Kate Chaney (Curtin, Independent) Share this | Link to 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 Over the last 10 years many block funded state support services have been withdrawn, leaving the NDIS as the only lifeboat in the harbour, as the minister puts it.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.

Alison Byrnes (Cunningham, Australian Labor Party) Share this | Link to this | Hansard source

Like all good social and health reforms in this country, the NDIS was brought to life by a Labor government, back in 2013. Led by the now Minister for the National Disability Insurance Scheme, alongside people with disability, community organisations, advocates and governments, we worked hard together to make disability reform a reality. This bill, the National Disability Insurance Scheme Amendment (Getting the NDIS Back on Track No. 1) Bill 2024, is legislative reform to return the NDIS to its original intent and improve the experience of Australians living with a disability as well as their families and carers. The NDIS once stood as one of the most life-changing reforms in our nation's history, serving as a beacon of support and empowerment for individuals living with disabilities and for their families. But, after a decade of decimation and neglect under those opposite, it is in desperate need of repair, and there is a lot of work to do.

This landmark program represents a fundamental change in how disability services are delivered, placing the power of decision-making into the hands of those who need it most. As of March 2024, the NDIS supports just under 650,000 adults and children nationally. In the electorate of Cunningham there are 3,808 adults and children with a disability, with many of these people receiving support for the very first time. For individuals living with disabilities, the NDIS should offer a lifeline of support, providing access to tailored services and supports that address their unique needs and aspirations. Whether it's assistance with daily activities, access to therapies and treatments or support to pursue education and employment goals, the NDIS should empower individuals to live life on their own terms, with dignity and independence. This bill represents a pivotal opportunity to address challenges the scheme has been facing head-on and to refine and fortify the NDIS.

I have been working with and for the community since before the introduction of the NDIS. Whilst I have seen the amazing impact the scheme can have on people's lives, I have also seen instances of neglect, exploitation and criminal behaviour, which have been allowed to flourish under those opposite. I meet with people who are struggling to get the services they need and those who are paying too much for the services they are receiving. The problems we have inherited are twofold: too many people receiving funding are being exploited, and many more are still struggling to access the NDIS. It is a delicate balance, but we must get it right.

Unfortunately, I've also heard of many cases where people feel that there is a profound lack of compassion and empathy from the NDIA. I have heard heartbreaking stories from many participants of the NDIS as they have told of the difficult and demeaning process of continually proving, year after year, that they are still disabled, or even of having to provide proof of life expectancy to ensure the services that are being provided will meet value for money. It is heartbreaking to see families and participants subjected to such traumatising and dehumanising requests when seeking the life-changing care that they desperately need. I urge the CEO of the NDIA to ensure that staff listen to participants and their families, and to make sure they are afforded the care, respect and support they deserve, and in a timely manner. I hope to see the agency resolve cases as quickly as possible, without losing empathy and compassion when dealing with some of our most vulnerable people. Too many of my constituents have been further traumatised by the processes, the delays and the treatment by the agency, and it is imperative that this stop. As a government, we should never be putting families or participants through this. These distressed and vulnerable families should not have to fight so hard. They should not have to go to such lengths for basic care and support.

I knew when we were first elected that it was going to be a huge job to fix all of the problems caused by a decade of neglect and laziness by the previous government. I commend the minister for taking on this tremendous task. I know the minister gets it, and my community knows this too. He understands the problems that we inherited and the huge task that it is to get the NDIS back on track.

This bill represents an effort to address the negligence of the previous government and ensure that the NDIS remains a strong and responsive system for individuals with disabilities across Australia. Through the proposed targeted reforms and improvements, as outlined in this bill, it aims to strengthen the NDIS and uphold its fundamental principles of empowerment, choice and inclusion for all participants.

An independent review of the NDIS commenced in October 2022. Over 12 months they heard from about 10,000 people, received just under 4,000 submissions, spoke with more than a thousand people with a disability and spent more than 2,000 hours listening to their stories, their ideas and their feedback. From this extensive consultation period, on 7 December 2023 the final report was released, making 26 recommendations with 139 actions to change the system so it will better support people with a disability. These recommendations, along with the integrated actions, form a blueprint on how the government can make the NDIS more inclusive and accessible for all Australians living with disability.

From the recommendations and actions, this bill will offer significantly improved clarity on who can access the NDIS. It will facilitate improved early intervention pathways for individuals with psychosocial disability and children under the age of nine experiencing developmental delays and disabilities. It will improve how NDIS participant budgets are set, making them more flexible and providing clear information on how they can be spent. It will also strengthen the NDIS Quality and Safeguards Commission.

The bill will provide clarity to all new participants who will be entering the NDIS, through the introduction of three new categories. The NDIA will be tasked with advising these new participants of their entry into the NDIS, which will be under one of three categories: the disability requirements, the new early intervention requirements or a combination of both. These new categories will not only aid in the assessment of the participant's future support needs but also ensure the establishment of a reasonable and necessary budget that is tailored to those needs and will provide clarity to healthcare providers, carers and participants. The NDIS amendment bill lays significant groundwork for the development of a new pathway for participants entering the NDIS through early intervention requirements.

The government has heard feedback about the proposed new definition of NDIS supports in the bill and is proposing to introduce amendments that, if adopted, will replace the definition of NDIS support currently in the bill to clarify it and make it more accessible. By changing the definition, it will provide more clarity around the supports that can be funded by the NDIS and those that cannot. With this proposed change, we are getting the NDIS back to its original intention, which is to provide support to people with significant and permanent disability and to people who are in need of early intervention supports. This proposed change is consistent with the recommendations of the independent review into the NDIS in that it focuses on the needs of a participant rather than a diagnosis. The new definition makes clear the constitutional basis for the new budget based planning framework recommended by the review and provides clarity and consistency across the entirety of the act.

The Albanese Labor government is delivering on our commitment to build a stronger and more sustainable NDIS by providing a further $468 million to get the NDIS back on track. We are also investing $45.5 million to establish an NDIS Evidence Advisory Committee to build more evidence about what works for participants. This will ensure the supports provided under the scheme are beneficial, safe, evidence based and cost-effective. We are also investing $20 million to start preliminary consultation and design work to help people with disability navigate services. With close collaboration between people with disabilities, states, territories and key stakeholders, this will ensure that any proposed model is suitable and adaptable to the diverse needs of the disability community.

We've also committed $5.3 million to undertaking preliminary work to reform NDIS pricing arrangements to help ensure NDIS participants get a fair deal and to increase the transparency regarding how prices are set. There's also $213 million of recently announced funding to fight fraud and to co-design NDIS reforms with people with a disability. This investment builds on the $732.9 million provided in last year's budget. The government has already begun to take initial immediate steps in response to the historic review. This investment will provide the necessary framework needed to bring people with a disability together with government and other experts to support the implementation of the reforms.

The bill will usher in a new era of NDIS reforms that ensure the scheme can continue to provide life-changing outcomes for future generations of Australians with disability and to make sure that every dollar in the scheme gets to the participants for whom the scheme was designed. It will also bolster the power of the NDIS Quality and Safeguards Commission to protect participants from illegal and unethical conduct. This bill includes provisions to strengthen governance and oversight within the NDIS, aiming to enhance accountability and transparency in the management of funds and resources. This includes measures to clarify the roles and responsibilities of various stakeholders involved in the administration of the scheme, ensuring that resources are utilised efficiently and effectively to meet the needs of participants.

The NDIS amendment bill represents a commitment not just to fixing what is broken but to envisioning a more inclusive, responsive and resilient NDIS for the future. Today the NDIS is as much a part of our society's fabric as Medicare or superannuation. We have the responsibility to ensure that this scheme is putting people with a disability back at the centre of the NDIS, ensure that we restore trust and pride in the scheme and safeguard its sustainability for future generations.

Sophie Scamps (Mackellar, Independent) Share this | Link to this | Hansard source

I rise in support of the broad intention of the National Disability Insurance Scheme Amendment (Getting the NDIS Back on Track No. 1) Bill 2024, but, after consultation with many in the disability community, I have significant concerns that there is the chance for unwanted and unintended consequences with this bill. It is well known that, since its introduction almost 11 years ago, the cost, structure and operation of the National Disability Insurance Scheme has become unsustainable. The NDIS has been stretched to its limits largely because it has expanded to provide services for conditions it was never intended to cover. It is generally agreed that something has to change, and this bill aims to start that process of change.

It is also well known that the NDIS has absolutely transformed the lives of hundreds of thousands of people with disabilities. It has been described as one of the most complex and ambitious pieces of public policy in the world. It is truly an example of progressive social and economic policy that this country can be proud of. Ensuring its continuation and sustainability should be one of our nation's top priorities.

I was pleased to see that, when this government was elected in 2022, it set about a process of understanding the problems with the NDIS. It commissioned a yearlong review, and the 329-page report of this review outlines 26 recommendations to be implemented over the next five years. Of the review's 26 recommendations, the very first was that the Australian government, along with the state and territory governments, should jointly invest in foundational disability supports, with particular investment in supports for children with disability and developmental concerns. This was recommended so that the NDIS would no longer be the sole source of disability support and, therefore, the federal government would no longer be the sole source of funding for it.

By way of a bit of background to this proposed change, when the NDIS was introduced, state and local governments gradually abandoned the vast majority of services they once provided to people with disability. Those services comprised what are known as 'foundational supports', and people were previously able to access those supports through local and state services without needing to apply to be a participant in the NDIS. Ten years on, however, the NDIS has had to completely take over responsibility for those foundational supports from the states and territories. This has contributed in a major way to the NDIS becoming unsustainable.

The recommendations stemming from the NDIS review aim to reverse this change and to make the state and federal systems work better together. Once the report was released, National Cabinet agreed that the states would double their annual contributions to the NDIS in return for the federal government paying for half of the foundational supports. As part of the restructured NDIS, these foundational supports would again be provided by state based institutions and systems, including schools, early childhood centres and health care. Then, in the first half of this year, the federal government set about drafting this first tranche of legislation, implementing the recommendations of the review, and this is the bill we're debating today.

But there are some very troubling things going on in the NDIS right now, even before this legislation has passed. My office is been swamped with pleas for help from desperate constituents. In addition to the well-known problems with the administration of the operation of the NDIS through the NDIA, resulting from a decade of neglect by the previous coalition government, this current government seems to have commenced already a process of slimming the NDIS down. This has taken the form of participants, including in my electorate of Mackellar, receiving letters from the government informing them that their participation in the scheme is going to be the subject of a review—not a review of their plan or the budget they receive but their eligibility to be a participant in the scheme at all.

Further, some letters go on to require specialist medical reports for the purpose of the review, to be provided within 28 days. Anyone who has had to receive specialist medical treatment lately would know it's barely possible to get an appointment, let alone a report, within 28 days. These letters have been received by families with members who are significantly and permanently disabled. To think that they could do the work necessary to participate in a full-scale eligibility review within 28 days is unthinkable, and extremely stressful for these people—terrifying, actually, to be told that within 28 days your child, your mother, your uncle or even you could be cut off from every support you currently receive. I urge the minister for the NDIS to look into these reports urgently, to ensure that no more Mackellar families, or families from around Australia, find themselves in this distressing situation.

But back to the bill. As I said at the outset, I support the intent of this legislation, because everyone agrees that something has to be done to keep the NDIS viable. But there is a raft of issues with it, expressed most emphatically and pertinently by the disability community. When the final report of the NDIS review was released, Disability Advocacy Network Australia, DANA, alongside other disability representative organisations, stated:

… continued access to support for people with disability is necessary and non-negotiable. Any changes to how support is provided, either inside or outside the Scheme, must not lead to any gaps in the support we receive.

Unfortunately, in DANA's view, this legislation does not meet that stated imperative. It considers that it will potentially raise the cost of the NDIS and shut people out of vital support.

And DANA is far from alone. I mention them as one example of what has become a chorus of concern reaching out to my office. The fundamental complaint about the bill from disability advocates is that there is no way to assess the full impact of the proposed changes because so much of it will be contained in subsequent delegated legislation which is not yet drafted. This means that the federal minister and the states will have the power to develop crucial new elements. The government has also stated that it failed to legislate its intention to develop the detail of the bill in consultation with the community. The disability community is deeply troubled by this, and insists that meaningful codesign of changes is so important that it must be written into the primary legislation.

There are other, more detailed, complaints about the legislation which are common in the disability community. They include that there is a fundamental lack of capability within the NDIA to implement this bill and that it is built on untested assumptions of automation. When we say 'automation' here, we're not talking about a new computer system but a fundamental change to the foundations of the NDIS which introduces new processes and concepts not yet legislated that will impact over 600,000 participants, thousands of providers and hundreds of thousands of other people caught up in the NDIS ecosystem. More than one person with knowledge of both systems has compared what is now being proposed for the NDIS with the automation that underpinned robodebt.

Another concern is that the new needs assessment tool has no detail, and the disability community has again not yet been consulted. The tool will only assess disability, not medical needs, and the current proposal suggests that either an allied health professional or a social worker will conduct the needs assessment. Social workers have a crucial role in the disability ecosystem but are not qualified to be conducting needs assessments. There is also a significant and troubling change to the definition of 'reasonable and necessary' in the bill—a well-established core concept under the current NDIS legislation.

One of the most concerning areas of change is with the process to review participant rights and plans. This draft of the legislation makes it possible for participants to be cut off from the scheme if their plan is subject to a review and they (a) fail to provide requested information within 90 days or (b) fail to have a required medical assessment within 28 days of it being requested of them. I've already commented on the difficulties my constituents are having with this section of the bill even prior to it being passed. In addition, disability advocates are confused as to whether participants' plans will be reviewable or not, including the needs assessment, which forms the entire basis of participants' supports.

The states too are worried. Despite having struck a deal in December with federal government to fund foundational supports on a fifty-fifty basis, state premiers and territory chiefs consider that the changes proposed in this bill go further than what was agreed. In a joint letter to the minister just a couple of weeks ago, all the premiers and chief ministers said:

The Bill will make immediate and fundamental changes to the way the NDIS operates, including how access to the Scheme is determined, how participant needs are assessed and how participant budgets are set.

…   …   …

We are deeply concerned that this way of going about the reform—including through this Bill—will lead to worse outcomes for more Australians with disability and their families.

In summary, I understand the need to reform the NDIS to make it sustainable, but I am concerned that this bill, as currently drafted, may have unintended consequences for participants. I would urge the government to hasten slowly, listen deeply to the concerns of the disability community and make sure we get this right. I would like at this moment to also thank the minister for his commitment to the NDIS and for his generous consultation with the crossbench. Thank you.

Susan Templeman (Macquarie, Australian Labor Party) Share this | Link to this | Hansard source

I rise to speak on the National Disability Insurance Scheme Amendment (Getting the NDIS Back on Track No. 1) Bill 2024. I want to reflect on what it was like for Australians with a disability and their families before the NDIS. Between 2010 and 2013, when the scheme was first being designed and began, I had many conversations about this. There was a lot of luck in whether you got support. Some of it was based on your postcode. For people in the periurban and outer west that I represent, that brought huge uncertainty and, for too many, poverty and disadvantage.

The 2009 report Shut out painted a grim picture. As the Minister for the NDIS described it, it painted a picture then of people with disability isolated and alone, their lives a constant struggle for resources and support. What he and fellow Labor minister Jenny Macklin recognised was that Australia needed a whole system of disability support and the NDIS for people with the most complex support needs. In the decade since it started, I think we can all say that the NDIS has made a profound difference to the way Australians think about disability and has changed this country for the better. But, in spite of its promise, the NDIS does not yet fully deliver the peace of mind that people with a disability and their families deserve.

One of the most powerful conversations I had prior to the introduction of the NDIS was with an older couple who told me about their son, in his 40s, with complex disabilities. They were all ageing, and their biggest fear was not being around to care for their son. It worries me that today I still hear too many families express the same concern. It's not always for the same reasons, but it is because of the complexity and challenge in interacting with the NDIS—that it can feel like combat when needs or circumstances change or that the NDIS asks year after year for people to prove that their lifelong disability still exists, as if a permanent disability will have suddenly disappeared. That is why securing the future of the NDIS is so important.

Our lives can change in an instant, and every Australian deserves the peace of mind of knowing that, if they or someone they love has or acquires a significant and permanent disability, the NDIS will be there for them. Our promise was to restore trust in the NDIS, and, in the two years we've been in office, I know the Minister for the NDIS has worked through a myriad of issues that we inherited. Some we knew of before coming to government, and others we've identified and refused to ignore. I'd like to acknowledge the work that has been done to date, including the slashing of the 4,500 legacy appeal cases at the Administrative Appeals Tribunal that had people in limbo for months if not years; the fact that more people with disability are being discharged from hospital onto the NDIS than waiting in beds when they are medically fit to go home; improvements to the board so there are now more people with lived experience and the first Aboriginal and Torres Strait Islander board member; and the fact that we've tackled fraud, waste and overcharging because we want to see that every single dollar goes to better outcomes for participants.

The Fraud Fusion Taskforce has investigated more than 100 cases involving more than $1 billion of NDIS funding. We've upgraded rules to make it clear that equipment and services cannot be more expensive because they're being bought under an NDIS package, and a new taskforce working alongside the ACCC will help identify people who are price gouging. Of course this is not the majority of good, dedicated service providers who would never betray their NDIS participants or taxpayers with this bad behaviour. But we have to stop those who do. The independent review we undertook, with some of the most extensive consultation with Australians ever, made 26 recommendations to us, and this bill is just the start of a very long reform process. Any change will take years. The process of reform will take years. And I know that creates anxiety for people.

I recently sat down for a detailed discussion with a group of parents in Springwood who care for their children with support from the NDIS. The families have a range of care in place under their plans. Some are self-managed, others are with plan managers, some have adult kids who live with them and others are in supported independent care. Each has a unique mix of supports to create a rich individual life. They all had fears and frustrations, and I am grateful for their honesty and bravery in discussing what is working, what isn't working, their concerns about some of the elements in this legislation and what they were afraid might be changed.

Frustrations included having to fight for things like shoes. One family explained their son needed special shoes in order to walk, but shoes are deemed a regular life expense, so they had to demonstrate the need for the more expensive shoes, and a decision was made that they should be funded for one of those shoes. They told me about having to fight to keep funding for therapies and programs that have allowed physical or psychosocial improvements, because, while there is an improvement, it's only an improvement while the therapy or program is able to be accessed, and they fear that they might lose that funding. One family fears that a son who needs three people to move him might not be able to keep that support.

Although, of course, the review recognised and stated very clearly that sometimes participants can't share supports, it said they might need more support because they have higher individual needs or are in more complex circumstances. These are the fears that people have.

I know that, at the same time that participants and families want to see consistency, transparency and a fairer and more compassionate scheme, they are also worried about any loss of the complex care arrangements that they have fought really hard to put in place. I recognise that anytime we talk about changing the NDIS it's scary, but we have committed to engaging and consulting with people with disability and their families, their carers, representative organisations, service providers, unions and the broader community over the months and years that it will take to fulfil the potential of the NDIS. There is an enormous amount of work to do together to achieve it.

I want to thank the minister for acknowledging the nervousness and for his reassurance to people who, as he says, have battled hard to create an NDIS and to get their packages of support. His commitment is that we will work with you to make sure that people are getting the right support in the right way.

What we're speaking about here today is a bill which is best described as enabling architecture for the rules and future reforms to restore the original intent, integrity, consistency and transparency of the scheme that Labor created. One of the key elements is also the agreement by every state and territory that we work to ensure that the NDIS is not the only source of support for people with disability but that it is part of a larger ecosystem of supports. Certainly, in New South Wales over the last decade, I have seen state government funded supports in a whole range of things, from early childhood services and early intervention through to allied health services and psychosocial programs, closed down and withdrawn. If you weren't eligible for the NDIS, it meant you were left with nothing, which was never meant to be the situation. That will change only by working with the states in coming years.

I know that this bill has a journey to go through in this place and that there is live discussion, but, essentially, the getting the NDIS back on track bill is laying the foundation for implementing key review recommendations on planning and budget setting. It'll provide clarity on who can access the NDIS, it'll enable better early intervention pathways for people living with psychosocial disability and children younger than nine years old with developmental delay and disability, and it'll improve how NDIS participant budgets are set, making them more flexible and providing clear information on how they can be spent.

Rather than going through all the technical elements, let me focus on a couple of key points. 'Reasonable and necessary' remains the core basis on which support needs are met through the NDIS. There are no changes to 'reasonable and necessary' in this bill. The minister, in his second reading speech, also addressed some rumours head-on, and I think it's worth quoting his words:

… (1) psychosocial disability is still included in the NDIS—full stop; (2) autism is still recognised as a disability—full stop …

For the first time, this legislation will link to the UN Convention on the Rights of Persons with Disabilities. Rather than reference a specific article of the convention, the definition requires the NDIS support to implement any of Australia's obligations under the convention.

Another change relates to the requirement to provide information for eligibility reassessment. We'll work with the disability community on the operating guidance on this matter. The minister has stressed that, while it's important for the CEO of the scheme to have the ability to request and receive information on participants, this will not result in people needing to re-prove their disability. But they or their nominee will need to communicate with the agency in a way that works best for the person on the scheme. Where there is a risk for a participant, including financial risk, with plan management arrangements, the agency will have responsibility to act.

This bill also includes amendments to provide greater flexibility for the NDIS Quality and Safeguards Commission in its compliance powers, which build on our comprehensive fraud reforms. These are not about the majority of providers who are good, trusted and ethical people and organisations. I'm privileged to have many of these in my own electorate of Macquarie. I see examples regularly of providers who go above and beyond their paid hours to advocate for or support people in their care with care and compassion. I thank them for that. Again I know that we need changes to make this system sustainable for you and that you are part of the NDIS being around not just for now but for the future.

There are many examples close to home for me. Recently, I was invited to give out awards to volunteers at not-for-profit Blue Mountains Food Services, who, along with providing the Meals on Wheels service to older Australians in their homes, run Ben's Cafe in Lawson and the in-home cook and connect program for NDIS participants. Not only have I eaten at Ben's Cafe and can attest to the great food but I also see the satisfaction it provides to the team and the skills they develop in food prep and front of house. I've spoken to participants in these programs and their parents, who all talk about the confidence they see develop in the kitchen. These are great examples of the NDIS done well.

But there are still those who are ripping off the scheme and using it to provide poor services at exorbitant rates or to not provide what they promised to at all. We will continue to up the ante for dodgy providers.

Finally, I know the registration element for all NDIS workers is unsettling for some families as much as it is for providers. Currently, only around nine per cent of providers are registered. We're waiting on the report of the NDIS Provider and Worker Registration Taskforce, led by lawyer and disability advocate Natalie Wade, to inform those decisions. But, for the immediate changes and those that will take longer to implement, the non-negotiable part for all of us is that these things have to be done in collaboration with people with disability. That doesn't mean just with the large advocates but also with those in my community who have invested so much in making the scheme work for them or are still trying to make it work for them or their loved one.

I'll continue to work closely with my community in airing their concerns and their worries as the reforms move forward in coming months and years. I know, like many MPs, that we don't always get to hear the good outcomes and we do tend to focus on the battles that we help families fight. But I am always grateful to hear the good stories, as I was at the weekend, when a father, who was meeting with me about something completely different, expressed his thanks for the scheme, which helps support his son. Like so many others, his son and, as a consequence, their family have experienced the transformational effects of the NDIS. We want that to continue for generations to come.

Aaron Violi (Casey, Liberal Party) Share this | Link to this | Hansard source

The NDIS is changing the lives of more than 660,000 Australians, and the coalition has a strong record of support for the NDIS. The coalition is committed to a fully funded NDIS, and, for this reason, it needs to be sustainable to ensure it delivers for the many generations to come.

When the National Disability Insurance Scheme Act was passed in 2013, in the dying days of the Rudd-Gillard-Rudd government, we saw a complex and important social reform poorly designed and rushed to implementation for political reasons. One of the most profound problems with the scheme was that it allowed the states to walk away from providing key services to those with a disability. Unfortunately Labor underinvested in the NDIS when it was established, failing to invest in the unmet needs of people with disability. If we look at the numbers over the time of the NDIS, at the time it was established the government committed $1 billion over four years for the first stage of the scheme. In its first year, the NDIS was to provide care and support for up to 10,000 people with significant and permanent disability, increasing to 20,000 people from 2014-15.

This year the budget revealed federal and state government spending on the NDIS ballooned by 21 per cent in 23-24 to $44.3 billion—or $2.4 billion more than forecast—in last year's budget. The Commonwealth picks up about 70 per cent of the cost of the scheme. There was an additional $3 billion in cost write-ups over the forward estimates, which included a combination of spending on participants and government initiatives to reform the scheme. To put this in perspective, the NDIS costs the Commonwealth more than double what the entire PBS program does and three times the expense of JobSeeker payments. The only program more expensive is the aged pension.

The question is: how do we trust this minister to make the NDIS sustainable when he thinks paying $620,000 for a personal speechwriter is a good use of taxpayer money. Based on the 28 speeches on his ministerial website, this equates to $22,000 a speech. This speechwriter was hired by Services Australia for the minister and paid $620,000 over two years, and this is despite the department saying that they have the capacity to provide speechwriting services in-house. The deputy CEO of Services Australia said in Senate estimates, 'It comes down to a question of choice.' There are 201 media and communication staff members currently employed by Services Australia, two of whom are speechwriters. Services Australia officials confirmed its staff had not written any speeches for the minister in the past 12 months.

To assist with the sustainability of the NDIS, the coalition established the NDIS Quality and Safeguards Commission in 2018 to ensure the safety and quality of NDIS services. After it was established, the coalition made further enhancement to protect NDIS participants from harm, and provided an additional $92 million to resource the commission. The previous coalition government invested a record $157.8 billion dollars over four years to support more than half a million Australians living with disability.

This legislation we debate today is the first in a proposed series of bills that amend the NDIS Act 2013 in response to the findings and recommendations of the independent review into the National Disability Insurance Scheme. For years now, concerns have been raised in relation to the NDIS, its financial sustainability, fraud and eligibility criteria. The last coalition government did not tolerate the misuse of funds intended to support people with disability and had a zero tolerance approach to fraud. The NDIS fraud taskforce saw significant results in 2021, leading to the seizure of millions of dollars in cash and assets acquired by individuals through fraudulent activity, as well as the successful prosecution of criminals who have targeted the NDIS and its participants.

The National Disability Insurance Scheme Amendment (Getting the NDIS Back on Track No. 1) Bill 2024 will provide new, much needed definitions of disability supports and clarify the scope of valid supports appropriately funded under the NDIS. Recent reports have described how some NDIS participants are abusing the scheme and what they use taxpayer funds for. I had a message completely separate to this about an hour ago from a friend and constituent whose daughter's funding had been cut. He's frustrated, like many others, about those that misuse the program when those that really need it don't get access. The following cases are just some examples that have been before the AAT, arguing the case for reasonable and necessary claims: infrared saunas, almost 2½ thousand dollars for security cameras, a two-bedroom apartment for one resident, a water filtration system, a Thermomix, a car fridge and freezer, $30,000 to $40,000 to purchase a new motorhome, horseriding lessons, a swimming pool, singing lessons, ducted air conditioning, sexual therapy or sex workers and the cremation of a participant's emotional support rat. What is and what is not an NDIS support must not be so strict as to not allow a participant to explain why it is reasonable and necessary for a requested support to be funded. However, this does not mean anything you desire is an NDIS support.

The success of the proposed reforms will depend on a viable sector with quality providers. Without the other elements required to achieve that—addressing of workforce shortages, realistic and independent pricing, and a regulatory system that promotes quality and an even playing field—the risk of any reforms not being successful is heightened. Unfortunately, there seems to have been a lack of a co-design approach to developing the bill. It is unclear who has been consulted in its development. Some disability representative organisations were apparently consulted; however, nondisclosure agreements were put in place. The bill makes multiple references to co-design, yet it was not open for public consultation, which comes back to a lack of transparency, fairness, compassion and accountability which this bill is supposed to support.

The bill will provide a new assessment process for gaining entry into the NDIS by way of the two eligibility streams—early intervention and/or disability requirements—and will set out the manner in which an existing NDIS participant will transition from an old plan to a new plan. This makes participants very nervous. Coming up on two years of this government, timeframes and wait times for planned reviews have drastically blown out, with participants now regularly waiting more than six months for reviews. That's six months where participants are without support and families are in crisis. Most of the local NDIS inquiries into my office are about this very issue.

In my electorate of Casey, in 2023, we assisted 23 constituents with complex NDIS cases, where their plans were wrong, late or approved but delayed. That number has now increased by 50 per cent, and we are only halfway through 2024. The common issues that I hear about include: support coordinators who have tried numerous times to contact NDIS with no resolution; and NDIS call-centre staff advising callers to contact their MP or giving advice on how to contact the Ombudsman to make a complaint, which is completely unacceptable. Requests for plan reviews or change-of-circumstances reviews are taking way too long to process. Planning meetings are not happening within 21 days of funding being approved for new participants, so participants are being kept waiting for too long without the support services they have been approved for. Support coordinators are putting in request for funds before funds run out in a participant's current plan, and their plan ends up expiring without those funds being approved, leaving participants without their vital support services, and the process to seek approval for invoices for support provided under the expired plan is challenging and complicated.

I want to share some of the stories from my community so we understand that there are people behind these failures in the NDIS system. Emma, age 47, has a number of physical and psychological disabilities. She lodged a plan review request in November 2023 in anticipation of running out of funds. She has now exhausted all of the funds in her plan and is in urgent need of funds to allow her support worker to attend a court domestic violence matter with her. Hannah, age 39, is a quadriplegic and is wheelchair bound, and her mum relies on support workers to help every day. There are only enough funds to last three more weeks, but Hannah's plan does not expire until September. A review lodged in March has not been actioned yet.

Louise, aged 57, with a psychosocial disability, lodged an urgent plan reassessment in November 2023 to provide additional support hours for her worsening health. This request is still awaiting action from the planning team.

Simon, aged 42, with level 2 autism, was approved for NDIS in December 2023. He's still waiting for the planning meeting meant to happen within 21 days so that he can access the mental health support workers needed to assist him with coping with autism outbursts.

Lachlan, aged 69, waited several months for approval of a quote for an already-approved item in his plan: to replace his prosthetic leg.

I could continue to share more stories from my constituents. Time does not allow it, but I hope this highlights the need for reform. Hopefully, the minister spends less time getting expensive speechwriters and more time fixing the system.

There are also problems that I can see with the bill for which I think we need more investigation and clarification from the government. It is not clear from the bill what a participant can do if they do not agree with the outcome of the needs assessment. NDIA decisions are notorious for being inconsistent and variable. There doesn't appear to be an avenue for review in the new legislation. The review recommendations themselves contain numerous contentious recommendations. The drafting of the bill lacked an opportunity for consultation. This will mean that participants, their families and providers would be scrambling to have fair and equitable access to the scheme and supports they need.

The coalition will not oppose this bill in the House of Representatives, but we do voice our concerns and call on the government to release the modelling that has led to their conclusions here, including the cost of savings to be made by this legislation and also a detailed outline of the inevitable cuts that participants should expect as a result of the changes.

The Senate Community Affairs Legislation Committee is conducting an inquiry into the bill and is due to report by 20 June 2024. We will of course reserve our final position on the bill until after the Senate inquiry is complete.

Steve Georganas (Adelaide, Australian Labor Party) Share this | Link to this | Hansard source

In the less than two minutes that I have before adjournment, I just want to make a couple of points about the NDIS. I think many on this side of the House would agree with me. When I talk to people who have a disability, are on the NDIS and have services from the NDIS, the conversation has one common thread and there is one particular discussion that I hear from these people: 'Thank God for the NDIS. Because of the NDIS, I can now go out once a week to a particular outing,' or, 'Because of the NDIS, I can now have equipment that makes my life easier.' From listening to what's been said by the opposition and the experiences out there, we see that the NDIS, because of a Labor government, is delivering to thousands of people with a disability. That's not to say that it can't improve and that's not to say that we can't make it better and stronger. That's exactly what the National Disability Insurance Scheme Amendment (Getting the NDIS Back on Track No. 1) Bill 2024 is all about. This government is delivering on its commitment to strengthen the National Disability Insurance Scheme, to build it and to make it strong and sustainable. That is very important. We know that, back in March 2024, a couple of months ago, this government introduced legislation to this parliament to be able to do exactly that: to enable important changes that are necessary to change the NDIS, to strengthen it, to make it better and to provide better services to people with disabilities. This legislation will pave the way for improvements that put participants back at the heart of the NDIS and make sure that every taxpayer dollar in the scheme gets to the participants for whom the scheme was designed.

Debate interrupted.