NDIS review urges dozens of changes as Bill Shorten under pressure over surging costs

A landmark review of the NDIS has found the critical lifeboat supporting more than 600,000 Australians with disabilities needs urgent fixes to ensure its sustainability for decades to come.

The federal government has been under pressure to develop a plan to rein in the multibillion-dollar scheme’s exponential costs after national cabinet earlier this year agreed to cap its growth rate at 8% from 2026.

The review’s primary findings centre around returning the scheme to its original intended purposes – focusing “first and foremost” on providing support to those with complex needs and “functional impairment rather than medical diagnosis”.

The NDIS should be seen as one part of a greater connected system of disability support services, the report found, urging governments over the next five years to build up mainstream disability services, and foundational supports, outside the NDIS for those who cannot access the scheme.

“Our view is that you can’t fix the NDIS without fixing everything around it,” the report’s authors said.

“We want to create a new system of support, including accessible and inclusive mainstream services, a new system of foundational supports as well as the NDIS.”

The much-anticipated report, released Thursday morning, recommended 26 changes, paired with 139 detailed actions, to fix the NDIS and to fix how Australians with disabilities access support more broadly.

Among the changes proposed is a rethink of how the disability support system looks, including a five-year transition for some people from the NDIS scheme to foundational supports.

The NDIS minister, Bill Shorten, has told those in the disability community that the changes won’t happen overnight and any reforms adopted by the Albanese government, expected to happen next year, will be developed in conjunction with them.

The report’s authors, Prof Bruce Bonyhady, one of the scheme’s key architects, and former bureaucrat, Lisa Paul, propose a three-layered system with the targeted individual support for those most in need of support delivered through the NDIS.

The middle layer would be foundational supports provided outside the scheme and would cover Australians with disabilities needing less intensive support, such as cooking and financial assistance.

Early intervention and support systems for children with developmental would also be targeted through this layer.

The third layer is mainstream services and community supports delivered through existing services, such as schools.

Bonyhady, one of the scheme’s original architects, and Paul, said the NDIS had shifted to a focus on diagnosis, rather than how to address functional impairment.

“There is no consistent approach to identifying developmental concerns early, or helping families find evidence-based supports that work for them,” the report said.

A system of automatically granting access to those with conditions on a pre-approved list would also be stamped out as part of the proposed overhaul.

The report found the automatic access list, which was introduced at the scheme’s inception to encourage more people onto it, led to inequity and favoured those who could get a diagnosis.

A more comprehensive assessment process has also been put forward, which the report’s authors say will better determine a participant’s needs and the most appropriate budget for them to meet them.

It is expected the assessments will be completed by a highly-qualified person who will spend enough time with participants to ensure they feel heard and can “account holistically the participant’s life circumstances”.

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Those who will no longer be assessed as part of the proposed system’s top layer would be gradually phased out of the NDIS and directed toward foundational supports.

“We recognise that change for participants can be very difficult. We have recommended a guide to transition to ensure participants are given time to understand and have a say in changes before they are affected by them,” the report said.

“Changes to access and budget setting processes for children and young people should only be implemented once widespread foundational supports are in place.”

Elsewhere, the report recommended a new role of navigator be introduced in a gradual phase out of existing case managers.

There would be two primary types of navigators – general navigators providing information on the available support services and specialists who help participants with complex needs.

A central online platform has also been envisioned as a one-stop shop for essential, accessible, timely and reliable information to inform users of the types of providers and services in their area.

Shorten welcomed the review’s public release on Thursday, saying it was the “most comprehensive and accessible” review of the scheme in history.

“This is a significant moment in Australian history, particularly for people with disability and their families, and the disability sector. Our nation will reap the rewards of the review’s work,” Shorten said at its release.

“The Albanese government has made a commitment to humanise the scheme and ensure every dollar goes to the participants for who it was intended.”

The report’s release follows an agreement between the commonwealth and the states and territories on Wednesday to jointly fund extra disability and mainstream support services on a 50-50 basis.

The prime minister, Anthony Albanese, said the NDIS’s growth trajectory was “unsustainable” without changes to the existing arrangements.

The NDIS’s growth is expected to exceed $50bn in next year’s federal budget with projections showing it could push past $90bn a year within a decade.