E&OE TRANSCRIPT
MATTHEW PANTELIS, HOST: Well, the federal government is promising a reboot of the National Disability Insurance Scheme. It's after a major review has been handed down, the Minister responsible, NDIS Minister Bill Shorten addressing the National Press Club yesterday, saying change is needed, 26 recommendations to tackle the program's soaring cost and improve the experience for those in the NDIS and frankly, that for taxpayers as well. Tighter eligibility rules, mandatory registration for providers to deal with rampant fraud and poor service, but one of the key things is moving away from the eligibility to the NDIS being based on a medical diagnosis to someone's functional impairment, meaning what a diagnosis would mean for the rest of their life, how they live with their disability as opposed to just a doctor ticking off saying, yep, autism, you qualify. Let's talk about that with the Minister, Bill Shorten, who is on the line. Minister, good morning.
BILL SHORTEN, MINISTER FOR THE NDIS AND GOVERNMENT SERVICES: Good morning. How are you?
PANTELIS: All right, thank you, thank you for your time. Quite a bit in this and a number of recommendations but obviously this is the crux of it is not just adding people willy nilly essentially.
SHORTEN: Well, the NDIS is changing lives. I don't often say this, but Australia is probably one of the best countries in the world to support people with disability, but we want to make sure it's here for future generations. Which means that whilst we want the scheme to keep growing, we recognise that the rate of growth of the costs is beyond what it should be. So, we've got to straighten it up, make it true to purpose. But one of the big issues in that is if we are to make sure the NDIS doesn't become the only lifeboat in the ocean with everyone trying to swim to it so to speak, we need to have a long overdue conversation - how do we support people whose disabilities that aren't that serious that warrant being on the NDIS but still need some support? So that's the debate. We think that with some of the money which we saved by cracking down on the fraudsters and the over servicers, we would reinvest some of that with states, to start improving the support for people with disabilities that are not so serious but still need some support.
PANTELIS: So, all right, functional impairment, whether it's a child who's just diagnosed with autism, then you get parents doctor shopping, trying to find someone to tick off on that for eligibility and away goes the gravy train. It starts from there, and not to say people don't deserve to be honoured, of course, if there is an issue, of course they should be, but I understand what you're saying. It's got to be reined in because the costs are showing. This is going to blow out to $100 billion in just nine years.
SHORTEN: That's right, and I think, first of all, if I had a child with a developmental delay who's taking a non-standard journey, you know, at two and three and four are not hitting the milestones that we might have expected, I'd do whatever I can to get them support.
PANTELIS: Yeah.
SHORTEN: But part of the problem has been that there's only been one option to support, the NDIS and the NDIS, the way it delivers early intervention is quite an expensive way of delivering it. One of the other things is… so what we need to do is be better at identifying kids with developmental delay earlier, then see what help they actually need and not just say every answer is an NDIS answer. But I do say to parents who've got kids with profound and severe disabilities, if your kid needs to be on the scheme, they're going to be on the scheme. But what we're engaging in is a conversation, how do we help the developmental delay and early intervention of kids who might be milder than the most serious? See, at the moment - and Peter Malinauskas played a very good role with Nat Cook, your state Minister, they get the need for change, but they also want to be consulted about how we implement these supports outside the scheme. So, we're going to do that. None of this happens overnight, but you have gone to… I realized I haven't answered one really clear point you've been making in your last two questions, when we say we're moving from diagnosis to functional impairment test, a diagnosis of autism, that's real. I don't argue that, but it's how it then affects you, and it's that second question which we have to answer before you come onto the scheme.
PANTELIS: Well, I want to ask you about that because functional impairment, what is that? How is that judged?
SHORTEN: Well, what we want to do is you might have a diagnosis, your child might have a diagnosis of autism, that's true. Then what we need to do is use a trained assessor to have a chat to the child, have a chat to the family, to understand and then see how much that's impeding their learning development, what sort of therapies would be best to help them move. For some kids, they're born with a disability, they're going to have it lifelong, and that's just a no brainer, how they should be helped. For others, we've learned so much more about neuro, neurodivergence and early intervention and autism in the last ten years, there's a lot of good stuff out there being done. Research based, your university’s amongst those who are doing world leading work. What we're going to do is use the best evidence to help kids, not just give them 40 hours of weekly therapy, which frankly, is not real.
PANTELIS: Yeah, yeah. Well, and that's part of the problem here, isn't it. Providers who are ripping off the system essentially, and you're going to mandate them moving forward?
SHORTEN: Yes, I must… I've always got to say this before I talk about the bad providers. The vast bulk of providers are great, but what happened with this scheme in the last ten years is that we created two systems, I kid you not, in the one NDIS. So, about 15% of service providers are registered, but about 85% aren't. Now a lot of those unregistered providers are doing great work, also, sometimes the reason why we've had to do this is that if you're a person with a disability, picking who your carers are, that's a really crucial decision. You just don't want to get anyone into your house. It's a very personal thing.
PANTELIS: Yeah.
SHORTEN: So, we respect this notion of choice and control, but the problem is that some unregistered service providers, we don't know what the invoice is for. We don't know how accountable they are, we don't know if they're doing the right thing or the wrong thing and if we get a complaint, it's very hard to get to the bottom of it. So, what we're proposing instead is not one size fits all registration, but a graduated registration system, so that if the work you're doing, which is remunerated by the NDIS, is very low risk, like, to be honest, mowing the lawn of a very disabled person, well, that's just, we just need to know who you are, but there might be others who are doing visits into the home, providing round the clock care, showering, toileting, clinical governance. We've got to make sure they've got to have a proper system of registration so we can actually keep an eye on what they're doing.
PANTELIS: Yeah. How will caps be put in, to stop the blowout? You're talking about an 8% increase in years to come and that's where it's going to be capped at.
SHORTEN: That’s the target, yeah.
PANTELIS: How is it going to be managed?
SHORTEN: Well one of the things which is very important to all of this is making it a more human experience, a less bureaucratic experience. A lot of people have complained to me in my journeys around the nation working with how we fix up the NDIS, that they find dealing with getting their plan and budget sorted out, they might have a great meeting, but then they get a plan which they feel has been written for someone else. There's been too much tick and flick, look at the paperwork, see what's right, see what's wrong. Whereas what I want to do is get to a system where if you want to come onto the scheme, you and your family meet what we call a navigator who says, all right, this is how you use the system. We've got to have a concierge service so that people know where to go and what to do, because if you're a, you know, to use a generalization, from a highly wealthy professional background in the middle of Adelaide, you can probably operate the scheme a lot better than people whose first language might not be English, they might be battlers and on the fringes and the paperwork is overwhelming. So, what we're going to do is put more humans into the system. So, we're increasing the Agency, are improving their knowledge of disability and then what we'll do is make sure that when we give them their package that there's a regular human they can talk to about it, how it's going. I know that sounds all basic, but it’s been missing.
PANTELIS: But it sounds expensive too. I mean, you want to save costs, but putting more people into the system creates more of a blowout, doesn't it?
SHORTEN: Well, I'll tell you one thing, if you just give people a package and then send them off into the ether, their packages get depleted, they get services which aren't right. We're strengthening all the protections around observation of real time use of these resources so that people can't just be ripped off.
PANTELIS: And part of this as well, I mean, this kind of goes against what you're saying because you are giving people, or the plan does call now for people on the on the scheme to be given their pool and they'll decide how it should be spent.
SHORTEN: Yeah, I think - what's happened currently is that we micromanage people on every little item. The aim of giving a family a package is not to second guess whether or not they're using a $20 item or a $10 item. It's not to second guess if they need to use some more money for taxis, and a little less for some other heading. But what we will also do is in real time, be monitoring their packages to see how the accounts are going. If they're being depleted - at the moment, you can deplete your account and then we never know about it until the money's gone.
PANTELIS: Yeah, yeah.
SHORTEN: So, it's about just working with people. Um, I actually think there's a lot of wasted time in bureaucracy. Thousands of people have had to take the NDA to court to sort stuff out, that's ridiculous.
PANTELIS: Yeah. The I in NDIS is insurance, but the scheme over the last ten years has become more welfare, hasn't it? Which is the whole problem here. Is this designed to try and get people to what was originally intended, to get them up on their feet and then into employment for those who are able to?
SHORTEN: Yeah, we want to focus a lot more on the outcomes from people's plans rather than just constantly just sort of dealing with the administration of the plan. We want more people with disability to be out and about. We want them to be able to work where they can. We want carers to have their time freed up, family carers, so they can work more, but we haven't been focusing enough on what works. Instead, we just focus on the inputs, we're not looking at the outcomes. Like, for example, we might pay an allied health professional for every hour of service, whereas we'd like to have a conversation with them, an annual budget with the allied health professional, not just every hour that they charge and say, what are we looking for in this year of dealing with this person? There's other things we intend to do, though. Do you know that we have annual plans? 70% of them are annual. It's very, it's such a waste of time, and it's in fact demoralizing. If you're a quadriplegic or if you have down syndrome or if you're blind, you're still blind, you've still got Down Syndrome, and we keep asking people to reprove - we’re asking people to prove to stuff we already know, and we're not focusing on how we get better quality out of the plans they've got.
PANTELIS: All right. Um, you'll respond to this formally next year, I imagine changes to follow from there on.
SHORTEN: Yeah. Well, I accept the direction of the review right now. We will certainly talk to people about the review and anything which we look at doing, we have to do with people. There's the law of unintended consequences. Now, Matthew, you can have a really good idea, but a good idea on paper can evaporate if it's actually not how the world works, but this review has been written up by people with disabilities. Some of the best people in Australia, trusted people, and we're not going to stuff around and play ping pong with this review for the next couple of years. We want to tighten up things now and legislation in the autumn session. That's the beginning of next year. But a lot of the rollout of what we call these foundational services or supports outside the scheme, we've got to talk to people. You know, just because you work in Canberra doesn't make you an expert on everything. And so, we've got to talk to the locals in Adelaide and in regional South Australia and see how do we provide better services there for people, because markets are different, aren't they? You know, you can get access to things in Adelaide, which are a lot harder if you live on the Yorke Peninsula or in Whyalla or elsewhere.
PANTELIS: All right, Bill Shorten, thank you for that. While I have you just quickly, the polls on the government of late, are you concerned with the direction the government is heading in alarmed even, many people suggesting the tough economic times we're in the government's performance over the last three or so months, could lead it to being a one term government?
SHORTEN: Oh, I think it would be premature to make that comment. Um, what concerns me is not the polls, but cost of living. What concerns me is how do we help take the pressure off the mortgagees because they're doing it really hard. I'm interested in how people are going, and that's the focus of the government. I mean, this NDIS stuff, for example, this is real world. There's no opinion poll talking about the NDIS, but if we can create a better NDIS over the next couple of years, well, that's useful for the people. So, the polls tell us how people feel about things, but what they don't tell me as a member of parliament or a member of the government, or someone who cares about the country is, what we've got to do. I've got to work that out and it's about keeping it real, isn't it? Getting stuff done. That's what I think really matters. Get stuff done.
PANTELIS: Will Anthony Albanese lead the party to the election?
SHORTEN: Absolutely.
PANTELIS: Bill Shorten, thank you for your time today.
SHORTEN: Good on you, mate. Cheers.
PANTELIS: NDIS Minister Bill Shorten.