20 April 2023

$50bn NDIS moves toward multi-year plans


With the cost of the NDIS predicted to swamp that of Medicare in a few years, Government Services Minister Bill Shorten has announced a plan to get the scheme back on track.

Speaking at the National Press Club on Wednesday, Mr Shorten stressed that the scheme – which supports more than 530,000 Australians with disability – needed major reform but was there to stay.

“The system is too rigid,” he said.

“It throws up Kafkaesque barriers to access, it lacks empathy, gouges on prices, is too complex, and often traumatising to deal with.”

Mr Shorten also said that the planned reforms to the NDIS were for the benefit of participants.

“It’s not a financial imperative – it is core to improving outcomes and improving lives,” Mr Shorten said.

Earlier this year, the NDIS’ acting actuary David Gifford told a Senate estimates hearing that the cost of the forecast cost of the scheme in the 2025-26 financial year was $50.3 billion.

In contrast, according to last year’s budget papers, the cost of government-paid medical benefits – i.e. Medicare – is estimated to cost about $35 billion in 2025-26.

Government spending on medical services and benefits in general is estimated to reach $44 billion at that time, with general administration costs projected to sit at around $3.6 billion.

The reform plan, as outlined by Mr Shorten, has six pillars.

The first is to expand the National Disability Insurance Agency workforce to improve participant experience.

The second prong, a move to long-term planning, seems likely to have the biggest direct impact on doctors with patients in the scheme.

Under current rules, patients who have a stable living situation and support needs can have plans up to three years in duration, but most other participants have plans that only last between six and 12 months.

When plans are due for reassessment, participants are often required to provide a fresh set of reports and assessments from different service providers.

“Frankly, it’s stressful, debilitating, frustrating and nonsensical that – every year or six months – participants have to ‘prove’ they are still disabled,” Mr Shorten said.

“Amputees must prove they’re still missing a limb. People who are blind must prove they still can’t see. People who have Down syndrome must prove that they still have Down syndrome.

“Instead of causing grief and wasting resources I want us to think long term.”

Moving forward, he said, the NDIS would lean towards more flexible and sustainable multi-year plans, freeing up time to produce higher-quality plans.

Policy directions three, four and five are to address spiralling costs, review supported independent living and tackle business practices that are unethical if not illegal.

To address cost , the NDIS will investigate providers that are overcharging for their services, as well as trialling early-intervention programs for conditions like autism in the hopes of reducing support needs later in life.

Some of the unethical practices Mr Shorten hopes the scheme can stamp out include pressuring participants to ask for services they don’t need, asking for additional fees and offering rewards for taking a particular service not on a participant’s plan.

The sixth and final prong looks at making mainstream community facilities more accessible and supportive for people with disability.

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