SixYearsandCounting:TheNDISandtheAustralianDisability

ServicesSystem

AWhitePaper

i

Synopsis

Whataretheissues?

• TheNDISisnotworkingformanyitis

intendedtosupport

• The2018/19$4billion+underutilisationandclearsignsofunsustainabilityinthedisabilityservicessectorconfirmthisreality

• TherolloutoftheNDISwasalwaysgoingtobedifficultandmistakeswerealwaysgoingtobemade.Goodleadershipmeansthatwelearnfromthisexperienceandmodifyourapproachinatimelymanner

• AsignificantpartoftheproblemisthelackofanindustryplanfocusedonreformingtheAustralianDisabilityServicesSystemnotjusttheNDIS,combinedwithashort-termapproachtoproblemsolving—changesbeingmadearenotpositivelymodifyingthesystemitselftheyaretinkeringwithbandaidsolutions

• Wenowhaveasignificantbodyof

evidencein63separatereports,primarilyfocusedontheNDIS,writtensince2013relatingtoproblemsandpotentialsolutionsacrossthesystem

• Peoplewithdisabilityaretheshock

absorbersforanyvolatilitycausedbypoorpolicyandpractice—theyaretheonesthatultimatelyfeeltheimpactofsystemicchallenges

• Thereisasignificantriskthatbeing

unresponsivetothegatheringofevidencewillcausedestructionintermsofthesystem’scapacitytodeliverappropriateandfitforpurposeservicesandsupports,increasingdifficultyforpeoplewithdisabilityandcostforgovernments.

Whatdoweneed?• Leadershipmustacceptthechallengesand

havethecouragetodriveforwardinnewwayswhereexperiencetellsuswhatwearecurrentlydoingisnotworking

• LeadershipmustacceptthatthesuccessfulimplementationoftheNDISrequiresafitforpurposeapproachdrivenbyacultureofclarity,certainty,accountability,collaborationandflexibility

• Acomprehensiveindustryplanandresponsibleinvestmentfundedoutofthesavingsfromunderutilisation,toguidethedevelopmentofindustryandsupportgovernmentdecisionmaking,andwhichutilisesthedecadesofexperience&capacitythatexistsnationallytoensurethewholesystemworks

• Anationalgovernancemodelandpolicy

frameworkallowingforpolicyandinvestmenttobeinformedcollaborativelybyallinvolvedinthesystemincludingpeoplewithdisability,governmentsandproviderpeakbodies

• Alocaldecision-makingmodelproviding

fit-for-purposeallocationofresourcesandcapacitytomakedecisionsinthecommunitywherethosedecisionshavetobelivedwith

• Transparencyofoutcomestoensureweareallworkingtowardafuturewherepeoplewithdisabilityarereceivingfitforpurposeservices&supportsandaremaintainingdecisionmakingcapacityandagency

ii

Contents

Howdidwegethere?............................................................................................................................1

ThisWhitePaper....................................................................................................................................2

TheNDISisnottheWholeSystem.........................................................................................................4

It’snotaboutthemoney........................................................................................................................6

AFit-for-purposePolicy,Planning&GovernanceStructure..................................................................9

WayForward........................................................................................................................................11

ThisDocument.....................................................................................................................................12

Funding.........................................................................................................................................12

Citation.........................................................................................................................................12

TransparencyStatement..............................................................................................................12

ContactDetails.............................................................................................................................12

1

Howdidwegethere?TheAustralianDisabilityServicesSystemasweknowitdevelopedoverthesecondhalfofthetwentiethcenturyseparatelyinthestatesandterritories.By2010,alljurisdictionshadastate/territoryrundisabilityservicessystembutthesesystemsweredifferentinrelationtohowtheywerefunded,howsupportsandserviceswereallocatedandhowtheseelementsarticulatedwithotherservicessuchasHealthandEducation.Itwasnotafederatedmodel.Someoftheseelementswereeffectiveandsuccessfulbutmanywereidentifiedasinadequate.TheNDISaroseoutofdissatisfactionwithboththequalityandvariabilityofservicesandagenerallyacceptedobservationthat,inawealthycountrysuchasAustralia,wecandobetter.

Followingconsiderablenationaldiscussionoveranextendedperiod,in2011theAustralianProductivityCommission’sreport"DisabilityCareandSupport"setoutavisionforafederatedfundingmodelestablishedonaninsurancebasis.TheNDISwaslegislatedin2013.

TheCommonwealthandstates/territoriesfundedtheNDISviaseparatebilateralagreements.TheCommonwealthagency,theNationalDisabilityInsuranceAgency(NDIA),waschargedwithestablishingandrollingouttheNDISnationallyandtheNDISwaslaunchedinatrialphasein2013.

TheintentionoftheNDISwastofunddisabilityservicesandsupportsinamodelthatgavetheusersoftheseservices(participants)choiceandcontrolwithinaframeworkdesignedtofundreasonableandnecessarysupports.MuchwasmadeoftheeconomicandotherbenefitsexpectedtoflowfromtheNDISasaresultofthethenestimated$22Billionoperationalexpenditurevalueofthescheme.However,theprocessforrollingouttheNDISwasoverlydependentonmarketeconomicsnotwithstandingitwasnevermeantthatmarketoperationsshouldbeappliedtofundalltypesofdisabilityservicesandsupports.Perhapsmosttellingly,theNDISwas,famously,builtwhileitwasbeingimplemented.

Importantly,unintendedconsequencesofthisimplementationprocesshaveincluded:abreakdowninpre-existinginter-governmentalandintra-governmentalservicestructures;increaseduncertaintypreventinginvestmentandexpansionbyserviceproviders;significantworkforceissues;andpricingbasedonfundingavailabilityratherthansounddataonneedsandcostsofservices.Mostimportantly,thesechangeshaveincreasedtheriskthatpeoplewithdisabilitywillnotgettheoutcomespromisedandareexacerbatedbyalackoftimelyinvestmentcapital.

2

Intheinterveningsixyearsmuchdiscussion,researchandexperimentationhastakenplacerelatingtomanyaspectsoftheNDIS,includingbutnotlimitedtosupportingcomplexneeds,mentalhealthservices,difficultbehaviourssupports,workforce,pricing,andtheimpactoftheNDISbusinessarrangementsaswellaswithrespecttotherolloutoftheNDISitself.Wealsohavemuchresearchandexperienceofsimilarmodelsadoptedearlierinothercountries.Indeed,wehaveidentified63reportswrittenbyuniversitiesandindustrybodiesthatidentifymajorweaknessesandimprovementsneededtoensuresuccessoftheNDISinthecontextofthewiderAustralianDisabilityServicesSystem.

ItisnowtimelyandappropriatetotakeanobjectivelookatthecurrentstatusoftheAustralianDisabilityServicesSystemandtoconsiderifalternativearrangementsatthepolicylevelareneeded.

ThisWhitePaperThiswhitepaperutilisestheobservationsandcommentsofawiderangeofstakeholdersandresearchabouttheimplementationoftheNDISanditsimpactontheAustralianDisabilityServicesSystem.ItisalsoinformedbyinternationalexperienceandacademicliteraturefocusedoneconomicmodelsandpolicyframeworksthataresimilartotheNDIS.

IthasbeensixyearssincethecommencementoftheNDISanditisnowtimelytostepbackandobjectivelyassesswhathasandhasnotbeenachieved,includingintermsofthe63reportspublishedthatarerelevanttotheNDIS.

Inthiscontext,thiswhitepaperisfocusedondescribingapolicyandpracticeframeworknecessarytorealisingtheobjectivesoftheAustraliancommunityinfundingtheAustralianDisabilityServicesSystem.

Amongotherthings,manypolicyleaders,stakeholders,evenserviceusershavetakenforgrantedthatmarketsolutionswillresultinbetterservicesandoutcomesforpeoplewithdisability,whilealsoimprovingtheefficiencyofsupplyandvalueformoneyfortaxpayers.

Intryingtomakethesemarketsolutionswork,muchtinkeringhasbeenundertakenatthegrassrootslevel(e.g.inrelationtopricing;transport).Thishasbeencriticalinhelpingtodecreasetheriskofsupplysidefailure(thatis,serviceprovidersclosingtheirdoorsorexitingthesystem),butasystemicviewhasnotbeentaken.AstheproportionofservicesandsupportsfundedbytheNDISovertakesthatfundedfromthelegacyfundingsystems,andasthelinkagesbetweentheNDIS-fundedservicesandthosestillfundedbystatesandterritories(orworse,nolongerfunded,suchasinthecaseofprovideroflastresortinanumberofjurisdictions)starttounravel,theriskrelatedtoservicesupplybecomesgreater—ariskbornebypeoplewithdisability.

WhyaWhitePaper?

InAustralia,awhitepaperisadocument

producedbygovernmentorindustrythatseeksto

fullyinformreadersonaspecifictopicandto

presentanargumentforchange.

Whitepapersmayfocusondescribingthe

problemorthesolution,orboth,andare

authoritativedocumentsbasedonexpertopinion

andresearch.

Thiswhitepaperaimstocommunicateto

governmentthatchangeisneedednow.

Itsummarisesthekeyfindingsandopinionsofthe

manyreportsontheNDISandtheNDIAsince

2013.Itidentifiescommonthemes,reasonsthat

remedialactionsarenotworkingandwillnot

work,andrecognisesthat,giventheNDISisonly

partofthenationaldisabilityservicessystem,itis

timetoplanforthewholeDisabilityServices

System.

3

Bandaidsolutionsarealwaysexpensive,butneverreallyworkandtheycertainlydonotcontributetowardaneffective,efficientandreliablesupplyofservicesacrosstheboard.Importantly,theoutcomesforpeoplewithdisability,ourcommunities—indeedallstakeholders—willbenegativelyimpacted.InlightofnumerousRoyalCommissionsintothecareandsupportofvulnerablepeopleinAustralia,wecannotgetthiswrong.

Weacknowledgethatthesolutionsandsuggestionsputforwardinthispaperwillrequirefurtherdevelopmentand,possibly,legislative,regulatoryandotherchangesatanationalandsub-nationallevel.Wealsorecognisethattheindividualbi-lateralagreementsbetweentheCommonwealthandthevariousstatesandterritoriesmayneedtobechanged.Wedonotthink,however,thatsuchrequirementsshouldpreventtheadoptionofbetterwaysandapproaches,especiallygiventhepersonalimpactonabout500,000participantsandtheirfamilies,andthecosttotaxpayerswhenthingsgowrong.

Inessence,thiswhitepaperproposesthatgovernments,advocacybodiesandindustrypeakbodiesworktogethertoreformtheAustralianDisabilitySystem,inclusiveoftheNDISelement,ratherthanfocusingontheNDISasastandaloneelement,utilisingatimeframeandindustryplanningstructurethatisinclusiveofall.

ThepaperhasbeendesignedtobereadilyaccessibleforpeopleinpolicyandpracticeandtofocusonthesolutionsnecessaryforthedevelopmentofaneffectiveAustralianDisabilityServicesSystem.However,theSystem(liketheNDIS)islargeandcomplexandthereisalargebodyofresearchandothermaterialsthathavebeenreviewedandthatsupportthispaper.Toimprovethereadabilityandcomprehensionofthefindingsfromthisresearch,wehavenotincludedallworkingsandreferencematerialsinthisdocument.Instead,wehavedevelopedasetofresourcesanddiscussionpaperswhichexaminespecificissuesrelatedtothiswhitepaperandhavecollatedthereportswerelyupononaproject-specificwebsite.

Weencouragereaderstoexaminethematerialsintheprojectwebsiteastheseformthebasisforourconclusionsandrecommendations.Wealsowelcomeyourquestionsorcomments.

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TheNDISisnottheWholeSystemItisimportanttoemphasisethattheNDISwasnotintendedtobethewholesystem—norcanitbe.Oftheapproximately4.3millionAustralianslivingwithdisability,theNDISwillsupportaround500,000participantsatfullrollout.However,statesandterritorieswillstillprovidefunding.

Likeeveryoneinthecommunity,peoplewithdisabilityhaveabroadrangeofneeds,includinghealthcare,housing,education,employment,socialopportunities—inshort,abigpartofthenationaldiscussionleadinguptotheestablishmentoftheNDISrelatedtogivingallAustraliansafairgotolivetheirlivesasfullyaspossible.

Asaresult,thesystemiscomplexbecausethepopulationofpeoplewithdisabilityarenotahomogenouscohort.Theirneeds,opportunitiesandaspirationsareasvariedasthecommunitiesinwhichtheyliveandthenaturalsupportstheyenjoy.Ofcourse,theirfamilies,friends,employersandothernaturalsupportsarejustasvariedintheircapacity,interestsandprioritiestoo.Forthesystemtobeconsideredeffective,itmustsupportallpeoplewithdisabilityeffectivelyandefficientlyinthecontextofindividualchoiceandcontrol,andwherethisisnotpossible,byofferingequityofaccess.

TheAustralianDisabilityServicesSystemisalsostructurallycomplex,partlybecauseofthepeopleitservesandpartlybecauseitincludestheCommonwealth,stateandterritoryGovernments—includingdifferentdepartmentssuchashealthandeducation—disabilityservicesproviders,theNDIS,aswellasthebroaderindustrycomponentssuchasbusinessesinvolvedinprovidingservicesliketransportandrecreationsupport.Figure3providesasimplifiedschematicviewofthecomplexityofthesystem.

FortheAustralianDisabilitySystemtobeefficientandeffective—andforthevalueintheNDIStobefullyrealised—wemustacceptthatthepolicyandpracticeframeworks(thesystem)mustbecomprehensivelydeveloped,seamlessandfullyintegratedwithexistingstateandCommonwealthservices.Itsdevelopmentandoperationmustalsobetransparenttoall,therebyensuringaccessandaccountability.

FortheSystemtobeefficient,itshouldmeettheseneedsbyensuringallNDISfundedservicesandotherstate/territoryfundedservicesarearticulatedatthelocallevel.Thiswillinvolvestate/territorylevelplanningandlocalplanningandcontrol.Itwillalsorequireinvolvementofallparties:peoplewithdisability,theiradvocates,governmentsandserviceproviders.

Thus,efficiencyandeffectivenessmeanslinkingandadjustingexistinghealth,educationandotherservicestoachieveequity,whilealsohavingsufficientflexibilitytoenableadditionaladjustmentsortoprovideadditionalsupportstomeetindividualrequirements.

Therefore,thecontextinwhichweconsiderthesuccessesandchallengesoftheNDISrolloutiscomplex.ItistoosimplistictospeakoftheNDISoutsideofthebroaderstructuralarrangementsinwhichourgovernmentandotherservicesoperateorevenasasingleelementwithinthesystem.Indeed,thepurposeofthispaperistoencourageanationaldiscussionfocusedonbuildinguponthenationalassetthatistheAustralianDisabilityServicesSystembylearningfromourexperienceoftheNDISrolloutuptothispointintimeandapplyingthoselessonstobuildamoreeffectivepolicyandpracticeframework.

Importantly,indevelopingthiswhitepaper,werecognisethattherearepeoplelivingwithdisabilitywhofindthecurrentarrangementseffectiveandforwhomthosearrangementsshouldbemaintained.TheSystemmustbefit-for-purpose,notone-size-fits-all.

5

Figure3:TheAustralianDisabilityServicesSystem

6

It’snotaboutthemoneyReformcostsmoney—themorecomplexthesystembeingreformedandthebiggerthechange,thegreaterthecost.However,Australiaisalreadycommittedtothisreformprocessandefficiencycombinedwitheffectivenessisthekeyissue.Awell-considered,comprehensiveandtransparentapproachtothereformprocess,viatheestablishmentofanindustryplan,decreasesinvestmentcosts,reducesriskandincreasesthelikelihoodofsuccessfuloutcomes.

TheAustralianDisabilityServicesSystemismultifaceted.TheNDISelementofitsreformispredicatedonthetheoryofmarketeconomicswithmuchworkbeingdoneonissuessuchaspricing,plandesignandfundingallocation.Inanimmediatesense,theseareimportant,ascontinuationofservicedeliveryiscritical—butaddressingtheseissueswillnotresultinreform.Indeed,withoutasystemicapproachtoplanningandreformcombinedwithflexibilityinfundingandaccessarrangements,thereisverysignificantriskofsystemicfailure—notjustmarketfailure.Suchfailurewill:

• Impactmanypeoplewithdisabilityastheywillnotreceivetheservicesandsupportstheyneed.Peoplewithdisabilityandtheirfamiliesarepositionedastheshockabsorbersforanyvolatilitycausedbypoorpolicyacrossthesystem;

• Impactgovernmentsbecauserectificationwillcosttaxpayersmoreanddivertfocusfromtherealworkofachievinganefficientandeffectivesystem—preventionisbetterthancure;and

• Reducesupplyasdisabilityserviceprovidersfaceincreasingfinancialpressure,uncertainty(preventinginvestment)andareincreasinglyincentivisedtoexitserviceprovision.

Importantly,thesearenotsimply“transitionproblems”or“risksthatwillbesolvedasmarketsadjust”.Thecurrentstateofthesystemisthenewsystem.Itisasystemthatonlyworksforsomeserviceusersandforsomeserviceproviders.Itisincreasinglyevidentthatitleavesmajorgapsintermsofresponsibilityallocationandfundingcapacitybetweenstate/territoryandtheCommonwealthgovernmentsincriticalserviceareassuchashousing,health,educationandemployment.Italsoleavesstatesandterritoriestopickupthebillwhenpeoplewithdisabilityaredivertedtootherhealthandwelfaresystemsduetosupplybreakdown.

Figure4:EffectivePlanningHorizons–worktobedonetogetthere

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ItisunlikelythatwecanquicklyandeffectivelyimplementsuchasignificantchangeandtransitiontothedesiredstateoftheAustralianDisabilityServicesSystemwiththeattributeslistedinfigure5belowwithoutacomprehensiveindustryplan.Wealsoobservethatanyindustrygoingthroughsignificantchange—regardlessofwhethertheyareascomplexasthoseimpactingtheAustralianDisabilityServicesSystem—shouldbesupportedthroughthatchangeviatheestablishmentofthreestrategichorizonstobepursuedconcurrently:short-,medium-andlong-term(seefigure4above),eachwithspecificgoalsincludingavisionofwhattheindustryneedstolooklikeatmaturity.Suchgoalsshouldbeincludedinanindustryplanthatsetsoutthepathtorealisationofthosegoalsandtheimpactonallpartsofthesystem.Importantly,therealcostoffailingtoreformthissystemwillnotbebornebyserviceproviders,taxpayersorgovernments,butbypeoplewithdisability.Todevelopandimplementagoodindustryplan,fivekeyelementsareneeded:

• Knowledge:thedevelopmentofopen-sourcedataassetsthatcanbeusedbyallstakeholderstoinformpolicydevelopmentandguideinvestment.Thiswillalsohelptoengenderacultureofcertainty,collaboration,trustandopenness.

• Transparency:cleargoalsincludingthedefinitionofsuccess,timingandinvestmentarerequiredtoreduceuncertaintyandagreeandcommunicateprioritiesacrossthesystem.

• Clarity:thedevelopmentofavisionofthematurefuturestatewillsupportdecisionmaking,increaseconfidenceandcommunicateprioritiestopeoplewithdisability,serviceprovidersandgovernments,increasinglikelihoodofinvestmentandsatisfaction.

• Certainty:stakeholdercertaintyandconfidenceimpactspeoples’capacitytoexercisechoiceandcontrol,encouragestheinvestmentneededforchangeandinnovation;allowsforalong-termplanningapproachandultimatelydecreasescoststogovernment.

• Collaboration:theemphasisonmarketeconomicsphilosophies(competition)todrivethepolicyandreformagendaincludingtheimplementationoftheNDISispoorlyinformedandwillresultinmarketandvaluedestruction,notgrowth.Withoutcollaborationbetweenallparties,includingadvocacygroupssupportingpeoplewithdisability,thesystemwillnotsuitablyallocateresourcestopriorityareas,communicaterationalesfordecisionmakingnorelicitthedecision-makingbehavioursought.Inthiscase,deficiencieswilllikelybehidden,asonlytheeconomicinformationdrivesthedecisionmaking.

Assuch,aholistic,systemicapproachtodevelopingandimplementinganationalindustryplan,usingresourcesfromunderutilisation,willserveasapolicyandpracticeframeworkinwhichthenationalobjectivecanbeachieved.

Whatisanindustryplan?

Industryplansaredevelopedwhenagovernmentand/orindustryhaveidentifiedtheneedforsignificantchange.Inthiscase,asanationwehaveagreedthattheAustralianDisabilityServicesSystemsneedsreform.

Itcommunicates:

- Whatthefuturestatelookslike- Expectationsonallparties- Whattheplanistogetthere- Whattheprioritiesareandthe

orderinwhichthoseprioritieswillbetackled

- Wheretheresourceswillcomefromforimplementingthenecessarychange

- Thestructuralprocessesrequiredtoachievetheplangoals

- Thearrangementsforthecreationofdataassetsandtransparencyinsupportofdecisionmakingandaccountability

- Identifiesresourceshortfallsandplanstomitigatethem

Importantly,anindustryplaniscollaborativelydevisedandimplementedonthebasisthatgoodplanningreducesriskofultimatefailure.

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Figure5:TheAttributesofaFit-for-purposeAustralianDisabilityServicesSystem

Objective AttributesParticipants Governments Industry

Choice&Control

AppropriatePlanControlEquityofaccessbeingthepriorityParticipantinvolvementinplanningandservicedesignProviderexpertiseandexperienceavailabletobuildcapacityforchoiceandensureplansareactionableChoiceandcontrolextendstosupportcommunity-levelprioritieswhereculturalprioritiesareidentifiedResourcesavailablewherenecessaryforsupportsandservicestobeprovidedduringtheperiodtoplanacceptanceFundsareprovidedinawaythatsupportschoiceandcontrolwherepossibleandequityofaccesswherenotandallowsforculturalandotherprioritiesassociatedwitheachcohortinthecontextoftheirgeographiclocation,disabilitytypeandeconomiccapacity

AcceptancethatworkingwiththeNDIScostsserviceprovidersandthatthesecostsmustbesupportedinthepricingstructuresApolicyframeworkthatincludesongoinginputfromparticipantadvocates&thedisabilityservicessectorClarityinwhatchoiceandcontrolmeansLocaldecisionmakingframeworksallowingfordivestmentofcontroltothelocallevelwithinanationalpolicyandgovernanceframeworkAcceptancethatdifferingculturalprioritiesimpacttheprioritiesofpeoplewithdisabilityandthewaytheyinteractandprioritisewithintheircommunityAcceptancethatthedisabilityservicesindustryneedstobesupported—likeanyotherindustry—tomakethesignificantchangesneededforachievementofthenationalgoal

AdequateresourcingtosupportcostoftheNDISengagementprocessParticipationinplanningandservicedesignParticipationinthepolicydevelopmentframeworkincludinginrelationtotransparencyandgovernanceResponsibleresourcingtosupportchangemanagementandinvestmenttochangefrombeingfit-for-purposeunderoldgovernmentpolicyframeworkstobeingfit-for-purposeundernewframeworks

Reasonable&NecessaryServicesandSupports

ClarityofentitlementEquityofAccessServicetypedescriptionshaveclarity,uniformityandcommonalitysothatparticipantsareabletodiscerntheirrequirementsComprehensive,seamless,joinedupserviceprovisionregardlessofsourceofsupply(government,provider)Avoidableriskismanagedoutofthesystem

LiaisewithparticipantadvocatesanddisabilityservicessectortodevelopservicedescriptionsandqualityframeworkAcceptancethatregisteredparticipantsrequireservicesandsupportsregardlessofthestageofplanningtheyareinandthattheseneedsmustbefundedInvesttoco-designanddevelopanintegratednationaldisabilityservicessystemInvestinthedevelopmentandefficientdistributionofprovideroflastresortcapacityInvestinstaffdevelopmentandinfrastructuretoraisecapacityofallstaffwithintheNDISrelevanttodisabilityneedsandcare

ParticipateatindustryandlocalleveltocontributedataandexperiencetodevelopmentofpolicyandpracticeframeworksIndustryparticipationindesignandimplementationofprovideroflastresortcapacityrecognisingthatnotallproviderscanparticipateinthisarea

Sustainability

Servicesareabletobeaccessedinatimelyfashion,regardlessofformalplanstatusServicesprovidedarecomprehensiveandappropriateinclinicalandqualitytermsParticipantsarenotimpactedbythedistributionofgovernmentresponsibilitiesbetweengovernmentsandwithingovernments

Investmenttodevelopandanalysedatasetstoraiseunderstanding,identifystrengthsandweaknesses,andincreasedtransparencyintermsofpositiveandnegativeoutcomesFundingofanationaldisabilityindustryplanwithshort-,medium-andlong-termplanninghorizonsdesignedtoresolveimmediate,highprioritysupplyissuesandensurethefuturestateisreachedbycommunicatingwithallstakeholdersandinvestingresponsibly.

InvestmentintraininganddevelopmentforpersonnelissupportedinfundingframeworkProvisionofdataforefficiencyandeffectivenessreportingwithappropriateresourcingforsameParticipatinginthedevelopmentofanationaldisabilityindustryplan

9

AFit-for-purposePolicy,Planning&GovernanceStructureItisnecessarytocontextualisetheindustryplanintotheproposednationalpolicy,planningandgovernancestructure.Theproposedstructureisprovidedschematicallyinfigure6below.Itwillbeseentherearethreebroadelementstotheframework:(1)theNational;(2)thestatesandterritories;and(3)localcommunities.

InafederatedcountrylikeAustralia,wheretheCommonwealthandstates/territorieshavedifferingrolesandresponsibilitiesthatcombinewiththerolesofserviceprovidersandadvocacyorganisationstoformthepolicy,planningandgovernancestructureforthedisabilityservicessystem,marketeconomicscannotbereliedupontoachievetheoutcomessought.Thecomplexityofdisabilityserviceprovisionitself,combinedwiththedispersednatureofthesystemmeanthat,forittobeeffective,keyattributesneedtobepresent.Theseinclude:

• Clarityandtransparencyoverrolesandresponsibilities.• Flexibilityintermsofpolicyandpracticeapplicationtomeettheneedsofspecificcohorts.• Atrulycollaborativeapproachtopolicy,planning,andgovernancesothatadvocacy

organisationsandindustrybodiesareabletocontributeeffectively,transparentlyandauthoritativelytothedevelopmentandimplementationofthestructure.

• Arisk-basedassuranceprocesssothattheapplicationofscarceresourcesintermsofoversightandassuranceareappliedwheretheycanmitigatethegreatestrisktothetaxpayer.

Theseattributesmanifestdifferentlyinthecontextofthethreelevelsofthesystemwehaveidentifiedinfigure6—national,state/territoryandlocal.Eachoftheselevelshavedifferingrolesandresponsibilitiesattachedtothemwithdifferentexpectedoutputs.Atthenationallevelthefocusisonpolicy,assuranceandreporting;atthestate/territorylevel,onco-ordinationandsystems.Atthelocallevelthefocusisonservicedelivery,inclusivityandrealisationoftheaspirationsofthesystem,includingthoseoftheNDISwhicharetheverypurposeofthesystemitself.

Forinstance,webelievethatforthesystemtobeintegratedandworkeffectivelyandefficiently,eachoftheselevelsofpolicy,planningandgovernanceneedaplanthatiscollaborativelyestablished,transparentlyimplemented,integratedthroughthepolicyframeworkandforwhichthepartiesareaccountableviaasystemofindependentassurance.

Atthemostsummarisedlevel,theseplanswouldinclude:

Theplanswouldalsoarticulateandbecross-informingsothatlearnings,processesandpracticesareabletobereplicatedwheretheyworkandsothatlocalsolutionscanbefoundwheretheyaremoreappropriate.Additionally,theywouldalsofocusonsecondaryobjectivessuchaseconomicdevelopmentatthelocallevel.

Werecognisethatthedevelopmentofanationalpolicy,planningandgovernanceframeworkwill,likethereformofthesystemitself,beanongoinganditerativeprocess.Changewillberequiredaspracticerevealslearningsandasthesystemmatures.

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Figure6:AustralianDisabilityServiceSystemPolicyStructure

11

WayForwardThenextstepsarecriticalforthefutureoftheAustralianDisabilityServicesSystem.The

developmentofanindustryplanisaprimarypriorityasthiswillguideallfurtheractions.However,

incontemplatinganindustryplan,afuturestateofthesystemneedstobearticulated.Thisshould

bedevelopedviaacollaborativeprocessincludingallstakeholders.

Theindustryplanshouldthenbedevelopedwhilethemomentumofthecurrentdisabilityservices

processesismaintainedtoensureservicesandsupportscontinuetoprovided,ensurepeoplewho

arecurrentlysatisfiedwiththeNDISarrangementsparticularlyareabletocontinuetoremain

satisfied,andtoensuresupplyoftheseisprotecteduntilafuturestateandplancanbeestablished.

Importantly,worktobeundertakeninpursuitofeachofthestrategichorizonsshouldbeconcurrent

sothatweareensuringcontinuedsupplyofservicesandsupports,reducingthedifficultiesbeing

experiencedintheimmediatetermwhilealsodrivingforthemedium-andlong-termoutcomes.

Ifwedonotpursuetheultimateoutcomesinatransparentanddeliberativeway,wewillbehaving

thesameconversationsandexperiencingthesamefrustrationsbuttheriskswecurrentlyfacewill

crystallisesuchthatrealhurtwillbefeltbythoseAustraliansthatrelyonthedisabilityservices

system.

TheAustralianDisabilityServicesSystem,includingtheprovidersandadvocacyorganisations,isa

nationalasset.Ithasbeenbuiltoverdecadesbycommunitiesaswellasviataxpayermoney.Itis

notreplicable,replaceableorabletobethrownaway.Asanation,wemustprotectthisassetand

drivechangeprocessesthatarethoughtout,haveclarityandaretransparentsothatanydestructive

processisguidedandwillultimatelyimproveoutcomesforpeoplewithdisability.

ResponsibleinvestmentbygovernmentandusingthefundsalreadyallocatedtotheNDISbut

unspentwillbeanimportantinvestmentinrestructuringtoensurethisassetisfit-for-purpose.

Withoutadequatefunding,changemanagement,systemsdevelopment,stafftrainingand

developmentaswellasITneedswillallremainunready.Suchinvestmentiscriticaltotheongoing

capacityofthedisabilityservicessectoraspreviousgovernmentpolicyhasensuredthebalance

sheetsoftheseorganisationsarelargelyunabletosupportinvestmentofthelevelnecessary—thisis

notaresultofpoorgovernancebut,rather,aresultofgovernmentspendingprioritiesovermany

years.

Overall,theAustralianDisabilityServicesSystemiscomplexandeffectivereformwilltaketime.This

isnotunusualandotherreformprocesseswithintheAustralianeconomyhavealsotaken

considerabletimetoaffect.Itisfarbettertogetitrightthantofootthebillformitigationsinacrisis

situation—abillthatisfeltinreducedorremovedlifechoicesandexperiencesforpeoplewith

disabilitynotjustfinanciallybytaxpayers.

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ThisDocumentFundingThispaperwasfunded,developedandwrittenbytheUniversityofWesternAustraliaAccFinNot-for-

profitResearchTeam.Noexternalfundingwasreceivedtofundthisproject.

CitationThispapershouldbecitedasfollows:

Gilchrist,D.J.,P.A.Knight,C.A.EdmondsandT.J.Emery,2019,SixYearsandCounting:TheNDIS

andtheAustralianDisabilityServicesSystem-AWhitePaper,aReportofNot-for-profitsUWA,

UniversityofWesternAustralia,Crawley,Australia.

TransparencyStatementProfessorDavidGilchristisaprofessorintheUWABusinessSchoolattheUniversityofWestern

Australia.HehasreceivedfundingforresearchandconsultancyfromtheNationalDisability

InsuranceAgency,NationalDisabilityServicesLtd,andseveraldisabilityserviceprovidersfrom

variouslocationsacrossAustralia.HeisadirectorofconsultancyBaxterLawleyPtyLtdandhasbeen

adirectorandchairofanumberofhumanservicesorganisationsincludingindisabilityservices.

DavidhasprovidedadvicetomanyNot-for-profitandFor-profithumanservicesorganisations.

PennyKnightisaresearchfellowoftheUniversityofWesternAustralia,pastresearchfellowof

CurtinUniversityandadirectorofBaxterLawleyPtyLtd.Sheiscurrentlyadirectoroftwolarge

humanserviceproviderorganisationsandshehasheldseveralpositionsonboardsinthepast.She

hasbeenfundedbytheCommonwealthGovernment,StateGovernmentsandindustrypeakbodies.

TheseincludetheNationalDisabilityInsuranceAgencyandNationalDisabilityServicesLtd.Shealso

providesstrategic,governanceandotheradvicetoindividualFor-profitandNot-for-profit

organisations.

CraigEdmondsisaresearchfellowattheUniversityofWesternAustraliaandhasparticipatedinthis

roleinanumberoffundedresearchprojectsaspartoftheUniversityofWesternAustralia’sNot-for-

profitResearchTeam.ThishasmeantthathehasbeeninvolvedinprojectsfundedbytheNational

DisabilityInsuranceAgency,NationalDisabilityServicesLtdandseveralprivateNot-for-profithuman

servicesprovidersaswellasindustrypeakbodies.

TomEmeryisaResearchFellowattheUniversityofWesternAustraliaandhasparticipatedinthis

roleinanumberoffundedresearchprojectsaspartoftheUniversityofWesternAustralia’sNot-for-

profitResearchTeam.ThishasmeantthathehasbeeninvolvedinprojectsfundedbytheNational

DisabilityInsuranceAgency,NationalDisabilityServicesLtdandseveralprivateNot-for-profithuman

servicesprovidersaswellasindustrypeakbodies.

ContactDetailsProfessorDavidGilchrist

T: +6186442787 M: david.gilchrist@uwa.edu.au

Post: M250,35StirlingHighway,Crawley,WA6009,Australia