Tighter eligibility rules, disappointment among those given false hope but an affordable program for the nation — this is the realistic scenario for the National Disability Insurance Scheme according to the Australian Lawyers Alliance, whose submission to the Productivity Commission is reported in our pages today.
Another warning arrived in February with the prediction, based on Department of Social Services data, that the cost of the scheme will jump by $10 billion to $32bn at the end of its first decade of full operation. This cannot be ignored by a government committed to fiscal repair. It’s another headache for Scott Morrison as budget day approaches. The NDIS will loom large in social services spending and the difficulty of reining in such spending has been a fixture of politics since the 2014 budget.
This newspaper supported the principle of the NDIS back in 2012 when the scheme won bipartisan support — and was priced at $7bn less than the latest shaky estimate of $22bn. The rationale was to replace a hodge-podge of state and territory disability support programs with a national insurance scheme, whereby the disabled could choose the services likely to improve their lives and in many cases allow them to hang on to jobs or find new work, with all the social and economic benefits that are entailed. Even at the outset, however, there was good reason for caveats.
In our April 2, 2012, editorial we said: “If the scheme is to become established and reach its full potential, it will need more than good intentions. Careful planning and good management to minimise officialdom and red tape must be its hallmarks. Tight fiscal policy across all levels of government will be vital to free up taxpayer funding.”
It may seem like something from an alternate reality but the then treasurer, Wayne Swan, who promised four budget surpluses and delivered none, boasted that big reforms such as the NDIS were possible because of the government’s strong fiscal management. Labor in power showed a callous disregard for dashed hopes by locking in long-term, feel-good programs such as the NDIS and the Gonski education package without fully funding them. At the time Tony Abbott, then opposition leader, made the sensible remark that “fully implementing the NDIS will require a return to strong surplus”.
The NDIS came with built-in faults of governance and design. Its claim to innovation in policy turned on the promise of early intervention and demand-driven services leading to social and economic pay-offs that in time would justify (and exceed) the amount of money invested. Yet the NDIS system lacked accountability, offering no mechanism to tie funding to clear measures of that social and economic dividend. The scheme was supposed to be an exercise in smart federalist policy but it left the commonwealth exposed to cost blowouts and subjected it to an effective state veto on the crucial matter of eligibility. And the scheme cannot prevent states playing the old game of shifting costs to the commonwealth.
Sure enough, the early stages of the NDIS rollout have been marked by cost overruns, federal-state squabbles, confusion over eligibility, technology glitches and poor management. Autism is the disability that best illustrates the struggle to set practical boundaries to participation in the NDIS. Autism spectrum disorder numbers have exploded in recent years. This is the subject of expert debate, with some suspecting over-diagnosis. The pressure on the NDIS is potentially overwhelming. As well, there is a tension between early intervention and the needs of those whose ASD is already severe. The situation is not helped by the fact we lack national standards for diagnosis of this disability.
For the federal government, it’s deja vu all over again. The Disability Support Pension used to be in the headlines for its unstoppable growth in numbers — from 168,784 individuals in 1975 to 814,391 four decades later. (A recent crackdown reduced the total to 788,099.) There is a hard core of real need, of course, but it’s also true that the DSP has paid better than the dole and helped politicians hide unemployment. The NDIS was supposed to elevate policy to a new, superior, level but it seems the foibles of government and human behaviour are difficult to escape.