Anne Urquhart (Tasmania, Australian Labor Party) Share this | Link to this | Hansard source

On behalf of Senator Gallagher, I present the progress report of the Joint Standing Committee on the National Disability Insurance Scheme, together with the Hansard record of proceedings and documents presented to the committee.

Ordered that the report be printed.

I move:

That the Senate take note of the report.

I seek leave to continue my remarks later.

Leave granted.

Rachel Siewert (WA, Australian Greens) Share this | Link to this | Hansard source

I wish to take note of this report. I urge senators to read this report because it is a report on the progress of the implementation of the NDIS by the NDIA. I have to say that it expresses some pretty strong concerns on a range of areas. It notes the work that the NDIA has been undertaking and the progress on the NDIS. It notes the issues that the joint parliamentary committee has been looking at and talking to people about. It also notes that we have done a separate report on psychosocial disabilities, and I spoke on that in this place during the last sitting when we tabled that report. That report highlights a large number of areas of concern in relation to psychosocial disabilities and the rollout of the NDIS. The report also talks about the concerns people have about the early childhood early intervention approach and highlights the fact that the committee has established a separate inquiry into that area. It also has established a separate inquiry into the transitional arrangements for the NDIS—in other words, how that's rolling out. And the report notes that we will be reporting very soon on our hearing inquiry, and there are huge concerns in that area.

One of the areas the report specifically talks about is planning. This area under the NDIS has generated a great deal of concern. People are being asked to complete their plan or engage in the development of their plan over the phone. There are concerns about the various skills and expertise of the planners themselves and the fact that the NDIA seems to have moved away from the 'reasonable and necessary' forms of support that form the very basis of the National Disability Insurance Scheme. I've got to say, that is what's in the legislation and the rules, but planners seem to have moved away from that, and in the report we point out where they have done that and give some examples from some of our public hearings.

I should say here that one of the public hearings was in the main committee room here at Parliament House. We had to move from one of our normal committee rooms on the second floor—2S1 or 2S3, where you'd normally expect to have your hearings—to the main committee room because we had so many people turn up: over 100 people. Participants, carers and providers turned up. That sent an immediate message to the committee: 'Something's going on here, folks.' The evidence that I particularly recall and that we articulate in the report about reasonable and necessary supports related to the supports for a relatively young person and a particular prosthesis that the person needed. The local planner approved it and had a trial of it and it worked really well, so the recommendation was that this relatively young person have that prosthesis that was needed. But it was knocked back by head office, because the prosthesis was not considered necessary for an ordinary life. Without it, this person would fall over and could not walk. What do you think you need for an ordinary life? But they changed from 'reasonable and necessary' to assess it against what's considered necessary for an ordinary life—unacceptable in my book. Anyway, we articulate that in the report.

We also articulate the fact that people have been raising concerns about the disregard by the planners for medical assessments and for the information that carers provide, as well as the fact that there's no opportunity to review plans before implementation. Some people haven't seen their plans. And there are concerns about the number of times they're reviewed, the lack of involvement in the review, the inconsistencies between plans and the unacceptable delays in developing and implementing the plans. And we deal in the report with service provider issues; they were raised a lot. These relate to people being able to get their accounts paid. They are not being told when plans are reviewed and therefore continue to provide supports under the old plan, to be told that no, there's a new plan, and they are not paid for the supports they gave under the old plan, because they hadn't been told there was a new plan.

Then there is the pricing issue—a humungous issue—and the non-contextual process for pricing. There are the issues around the portal—IT issues. I'm sure that when the transition happened in June, July and August last year every member of this place got phone calls about the problems with the portal and people not being able to get accounts paid. When we held the hearing, we heard, again, a lot of concerns from the providers. The NDIA tells people that that's fixed. That's not what you hear on the ground, and you don't hear from the providers about it being fixed.

There are issues around transport and the transport market design. This is a huge issue that we've had evidence on. In fact, we heard from the transport providers a number of times about the issue around generating a market here. The concern here is that, by being so focused on generating a market in transport, you actually may take the situation backwards, because there are very strong concerns that the market in this particular area will not operate. In fact, we may very well leave people worse off.

These are all areas that I know we are transitioning in. I know that we are still in the process of rolling out the NDIS, but these issues need to be resolved now because they are causing very deep distress and concern for people to the point where people are saying—and I read out some participants', carers' and parents' views last night in this place during adjournment—that they're actually worse off under the NDIS than they were under the various states' proposals. That's actually saying something, in my view.

The report makes a number of recommendations. The first one is:

The committee recommends that the National Disability Insurance Agency provide an opportunity for participants, and those who support them, to view, comment, and rectify any errors in their plan in advance of it being finalised and implemented.

Sorry, but that's basic commonsense, so can we please implement that? The committee also makes the recommendation:

The committee recommends that the National Disability Insurance Agency publish the results of its participants and providers pathways review, specifically the areas identified for improvement, and the strategies in place to achieve improved outcomes.

That's a particularly important point—that that occurs. Then we say:

The committee recommends that the National Disability Insurance Agency include progress on issues identified in the participant and provider pathways review in future Quarterly Reports.

Again, you'd think that that is a fairly obvious thing to do. We recommend:

… that the National Disability Insurance Agency review its quarterly reporting terminology and metrics to ensure consistency, and apply this to all future reports.

Again, you'd think that this is rocket science so that we can actually get an accurate measurement and reflection of progress being made. Finally, we say:

The committee recommends that the NDIA ensure that only criteria underpinned by terminology set out in the NDIS Act and associated Rules is used in the assessment of appropriate supports.

That relates back to the fact that they are moving away from the reasonable and necessary approach and using terminology that's not in the legislation.

There is urgent need for change in the NDIS, and people are getting increasingly impatient. As I articulated yesterday, we remain strong supporters of the NDIS. We think that it has the potential to make profound differences and improvements to the lives of people with disabilities. But, if we don't fix these issues, that won't become a reality because people are already saying that they are not better off. They're so frustrated and so downhearted. Please, government and NDIA, listen. We encourage you to please read these recommendations and get on with making this scheme the best it can be.

Carol Brown (Tasmania, Australian Labor Party, Shadow Parliamentary Secretary for Families and Payments) Share this | Link to this | Hansard source

This progress report from the Joint Standing Committee on the National Disability Insurance Scheme provides an update on the progress being made in the nationwide rollout. The reports seeks to highlight concerns raised with the committee, and those concerns are particularly highlighted in chapter 3. I will say at the outset that I concur with many of the statements that Senator Siewert made in her contribution, but I also would like to say that many people have had very good packages with the NDIS. Having said that, there are also people who have had concerns and whose package hasn't delivered what they thought it would deliver. This is an issue not just for participants but also for providers, and it is also a concern raised by unions that represent the workforce within the disability sector.

I want to go through some of the concerns that have been raised. They are considerable concerns but they are also concerns that should be able to be rectified. As has already been stated, we urge the NDIA to take note of the recommendations in this report. There are five recommendations. They are very simple recommendations that really shouldn't need to have been made because the actions recommended should already have been happening. I'm sure each and every one of us in the chamber has spoken to constituents who have been trying to access or become participants of the NDIS. There have been concerns regarding access to the scheme and, of course, we are behind in terms of the number of participants waiting for access. We have particular concern for participants in the planning process and also for those participants who have families and carers who also wish to be involved. This issue has come up time and time again. Participants, families and carers have raised their dissatisfaction with plans and how they are being developed. There is an issue about plans being developed over the phone. That issue has come up time and time again, and another issue that has come up is the skill and competence of planners, the inconsistency of planning decisions and the delay to plans and plan reviews.

I'm just going to touch on a couple of those concerns in more detail. We are being told that someone is given a call, they talk about the plan over the phone, and if that participant has a carer or a family member who wants to help them that carer is not necessarily involved in the conversation. A plan is then developed and that's it. The plan does not go back to the participant for further review—it is finalised and then activated. Obviously that process is always going to run into trouble. That is not a process that bodes well for successful plans. Carers have told me time and time again that they are shut out of the planning process. On many occasions they have not been told that they are entitled to be part of the planning process. Indeed, they are entitled to give carer statements, and that has not been happening. We've also had issues with the portal. Most of those issues seem to have been rectified, but we are still being told about portal issues. It is not only the participants. Providers will tell you themselves that they have those issues, particularly in terms of payments for services that are directly required from the NDIS.

So, what I hope we will achieve from this progress report is that the NDIA will look at the five recommendations we have put to them and will act on them. My understanding is that there has been an announcement that planning by phone will not be taking place in future. I hope that is the case. I understand that the assistant minister said it would no longer be happening. But if that is not the case and it continues to happen, the concerns that have been raised within this report will continue to come up. People will continue to be frustrated about what they receive in their plan and the process they need to go through, because the NDIS is a transformational system. For some people, it has been life changing. But we have to make sure that is the case for everyone who is a participant in the NDIS. It has to be ensured that when these concerns are raised the government and the NDIA act quickly to rectify the issues, because these are not isolated instances; these are concerns that have been raised by many, many people. As I said, I'm sure every senator in this chamber will be well aware of the concerns people have, because they're out there talking to their constituencies, getting the emails and the phone calls.

So, I would recommend that senators read this report. I think the progress report is a good one. It also highlights the work of the Joint Standing Committee on the NDIS and the further reviews that are currently underway and that will be reported on to the Senate and the House of Representatives in the future. I commend the report to the chamber and thank the NDIS committee for the work they've put into producing this report.

Deborah O'Neill (NSW, Australian Labor Party) Share this | Link to this | Hansard source

I certainly endorse the comments of my fellow Labor senator here, Senator Carol Brown, and I'm very happy to put on the record the praise with which she is spoken of in the electorates I've visited in New South Wales for her care for the disability sector and the important work she is doing in that region.

I rise to speak to the Joint Standing Committee on the National Disability Insurance Scheme report on the provision of services under the NDIS for people with psychosocial disabilities related to mental health conditions, and I do that with a particular sense of responsibility, because I'm very pleased to have the role of assisting the member for Franklin, Julie Collins, in her role as the shadow minister for mental health and assisting her particularly with young people. By 2019-20 a total of 64,000 people with psychosocial disabilities related to a mental health condition will become NDIS participants. That is 13.9 per cent of the total expected participants in the NDIS. However, people with mental illness will continue to require services even if they're not participants in the NDIS, and all governments need to provide that continuity of support for people with psychological disabilities who are not eligible for the NDIS.

Just yesterday, I met with Tony Stevenson, National CEO of the Mental Illness Fellowship of Australia, MIFA, who visited me on one of his rounds of advocacy for this very important national issue. MIFA is a peak body consisting of longstanding membership-based organisations. It's a fantastic organisation delivering specialist place-based community building programs, with a strong focus on recovery and on lived experience. Currently MIFA has over 100 front doors across Australia, with over 50 per cent of its staff having lived experience as a consumer or a carer, such as a parent or a child. In the last parliament I recall being at hearings in Sydney with Senator Moore, who is in the chamber this afternoon, taking evidence on mental illness. I particularly recall the power of the testimony that we received from people who had lived experience themselves or were in families with people whose lived experience of mental ill-health provided incredible challenges for the whole family to confront and manage and overcome. Yesterday, Mr Stevenson stressed to me the importance of each and every one of us remembering that not everyone with a psychosocial disability will be a participant in the NDIS. MIFA collaborates and has connections with service providers and organisations in every single state in Australia, including organisations such as Suicide Prevention Australia, the national peak body for the suicide prevention sector.

Earlier today I moved a motion in the Senate noting that this Sunday coming, 10 September, is World Suicide Prevention Day. I'd like to make a few comments with regard to this. World Suicide Prevention Day aims to increase awareness about the problem of suicide and the many ways each of us can work together to reduce suicide. This year, the theme for Suicide Prevention Day is 'Take a minute, change a life'. And that's all it could take—one minute of talking to someone to actually change the trajectory of a decision that they might make with a very long term consequence to a temporary solution to a problem. This theme complements the work undertaken by R U OK? Day, which encourages all of us to take the time to notice what's going on with our families, our friends, our colleagues and ourselves. Next Thursday, 14 September, we will be highlighting R U OK? Day. It is a day that reminds all of us that, if we're worried about someone, we have to take time to start meaningful conversations and to take time out to notice one another and to respond to the people who live around us, in whatever context we might find ourselves. There are four simple steps to this: to ask, to listen, to encourage action and then to check in with the person and see how things are going.

It's very important for all of us to remember that suicide prevention is something that's the responsibility of each one of us. At this time in Australia's history, suicide is, very sadly, the leading cause of death for men and women between the ages of 15 and 24, and that is simply not okay. In 2015, more than 3,000 Australian men and women lost their life to suicide. This is an average of 8.3 deaths by suicide every single day. When we say these numbers—and there are many numbers recorded on the Hansard in this place—the reality of losing eight lives to suicide across this country has a powerful and significantly awful effect on the whole community. Those 8.3 statistical numbers are real people having an impact on their community. Sadly, the figures that I'm citing to you here today represent the highest suicide rate in 15 years. One death by suicide is too many. An estimated 65,000 Australian men and women also attempt suicide. That is not okay.

These heartbreaking statistics are a stark reminder of the need for a coordinated effort across government and community to reduce suicide in Australia. The seriousness of Australia's mental health and suicide burden reminds all of us that we have to do more to reduce the thousands of Australian lives that are lost each year.

Sadly, suicide continues to disproportionately impact Indigenous communities. Aboriginal and Torres Strait Islander people are twice as likely to die by suicide than non-Indigenous people. Young Aboriginal and Torres Strait Islander people aged between 15 and 17 had a suicide rate more than five times that of their non-Indigenous peers. That is not okay.

We must work together—all of us—to reduce the rates and the impact of mental ill-health and suicide in Australia. Research tells us that suicide is mostly preventable, and we can all play a part in that. At this point in time I'd like to record an incident that shocked me in my experience as a teacher. It was at a year 12 farewell day. Having finished his schooling, a young man I had taught came up to me, and his farewell was a little unusual. He said, 'I want to thank you for taking the roll.' He did it in that grumbly way that teenage boys can do. I asked him to repeat it. He said, 'Thank you for taking the roll, Miss.' I was a little puzzled by what he said. I said to him, 'Did you just thank me for taking the roll?' He said, 'Yes, Miss, because I was thinking about suicide and the only thing that stopped me was knowing that you would miss me when you took the roll.' Now, you don't realise the power of a single conversation with a person when it comes to preventing suicide. And, certainly, I didn't have any sense of what taking the roll was doing. In the essence it proved one thing to me: what we have to do is see people. We busily move around in our lives but we have the opportunity to stop and to notice those who come into our field of view, and people for whom we have some responsibility—and that is everyone. That's everyone we interact with.

So, from the smallest things like that, everyone can do more to reduce the loss of thousands of Australians lives every year. Everyone can be a part of creating a suicide-safe Australia. That's why Labor has offered to work with the Turnbull government in bipartisanship to address this significant national challenge. A lot of great work has already been done. But we can all do more and we can and must do better. As I have already said, one death by suicide is too many. We are always continuously inspired by the efforts of dedicated individuals and organisations such as Suicide Prevention Australia and the Mental Illness Fellowship of Australia, who are working to address suicide prevention and to tackle the stigma around mental ill-health. It is up to all of us to establish systems of care as well as actions of care and conversations of care with people we interact with daily. We can do more to take notice. We can do more to ask the question, to check in with people after we've encouraged them to seek help and to make sure that we take responsibility for our fellow Australians to keep them well and help them to get over the crises that are a part of living. I seek leave to continue my remarks later.

Leave granted; debate adjourned.