Tim Ayres (NSW, Australian Labor Party, Assistant Minister for Trade) Share this | Link to this | Hansard source

I table two supplementary explanatory memoranda relating to the government amendments to be moved to this bill.

Hollie Hughes (NSW, Liberal Party, Shadow Assistant Minister for Mental Health and Suicide Prevention) Share this | Link to this | Hansard source

I move opposition amendment on sheet 2649:

(1) Schedule 1, page 55 (after line 2), after item 103, insert:

103A At the end of subsection 118(2)

Add:

; and (c) ensure the financial sustainability of the National Disability Insurance Scheme.

Jordon Steele-John (WA, Australian Greens) Share this | Link to this | Hansard source

We've heard during the inquiry into the bill that the detail of the needs assessment proposed in the bill is being developed. Before voting on this, I would like to know some of the detail that sits behind this proposal. Firstly, who will be conducting the need assessments?

Tim Ayres (NSW, Australian Labor Party, Assistant Minister for Trade) Share this | Link to this | Hansard source

Senator Steele-John, I didn't hear the middle bit of your question. You said, I think, something about the 'something' behind the bill.

Jordon Steele-John (WA, Australian Greens) Share this | Link to this | Hansard source

I'll repeat it. During both inquiries, we heard repeatedly as committee members that the detail of the need assessments that are proposed in the bill is being developed, so it's currently under development. Before voting on this bill, I am seeking to understand some of the detail that sits behind the elements of this proposal. My first question to you is: who will be conducting the needs assessment that is specifically referenced in the legislation?

Tim Ayres (NSW, Australian Labor Party, Assistant Minister for Trade) Share this | Link to this | Hansard source

The answer to that question is, in short, that the needs assessment tool or tools will be developed through an extensive consultation and co-design process, which will involve deep engagement with the disability community and relevant experts. There will be an iterative process of design and testing with people with disability as well as with health and allied health professionals and people with technical expertise in the development of needs assessments.

One of the major changes, of course, proposed by the NDIS review was to create a new budget based planning framework, which will be based on an assessment of need at a whole-of-person level rather than for individual support items. The review also recommended what it called a trust based approach, where participants are provided with a flexible budget and there is a focus on providing guidance and support to participants to spend their budget appropriately. The new needs assessment set out in the bill is consistent with the recommendations of the NDIS review about how a participant's support needs should be assessed. It will result in a budget being allocated to each participant on the basis of their assessed needs, with participants having the flexibility to purchase a range of supports rather than a prescriptive line-by-line plan.

The needs assessment will be conducted in accordance with an assessment tool or tools, as I indicated before, that will be carefully co-designed—not in a hurry—with people with a disability and a range of relevant experts. The tools will be the subject of extensive consultation and discussion to ensure that they can assess every participant's needs to take into account, of course, many participants' multifaceted and diverse experiences of disability. Once that process has occurred, the assessment will be made transparent, and the process will be made transparent through a legislative instrument. These steps ensure it is an entirely different process to the previously proposed independent assessments. I hope that assists.

Jordon Steele-John (WA, Australian Greens) Share this | Link to this | Hansard source

Minister, what you've just given us there is the contextual information that we as committee members went into the inquiry with. The government departments gave evidence multiple times during the course of both inquiries and spoke to a development process—a process in development—around the needs assessment. I understand that contextual information. That's been in the public domain for a while now. What I'm seeking to get from you is the detail on where that development process is up to right now. My first question is: who will be conducting these needs assessments? Just to clarify, that's what I'm trying to get from you.

Tim Ayres (NSW, Australian Labor Party, Assistant Minister for Trade) Share this | Link to this | Hansard source

In the previous answer, what I was describing was the process that will be engaged in to develop the needs assessment tool, and that, of course, will go to who is doing the assessment and the processes that they will undertake. As I indicated, the process of developing that needs assessment tool will be an iterative process where the co-design principles will be developed in deep consultation and be responsive to the discussions with members of the disability community, experts and all of the relevant stakeholders.

What is required for that process to commence—and this is why I can't be more precise with you, Senator Steele-John—is for this bill to be passed. Upon passage of the legislation through the Australian parliament, that process of the development of the needs assessment tool will commence, and all of the considerations I've referred to—and more—will be undertaken at that point. The needs assessment is a procedural step that will provide information required for the decision to approve the statement of participant supports, which, of course, goes to the level of funding and the budget for individual participants.

That is the purpose of this process. One of the reasons, I think, that senators across the chamber, including in the committee, came to the view that this particular piece of legislation needed to proceed with some urgency is that it starts that process—and starts that process properly. I look forward to, and don't want to pre-empt here, the outcomes of that process.

Jordon Steele-John (WA, Australian Greens) Share this | Link to this | Hansard source

Minister, can you detail for us the co-design principles that you just mentioned?

Tim Ayres (NSW, Australian Labor Party, Assistant Minister for Trade) Share this | Link to this | Hansard source

I want to make sure the response here is precise. If we're not in a position to give it to you straightaway, we'll come back to you later in Committee of the Whole.

As a matter of general principle, co-design has its own meaning. I want to be precise, in terms of the way that it is intended to operate, in relation to the scheme and to the bill. One of the difficulties here is that express requirements for consultation or co-design on specific instruments beyond what already appears in the act and the legislation could cause significant uncertainty for the operation of the scheme.

There is no broadly accepted definition or process for co-design in Commonwealth legislation. So, while we talk about the principle of co-design in its ordinary meaning—when I say 'ordinary meaning', I think it has an ordinary meaning here in the way that service delivery agencies talk about the way that they deliver services—I expect that it's not a phrase that most Australians have heard before. It doesn't have a precise legal meaning—that is, there is no definition across the various agencies, beyond the NDIS, where these principles are articulated by public servants, by community organisations and by representative organisations when they are talking about policymaking or policy implementation. So, while it has that commonly understood meaning at that level, inserting specific references to co-design would create significant legal uncertainty. You might know what we mean and we might know what we mean but a court, the Administrative Appeals Tribunal, or whoever it is who engages in decision-making about these questions would not have that proper legal meaning.

Subsection 17(1) of the Legislation Act provides that, before a legislative instrument is made, the rule maker must be satisfied that appropriate and reasonably practicable consultation has been taken. The requirements under the act and the Legislation Act together impose a requirement on the minister to consult with the disability community when making any legislative instrument under the act. So, given that that requirement already exists, it's, in the view of the government, not necessary to impose any further consultation obligations on the minister beyond the argument that I have taken you to around the precise legal meaning of the term. In addition, the government has moved an amendment to table a consultation statement with each legislative instrument outlining consultations undertaken and views expressed. That is beyond a requirement for administrative co-design. When each legislative instrument comes here, there will be a requirement to table what is an exhaustive consultation statement that outlines who has been consulted with and also the views that have been expressed by each of those consultation participants.

Jordon Steele-John (WA, Australian Greens) Share this | Link to this | Hansard source

Minister, in your contribution, you stated that the needs assessment tools and the needs assessment itself would be developed in line with detailed co-design principles. For the clarity of the Senate, I want to understand what you were referring to then, given that you have subsequently given us a legal view of co-design which seems to suggest that, in the government's view, there are impediments to the implementation of co-design. Mere moments ago, when you referenced co-design principles, to what were you referring?

Tim Ayres (NSW, Australian Labor Party, Assistant Minister for Trade) Share this | Link to this | Hansard source

I think it's always very important when I'm at this table articulating a view about these questions to note that I'm not a lawyer and not even a bush lawyer, Senator Steele-John. The argument in relation to the insertion of the term is that it doesn't have a precise legal meaning beyond what I've already indicated. What I should have, of course, indicated to you in relation to co-design is that the minister, department and agency have published a statement and a commitment to co-design on the agency's website which should give participants and Australians a clear idea of what it is that the government means when it talks about co-design.

Hollie Hughes (NSW, Liberal Party, Shadow Assistant Minister for Mental Health and Suicide Prevention) Share this | Link to this | Hansard source

Here we are today, after two years and four months.

Linda Reynolds (WA, Liberal Party) Share this | Link to this | Hansard source

Two and a half years.

Hollie Hughes (NSW, Liberal Party, Shadow Assistant Minister for Mental Health and Suicide Prevention) Share this | Link to this | Hansard source

Two years and four months of inaction—I didn't want to give him the extra two months; I thought that might have been a bit cruel. I like to get my figures correct—something the minister isn't too big on. There has been two years and four months of inaction by the minister who was the shadow minister for the NDIS when the government was in opposition and who was an architect of the scheme. Yet it's taken him two years and four months to bring his first piece of legislation forward. What a joke! It's unbelievable, but here we are.

This should be, you would have thought, a positive day because the NDIS does have bipartisan support. We, in government, acknowledged that there were problems around sustainability and were referred to by the minister as 'pearl-clutching kabuki theatre players', because it was an absolute fallacy that there were ever any sustainability issues in his mind when he was the opposition spokesperson. Now he's the minister and it's: 'Oops, oopsie there are lots of sustainability issues. Now we now need to do something about it.'

We are trying to get to some reform of this incredibly important scheme. We need to make sure that the NDIS is sustainable. Maybe everyone in the disability community and in this place would have had some more confidence if they had actually been given the opportunity to properly scrutinise this bill. In the minister's contribution, we heard him say very proudly that there had been 5½ days of hearings on what is an enormous part of the budget. This is an enormous contributor to the budget in so much as cost, yet we had 5½ days because every government member of the Community Affairs Legislation Committee was way too busy to ever hold a hearing when we wanted to look into this legislation. It's funny, though, that the references committee, which has many of the same members, could find more days and more opportunity to travel for our current menopause inquiry. We have had more days of hearings into menopause, of which there is no legislation around, than we've had on the NDIS, because the government doesn't want scrutiny of its legislation and will do anything it can to block it. We've seen the constant politicking, time and again, trying to block transparency and make sure that no-one really understands what's going on.

In response to Senator Steele-John's questions, they bandy the word 'co-design' around as if it's warm and fuzzy so that people in the disability community feel that we're here with you and we going to co-design. We're probably going to make you sign an NDA, and you going to be invited to the party only if someone on your board or organisation is a former NDIA board member or is someone that those members of the board of the NDIA happen to like. They're the only organisations that are consulted with. They're the only organisations that are spoken to, and then they're made to sign NDAs.

Lots of people in the community were not consulted about this legislation. We hear that it's in response to the NDIS review that the government hasn't even released its response to. It hasn't let anyone know what their response is to the review, but this legislation is somehow based on it. It is an absolute joke. We're here waiting for amendments. Apparently, there are more amendments coming. Hold the phone—apparently there are more amendments, but no-one has seen them yet. We're not quite sure what is happening. No-one knows what's happening with those amendments. This is based on the fact that the states and the territories don't know what is going on. We are told back in December that the financial sustainability was all tickety-boo, that it was all signed off by the premiers and that everyone was happy. We were told that there's a financial sustainability framework attached to the NDIS now to cap future growth at eight per cent. We've been in here asking for the modelling behind that sustainability framework for months. We actually had NDIS Monday this morning, again—six or seven months.

You're right, Senator Reynolds: it's becoming a joke, because they won't provide it. And now they want us to pass legislation that's basically adhering to it, saying that this model is how we're going to cap growth at eight per cent. No-one is saying we don't want growth capped. Everyone wants this scheme to be sustainable. But, when you've got a demand-driven scheme, there are two ways you cap growth—you reduce the number of participants, or you cap the amount on the plans; you reduce the amount on the plans.

I'm the first to say that I think there are too many people on it. The Greens and I are going to disagree when it comes to who's allowed on this scheme. I do think there are too many people on it. I do think we need to define 'reasonable and necessary', and we need to define 'lifelong and permanent'. This is a scheme that was established for people with a lifelong and permanent disability. My heart breaks when I talk to families of people that have severe disabilities that completely impair their ability to live an individual life full of freedoms and choices. It is the NDIS, when done properly, that opens up the opportunities for these participants and their families. But then we see all of this expenditure for people who, quite frankly, shouldn't be on the scheme, who should never have been allowed on the scheme.

I'm going to go out there right now and say that there are a whole lot of autistic adults who get diagnosed in their 40s and 50s or so, and they're university professors. They've got families. They've got a house. They've got a job. Then, all of a sudden, they get a later-in-life diagnosis or a self-diagnosis—that's my favourite type!—and expect NDIS supports. I'm sorry, no. That's not what this is for.

The way that autism is bandied around is absolutely appalling, and I say that as the mother of a classically autistic son, someone who would be defined as having profound autism, who was diagnosed before the level 1, 2 and 3 rubbish came into the DSM-5, someone who was actually given a diagnosis of autism when autism existed outside of PDD-NOS and global developmental delay and even before Asperger's was taken away. These are the kids who need it. These are the kids who have significant cognitive impairment and are never going to be able to live by themselves. They're always going to need supports. Yet it is them at jeopardy because no-one is prepared to actually stand up and say who should and shouldn't be on this scheme. That's the first thing, but this doesn't really address what we're looking at. We're tinkering around the edges here.

Some of these people that shouldn't be on the scheme, in my view—and I say it's my view that they should not be on the scheme. What they are being offered so that the NDIS is not the only lifeboat in the ocean—which it is at the moment because the states and territories vacated the fields. Part of this legislation is proposing that there is an introduction of foundational supports. I don't mind the principle of foundational supports. They used to exist. What they were was community health where there was an OT or a speechie. Kids who had a little bit of a delay or who needed a little bit of a help along, who couldn't say the 'er' sound or something like that, could go and get a little bit of help and then go on with their lives. Now, those community health services don't exist, so families who've got a child with a bit of a developmental delay are all looking to the NDIS because it's the only way they can access some of these now private speech therapists or OTs, as they don't exist in a public system anymore because the state governments removed the funding for those. As soon as Julia Gillard as the Prime Minister, along with the then Minister Shorten and Minister Macklin, introduced the NDIS and said to the states, 'Don't worry, we'll absorb any of the additional cost blowouts,' the states went, 'You beauty; we're off,' and vacated the field. So we're supposed to be bringing in these foundational supports.

To Senator Steele-John's question about what is co-design, what is a foundational support? I know what I think they should be, and we heard, during the 5½ days of inquiries we were so kindly granted by those opposite to look into this bill, from lots of groups in the community and disability workers and representatives and advocates of those people what they think a foundational support should be, but we don't know. There are no guidelines. There is no draft. These are to be developed at a later stage.

Some people might be comfortable with that. They might think: 'There's pretty much general understanding. We want some community health, some access to public speechies and OTs. We need better supports in schools. We need the education departments to step back up. So that's fine—what we kind of think they are.' But is that what the government is talking about?

So, Minister, what is 'a foundational support'? When will a draft of foundational supports be available publicly? And what supports have the states agreed to deliver?

Tim Ayres (NSW, Australian Labor Party, Assistant Minister for Trade) Share this | Link to this | Hansard source

Before I respond to that contribution, I table an amendment to the explanatory memorandum relating to the National Disability Insurance Scheme Amendment (Getting the NDIS Back on Track No. 1) Bill 2024. The addendum responds to matters raised by the Scrutiny of Bills Committee and the Parliamentary Joint Committee on Human Rights.

There were a number of assertions in that contribution, Senator Hughes, that I want to respond to. The first is about the consultation that has been undertaken by the government in relation to this bill, beyond the two Senate committee inquiries which have been undertaken. Of course, the changes themselves made by the bill address some of the key recommendations from the 2023 Independent Review of the NDIS. There has been deep engagement—not selective engagement; deep engagement—across the disability community, across Australia. It heard not just of people's responses in relation to the recommendations but of the experience of people with a disability, to inform their recommendations. The panel itself heard from over 10,000 people and organisations. It received over 4,000 submissions. It spent over 2,000 hours listening to the stories, ideas and feedback of people with a disability. The panel had regular meetings with Commonwealth, state and territory disability ministers. The panel used findings from other reviews and inquiries, like the Royal Commission into Violence, Abuse, Neglect and Exploitation of People with Disability. And the voices of people with disability will stay at the centre of designing and implementing the changes to the NDIS. What Australians can expect—what Australians with a disability and carers and families of Australians with a disability can expect—is that the government will take the same deep consultation approach, as it implements the provisions of this bill, as it has taken in terms of the whole process.

Senator Hughes asks us to look at the number of days that were allocated by the Senate committee—a matter for the committee, I suppose—but also to look at the number of days spent. I'd just say: there have been thousands and thousands of days and thousands and thousands of submissions. There has been deep consideration of those issues, when developing the panel report, the government's response to the panel report and the bill that is in front of us today.

In terms of foundational supports, the NDIS review recommended that governments invest in foundational supports to bring fairness, balance and sustainability to the ecosystem supporting people with disability. That is at the Commonwealth and state and territory levels. The review defined 'foundational disability supports' as disability specific supports that are available to all people with disability and, where appropriate, their families and carers. In 2023, National Cabinet agreed to the design of foundational supports that will be engaged by the Commonwealth and states and territories, to create more pathways outside of the NDIS for young children and people accessing the scheme. Foundational supports will work towards a model of care that incorporates mainstream services. Foundational supports will be evidence based supports and services that will better connect people with disability with supports and services that the NDIS itself is not necessarily best placed to provide. It's the intention of the government's approach to foundational supports to create an inclusive and accessible disability ecosystem.

The decision to bring forward the legislative changes and associated rules was made by National Cabinet in December 2023. It was a decision of Australian governments to respond to key recommendations around restoring the scheme to its original intent. The experience of participants was clearly heard through the NDIS review and, while governments are considering their responses, a key initial step in responding to the NDIS review is developing the new budget based planning framework. While it's important to ensure that there is careful sequencing of other key recommendations from the NDIS review, such as foundational supports, the bill establishes the framework to allow the time that it will take to carefully co-design and develop the detail in subordinate legislation. Participants will be carefully transitioned to the new approach over time. The phased approach will provide the NDIA with appropriate time to design and test operational changes and provide governments with time to develop the system of foundational supports outside of the NDIS.

I listened carefully to Senator Hughes's contribution. Indeed, when I was responding to Senator Steele-John about the question of co-design, I appreciate very much that the language around co-design is language that is used by government, by participants in the scheme and particularly by stakeholder organisations to describe the kind of iterative process that we've set out. It is not language that people in the street would normally use, and it is prone to being described in the way that Senator Hughes described it. It is important, though. It is important to hold on to the ordinary meaning of this idea in terms of the way that the government sets about this kind of important reform. That is why the minister, the department and the agency have set out on the website what those principles mean: it is important for participants and stakeholders to have confidence in the scheme.

I make this point as well. It was the Labor Party and, in fact, this minister and this government, who established the scheme. It was the previous government, over the course of the nine years when it occupied the Treasury benches, who administered this scheme. Now we have responsibility as a parliament, and I just say this: we could spend the next few hours or days hearing people defending their legacies, blame-shifting and pointing at each other. But, actually, when a sensible set of reforms is put in front of it—reforms that will make the scheme more sustainable, that will moderate the growth of the scheme so that it is sustainable, that will make the processes in the scheme fairer, that will set up not in two minutes but over the course of time a proper process of reform, that will set out that process of reform and enable that process of reform—I do think it's the job of this place to support that legislation in the interests of the Australians we are here to represent.

Hollie Hughes (NSW, Liberal Party, Shadow Assistant Minister for Mental Health and Suicide Prevention) Share this | Link to this | Hansard source

It's interesting to hear about the government response to the review. I didn't know there was one. Perhaps Minister Ayres could table the response to the review, because no-one else has seen it. It's typical of the transparency of this government. They'll just make it up as they go along and won't share the information with anyone.

Where is it—the secret response to the review? It's the very, very secret response to the review.

Ross Cadell (NSW, National Party) Share this | Link to this | Hansard source

A muted response!

Hollie Hughes (NSW, Liberal Party, Shadow Assistant Minister for Mental Health and Suicide Prevention) Share this | Link to this | Hansard source

Yes—no-one's allowed to see it. I want to tell you a story, because that was just absolutely appalling. I don't think Senator Ayres actually knows what a foundational support may or may not look like. They clearly didn't define it for him in the minister's information that they provided to him.

Part of this is that the states and territories need to pick it up. If the current ineptitude of state and federal systems to be able to work together doesn't shock you and horrify you, this sort of instance is likely happening way more than the instance I have been dealing with and is probably going to get worse when some of these things are put into place. Over the past couple of months I have been dealing with a family of a 16-year-old profoundly autistic verbally limited boy with an intellectual disability as well as significant PTSD and trauma who comes from a broken home. The mother and the son, who I know, are amazing. The brother of this boy and the mother are amazing humans who love this child very, very much, but it has become unsafe for him to be in the house with them. He has psychiatric and psychological supports who referred him for admission to care, to be placed into psychiatric care.

The mother first contacted me one Sunday morning when there had been an episode, when there had been an incident. She had taken him to the emergency ward asking for the admission to go ahead with the referral. She was told, 'I just had to go home and get more NDIS funding.' 'Go home and get more NDIS funding' is what state health systems in New South Wales said to the mother of a profoundly autistic son who is intellectually disabled, has limited verbal skills, PTSD and significant behavioural issues, which make it unsafe for him to be at home with his younger brother and his mother because he is now about half a foot-plus taller than his mother and considerably larger.

I worked with the mother through that Sunday and we managed to achieve some sort of solution. We then found that, because he is under 18, it became a matter for Family and Community Services in the hospital and the NDIS. The mother was consistently told he was going to be basically booted out of the psych ward at the end of the week. She said, 'He can't. He's not ready. We're not ready. We don't have the tools yet to be able to handle this.' Family and Community Services and the NDIS could not get together and talk. This mother called me in such a state because it had got to the point that she was going to be forced to relinquish her son to the care of the state because it was not safe for her to take her son home. It was not safe for her, not safe for her other child. It was not safe for this boy, yet the NDIS and the New South Wales health department and Family and Community Services could not get together and talk to find a resolution. In desperation, I ended up emailing the CEO of the agency, Minister Shorten and the Attorney-General of New South Wales, begging them to please put something together to try to resolve this issue. We managed to get a temporary stay for a period of time.

Every child and every family that is faced with the inadequacies of state and federal systems, because of the failure to link those services together, because of the silos that exist between governments and government services—it is not defined, who is responsible for what is an important lack of definition. There is a requirement for no wrong door for these families and these kids. People don't seem to understand, even in this place, when we talk about the importance of how these things operate. The importance of getting this right is too often thrown out with the politics of the situation—casting aspersions and smears—when the reality is there are people whose lives depend on it. A child whose family may be forced to relinquish him—this is not a child who is not well loved or is not wanted; this is a child who has an incredibly supportive and loving family and who has been accessing amazing therapy since he was two because the family has been so engaged. But such is the extent of his disability and impairment that going home was not possible.

When we look at this through the political lens, we look at it by saying: 'This is my bailiwick. That's your patch. I'm not touching you over here.' What this does to families is bad enough, let alone what it would cost for this child to receive the support that he requires in the right psychological residential situations versus what it would cost for him to be relinquished to the state to be responsible for everything around that. We know most kids who go into family and community services, certainly in New South Wales, end up in a motel because there isn't enough foster care and there aren't enough support services for them in family and community services. So what was an already terrible situation was on the precipice of being made absolutely fundamentally worse, and possibly irrevocably worse. Maybe it's lucky this mum happened to know my mobile number and could come to me, but not everyone on the NDIS has that. Not everyone on the NDIS has the capability or even the mindset to be able to do that—to literally have a senator reach out to those responsible begging for some action.

This is not something that we should just toss around as if it's not going to cause a fundamental difference. We hear about people using money on different things. Yes, there are things that are bought on the NDIS that are wildly inappropriate. Nothing makes me more angry, as the mother of a participant, than when I hear of people rorting this system. But more times than not it's the providers that are rorting the system, not the participants or their families. We know there is no safety net in this legislation when it comes to the plan managers who overspend plans without the participant's knowledge. There's nothing in it. We don't address what's actually happening when it comes to providers and plan managers, because it's all about: 'Let's just throw people with a disability into some big basket and say that they must all be rorting the system. They must all be using this for ill-advised purposes.' We know it is a very, very small number of people. What a surprise! This is government money with very little framework put in place around it. Who knew there would be bad actors coming into that space? What a joke!

I come back to foundational supports and what they are, and the importance of getting them right. As is the case with this 16-year-old autistic boy, the foundational supports, the foundations of care that should have been available in the state system—what the state is actually responsible for providing—weren't there, and they were pushing it back to the NDIS. If there was so much consultation taking place, why are the state premiers still writing to the committee? Why are they putting out a statement today saying they want the bill delayed because they haven't agreed to what they're expected to deliver, they're not ready to deliver what they're supposed to be delivering and they are concerned people with a disability will fall through the gaps? If that one case I just shared with you doesn't demonstrate how the states, in so many ways, are not up to the task and have decided not to deliver the services they should for disabled people because of the NDIS, what are we doing to bridge that gap?

Tim Ayres (NSW, Australian Labor Party, Assistant Minister for Trade) Share this | Link to this | Hansard source

Of course, Senator Hughes, I can't comment on the individual case of the young man to whom you've responded, but it is clear that his mother was fortunate to have your mobile telephone number. It's a reminder, in my view, that, as we seek to improve the rules and the processes and the scope and the relationship of the scheme to the work of the states and territories, including the foundational supports, at the end of all of this there is always a person. There are always their carers or their family. There is always the community around them. And there are inevitably tough stories. There are inevitably tears. There are inevitably difficult outcomes. That is the truth of it. As we continue to reform and refine, we should not expect that the kinds of things that you described will never happen. The case is that it is our job as a Commonwealth government to continue on a pathway of reform to improve all of these things. These principles of co-design, of dealing with the foundational supports offered by the states and territories, are going to be crucial over time to the sustainability of the scheme and improving the outcomes from the scheme.

But it's also true that, at the end of this, as we reform it, there will still be, whether it's at the Commonwealth level or the state and territory level, silos and bureaucratic decision-making, and we have to improve that over time. The truth is that, if we are honest about it, these are problems that existed at the foundation of the scheme. They existed in 2013 too, and in 2014, and in 2015, 2016 and 2017, all the way through to 2022, and they exist today. It's the job of this parliament and this reform process to tackle those challenges. Senator Hughes asks: what would it cost? Of course, one of the founding principles of the NDIS was that it was about providing for social justice and also that it made economic sense. She is exactly right to point to better outcomes in terms of more efficient, effective and impactful spending if we get the architecture of the scheme right.

In relation to reforms in terms of plan managers, there is more to come. As I said in the second reading speech, and as the minister has indicated in the parliament and publicly, this is the first step in terms of legislation. It begins its own enabling reform process itself, but there will be more to come over time because this is a big scheme, it is an important scheme, it is important to the welfare of Australians right across Australia, and it is going to require attention to detail and a lot of sustained work to keep the scheme sustainable and effective for ordinary Australians.

Jordon Steele-John (WA, Australian Greens) Share this | Link to this | Hansard source

Returning to the question of the needs assessment: how many needs assessors does the government believe will be required to ensure that the role as stated in the bill is able to be fulfilled?

Tim Ayres (NSW, Australian Labor Party, Assistant Minister for Trade) Share this | Link to this | Hansard source

As I indicated before, this process of developing the needs assessment architecture is going to be the subject of that co-design principle or process or that consultative process. Over the course of this debate, there may well be many questions that you ask me about the detail of the needs assessment tool that I will not be in a position to answer or to pre-empt. This bill starts the process of designing that tool and that process, and we do not want to put the cart before this particular horse with questions like how many workers or how many people will need to be engaged in that process. The bill sets out a process. The process will be engaged in, and it will begin when the bill passes through the parliament.

Jordon Steele-John (WA, Australian Greens) Share this | Link to this | Hansard source

To be clear, Minister: I have heard your response in relation to the needs assessment tool and the process by which that tool will be created. My question was and is in relation to the role of needs assessor, which is established as a requirement in the bill. I'm seeking to understand from the government how many workers the government has estimated will be required for that legislatively mandated role to be carried out.

Tim Ayres (NSW, Australian Labor Party, Assistant Minister for Trade) Share this | Link to this | Hansard source

I can't offer you any more on this issue except to say that, if the bill passes through the parliament, that consultation process will begin. The outcomes of that will determine many of these questions of detail: who will be engaged; the relationship to their role; all of those process questions. The government does not intend to pre-empt that process by the legislation defining the outcome any further than it does. The process begins. It'll be a good, thorough process. It'd do it a disservice if we constrained it by responding in the way that you've suggested.

Jordon Steele-John (WA, Australian Greens) Share this | Link to this | Hansard source

Has there been any investigation of the workforce capacity required to undertake the scale of needs assessment that will be required by this legislation?

Tim Ayres (NSW, Australian Labor Party, Assistant Minister for Trade) Share this | Link to this | Hansard source

The review itself had some commentary in relation to this question. Needs assessors will only be needed when the new framework planning commences, which is, of course, subject to the design and development of the rules and processes. That question is really going to be a relevant question for when the process set out in the act concludes. It wouldn't be very helpful, in the government's view, to try and answer that question before that process has concluded.

Pauline Hanson (Queensland, Pauline Hanson's One Nation Party) Share this | Link to this | Hansard source

You talk about needs assessment. In the bill, it states 'reasonable and necessary'. Having spoken to the minister myself, I understand they're now going to clamp on, to name only a few: donations to political parties; court fines; alcohol, cigarettes and vapes; jewellery; fuel; luxury cruises and holiday packages; makeup and cosmetics; pet funerals; and cuddle therapy. How did you arrive at this decision to get rid of only these items on your list?

Tim Ayres (NSW, Australian Labor Party, Assistant Minister for Trade) Share this | Link to this | Hansard source

The minister's acted on the advice that he's received based on current operational practice.

Pauline Hanson (Queensland, Pauline Hanson's One Nation Party) Share this | Link to this | Hansard source

I noticed on the list, also, that sex workers are not included. Can you explain why?

Tim Ayres (NSW, Australian Labor Party, Assistant Minister for Trade) Share this | Link to this | Hansard source

They are excluded on the basis of the current operational practice, and it's quite clear on the agency's website. They're currently published on the 'out' list on the consultation material provided during the course of the consultation about these processes.

Pauline Hanson (Queensland, Pauline Hanson's One Nation Party) Share this | Link to this | Hansard source

Still, I need a 'please explain' to that one. You talk about sex toys. You talk about what is reasonable and necessary. Is the government going to get rid of sex workers as part of the NDIS plan? Most Australians will consider it not to be 'reasonable or necessary'.

Tim Ayres (NSW, Australian Labor Party, Assistant Minister for Trade) Share this | Link to this | Hansard source

The use of the kinds of services that you describe is currently on the 'out' list—that is, not available. I understand there is an amendment that goes to that question that has been moved for the committee stage. It is absolutely clear in the government's mind that it is on the 'out' list. The phrasing is not ordinary language, but that is the phrasing used in the consultation process.

Pauline Hanson (Queensland, Pauline Hanson's One Nation Party) Share this | Link to this | Hansard source

I'm pleased to hear that. It's my amendment that I'm putting up to get rid of sex workers, so I will be looking forward to you voting to support my amendment. On another point, Minister: can you tell me how many people on the NDIS are on plans of over $1 million a year?

Tim Ayres (NSW, Australian Labor Party, Assistant Minister for Trade) Share this | Link to this | Hansard source

Before I respond to that, I table a supplementary explanatory memorandum relating to the government amendments to be moved to this bill.

I'm not in a position to be able to tell you how many participants on the scheme are provided with more than a million dollars per annum. If we're able to assist you with that, we will, over the course of this—or it's a proper question to be directed towards the agency during estimates. It is certainly the case that there are some participants in this scheme who have deep and complex needs, and the provision of those kinds of services is sometimes very expensive.

Pauline Hanson (Queensland, Pauline Hanson's One Nation Party) Share this | Link to this | Hansard source

Minister, can you tell me how many people are on the scheme? Do you have those numbers?

Tim Ayres (NSW, Australian Labor Party, Assistant Minister for Trade) Share this | Link to this | Hansard source

I can be no more precise than to say that around 660,000 Australians are participants in the scheme. If the agency is able to provide a precise number, then, of course, we'll do that, but around 660,000 Australians are participants in the scheme.

Pauline Hanson (Queensland, Pauline Hanson's One Nation Party) Share this | Link to this | Hansard source

That's about correct. I can inform you that the best figures I have are, in 2020, there were 450 participants actually on million-dollar-plus plans, and there were 5,100 who were on plans between half a million dollars and $1 million. Maybe you can actually verify those figures. I've given you a start, but I haven't been able to find them out. My question, then, is: why have you kept this secret from the Australian people? This question has been asked of you. At the drop of a hat, you can tell me how many people are on the plan, but you can't tell me how many people are on a plan of over $1 million, when it is taxpayer funded.

Tim Ayres (NSW, Australian Labor Party, Assistant Minister for Trade) Share this | Link to this | Hansard source

The figures that you've advanced, Senator Hanson, are almost five years old. I'm not in a position to verify those figures, but let's assume that they are correct. We know that participation in the scheme has increased over time, and the provision of necessary services that are provided to participants in the scheme does not get less expensive over time; it becomes more expensive over time. So, if those numbers—of over half a million dollars or over a million dollars—in relation to services that are provided are correct, I'd be very surprised if those numbers had got smaller over time.

But I want to be really clear about the government's intention here. It is the government's approach here to moderate the growth of the scheme. I heard some pretty unhelpful language earlier in the second reading debate about cuts to the scheme. There will be no cuts to the scheme. What is apprehended here is moderating the growth of the scheme. That is a sensible objective that I think most Australians would support. But it's also the case that people who access very expensive services from the scheme need those services, and they should not feel any sense of opprobrium from us about their genuine requirement for those kinds of services. Some of the people who access the scheme have very complex needs, and some of the kinds of supports that they are offered cost more than others. So all of this is being balanced by the government in terms of its approach.

I think most Australians would expect that the cost of this scheme is going to increase over time. Most Australians want to see the cost of the scheme and its growth be moderated over time to ensure that the scheme is sustainable for our kids, our grandkids and our great-grandkids. That is the task of the minister, of the government and, ultimately, of this parliament. Most people want to see the scheme and its processes be fair and for a balance of processes to be struck so that the agency can fulfil its function properly and in the way that most Australians would expect it to—to provide the kinds of services that most Australians would want their kids or grandkids to have today and into the future.

Pauline Hanson (Queensland, Pauline Hanson's One Nation Party) Share this | Link to this | Hansard source

Minister, don't get me wrong: I fully support your changes to the bill and will be voting for it. But I don't feel that you've gone far enough. Hopefully, the next tranche of amendments or the next bill that you put up will go further.

You say that the costs need to be reined in, because, the way it is going, it is unsustainable and the costs are exploding. A case in point, which I have raised constantly with the minister and his office, is that support services supplied to NDIS clients are completely out of proportion when compared to what all other Australians have to pay. For example, jobs for relatively unqualified support workers in aged care are being advertised at a rate of around $30 an hour, yet if you were going with the NDIS as a support worker it's $67 an hour, and it can go to $218 an hour on weekends in rural and remote areas and higher than that in very remote areas. For professional services—say, if you were a psychologist providing counselling to an NDIS patient—you'd be receiving a minimum rate of $214 an hour. Again, the rate in remote areas is a lot higher than that; it can be over $300 an hour. The rate in very remote areas can be over $500 an hour, plus your travel on top of it. But for anyone else who requires that service—say, a veteran—you're looking at $153 an hour. So this has been a bone of contention. Even registered nurses—those in the nursing profession—may get around $50 an hour, approximately, but an NDIS worker get might $100 or $125 an hour, approximately.

So what I'm hearing from veterans and the general public is that they cannot get services provided to them because a lot of these people in the workforce are leaving their jobs and going to the NDIS to provide the services to these people. We're talking about 660,000 people, compared to the rest of the population—basically, 27 million people—in Australia. When do you intend to rein in the cost blowout in what can be charged for services provided to people on the NDIS compared to other Australians?

Tim Ayres (NSW, Australian Labor Party, Assistant Minister for Trade) Share this | Link to this | Hansard source

Some of the services, of course, that people access in the health system are expensive. As to psychologists—for ordinary people, when they look at the numbers that you just described, they are very expensive; that is true.

The NDIS review made recommendations about pricing, of course, which the government is examining and will examine in the context of future rounds of legislative reform. I want to take a careful and balanced approach to this, because, as you say, there is a relationship between the labour markets here for different services, and there is a relationship between these pricing issues and making sure that—as I think everyone would want—where a service is provided by a disability worker, that is reflected in the wages that the disability worker gets themselves as well.

These pricing issues are absolutely on the radar of the minister. They were dealt with in the context of the review. Like many of the problems in terms of the scheme, not everything is solved by this piece of legislation. But they are definitely in scope for future rounds of legislative reform.

Pauline Hanson (Queensland, Pauline Hanson's One Nation Party) Share this | Link to this | Hansard source

Well, I'm pleased to hear that, because your industrial relations bill was 'same work, same pay'. So either you raise everyone else's wages up to those of the NDIS or you have to lower what NDIS workers are charging that's relevant to the rest of Australians, because it's not in line with the industrial relations bill that you've passed.

My understanding—and correct me if I'm wrong—is that a letter was sent out to all participants in the NDIS about the cost blowout. If that is the case, and if workers are going to continue to overcharge clients, what penalties are going to be imposed on these people—or will you continue to pay their bills when they send in their invoices?

Tim Ayres (NSW, Australian Labor Party, Assistant Minister for Trade) Share this | Link to this | Hansard source

As I understand it, the minister wrote to participants in this scheme advising them of their rights in relation to overcharging. I'm going to avoid the temptation that you put in front of me in relation to describing the industrial relations principles that sit behind the same job, same pay legislation. I know that you'll welcome that decision to leave that alone.

Pauline Hanson (Queensland, Pauline Hanson's One Nation Party) Share this | Link to this | Hansard source

Because you can't answer it.

Tim Ayres (NSW, Australian Labor Party, Assistant Minister for Trade) Share this | Link to this | Hansard source

I wouldn't encourage me on these issues. Suffice to say that the principles are quite different. But I understand the motivation behind the question, and the government is attending to those and will deal with those in future tranches of legislation.

David Fawcett (SA, Liberal Party) Share this | Link to this | Hansard source

Senator Hanson, I do have other senators seeking the call. This is your last question, thank you.

Pauline Hanson (Queensland, Pauline Hanson's One Nation Party) Share this | Link to this | Hansard source

I want to ask you about means testing. I notice there is no means testing under the scheme whatsoever. So you can have a multimillionaire—in fact, even a billionaire, but I don't think they'd bother going on the scheme; I think they'd pay for it themselves. There are multimillionaires—asset rich—and people on the schemes who can well afford it for themselves. We means test the age pension and we means test self-funded retirees for jobs, and what should be relevant to the fact is whether a person can pay for it or not.

I am aware that you're concerned that health should be free to everyone, so it shouldn't be means tested. Surely it is, because we have public hospital systems. Free health is available to every Australian. Some Australians may have to wait a long time to get it, because our system is broken. Our system is pathetic in some states—in most states, to tell you the truth. Anyway, that is the case. If you believe it should be free of means testing, I ask the question: why aren't you allowing NDIS to people over 67 or of pension age? Why aren't you opening it up to everyone? If you feel that health care should be free to everyone, why not older Australians? It's not available to them. You can't have your cake and eat it too.

I know of a judge who was on the NDIS and wanted to have the decking extended, at the back of his property, to take the decking down to the river. That was not necessary, but it was put in. Here was someone in a position where they could afford to have extensions done at the house and yet it was put in for the taxpayer to pay for it. You say, no, everyone has their health reasons. But if that person is able to pay for extensions or anything that needs to be done to their house that is not immediately connected to their health issues—like a new wheelchair or apparatus they need for their immediate health care—why are we not means testing people who need to have other assets provided to them when they can clearly afford it?

Tim Ayres (NSW, Australian Labor Party, Assistant Minister for Trade) Share this | Link to this | Hansard source

Thank you, Senator Hanson, for that question. I understand the argument made in relation to means testing. I understand how that proposition would attract support in some quarters. I would say the government's view in relation to the NDIS and universality of the scheme is fundamental, and I want to explain why we take that approach. It's the same approach the government takes and previous governments have taken in relation to, as you say, Medicare and the provision of health services or in relation to education services. We don't means test a whole range of services that the government offers.

It is true that access to some benefits and payments is means tested, because there's a relationship between the payment and the objective of the payment, which is about supporting a particular level of income. There's a policy basis for means testing in relation to the age pension and a range of other benefits or payments that the government makes under the social security system.

The principle of universality for the provision of these services is founded in two things. One is efficiency. It is more efficient if we don't add another layer of compliance and do an assessment of individuals' incomes, which would be hard to do in relation to children, wouldn't it? I think, if we think about it for a second, we know it would be hard to do in relation to children. It would be hard to do in relation to adolescents as they are growing. That would itself contain some unfairness, both unfairness at the time of the assessment and unfairness as people become less eligible for access to services. I'll just ask you to consider children and adolescents in that context.

The second basket of arguments goes to community support. The Australian community, in many respects, supports the Medicare system because all of us have an equal stake in that system. Whether you are on the age pension, a middle-income worker, a mining worker or a labour hire worker, whether you are very well to do or not, each of us has an interest in the system, supports the system and demands a level of quality in the system. That consensus and support across the community is undermined if we disengage from those universality principles. If we means tested access to the scheme, in the government's view—I appreciate it's not your view—that would undermine support for the scheme.

We are determined to embark upon a process of reform that embeds the scheme for the long term for Australia. That means that people across the political spectrum, across the income divide, in regional Australia and in the cities, no matter what their circumstances, will know that the scheme is fair dinkum and that it provides the kinds of services that you would expect and I would expect. And I don't think there's too much difference between what you would expect and what I would expect in terms of the kinds of services and support that the National Disability Insurance Scheme and the agency should provide to individuals.

In terms of access for people who are over the age of 67, the aged-care system is designed for that purpose. That is why there is not an overlapping set of rights and benefits and entitlements that Australians have here. Sixty-seven is the appropriate age for the aged-care system to jump in to provide those services.

Of course, universality itself doesn't mean that there aren't inequities still in the system. It's a universal system for every Australian, every disabled Australian, for their carers and for their families and for their communities. It is, as you say, for regional Australians where some of these services aren't as readily available. If you're living in a small country town or on a property—or in some of our suburbs—those services aren't as readily available, so there are always going to be inequities in the way that Australians access the scheme. And one of the purposes of the reform process that the government is undertaking is to attend, in a structural and process and rules sense in terms of the scope of the scheme, to those inequities as far as it possibly can; to build fair processes that are fair dinkum for Australians to access the scheme; and to make sure there's public confidence in the sustainability of the scheme not just over the course of the coming years but over the course of the coming generations.

Progress reported.

Catryna Bilyk (Tasmania, Australian Labor Party) Share this | Link to this | Hansard source

We will now move to two-minute statements.