The NDIS and the Need for Inclusive Reform
The NDIS (National Disability Insurance Scheme) was established because the previous block funding system was failing. Widespread fraud was occurring, and individuals had very little autonomy or control over their own care. This led to a significant shift, resulting in many state-run disability services being halted and replaced by the NDIS—a system that, to this day, only serves approximately 10% of people with disabilities across the country.
Those over the age of 65, including individuals with profound disabilities, were largely abandoned under the new system. Mental illness was grouped into the NDIS without proper planning, resources, or preparation, earning the scheme the description of “a lifeboat in the ocean.”
Addressing the Gaps in Mental Health and Disability Support
It is no surprise that we are now facing a mental health crisis, even though mental illness was never supposed to be included in the NDIS framework.
If someone was not on the NDIS, there was simply no help available. Outside of the NDIS, the health and hospital systems functioned independently, disregarding the inclusive principles of the scheme. Hospital staff often lack knowledge about mental illness and know even less about disabilities or the workings of the NDIS.
They frequently refuse to allow a participant’s support team to accompany them in the hospital and often fail to meet the individual’s needs. Consequently, many individuals return home in worse condition than when they arrived. Hospital staff are often unsure whether support personnel work for the NDIS or are casual employees within the system. This lack of understanding contributes to a bullying culture towards perceived members of their staff. Although this doesn’t happen every time, it occurs frequently, leading to situations where casual staff assigned to a participant move on to another, forcing the original individual to find a new support team to leave the hospital.
A lack of knowledge and understanding has left many people stranded.
To address this, reform initiatives have introduced foundational support to fill these gaps. This support assists those who are not on the NDIS but need help, as well as aids those transitioning out of the system to avoid being left with nothing. The goal is to reduce dependency on the NDIS for anyone seeking support. While the ideologies behind the reform are commendable, they are ineffective in real-world situations where individuals need to go to school, work, shop, and live their lives. It seems the NDIS did not communicate its intentions to the rest of the nation, resulting in access and support being overly concentrated within the NDIS framework, with little else available.
However, there is still confusion about what foundational supports will look like. States that have historically neglected the disability sector are reluctant to develop these supports further than necessary. By offering services and access outside the traditional disability support system, we can prevent the worsening of conditions, promote greater inclusion, and stop the NDIS from remaining the only option for support.
Many are concerned that this initiative may merely serve as a mechanism to remove people from the NDIS.
Carers and advocates play a crucial role in providing some of the essential connections missing from the system. They offer crisis care to assist participants in danger and work with them to rebuild their support teams, reducing unnecessary hospital stays and transitions. We also provide an advisory line as part of our training program and franchise. Currently, many calls to the SA Health triage line are inappropriately related to the NDIS, highlighting a lack of supervision and avenues for seeking advice or help. Our franchising initiative addresses this gap by creating an accessible healthcare system, offering services such as pap smears and other procedures often unavailable in mainstream healthcare. We also provide palliative care, education, and accreditation for businesses to become accessible, along with training on the NDIS for healthcare and government staff. Our staff training program prepares support personnel to work in hospitals and alleviates the burden on registered nurses. Additionally, we train educational support staff to assist individuals with disabilities.
The current system operates within financial constraints, meaning we can only provide rights commensurate with what we can afford. There is a limit to what can be achieved. The issue of mutual obligation and contribution also arises: the costs associated with delivering services and ensuring human rights can compromise the quality of human capital and societal productivity. If there were a “magic pudding,” it would mean that inclusion requires every Australian to experience a quality life. Currently, the approaches in both the disability sector and mainstream society are far too erratic. People with disabilities must be supported to a level where they can strive, achieve, and dream just like anyone else.
Care services are often unreliable and inconsistent. Some individuals are either over-serviced or receive support in the wrong areas, compounded by a mismatch between workforce skills and actual needs. The existing business model is not sustainable, lacks focus, and fails to address the concerning outlook for staff. People with disabilities don’t just need a seat at the table—they need to own a share of it. Care must de-institutionalise, which requires identifying new models that are innovative in both design and funding sources. We need sustainable models that are financially, environmentally, and socially viable.
