National Disability Insurance Scheme (NDIS)
Potential Down Sides!
The number-one principle of NDIS is to give people rights, entitlement-based services and equipment. The second most important principle, is choice of services and equipment through personal control of funding – individualised funding - “Individualised Service Package (ISP)”.
This is a real sea-change compared to the present charity hand-out. Where people, already disadvantaged, have to beg, crawl and lick state government bureaucratic boots to get a few crumbs - if they are lucky. And, they must always be eternally grateful to big bureaucratic brother for whatever they get or don't get. And, never, ever, complain!
Nevertheless, despite the potential sea-change, if state government bureaucrats devise a means of retaining their present power-over-people power base (including the DSR, in Victoria), this will be a potential down-side for the NDIS/ISP freedom of choice for consumers.
With state governments handing-out a few ISPs over the years since families pressed for an extension of “Futures Funding”, there has been a rise in “BadDebts”. This is service providers not being paid for services provided within the ISP funding. There has always been problems of living expenses not being paid to group home service providers, for example.
Service providers in Victoria, especially, are experiencing non-payment or delayed payment of funds for transport, day activity, respite and support services. Where payments are due through a financial intermediary or direct.
Service providers in Victoria report having to write-off thousands of dollars of bad debt every year. This must equal lower level and quality of service overall. And, is not the intention of ISPs.
Other potential down sides are the availability of staff, and the number of alternative service providers. Even now, staff numbers are limited, as are service providers.
Certainly, new federal (NDIS/ISP) funding will encourage market expansion. Lets hope this is in new service providers, rather than an expansion of the old-guard. Staff, on the other hand, is an almost finite resource now.
Without adequate resources, the potential for the ISP to be a market-place service level and quality driving factor will be depleted.
The ISP principle will certainly put choice in the pocket of the consumer. Only if there are adequate resources in the market place, will this be fully realised.
With a poor supply of service providers, and/or a poor supply of direct care staff, the situation with NDIS, quality wise, might be little better than we have now. Just a different funding source!
LISA Comment: We have always maintained, it is important to ensure the present system is providing service as it was/is intended, before moving to a new system.
The Productivity Commission clearly considered it was impossible to get the present captive market system to be accountable to the consumer, as did Jeff Kennett with his attempt to get the Department of Human Services, Disability Services, Victoria, out of direct service provision.
Non-government service providers, funded by government, can be held accountable through funding and contract agreements. Government direct care services cannot! And the power and influence of individuals with ISP funding is very much dependent on 'supply and demand'.