Designing Social Service Markets by Gabrielle Meagher;Adam Stebbing;Diana Perche

Author:Gabrielle Meagher;Adam Stebbing;Diana Perche
Language: eng
Format: epub, mobi
Tags: Marketisation;Privatisation;Regulation;Australian public policy;Social services
Publisher: ANU Press
Published: 2022-09-13T05:52:59+00:00

Epilogue: Recent developments and future challenges for the NDIS

Since this chapter was written, the Covid-19 pandemic, the Royal Commission into Violence, Abuse, Neglect and Exploitation of People with Disability, and changes to the NDIS made by the conservative Coalition government have further highlighted the contradictions and tensions inherent in the scheme. In the first half of 2020, when Covid-19 cases were on the rise in Australia, frontline disability support workers and people with disability more generally were overlooked in the pandemic response, including in the national distribution of personal protective equipment. The health risks to workers delivering NDIS services and NDIS participants themselves were amplified by problems of poor management, under-resourcing, low pay, poor job security, multiple job-holding and unpaid work (Cortis and van Toorn 2020). While Covid-19 shone a spotlight on these problems, they pre-dated the health crisis and were closely bound up with the long-running marketisation of the sector. To protect the safety of NDIS workers and participants in (post-)Covid-19 conditions, more planning and investment are needed in critical overheads and infrastructure (for example, for staff training, supervision, safety and reporting), and government regulators including the NDIA must ensure the NDIS pricing schedule can adequately cover at least minimum entitlements for workers.

The need for regulatory reform of the disability sector was further highlighted by the Disability Royal Commission. Established in April 2019, the commission found that ‘inappropriate funding structures’ combined with a lack of regulatory oversight had enabled provider organisations to prioritise financial imperatives over client safety and wellbeing (Australian Government 2020: 20). The safety implications of marketisation were underscored by testimony from NDIS participants who felt that ‘some providers of disability services saw people with disability as a “commodity”’ (Australian Government 2020: 181). Better regulation of providers will go some way towards remedying these issues. However, NDIS participants will continue to face risks to their safety and wellbeing if providers are incentivised to prioritise profits over the quality of services.

In 2021, the NDIA drastically increased its projections for the number of people anticipated to be in the scheme by 2030, from 582,860 to 870,761 (Disability Intermediaries Australia 2021). While the assumptions and information on which these projections are based have not been made public, the Coalition government has made clear its intentions to try to contain the cost of the scheme, which is now expected to reach an estimated $60.3 billion by 2030 (NDIA 2021: 15). Notwithstanding the accuracy or otherwise of these figures, they are currently dominating debate over the future of the NDIS. They have been used to justify a range of measures, including government plans to take control of the assessment process through which a person’s eligibility for NDIS funding is determined and cede it to government-contracted health professionals and computer algorithms (van Toorn, forthcoming). These plans were recently abandoned in the face of strong opposition by disability, legal and medical groups, who argued the new assessment process would undermine the scheme’s core principles of choice and control. Against the backdrop of these various developments, the Coalition government allocated an extra $13.

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