith behaviour puts in jeopardy the incredible support the NDIS provides to those who rely on its so heavily, and it must be stamped out.

This system, the NDIS, has undoubtedly changed millions of lives for the better but it is financially unsustainable without real reform. Something needs to be done, and done quickly, to more effectively manage the costs of the NDIS while continuing to support the community it serves. While it is never easy to undertake significant changes to a system affecting such vulnerable and worthy recipients, growth at the level we are seeing is only going to hasten the system's decline.

I understand that this bill will be the first in a series of changes the Australian government will make in response to the NDIS review presented at the end of last year. This bill will make several substantial amendments to the NDIS Act, including clarifying the access requirements and supports that the NDIS will provide to a participant, creating a new model of determining a reasonable and necessary budget and giving new powers to the NDIA to request information and change or manage a participant's plan.

Understandably, the substantial changes the bill proposes are concerning many in my community who either have a disability or know a friend or family member who relies on the NDIS, and they want to make sure that we get any changes right. There is a lot of concern because a lot can go wrong when much detail is left out of the legislation.

I am concerned that the new definitions of support will potentially infringe upon the fundamental principles of the NDIS—choice and control. While further prescribing the types of goods and services that can be purchased under public schemes sounds reasonable, it may restrict many people from using funds in a way that works best for them and their specific needs. It may also not achieve the stated objective of managing expenses.

As Occupational Therapy Australia note in their submission, there is a risk of inadvertently increasing costs by excluding types of support from the NDIS. For example, it may be cheaper and more dignified for a participant to be able to purchase a robot vacuum cleaner rather than pay for regular cleaning services or additional in-home care. Similarly, it may be cheaper and more effective for a participant with chronic pain to see a yoga instructor once or twice a week rather than see a specialist physiotherapist once a month. The option and ability to use non-prescribed services also provides some amount of downward pressure on the prices for prescribed services. We already know that some service providers overcharge participants on the NDIS, so it is not unreasonable to be concerned that further restricting the services that money can be spent on will result in further inflation of NDIS service prices. Professor Helen Dickinson, of the University of New South Wales, noted before the Senate Community Affairs Legislation Committee that the more narrowly we define these supports, the less effective these supports are and the more expensive they become.

This bill also introduces powers to change management plans or revoke status due to noncompliance, but there is a lack of clarity about what might constitute a breach. While I'm not suggesting the current NDIA would seek to use this power maliciously, it creates an opening for a gradual erosion choice and control over time in an effort to better manage costs. Among many possibilities, the implication of this could be that participants lose their ability to hire their own selected staff, some of whom participants have had for many years, and with whom they have developed bespoke and personalised care routines and procedures. While it may be necessary in some instances to take over management, this power should be restricted by the bill to only the most egregious and/or repeated infringements.

I am concerned that the assessment procedures under the bill are not sufficiently detailed and that there are inadequate options for participants to review or challenge a determination of either their needs assessment or their budget—similarly, the powers to request information that could determine whether a person stays on the scheme. As the member for Kooyong pointed out, the rigid timeframes in the current bill are short and could result in eligible participants being excluded from services due to difficulties in seeing the required specialists in time.

A woman came into my office last week and said something that has stuck with me. She said she didn't disagree with the direction of this bill; she understands the system is unsustainable. But she noted that this bill in its current form requires a lot of trust from participants—a lot of trust that the legislative instruments, of which there are many, will be formalised with the correct and proper consultation; a lot of trust that the services participants rely on will not be excluded based on cost alone, either now or in the future; a lot of trust that the assessments conducted to review a person's eligibility will be transparent, contestable and conducted by people with the appropriate skills and expertise; a lot of trust that the states and local communities are ready and willing to step up and provide additional supports no longer covered under the NDIS; and a lot of trust that participants will still be able to choose the people they want to care for them, to support them, to touch their body.

I have discussed my concerns with the minister, and I commend the minister for bringing this difficult and complex issue before the parliament and for being willing to meet and work with me and my colleagues on the crossbench. I will not be voting against this bill, because I strongly believe reform is required to ensure the sustainability of the NDIS for future recipients, but I urge the minister to incorporate considered amendments put forward by people on the crossbench and to acknowledge the trust that my community and I put in his department to get this right.

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