E&OE TRANSCRIPT
SUBJECTS: NDIS reforms; art and music supports; state disability services
LEON COMPTON, HOST: Two weeks ago, you gave us a call, a listener gave us a call and talked to us about your concerns about music therapy to be cut from the National Disability Insurance Scheme, as the scheme looked to provide efficiencies. Ulverstone mum Carol gave us a call and talked about her boys, aged eight and four. Another mum, Danielle, called us from the south of the state and was one of so many of you who dropped us a note to share your story.
CALLER: Evie has level three autism and global developmental delay. She is non-verbal, so music for her is how she connects with the world, how she communicates.
CALLER: He can regulate himself instead of you know he was before that he was turning over the bookshelf, rolling his bed over, you know, completely losing his mind. Um, and now he's got the skills to be able to regulate himself. They've just come so far with music therapy.
CALLER: We actually support the most vulnerable families in our community, the people that come and see us. Aren't those people that just have a small speech delay. They have incredibly complex needs and are incredibly vulnerable, and which is why music therapy works.
CALLER: For us, taking the music therapy away as a as a therapy option is it's really going to hurt the boy's progression and their functional capacity going forward as they grow into adults.
COMPTON: Bill Shorten is the Minister for the National Disability Insurance Scheme. That's some of what you told us from around Tasmania about your concerns that music therapy is to be cut. You talked about the power that it had in helping your young people, particularly in dealing with and supporting them on their autism journey. Bill Shorten, good morning to you.
BILL SHORTEN, MINISTER FOR THE NDIS AND GOVERNMENT SERVICES: Oh, good morning, Leon.
COMPTON: And thank you for coming into the studio this morning.
SHORTEN: My pleasure.
COMPTON: Is it still your intention to cut music therapy out of the National Disability Insurance Scheme?
SHORTEN: Well, let's get some - I listened carefully to those selected comments from the callers, and I can respect their concern. But I need to get some facts. I'll lay them down pretty quickly. One, it was never proposed by the NDIA, the Agency makes these decisions, not the Minister, it was never proposed that there shouldn't be music or art classes for people with disability. So, that was never going to be cut. The issue is that if you have it in your plan, you can get it for $68 bucks an hour. Or if you have a special therapy in your plan, you get $193 an hour to pay the therapist.
The Agency formed the view that there wasn't a lot of evidence that it was the $193 an hour therapy was delivering results. They made a decision that from February the 1st, it wouldn't be in people's plans going forward. Now, if you already had it in a plan, though, you would keep it til the end of your plan.
This led to a backlash from some music and art therapists and some families who use it, and they said, hey, don't cut this $193 an hour therapy. And so, what we've said is that we will do – I’ve asked the Agency to stop what they were doing and changing the pricing of music therapy, that's the difference, changing the price is not cutting it out of people's plans altogether - and so, we've got a guy called Professor Stephen Duckett. He was the godfather of Medicare. He is going to do a review where everyone can put forward their evidence to see if this therapy is delivering outcomes.
COMPTON: Can you hear our audience there telling you about the outcomes that it's delivering to them?
SHORTEN: Yeah, I can –
COMPTON: Can you hear them talk about what it means to their children with profound autism?
SHORTEN: - but what I won’t do is that - I'm not a autism expert. So, I'm going to ask experts to tell us what the evidence is. I don't disbelieve anything that your listeners said calling in, but what you didn't have on your show is people who are pretending to be music therapists, charging $193 an hour who are unregistered and ripping people off. What you didn't have ringing in was the people who can't afford it in their packages, because it's $193 an hour, and the social and participation changes to allow classes of four, where you can actually charge $193, but you have to have four people in your class, not one.
Now, the music therapists and the art therapists I met with, some of them have got university degrees, master's degrees. They say, hey, there is a lot of evidence showing the impact, along with the callers that you're talking about. So, I'm prepared to believe that they could be right. But also, the experts in the Agency say that's not right. So rather than a politician playing God, which I'm not qualified to do, we've got an independent expert who everyone recognises has been very good over the time for assessing therapies. And we will allow, the review is going to report on the pricing arrangements for music and art therapy, and it will review the evidence base about whether or not it's making a difference or not.
COMPTON: So, I'll play you a little bit of Carol. This was talking to us yesterday. This is a mum of an eight and a four-year-old, talking about what this review means in real terms for her in terms of uncertainty going forward.
CALLER: It still provides a lot of uncertainty, and a lot of uncertainty brings anxiety. And our life is already filled with anxieties.
COMPTON: She's talked about how critical music therapy is for her sons. They have profound challenges. They need to be lessoned one on one. Their music therapist is a qualified, degree qualified teacher. And so, you've started a process, or the NDIS started a process under your direction, that will mean a long period of uncertainty, not knowing whether it will be in or out into the future. How is that a good plan?
SHORTEN: Not really. The review will report back by March, the middle of March.
COMPTON: They want it on their plan now.
SHORTEN: If it's in their plan now, they keep it until the review concludes. So, there's actually not the uncertainty. Now people believe in this, some people believe in this therapy. Other people say it's not delivering outcomes. I'm not going to tell some of your callers what their truth is. That's their truth. But what we do have to do is - and it's not going to just be art and music therapy. The NDIS pays, invested, $41.8 billion last financial year. It's been now provided to 680,000 participants. We're not cutting the Scheme. The Scheme before I became the Minister was growing at 23% in cost outlays and 15% increase in numbers. That's not sustainable.
See, I get Carol's point. I've spent the last 17 years, I helped create the NDIS before there was an NDIS, I was the first politician in public life to ever talk about an NDIS. I'm really pleased that we've set it up, but after nine years coming back in as the Minister, it's growing too fast. I'll tell you what will create anxiety for Carol, is if there is no NDIS, that would be a disaster.
So, decisions have to be made. All we're saying is not ‘is art or music therapy a good or bad thing’? It's what benefits is it delivering? Let's look at the evidence. And then, as I've said to the art therapists and the music therapists, if the evidence is there, then that's fine. If the evidence isn't there, well, that's a problem. I don't think the Agency communicated this issue well, so I asked them to reconsider their position. So, they have, and I've said, let's find someone who doesn't have a dog in the fight, but just is a genuine person. And Professor Duckett is genuine, and no one argues about that. He's very credentialed.
COMPTON: And one person did raise the issue yesterday. This is a female dominated profession, and you've put a man in charge of reviewing it. You're comfortable with that?
SHORTEN: Yeah. Duckett is not - he's not a misogynist. He listens to women as well as men. Sometimes in life, if there's one position, it'll either go to a woman or a man. In my time, I've now made the head of the Agency, the CEO is the woman. That's the first woman. The head of the Safeguards Commission is a woman. Half of my directors of the NDIA are women. But sometimes if you've got the right person, that's just the right person. And I met with the head of ANZACATA, that's the art therapists. I met with the head of the music therapists’ associations. They're both women, and they'll make their submissions. If someone thinks that Duckett applies a gender lens, let me know. But in the meantime, I just want to get on with business.
COMPTON: You're on Mornings around Tasmania. Bill Shorten is the Minister responsible for the National Disability Insurance Scheme. So many texts and calls, we've got you for another eight minutes. Can we really run through some of the input that we're getting?
SHORTEN: Alright, I take that as code for quick answers.
COMPTON: Well, yeah. Quick answers please.
SHORTEN: Alright, but if the question requires quicker than a grab, I'll go longer. But I'll give you a quick answer where I can.
COMPTON: And I know you've got other stuff, and we'd love to have you for as long as you possibly can.
SHORTEN: That’s very generous, Leon.
COMPTON: Give me the signal when you need to leave.
SHORTEN: That’s alright, let’s fire away.
COMPTON: Otherwise, we'd like to keep asking and an advocate that you probably know well, Jane, a person living with disability says, quote, to be honest, I understand overall why the Minister is implementing some of the recommendations of the Royal Commission and the review. The challenge, however, lies in the unintended consequences of the policies and rules evolving rapidly to support the disability reform agenda. People with disability who self-manage their funds are terrified of doing something wrong and losing their option to have control over their lives, losing funding or a debt they can't afford to pay back. How is that a good system? Are you aware of those concerns?
SHORTEN: I think that whenever a politician uses the word change or reform, people think that's not the word they hear. They say, am I going to get shafted? Am I going to lose what I've got? If you're a person with a disability or love someone with a disability and you've finally got your hands on an okay package, you're worried when they talk about change, what am I going to lose?
I would say to Jane, everything we're doing is budgeting on an increased growth in the Scheme and more people on the Scheme. But we want to focus on quality, not just the input. So self-management is part of the goals of the Scheme. If you can self-manage, we like that. Sometimes though, people are spending money on stuff they just shouldn't be spending money on. So, what are we meant to do? Just say, not a problem? What we've got is a 12-month grace period for people who might spend their money on the wrong things on the Scheme, and if they make mistakes, we'll just work it through with them. We haven't budgeted for a single dollar in debt recovery. That doesn't mean that periodically people don't create debts, but that's not what's driving us. There's not a single – remember when we had Robodebt under the Libs, they budgeted for billions of dollars of debt recovery. We're not budgeting for a cent. That doesn't mean we won't look at debts, but I'm just saying it's not what's driving us.
COMPTON: Mornings around Tasmania. Bill Shorten should NDIS recipients be required to make a co-contribution for some or all of their services, like an excess on any other kind of insurance?
SHORTEN: No, I don't think that. The reality is that this myth that somehow people with disabilities live high on the hog is not true. Disability is one of the indicators of greater economic disadvantage. The other thing is disability is universal. It can be any of us or anyone we love. Therefore, I don't support it being sort of rationed in the way that that suggestion makes clear.
COMPTON: Front page of The Age this morning, $1 billion for the NDIS in extra staff. We're seeing so many people talking about questions about who is doing the reviews of their plan, talking about the problems that come with doing that over the phone rather than face to face, and the need for more expertise. What's this billion dollars for the NDIS designed for? Is it targeted to improve that area?
SHORTEN: Yes, it's building on the capacity of the Agency. Fun fact, in 2017, when there were 170,000 participants on the scheme, there were 4000 people working at the Agency. When I became Minister, there's over half a million people on the scheme and still 4000 people at the Agency. The Agency was making mistakes not because they're bad people, because they're simply overloaded. So, we are putting more people on who are better trained in disability, allied health professionals, people with a disability support background. So, we have to increase the workforce of the agency so we can get better, more consistent, better-informed decisions. Too many people on the Scheme would complain to me that they felt that they were sending reports to people who didn't understand what they were reading. So, this is all about investing in a more humane, informed, disability aware workforce at the Agency. And one other good little fact, 22% of the Agency are people who self-report as having a disability.
COMPTON: Question for Bill Shorten regarding the NDIS. This is from one of you texting us on 0438 902 936. I work in the medical device industry. Many suppliers of medical consumables charge NDIS clients significantly more than the recommended retail price for basic products. I have seen 50% higher. What are you doing to keep these companies accountable?
SHORTEN: I made that illegal. I found $5 million to give to the ACCC. There was a story in The Mercury yesterday. We've now written to every participant and said that we want to outlaw the wedding tax, that's when a price jumps up, when a person provides a good or a service, as soon as they know the customer is on the NDIS, the price goes up. I hate that price gouging. We're taking people to court. It was reported in The Mercury as recently as yesterday. If that correspondent of yours has some evidence, please give it into us. You give me the info; I'll hunt down the scallywags and kick out the price opportunists.
COMPTON: Good morning, Scott in Tranmere. I'm not a Labor voter, but I agree with Bill Shorten. The evidence needs to show that music therapy is working. That's more than the anecdotal evidence of some therapists and users, says Scott in Tranmere this morning. Scott, we’ll take it as a comment, although maybe we'll come back to it as our last question this morning. You can join us too, 1300 222 936 is the number, 1300 222 936 Polly in Newtown. Why is a blind person, Bill Shorten, who cannot read text, am I no longer able to subscribe to audible on my NDIS plan? Asked Polly in Newtown. Polly, I think you're talking about the podcast provider and have that covered under your NDIS plan.
SHORTEN: Okay, the short answer is I don't know what's in your plan and I don't know why that decision has been made. If you want to give us the info offline through the ABC, I'll find out. The more general issue is the NDIS provides supports that are not available through mainstream services. So, I'm not saying that's the case with you, Polly, but if there's something which a hospital can provide or a school can provide and I don't know the circumstances of what you need, but as a general rule, what we can't be is a surrogate education system, the surrogate healthcare system. And that's why we're building out supports outside the NDIS as well. I have to give a shout out to the state Minister here, Jo Palmer. She's good to work with. She's very committed to working with people with disability just as is Ella Haddad, the opposition spokesperson.
COMPTON: Have they stepped up? Has the state government stepped up? One of the issues that happened when the NDIS was introduced was that state governments said, oh great, we'll get out of providing support in this space and hand it over to the feds. You've started to push back on that?
SHORTEN: Yes.
COMPTON: And in school systems. Oh get a diagnosis is the common refrain that we as parents hear. Because ultimately, then the NDIS can step in. How have you gone in managing that return of some responsibility to the States?
SHORTEN: Well, I'll acknowledge, I actually - Jeremy Rockliff was good enough to fly to Moonee Ponds in Melbourne, where I have my office. I met with him and Peter Malinauskas. I think the states do recognise the NDIS can't be the only lifeboat in the ocean. Of course, the states are worried about extra sort of cost. No, I think Jo Palmer and Jeremy are quite committed to Tasmania, stepping up and doing more. The contribution at the moment from the States is about 30% to the NDIS and the feds pay 70%, that's out of whack.
The states have agreed to increase their contribution, but I also think the Federal Government has got to provide some support outside the Scheme for people whose disability doesn't make them eligible for the NDIS but do need interventions. So, we're working constructively with the states and to be fair, Jeremy gave a bit of leadership to that on the national stage, along with Peter Malinauskas.
COMPTON: You're on Mornings around Tasmania. Bill Shorten is our guest this morning. You're the architect of this scheme. You built it.
SHORTEN: One of.
COMPTON: It's one of the most significant policy reforms in modern Australian history. How do you feel about the fact that - when are you leaving Parliament to take up a role in the university sector, and how do you feel leaving this policy behind and this program behind to someone else?
SHORTEN: It's difficult. What I've tried to do in the last 930 days that I've been the Minister, I mean, that's a statistic no one else cares about but me, is I've been trying to politician proof the Scheme.
What I want to do is make sure the Scheme doesn't rely on the level of interest, doesn't depend upon the level of passion and interest to the Minister. There's many passionate, interested people who will be Ministers in the future, but I don't want to make that the X factor. So, what we're doing is building up the capability of the Agency, getting both sides of politics to agree on a common direction so it's not chopped and changed. Getting a commitment to growing the Scheme from both sides of politics, but also building a support system for Australians with disability beyond the NDIS.
The NDIS is a chapter about inclusion in Australia, but it's not the whole book. So, it's politician proofing the Scheme so that and that's not denigrating my profession, it's just saying I want to make sure that that for the NDIS it's a bit like superannuation or perhaps Medicare, that there's general agreement it's a good thing and it should be there for the future.
Having said that, I'm very proud of the NDIS. And I have to say, there's lots of problems with it, okay? I do not say mission accomplished. But when I had a chance to lead an Australian delegation to the United Nations, annually, all the member states of the UN report on what they're doing on disability. No one in the world has seen a nation as committed to disability as we are. That doesn't mean other countries aren't doing good things.
But overall, the NDIS is now nearly 2% of the GDP, it employs, perhaps towards half a million people. There's 680,000 participants on the Scheme and their family members benefit. We're seeing 75% of people on the Scheme say it's just making their life better. 50% plus of carers are able to work now when they couldn't.
So, I love the fact that this nation prioritises people with disability. So yeah, I want to make sure it's sustainable. I think there's enough money in the Scheme. We want to make sure that the shonks are run out of town, but I'm very proud of it.
I never thought that might be the thing which I'd be proudest of. I mean, I was very proud to lead the Labor Party for five and a half years, but I know that in the future this Scheme, for all its imperfections, is changing hundreds of thousands of people's lives. And if you can make a difference to people's lives, so they're not defined just by their disability, that is a privilege. It gives me goosebumps. It's a privilege to be part of that journey.
COMPTON: Just a final question on where we started and then we'll let you go. I know you've got a function to get to in a moment. If the Duckett report comes back and says, $193 an hour, one on one music therapy has evidence in science and in what he hears from our listeners, will you allow that to continue?
SHORTEN: I couldn't be happier if that's what the answer is. And I think we'll find that in some cases - my own hunch is that in some cases, it is having positive effects, and it is being able to demonstrate the quality of outcome because you've got highly trained people. I believe the stories that I'm hearing, I think I'm hearing truth. But I also know there's a lot of BS around some of the delivery of some of this, and that needs to be cleaned up.
COMPTON: It's been great to see you in the studio this morning. I suspect it's the last time. Bill Shorten thank you.
SHORTEN: You can always have me in.
COMPTON: Well, yeah. The last time while you are sitting officially, with an office in Moonee Ponds, that'll be shifting to Canberra. Thanks for coming in and talking with our audience around Tasmania this morning. Have you got a tip? Who do you want to you?
SHORTEN: Oh, that'll be up to the Prime Minister. But I tell you what, for people worried about the future of the Scheme, the people who you can count on are the people you see in the mirror. This is borne of people with disability and their carers and families. Trust yourselves. My only advice to the NDIS world is, back yourself. Make serious decisions. Make the changes that need to be changed, because we know some changes need to be made. But trust yourselves because never again do I want to see people disability at the back of the queue.
COMPTON: Thanks for coming in this morning, Bill Shorten.