Funding Disability Support: An Overview of the NDIS
What is the NDIS?
The National Disability Insurance Scheme (NDIS), one of Australia’s largest public policy reforms, is Australia’s federal source of funding for disability support for individuals with a ‘permanent and significant disability.’ The NDIS was designed as an actuarial model, aiming to use short-term investments – including creating a dedicated reserve fund and providing vouchers for support costs to persons with disabilities – to reduce long-term costs by facilitating social participation and economic independence for individuals.
How did the NDIS come to be?
Prior to the NDIS, disability support was based on a patchwork state and territory-based ‘system’ described by the Productivity Commission as ‘increasingly unstable’ with insufficient and inequitable funding based on outdated models. The development of a National Disability Strategy was the result of years of lobbying by disability advocates, carers and disability service providers, with the bill to establish the NDIS introduced to Federal Parliament in 2012 by then-Prime Minister and Leader of the Australian Labor Party, Julia Gillard.
During the Australian Government’s preparations to develop this Strategy, the Productivity Commission’s 2011 Disability and Care Support Inquiry Report recommended that the Scheme should have 3 main functions (Recommendation 3.1) – to:
‘cost effectively minimise the impacts of disability’ and ‘maximise the social and economic participation of people with a disability…’
‘provide information and referral services’
‘provide individually tailored, taxpayer-funded support.’
Legislated through the National Disability Insurance Scheme Act 2013 (NDIS Act), the NDIS has since been the federal funding source for disability supports for individuals with disabilities, covering a range of supports including household and personal activities, transport and workplace help, therapeutic supports, home modification, and mobility equipment.
The achievements and failures of the NDIS
The core achievements of the NDIS have been:
Significant increases in overall funding for disability support – from $7 billion annually under the previous patchwork ‘system’ to an estimated $22 billion annually after its implementation.
Significant increases in the number of people receiving support services – with ‘tens of thousands of people who languished on waiting lists under the old state and territory-based system…receiving support services for the first time’.
However, despite being an improvement on the previous approach, the NDIS has been subject to significant criticism, both for specific policies within it – such as the mandatory independent assessment program for reviewing NDIS plans which was raised in 2021 but ultimately dropped after significant pushback from disability advocates and service providers – and for the absence of important policy components. The NDIS does not fund advocacy for persons with disabilities, who must navigate the service market created by the NDIS when many have a limited ability to do so. Scholars such as Dr Allan Ardill, Member of the Law Futures Centre at Griffith University, have argued that this absence of advocacy funding fails to meet the standard set under article 12 of the Convention on the Rights of Persons with Disabilities, which requires governments to ‘take appropriate measures to provide access by persons with disabilities to the support they may require in exercising their legal capacity.’
Additionally, though the provision of needed funds to a greater number of persons in need has been an improvement, the NDIS has been criticised for the amounts involved. As of 2022, the NDIS’ annual cost was $31 billion, and is predicted to rise significantly to $59.3 billion by 2030. Additionally, participant numbers have increased from 172,000 in fiscal 2017 to 502,000 at December 2021, and average plan costs have also risen sharply from $38,900 to $54,300 over the last four budget years. Concerns have arisen about service providers overcharging NDIS recipients and thus undermining the system’s purpose of providing vouchers for needed supports.
In his recent speech on addressing NDIS concerns, Bill Shorten, the Minister for the NDIS, has identified two key areas for an NDIS overhaul, these being:
Reducing complexity and confusion for NDIS recipients, who often have difficulties navigating the ‘rigid’ market system.
Cracking down on unethical service providers who overcharge NDIS recipients, or charge them for unnecessary or unhelpful supports.
What does a different (or more holistic) conceptual approach look like?
On a more conceptual level, the NDIS has been criticised for taking an individualist approach to the structural challenge of disability support by effectively operating as a voucher program, rather than providing direct support in a publicly accountable way. Writers such as Nicholas Haines, writing for Independent Australia, have argued that a better system would involve a well-equipped public agency with a direct role in facilitating the disability support workforce, as well as improving additional measures beyond individual support, such as:
improving accessibility (to buildings and public spaces, to print accessibility services such as producing large text, Braille and audio versions of documents, to ASLAN interpreters, etc.)
using fiscal policy to eliminate underemployment and non-frictional unemployment, facilitating a tight labour market of the kind that increases workers’ bargaining power. The result being significant pressure on employers to both:
improve wages and working conditions for disability support workers; and
create jobs and work environments that are suitable for people with disabilities, to maximise their capacity for full social and economic participation in a safe and equitable way.