Ensuring the provision of high quality disability services will pose a significant challenge for the Albanese government's second term.
Authors
- Helen Dickinson
Professor, Public Service Research, UNSW Sydney
- Anne Kavanagh
Professor of Disability and Health, Melbourne School of Population and Global Health, The University of Melbourne
The National Disability Insurance Scheme (NDIS) cost A$43.9 billion in 2023-24 and is one of the fastest growing pressures on the federal budget.
As the government seeks to moderate growth of the scheme budget, some NDIS participants are finding they are no longer eligible for the scheme.
The problem is, the supports they're supposed to be able to access instead aren't yet in place - or don't exist.
Containing growth
Concerns have been mounting for some years about the NDIS's growing budget. In 2024, National Cabinet set a target of moderating annual growth to 8%. If met, the scheme will still grow to $58 billion by 2028.
The previous government attempted to limit its annual growth through legislative changes and a focus on weeding out fraud .
But there have been a number of reports in recent months of the National Disability Insurance Agency (NDIA) reassessing eligibility of NDIS participants to determine whether their supports are most appropriately paid for by the scheme.
If individuals are unable to provide evidence within 28 days they may lose their funding. This can be a challenge to get if participants need to see a clinical professional to gather evidence.
One group particularly impacted by eligibility reassessments are children. Some participants report being told they are no longer eligible for NDIS funding and should instead seek supports from other mainstream services such as health or education.
But all too often, parents find these services don't fund the necessary supports, leaving them to either fund this themselves or have their child go without.
If opportunities for early intervention are missed, they may require more intensive and expensive supports in future.
What are foundational supports?
The NDIS was never intended to provide services to all people with disability. About 86% of disabled Australians do not have NDIS plans .
But this doesn't mean that people with disability who are not on the NDIS don't also have support needs.
New research found people with disability who were not NDIS participants had high levels of need for assistance for tasks of daily living including transport, cognitive and emotional tasks, mobility and household chores.
These supports aren't usually provided in the health system, but similar supports are provided through aged care.
The NDIS review argued a lack of accessible and inclusive mainstream services for people with disability meant people were being pushed into the NDIS as their only potential source of support.
A key recommendation of the NDIS review was states and territories should provide "foundational supports".
Foundational supports are split into two categories. General foundational supports includes things such as peer support, improving self-advocacy skills, and information and advice.
Targeted supports include shopping and cleaning for those not eligible for the NDIS. Supports are aimed at particular groups such as those with psychosocial disability (from a mental disorder), families of children with developmental delay, and transition supports for young people preparing for employment and independent living.
Foundational supports are supposed to be available from July of this year so people with disability who aren't eligible for the NDIS can access support without having to join the scheme.
But people who are reassessed as ineligible for the scheme are having their funding cut before these foundational supports have been established, leaving a worrying gap.
There is currently significant confusion in the disability community about what foundational supports will look like and who will be able to access these.
What is clear is there is significant unmet need for people with disability outside of the scheme and this might lead to a deterioration of functioning among those in this group and potentially burnout of informal carers.
Getting foundational supports right will be a key point of negotiation between federal and state and territory governments if people with disability are to be supported appropriately and the NDIS is to be sustainable.
New ministers and ministries
The new government has moved responsibility for the NDIS from the Department of Social Services into the new Department of Health, Disability and Ageing led by Mark Butler.
While Butler will sit in Cabinet, Jenny McAllister has been appointed to the outer ministry as Minister for the National Disability Insurance Scheme.
The shift of the NDIS to this portfolio has raised concerns among the disability community that it might not be a priority in an government department that also deals with health and aged care.
There are further concerns this move might medicalise how disability is seen. This would go against the human rights basis of the NDIS, where issues of choice and control are crucial.
The ministerial and departmental restructures do present new opportunities to harmonise services for people with disability.
Currently health, disability and aged care are competing to attract similar workforces across allied health, aged care and disability support. A cross-sector approach to workforce planning could be streamlined if it is the responsibility of one department.
Without this, we risk putting more pressure on the NDIS and leaving people with disability not on the NDIS without the supports they need.
The government's ministerial and departmental restructure will likely further delay the implementation of foundational supports. Given the breadth of responsibilities of the health, disability and aged care portfolio, other policies - and election promises - might take precedence over work on foundational supports.
Helen Dickinson receives funding from ARC, NHMRC and Department of Social Services
Anne Kavanagh receives funding from the ARC, NHMRC, MRFF, MS Australia and the Australian government.
