Interview with Patricia Karvelas on Radio National

E&OE

Patricia Karvelas:
For more, we're joined by the Minister for Government Services and the National Disability Insurance Scheme, Stuart Robert. Stuart Robert, welcome.

Stuart Robert:
Thanks, Patricia.

Patricia Karvelas:
The Government started working on a plan to respond to coronavirus outbreaks in disability care in March. Why did you decide that more was needed? And when did you start this work on this update?

Stuart Robert:
You're right, we started this- well, in fact, in February was the planning phase, and then 18 March I pulled together the Disability Reform Council, all the state and territory ministers, so we could coordinate it all. Of course, that went really well, through the first wave, and then as things started to look a little interesting in Victoria almost a month ago, we started pulling together what is now the critical response group for the nation to prepare ourselves if something like a second wave came upon us. And unfortunately, that's what we're seeing now.

Patricia Karvelas:
Take me through the key changes that are contained in this plan and the process for managing an outbreak in disability care if it happens.

Stuart Robert: 
One of the reasons we put the critical response group together was to look at if things went dangerous across one, two, or multiple jurisdictions, we need it to be able to respond very quickly, so I took one of my deputy secretaries to head the group up. That includes elements of the Disability Insurance Agency, the regulator of the departments; it stands up to me every day at 4:30 in terms of a full brief. We're putting(*) place providers of last resort for large providers in Victoria, although we're working across the country to have that in place, but that's been formally signed-off in Victoria as well as a critical response capability, and the intent being that we can move very quickly if we find providers aren't coping, if we find what used to be called group homes - it's now supported independent living - we might have two or three participants in a home. If one participant becomes positive, we need to be able to move rapidly in there to ensure those participants are well. The other participants in the home are fine that we can get [indistinct] alternate accommodation, those sort of things. So, it's a fairly comprehensive capability that has been well planned-for, well stood up, and it's being used.

Patricia Karvelas:
The Commonwealth, as you say, is working with the Victorian Government through its Disability Rapid Response Group, so who's ultimately accountable if something goes wrong?

Stuart Robert:
Yeah, interesting question. We both are, and it's not ducking the question. It's that the disability response group in Victoria is responsible for all people with disability. And there's probably a million people if you go to the survey of disability and aged in care in Victoria with disability, but only 100,000 are participants. So the Victorian Government has a wide agreement for care, for providing mental health for hospital care, for all people with disability, including NDIS, but in terms of NDIS specific in a group setting or specific for [indistinct]… care, it's the NDIS. And then to make it even more complex, there's 5300 NDIS participants who are in a supported independent living, a group home, if you will. Fifty-five per cent of those are responsibility of the NDIS- NDIA, the agency, and 45 per cent are responsibility through an in-kind(*) arrangement with the Victorian Government. So it's a little complex, but it is actually very clear between the Victorian Government and the Commonwealth Government how it runs. Minister Donnellan and I were speaking this morning. We've got representatives on their rapid response group, so we all know who's responsible for what.

Patricia Karvelas:
Okay, but ultimately who does the buck stop with if there is an outbreak like we've seen in aged care?

Stuart Robert: 
Well, if it's in the- running rampant through your group home settings that the NDIS is responsible for, clearly I as a responsible minister would be. If it's in the in-kind support arrangement group homes, then clearly it's the Victorian Government's, and it is well-understood across both jurisdictions who is responsible for what.

Patricia Karvelas:
Okay. As part of this, a panel of four large providers will offer advice, support staff and isolation accommodation for smaller providers in an event of an outbreak. Is that in place right now?

Stuart Robert:
It's in place right now, absolutely.

Patricia Karvelas:
Okay. And the majority of infections in disability care in Victoria are amongst staff. What is the capacity of this system to provide a replacement workforce?

Stuart Robert:
Quite substantial. These are very, very large providers. Now, at present, this capability has not been deployed. So, we've identified [indistinct]… example, 138 providers that we've been communicating with that are perhaps smaller but might need some support or guidance or assistance, and all of those providers are actually doing a very good job in terms of where they're up to and haven't needed support yet. We're ensuring that there's enough PPE for 262 organisations, and providers have actually got over 190,000 pieces, so ensuring that's moving through. We just want to make sure that we're not leaving any stone unturned and we have a very large response capability if we need it. And at present we haven't need to deploy any of it yet.

Patricia Karvelas:
Okay. The aged care sector set up is very complex too. People have said this is an issue. Are the chains of command clear?

Stuart Robert: 
Absolutely clear considering that the response group briefs me at 4.30 every day. That group concludes the regulator, the CEO [indistinct], the CEO of the agency, and their key staff includes the Department of Social Services as well as a critical response lead. So, it's one call directly to the Minister in terms of decision making requires and of course a daily briefing and daily reporting on looking at where figures are, where participants are, how providers are going, including a health check on the sector with a focus on Victoria.

Patricia Karvelas:
Concerns have been raised that disability care workers moved between homes in a similar way to aged care workers. Have plans been put in place to limit the movement?

Stuart Robert: 
A lot of work's gone in place to encourage the limitation of that movement. You can't eradicate it. Remember, there's 100,000 participants in Victoria alone. A lot of them- in fact, most of them will need some sort of interaction on a daily basis. Some would need attended care to help with washing or cleaning. Others will need support in terms of allied health, and others would just need community support and engagement. So, it's quite clear that we want to limit as much as possible. And we've asked providers to do that as much as possible in terms of their schedule-

Patricia Karvelas: 
[Talks over] So, at this stage- I don't mean to be rude, at this stage you're just asking them to. There is no requirement on them limiting the movement?

Stuart Robert: 
We've asked them to limit it because with 100,000 participants all having detailed interaction with providers of some sort, with the vast majority of them- not by big providers, a third of them alone are self-managed. So they determine their own supports and their own people that provide care with no visibility to government because that's choice and control as per the NDIS act. At present we can only strongly encourage and put in place facilities where if we need to step in, we can.

Patricia Karvelas:
Okay. So, will it be enforced? How will you be able to ensure that that happens.

Stuart Robert:
Remember the disability sector, Patricia, is very, very different to the aged care sector. The aged care will have 150 residents in a home. The average group setting is free within disability. The vast majority- so, 95,000 participants aren't in supported independent living - group home, if you will. They're in their own home, or they're living with mum and dad - I mean, the 50 per cent are under the age of 18. So, it's a very, very different setting. Something you can enforce to say, well, providers can't work across multiple sites because the vast majority of people providing support in disability aren't from large established providers. That's not how it operates. So that's why we work with participants to say here's what we'd like to happen. If there are any issues, we can assist with limiting that move if necessary.

Patricia Karvelas:
One of the issues in aged care seems to be the facilities weren't as well prepared and that the regulator basically was unable to do this kind of work. What steps have been taken to verify the plans in place for group homes?

Stuart Robert: 
Well, [indistinct] in Victoria have all been contacted. There's been desktop audits done. We're working with 138 providers now to assist them with anything that they may need. If you look at the group homes, if you like, in Victoria right now, there are 17 participants, is the numbers from the commission that I'm reporting. 17 participants COVID positive in only six group settings. Remember, this is 17 out of 100,000. We've contacted over 68,000 vulnerable participants across the country to ensure they've got access to what they need, their support plans are in place, they're comfortable, they know who to contact in case there are any issues. So, we are about as prepared as we can be in this setting.

Patricia Karvelas:
Just finally, a story has broken in The Australian that the Coalition, or the government, it's trying to woo two particular politicians who are in the Centre Alliance to join with the government. That's Rebekha Sharkie and also Stirling Griff. Is that going on?

Stuart Robert:
No idea. I've got my head down dealing with not just disability but of course the entire service delivery for welfare across the country, as well as for digital tech solutions, so I'm pretty busy. But having said that, why wouldn't an independent want to join the government? The government's performing well, we're delivering for the country. I'd encourage every independent to look at coming and joining.

Patricia Karvelas:
Thank you so much for joining us.

Stuart Robert:
Great to talk to you, Patricia.

Patricia Karvelas:
Stuart Robert is the Minister for Government Services and the National Disability Insurance Scheme.