Children are the fastest-growing category of participant,and quarterly NDIS datapublished in May revealed 11 per cent of 5- to 7-year-old boys and 5 per cent of girls are now on the scheme – more than was ever expected.
“With so few supports outside the NDIS,it is not surprising that parents are fighting to get their children with developmental concerns,delays and disabilities into the NDIS. Then,after receiving early intervention supports,they are not leaving the scheme,” the report said.
It means the focus has landed on diagnoses rather than need – a dynamic experts have warned is fuelling an over-diagnosis of level two autism in children – and children are being funnelled into clinical settings rather than receiving support at home and school.
“The increasing reliance on therapy delivered in clinical settings has got in the way of children living ordinary and inclusive childhoods,” the report said.
“These failings – together with the lack of supports for all children with disabilities in mainstream settings –[are] undermining the sustainability of the NDIS.”
Home care andpsychosocial support for people who aren’t on the scheme are also insufficient and inconsistent,according to the report.
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While governments have boosted their funding for disability services in the 10 years since the NDIS was introduced,from $8 billion a year to more than $30 billion,almost all of that has been poured into the scheme. In 2021-22,NDIS supports made up 93 per cent of all disability funding.
Bonyhady said the spiralling costs of the NDIS came down to two factors. First,the overall rate of disability is higher than estimated a decade ago,when the scheme was designed.
“But the second thing is,the absence of supports outside the scheme mean that this is the only option,” he said.
“That’s driving all these families to seek access to the NDIS. Quite frankly,if my children were younger,I would be doing the same. So would everybody. It’s the system leading to the outcome we’ve got. We need much better supports for those kids,outside the scheme. That would also mean we’d be able to pick up developmental difference much earlier,intervene much earlier,and get much better outcomes.”
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The same applied to adults with disabilities who need assistance. “At the moment,if you need a little bit of gardening or cleaning,you can’t get it. The only solution is the NDIS,” Bonyhady said.
When people did not get adequate support,he said their conditions often deteriorated,their needs increased,and they then entered the NDIS later,at a higher cost.
For the half a million Australians who have accessed the scheme,he said the planning process was “deeply disempowering”,in part because there was a lack of clarity about what constituted reasonable and necessary support.
“People with disability feel the need to produce volumes and volumes of evidence to support their plan reviews ... The whole thing is deeply stressful,” he said.
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Bonyhady welcomed the national cabinet’s interest in the scheme,as Shorten commits to a “reboot” of the NDIS.
“Future costs have to be predictable. In the absence of[that],there’s a real risk of loss of public confidence in the scheme. And the scheme needs to be there for people with disability today and in the future,” Bonyhady said.
The report has also called for better measurement of outcomes and better designed markets. “We know that providers often charge participants at the maximum price ... So there is little reason for providers to compete by lowering their prices or improving the quality of supports,” it said.
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