The NDIS represents the largest investment in disability services in Australia’s history. It is a massive, and needed, shift in disability funding. But as the program is being rolled out the implications of it are now finally being felt.
With the NDIS being rolled out, it has become clear that the program will mean the privatisation of the entire state disability sector.
The ACT Government has already announced a shift of all Government provided services to the private sector by 2017, whilst similar moves are happening in NSW. This has lead to Unions NSW calling the NDIS "the largest (and most complex) privatisation in NSW history."
Whilst we cheer about the rollout of this massive amount of funds for people with a disability, these moves should be raising alarm bells.
Current disability funding is simply not meeting the needs of people with disabilities. Disability funding has long been at the bottom of the social safety net, with many people unable to get their basic needs met. Basic needs like regular showers, independent housing and accessible transport. You know, that kind of fancy stuff.
We make education and health services available no matter where people live. Undeniably, there is less service provision in regional, rural and remote areas, but everyone contributes to make sure there is some. As a system such as telecommunications has shown, the market has created great services in city, but only mandated universal service obligations have ensured regional areas have been serviced at all.
The NDIS is intended to replace this broken and fragmented system, with a single national scheme that is focused on what people with disabilities actually need, not the specifics of their disability. People with a disability will receive individualised funding for a specific set of supports tailored to what they need. For some people this includes mobility aids, such as wheelchairs, while for others, support will be available for activities that encourage community participation.
In doing so, the NDIS has been developed as a consumer-based system of care. Under the program people with a disability will be able to shop for their care, creating a free market for disability services.
The roll out of this market is already happening around the country. There are currently trials of the NDIS going on around Australia, with everyone to be included by 2018-20. NSW and Victoria are testing the full rollout, while other areas are focusing on children and young people. This year, the ACT will begin their trial in July, as will the NT and WA. As part of this state and territory governments are actively planning to hand over all disability support to the Federal government.
In both NSW and the ACT, full privatisation of state disability services have been announced, with all current public servants to be "supported" to move over to the non-government sector. Similar announcements should be expected around the country, as disability services are fully privatised. This privatisation should leave everyone extremely concerned.
Moving services onto a free market will lead to a downshift in their quality and the conditions of workers in the sector.
For-profit companies do not have the same social requirement as the Government to provide adequate services to all in need. With a profit motive, service provision quickly becomes about what is most efficient, rather than focusing on the actual needs of the consumer. This can lead to real downfalls in service provision, as people in rural and remote regions, from culturally or linguistically diverse backgrounds, or those with complex needs, are left out in the cold as the provision of their services is not profitable enough. The primary incentive for companies is to make money, meaning the commitment to services and human rights that should form the basis of the scheme gets left behind.
Whilst non-government organisations have similar social responsibilities as governments, we cannot rely on them to manage the entirety of our social services. Non-government organisations face similar problems to corporations - due to their size and capacity they can often focus resources in major city centres, rather than in regional or outer urban areas. This is exacerbated by the fact that service tenders are often won by the larger charities. Whilst these charities can often provide services to those with the simplest needs, they often lack the specialisation of smaller organisations, who whilst they may deliver better support, are unable to get their foot in the door.
Companies and NGOs are also unable to provide the same service-security as government operators. Without the social requirement to provide services, companies and NGOs can often move or close up shop at the drop of a hat. This can leave people stuck without a service they desperately rely on.
The privatisation shift also has negative impacts for workers. No longer provided with the base-line of pay and conditions available in the public sector, workers are left the mechanisms of the free-market. This leads to significantly reduced pay, conditions and employment security. This is particularly relevant with the NDIS, where experts have raised concerns that prices for service providers allowed in the scheme are simply too low. In turn this results in a thinning out of the disability sector - as those with skills in the area seek better jobs. This hurts people with a disability as service options become fewer and more far between.
It is these same concerns that have left progressives - the very people who have become the main backers of the NDIS - to fight against the privatisation of other social services. Other social services, such as health or education, are not delivered in the same way the NDIS is structured. People don’t have individual health budgets that they can use to shop around for the services they need, nor do an individual education budget. We all contribute so these services are available to everyone. We have long resisted voucher systems in health and education, arguing they compound existing inequities by benefiting middle and high income families and undermining social cohesion.
This is particularly relevant given Australia’s geography. We make education and health services available no matter where people live. Undeniably, there is less service provision in regional, rural and remote areas, but everyone contributes to make sure there is some. As a system such as telecommunications has shown, the market has created great services in city, but only mandated universal service obligations have ensured regional areas have been serviced at all.
So why is the NDIS so different?
Here, the need for a more flexible, responsive support system is being sold as individual consumer choice in a market. But social services are not intended to be a marketplace. Social supports developed because of market failure.
There’s no doubt that this model has been developed as people with disabilities often have very negative experiences of state services. But maybe these problems were because disability support was always at the bottom of the funding pile for decades, leaving people with crumbs instead of equal access to services.
The individual nature of self-directed funding is a policy goal for many people with disabilities. This allows people to make decisions about their lives in the same way that able-bodied people do, rather than having to do what a service provider says. People with disabilities want the same rights to make mistakes, have some fun and figure things out as everyone else. But this is possible without privatisation of state disability services or the creation of a market based social support system.
More importantly, state disability services have a broader role than just delivering support. The social model of disability, that underpins much disability activism, requires society to change. Transport and the built environment must be accessible, discrimination fought and institutions need to open their doors to people with disabilities. With no presence in disability at all, where will the incentive to change other areas of state service provision come from?
The NDIS represents the largest investment in disability services in Australia’s history. It is a massive, and needed, shift in disability funding. But as the program is being rolled out the implications of it are now finally being felt. People with a disability should be deeply concerned about what the privatisation of disability services means, whilst everyone should be concerned if this represents a precursor to similar moves in other sectors in the future.