Four years after the initial roll out of the National Disability Insurance Scheme (NDIS), it is becoming clear that many people with disabilities are not getting the care they need. There is a heavy burden falling on their families and carers, and the promises of flexibility and choice were largely empty.
According to research conducted by Melbourne University into service user’s perception of the NDIS it was found that for adults with a disability there was often no improvement in the levels of support they received. There was however an increase in administrative barriers with many service users having issues exercising choice and control. Often, they had to rely on families and carers to help them, and some service users had little choice as to what they could actually spend their funding package on.
The primary issue with the NDIS is that it is a voucher system – the government essentially issues people with vouchers which are then used at providers. Private for-profit providers offer services alongside public and community-run providers. Over time the public and community-run providers will be defunded and more people will be forced to rely on the for-profit sector. Voucher schemes are an attempt to privatise services by stealth.
The way the government sold the idea of the voucher system was to explain that rather than block-funding disability support services, packages of funding would instead be allocated to eligible individuals. Proponents of this type of system claim that it encourages people to use the funding to access the support and services that meet their own specific needs. They promoted the NDIS as a model that would increase “flexibility and choice”.
However, once you are in the clutches of the for-profit system there is nothing to stop the providers putting up the prices making services less personal.
Currently welfare and disability care make up a big part of the federal budget and both of the major parties want to reduce this over time. They want to reduce the role of the state in providing for people and entrench a user-pays privatised system. As with all other forms of privatisation the outcome will be the working class bearing a bigger portion of the costs alongside a poorer quality service.
Already the NDIS is being funded by the removal of the $8 per fortnight carbon tax payment for new welfare recipients, and by increasing the Medicare levy from 2% to 2.5%. While ordinary people are being asked to pay more, we have the spectacle of the government wanting to reduce the company taxes even further.
In contrast to this type of a model, socialists stand for a publicly owned and democratically controlled disability care system that is accessible to all who need it. Rather than the burden being placed on ordinary working people we advocate funding it by increasing taxes on big business profits.
The idea of an NDIS was first floated in 2010. At the time, it was supported by the trade unions, the peak bodies and the large service providers. The Productivity Commission described the then existing disability services as being ‘underfunded, unfair, fragmented, and inefficient’. The NDIS was meant to “revolutionize disability services” in order to deal with systemic dysfunction in the industry.
There is no denying that the previous system was inadequate, but at its core the problem was that it was underfunded. Neither of the major parties wanted to force their big business backers to pay more so they came up with a scheme to offload the costs onto ordinary people.
Dealing with the problems in disability care requires much more than a voucher system and an increased bureaucracy. In the first instance, there is a desperate need for thousands of more staff and better training. As long as any part of disability care is run on a for-profit basis there will be an in-built motivation to cut corners, underpay staff and reduce the level of care provided.
Kevin Stone, the head of the Victorian Advocacy League for Individuals with Disability (VALID), has publicly denounced the program saying “It’s an absolute corruption of what the NDIS is supposed to be. Each person is supposed to be treated as an individual, but in order to get everyone through, they have cut heaps of corners”. And he is not the only critic. More and more people with disabilities, their parents, workers and academics are coming out to criticise the scheme.
One of Kevin Stone’s main concerns is that people with intellectual disabilities and challenging behaviours are having to deal with more bureaucracy. These are people who often already experience the greatest difficulty in accessing services and also experience the highest levels of abuse and neglect, both at home and in care.
While in many cases the NDIS has resulted in more funding being assigned to individuals, this funding is being poorly allocated, with a portion being whisked away by the profit motive. On top of this the federal government is doing all it can to “tighten the criteria” for the Disability Support Pension (DSP). This has already resulted in fewer people with disabilities receiving the DSP. Instead many have been forced onto the much lower Newstart allowance. This will only increase the already high number of people with disabilities who live in poverty.
What’s the alternative?
The alternative to the NDIS is a socialised disability care scheme that is free at the point of access, but the truth is that if we really want to afford people with disabilities equal rights and opportunities then we need to go much further. In addition to care, people with disabilities also need things like affordable housing, proper access to public transport, and decent education and training.
For example a socialist plan for society would include a fully funded public housing scheme. As a starting point, we would build at least 200,000 new homes, many that are specifically designed for people with varying disabilities. This would not only help ease the burden on disability services and provide dignity, safety and security to people with disabilities, but would also provide relief to the tens of thousands of people already on the waiting list for public housing and those experiencing, or at risk of experiencing, housing stress.
As a matter of urgency, we would also fund a free, integrated and fully accessible public transport system. This would make it much easier for people with disabilities to access the services that they need, and if they choose to work or study, to get to and from work or school. An expanded public transport system would also help to get cars off the road and would be an integral part of the fight against climate change.
A fully funded universal healthcare system, that includes dental and mental health care would also be a huge help to people with disabilities. Specifically, we would seek to ensure that adequate amounts of hospital and healthcare staff are properly trained to work with people with disabilities.
Proper training and education for disability workers is also crucial. There is currently no minimum training level required to be a disability worker. All workers should have a mandatory level of training which should be free to access, and people already working in the sector should be given paid time off to complete this.
For those people with disabilities that want to work we would ensure that they have access to free training and education. At the same time, unlike now, where people with disabilities are often super-exploited in the workplace, we would ensure that employers are forced to pay people with disabilities a living wage.
A big part of cleaning up the disability sector is taking services out of the hands of churches and charities. While there are justified concerns about institutionalisation and neglect and abuse in state based care, the solution isn’t putting services in the hands of organisations with vested interests. We need to ensure that publicly owned facilities are democratically run by disability workers, people with disabilities themselves and their families and support networks.
If a broader socialist program like this was implemented it would create hundreds of thousands of new jobs, not just in disability care and other areas of the health sector, but also in construction, public transport, education and many other industries. Far from just costing money in it would be a boon to the economy and create huge amounts of wealth in the long term, not to mention improving the lives of many.
How to pay for it
Right now, there is more than enough wealth being created to pay for such a program. The problem is that much of it is being horded by an extraordinarily wealthy, tiny elite. For instance, in the 2017-18 federal budget, over $11 billion in subsidies have been earmarked for the private, for-profit fossil fuel industry and over $30 billion has been allocated for the defence budget. The five biggest banks alone make a combined $30 billion in profits each year while BHP Billiton, the country’s largest mining company, made $4.2 billion in profits in just six months.
This wealth, which at base is created by the labour of working class people, should be spent on providing jobs, homes and services for everyone, including those with disabilities. A determined campaign of community service and public health workers, alongside people with disabilities and their families has the potential to win widespread support. If such a campaign linked up with other working class people to fight for their shared interests it would be able to win real gains and force the political shift necessary to change society for the better.
A socialist society is really the only way to secure a decent standard of life for people from all backgrounds and levels of ability.
By Meredith Jacka