E&OE
PATRICIA KARVELAS, HOST: On any given night in Australia, there are around 1,500 people in hospital beds that don't really need to be there. National Disability Insurance Scheme participants are waiting 160 days on average for the National Disability Insurance Agency to get them out of hospital and into medium or long-term accommodation. It's clogging up hospital beds and costing around $1 billion a year.
The Minister for Government Services and the National Disability Insurance Scheme, Bill Shorten, is making clearing this a top priority of his, and he's in the studio with me. Minister, welcome.
BILL SHORTEN, MINISTER FOR THE NDIS AND GOVERNMENT SERVICES: Good morning Patricia.
KARVELAS: According to media reports, the hospital discharge operation plan shows more than half the NDIS participants in hospital are ready for discharge. What sort of situations are we talking about here?
SHORTEN: Well, as you said in your opening, I was surprised and shocked to discover that we have literally hundreds - and indeed 1,500 according to the latest estimates from states. People with profound and severe disability who are medically fit for discharge, but they're still in hospital. And in fact, I visited Caulfield campus at the Alfred Hospital recently as part of my tour to get to the bottom of this problem, and the clinicians there were telling me of 20 to 30 people who really should be in other accommodation. It's not in the best interests of the welfare of a person with a disability to be stuck long term in hospital. And it's a very expensive way of supporting a person.
So as to why this is happening, it could be clunky bureaucracy, it could be a lack of housing for people to move into, but we need to get to the bottom of it and resolve it because it's tough on the person with a disability and it's costing Australians in hospital payments about $3 million a night in taxes.
KARVELAS: $3 million a night?
SHORTEN: Well, it costs about $2,000-plus to have a person with profound and severe disability looked after in hospital when they're medically fit to be put somewhere else. So if you multiply $2,000-plus times about 1,500 people, it means $3 million a night, and it's causing bed block in hospitals as well.
KARVELAS: So what are the experts telling you? Is it a lack of accommodation? So nowhere to actually take these people, or a lack of staff to do the assessments as part of that very complex discharge process?
SHORTEN: It's all of the above. I don't pretend that this is a simple issue, but having said that, there are things which I believe can be done which will start to reduce the waiting times and therefore the cost and the harm.
One is quicker decision making by the federal National Disability Insurance Agency. Now, that's something which should be within our control. What happens now, to explain it to people who are saying, well, why can't they just sort it out, is that it seemed to me there's a lot of binary decisions.
In other words, you make a decision is someone eligible, and that's the only thing we think about. Then once we determine if someone's eligible, we make a decision about what sort of home modifications might they need or where should they live, and then we wait on that decision. And then there's toing and froing, so we don't seem to do a lot of things concurrently. We seem to make every decision consecutively.
Treating people and getting them- who have a severe disability and then moving them from hospital to a post hospital environment's not new. We've been doing it since World War One with our veterans. So it is, to be honest, a bit of a mystery to me that we've- that this situation's been allowed to blow out in previous years.
There's good people working in the hospitals. There's good people working in the disability agency. We've just got to perhaps also allow the people at the coalface to make decisions rather than getting everything double checked, triple checked, quadruple checked by other people. So delegated decision-making, bringing in planners who are more familiar with rehabilitation would be also, I think, a really good development. So I think there are parts of the puzzle at least that we can put together.
KARVELAS: And it costs about $1 billion a year. Do you envisage saving that billion dollars if you change this, or is it about more redirecting where that money is spent?
SHORTEN: Well, it's costing perhaps about $1.5 billion a year to the states. Ultimately, the NDIS pays for people once they leave hospital. And whilst they're- the NDIS is co-funded by the states and the Federal Government, when they're in the hospitals they're funded by the states. But I don't view it as necessarily saving in one area or saving in another.
The reality is that Australians want to have an efficient hospital system and a good safety net for people with disability. This is just a waste of resources. I think we can do it smarter and a lot more equitable outcomes for everyone.
KARVELAS: You're introducing some new benchmarks. So an NDIS participant must be contacted by the NDIA within four days of the agency being made aware they're medically fit to be discharged, and have their NDIS plan in place within 30 days. How do you plan to achieve that? Do you need more staffing to actually make that happen?
SHORTEN: Well, I think maybe. I mean, I know maybe is an answer that journalists hate, but we've just got to see how it goes. We are putting on some extra staff. Most hospitals- all hospitals in Australia have disability teams. That's what they do. They work on rehab. What I want to do is to have- this is how government departments talk to each other, and citizens hate it when the different government departments can't seem to talk to each other. So what I want to do is have more skilled disability planners from the National Disability Agency working with, if not embedded with, hospital rehab teams.
One of the things that we sometimes do is we wait till a person, their condition has to have stabilised. Now, sometimes a rehab team in a hospital know if someone's been in a catastrophic car injury or work injury or what have you. They can predict the person's condition will stabilise, but it might not stabilise at a particular point. I think it's unsatisfactory to wait till, you know, every t's crossed, every i's dotted. If you've got a profound disability, you can see where that journey and pathway is taking you. So I'd like to see the agency engaged with the hospitals a lot earlier so we can start building the plans, start the hunt for suitable accommodation.
Quite often people require seven day a week, 24-hour care. It takes time to put together a team of carers. The earlier we can start that process, just the better it is, the less stressful it is on the whole system and, most importantly, the person with a disability.
KARVELAS: And how quickly do you believe this new benchmark can be met?
SHORTEN: I don't know. I think if we don't set some goals, though, and some targets, then I can guarantee you we'll never get there. I've had people say to me it's impossible to do this. I've said back to people who work in the system. And what I've said is, well, it's definitely impossible if we don't try. And I want to try, and I think we can do better. And there's a lot of good people- right now across Australia, there's literally thousands of people working on helping people deal with trauma, deal with injury, deal with disability. But I think too often there's just too much red tape. Now, you did mention at the outset of the interview, perhaps there's a shortage of appropriate housing. I think that's a problem. That can't be fixed overnight. But one thing we can do is improve our processes by the targeted use of some extra resources, which I think in the long run saves our community and the people involved.
KARVELAS: Now, one of the things we keep hearing, and it's certainly backed up by the evidence if you look at the Budget and the forward estimates, is that the NDIS is growing. And some people argue - in fact, the previous government before they started reining in some of their language, growing out of control, and that the NDIS is one of the big costs in the forward estimates on the Budget. Have you been asked to find savings in the NDIS for this forthcoming Budget?
SHORTEN: No. I think everyone is aware of the fact that the NDIS is growing faster than expected, and it's growing faster than a lot of other matters in government expenditure. I think though, the solution is not to view every person in the NDIS as a cost, but rather that the money we spend in the NDIS is an investment.
In other words, every dollar that gets spent there generates more economic activity, so it's an investment. And the more you invest in individuals and work towards their personal goals, there's an overall saving to society in the long run. But in the short term, I think we can do more to clamp down on waste.
I do worry profoundly that there's overcharging in the system, that somehow when you say that you have an NDIS package and you go to some service providers, the cost of the service doubles. And this isn't just anecdotal, I- the ironic thing, and I'm not really here today to talk about the old government, but they concentrated on stopping people getting onto the scheme or cutting the packages of people on the scheme.
I think a far more productive use of Government's effort is to look at the back door of the Scheme to make sure that when invoices are submitted it's for services actually delivered, and when invoices are submitted to make sure that they're not being overcharged hundreds of dollars. And I think as a first step to reform we view the scheme as an investment.
But we- tell you what, we don't take any nonsense from people who are syphoning money off between the taxpayer and the NDIS participant, and I think that's where quite a lot of our effort can go.
KARVELAS: Just on another issue before I say goodbye to you. Do you think it's appropriate for pandemic leave payments to stay in place for as long as COVID isolation payments are- periods are enforced? So at the moment, we've changed to this five day isolation. There are some, like the New South Wales Premier, that would like to get rid of it altogether, but medical advice apparently says we must have five days at this stage. Should payments follow any legal obligation to isolate?
SHORTEN: That'll be a matter for National Cabinet to discuss. I can certainly see the argument you're putting forward if you're obliged to stay home, if the state tells you to stay home. But there should be some payment balance against that. My- one of my departments pays out the Pandemic Leave scheme and there's been 500,000 claims since July the 20th this year, 500,000 claims and $320 million has been paid out. That's quite a lot of money. So I don't think it's a simple or easy question when people's, you know, income is affected, that's a disaster, but also there is an issue of the ongoing costs. So I'm sure National Cabinet, now that Prime Minister Albanese was able to secure the states paying half the of scheme, I think that's focused everyone's minds in what does the future look like.
KARVELAS: Yeah. But, while there is that obligation on people.
SHORTEN: Oh, I can certainly see your point, I wouldn't insult anyone's intelligence listening. I think that is a point. But I also- in preparation for this interview this morning, found out that we've paid $320 million, really, since July the 20th for people who have to stay home. So this is a balancing act, and I…
KARVELAS: It also demonstrates, though, doesn't it? When you give me that figure that a lot of people are isolating and claiming the payment.
SHORTEN: Yeah. And it demonstrates quite a few things, that number. So one of the things which we are doing is making sure that people who are submitting claims are not falsely submitting claims. That's an important subtext as well to make sure that we're…
KARVELAS: I'm intrigued by that. Do we know many people are falsely submitting claims?
SHORTEN: No, I- we don't. What happens is that you submit a claim online. You have to have proof of a PCR or that you've got a stay at home test which the state, particular state, respects. In the online form you then submit, you have to explain that you don't have any other sick leave available, and then what happens is if there's a red flag in that, it's then checked by Human and Services Australia just to sort of see if the claim should proceed or not. But I think the vast bulk of people are doing the right thing. I don't have any doubt about that.
KARVELAS: Bill Shorten, many thanks for joining us.