The disability sector had a significant win in July.

Following months of campaigning, the federal government was forced to remove the National Disability Insurance Scheme’s (NDIS) independent assessments.

It is rare to get an advocacy win this late in the policy cycle and it is worth reflecting on how we got here.

It was a policy backflip like no other.

The legislation was all but drafted and the government was not backing down—it had even signed contracts with future providers of independent assessments in a 'cart before the horse’ kind of move.

It was the government’s own independent advisory body to the NDIS—and the state and territory disability ministers—who eventually forced the decision.

In any case, this policy should have been shot down much sooner, even with the COVID-19 distraction.

However, despite a strong community backlash, a united disability sector opposed to the change, some powerful advocates and the strength of the cause, the sector still endured months of uncertainty.

We came very close to an automated ‘robo-planning’ policy shift that would have fundamentally altered the NDIS and nearly destroyed what so many have fought so hard for.

This is a sector that is now suffering from an acute lack of trust—this was morally corrosive policy.

Let’s take a look at how it all unfolded.

How we got here

The plan to introduce functional assessments was announced in August 2020.

The NDIS then proceeded to trial the program—still insisting this was not a cost-cutting exercise.

Initially, independent assessments were introduced with a stated aim of addressing consistency and reducing inequities in the scheme.

Later, however, the government changed tack.

It became very clear that the introduction of independent assessments was designed to address what the government described as a cost blowout.

The National Disability Insurance Agency undertook sector-wide consultation and then essentially ignored responses.

It claimed feedback from the pilot was positive—only for the integrity of the survey to be questioned, given the low sample of about 28 per cent (SBS News 2020).

It also claimed that the policy itself, to introduce independent assessments, was based on the Tune Review—with allegations later emerging that the review had been rewritten before it was published (The Canberra Times 2021).

The shift to a cost blowout discussion at least provided some clarification as to the real policy intent.

But there was a significant erosion of trust well before this admission, which only cemented it.

Even so, Minister for the NDIS Linda Reynolds hardly flinched, other than to announce her intention to pause the rollout in April shortly after being named incoming Minister for the NDIS.

It seemed the government would push ahead despite strong sector-wide opposition and a parliamentary inquiry still in progress.

A little on what was promised

It is also important to retrace the scheme’s original intent to show the extent of the policy drift.

On 7 December 2012, all states, territories and the Commonwealth signed an agreement aimed at revolutionising the delivery of disability support in Australia.

At the time, the Productivity Commission said the current disability support system was ‘underfunded, unfair, fragmented, and inefficient, and gives people with a disability little choice and no certainty of access to appropriate supports’ (The Productivity Commission 2011).

In response, the commission recommended a new national scheme, the NDIS, to provide insurance cover for all Australians in the event of significant disability.

It also recommended that funding of the scheme should be a core function of government (like Medicare).

The scheme was to inject much-needed funding into disability support.

It would recognise the rights of people with disabilities and provide them with reasonable and necessary supports.

It would provide certainty that they will receive the lifelong care and support they need.

Importantly, the benefits of the scheme would significantly outweigh the costs.

The policy drift

How did we drift so far from our original policy promise and key features of increased funding, choice and certainty—to a policy shift driven by containment around costs?

Independent assessments seemed a cruel response, an attempt to find savings by setting an unjust test to make applicants prove disability.

This was a proposal so fraught with inequity that it is hard to work out how we got here in the first place.

The APA’s submission on independent assessments to the Joint Standing Committee on the NDIS highlighted the shortcomings of the government’s approach, stating that it locked out the required clinical expertise in making holistic assessments and was reliant on untested and invalid tools.

In a recent media release calling on the federal government to reconsider its intention to introduce independent assessments to the NDIS, APA National President Scott Willis said, ‘The policy promise to provide Australians with true choice over the design and delivery of their care cannot be delivered through such a blunt instrument.

'This will only lead to more trauma for people with disability.

‘It is a harsh deficit-based approach that won’t provide consistency in decisions or individualised planning.

'The heart of any reform must be about supporting the individual—their goals, safety, dignity and inclusion.

'This is what must be considered when determining reasonable and necessary support.’

Beware of misleading numbers

It is clear that this was a significant shift made while we were distracted.

The use of a cost blowout to justify such significant change clearly didn’t work.

Even to attempt it was to underestimate the true strength of the sector.

The NDIS has proven the opposite of a welfare model.

It has provided certainty of funding based on need and genuine choice on how needs are met.

It means participants can be more independent in their daily lives and they have a chance at living more fulfilling lives.

For some, it means they can return to work.

It also means they can afford treatment to reduce functional decline—in turn, avoiding hospital admissions.

The benefit stream from the NDIS is significant.

This is a policy that has shifted the nation towards a more inclusive social model of disability.

This should never have been a case of costs but one of equity.

Email policy@australian.physio to provide feedback or for more information on submissions, position statements, background papers, elections and budgets.

References

Young, E. (2020). ‘Senators question integrity of pilot for controversial NDIS independent assessment reforms’, SBS News website, sbs.com.au/news/senators-question-integrity-of-pilot-for-controversial-ndis-independent-assessment-reforms.

Jervis-Bardy, D. (2021). ‘David Tune NDIS review “tampered” to justify independent assessments: ALP’, The Canberra Times website, canberratimes.com.au/story/7197342/astonished-anger-over-tampered-ndis-review/.

The Productivity Commission (2011). Disability care and support, Report no. 54, Canberra.