This government, or the next, will have to fix the NDIS

Conceived by the Gillard government and supported by the Coalition, all with the most admirable and noble of intentions, the NDIS is running off the rails. If it is not reined in, it will become unsustainable and collapse. That is the firm view within government, both publicly and privately.

The aim, according to a source, will be to “slow growth and get those out who weren’t meant to be in it”.

The view within is that the NDIS it not the insurance scheme it was designed to be in that it was meant to supply long-term support to those in genuine need, and act preventively, where possible, to treat certain conditions to avoid long-term dependency.

The goal of early intervention was that people would exit the scheme when no longer needed, but that has not been the reality. Instead, the NDIS has become, in the eyes of the government, an uncapped welfare scheme, covering costs and conditions it was never envisaged to pay for.

Lines between health, disability and aged care have been blurred.

For example, problems associated with obesity are falling under the NDIS’ remit rather than the healthcare system. The NDIS is not supposed to cover people aged over 65 but those with early onset dementia are covered for the rest of their lives by the NDIS, rather than the health or aged care system.

Almost one-third of the cost of the NDIS is dedicated to helping those with autism. NDIS eligibility only applies to people with stage two autism and above, but the figures have shown a spike in stage two diagnoses since the funding has become available.

The government would never say it publicly but suspects doctor shopping in cases of mild autism in order to receive a stage two diagnosis and funding.

And like any big pot of government money, there are always those looking to rort it. One MP tells a story of a constituent with a disabled child. Two men came to clean the gutters, charged $3000, and the NDIS paid.

Such stories are common, all while parents with children needing items like calipers, wheelchairs and epilepsy mattresses struggle with bureaucratic hurdles and inconsistent decision-making.

The May 11 federal budget dedicated $13.2 billion in additional funding for the scheme between the year ending June 30 and financial year 2024, and forecast its cost next financial year to be $26 billion, and over $40 billion a year by mid-decade.

That’s more than Medicare and well above the $22 billion maximum forecast by the Productivity Commission in 2017.

In the past three years the average payment per participant increased 12.5 per cent a year, well above the Productivity Commission’s assumption of 4 per cent a year growth.

It currently supports 450,000 people and is headed towards 530,000 which is, again, much higher than anticipated.

Under the original deal with the states, the Commonwealth is on the hook for all increases in cost and by financial year 2024-25 its share will be to pay 61 per cent and rising.

The aim, according to a source, will be to “slow growth and get those out who weren’t meant to be in it”.

Scott Morrison, who warned before the budget that the scheme would become unsustainable if not brought back to its intended purpose, wants to introduce a system of mandatory independent assessments to determine each participants’ eligibility and needs.

These would be conducted by a panel of private providers such as psychologists, occupational therapists, physiotherapists and speech pathologists

This is similar to what was done when the Disability Support Pension blew out, in part because of rorting.

For various reasons, Labor, the industry and the states are vehemently opposed.

The industry views it as demeaning to have every recipient reassessed in order to justify their funding.

A March joint statement by 20 disability groups voiced significant concerns at what they say will be the biggest change to the scheme since its introduction and what they believe to be little more than a crude cost-cutting exercise.

“These changes will fundamentally alter the individualised and personalised nature of the NDIS,” they said.

“While we all want greater consistency, we are very concerned this increasingly automated process will not consider individual need and circumstance.′

In coming weeks, NDIS Minister Linda Reynolds will take a proposal to cabinet and, on July 9, sit down with representatives from the states.

The politics of this will be enormously difficult because it will be portrayed as taking money and support from the country’s most vulnerable people. And this is not a government that has shown a strong stomach for a fight.

Opposition NDIS critic Bill Shorten, who oversaw the birth of the scheme as a minister in the previous Labor government, accepts poor administration and shonks are problems but says the assessments plan is a vehicle for cutting costs and services.

The state of the NDIS belongs to both major parties. Labor introduced it with legislation that one industry source said “you could drive a truck through”, meaning there were insufficient boundaries as to what and would and would not be covered.

The scheme has blown out in the past eight years while the Coalition has been in government. Poor administration has been a common complaint.

What matters now is making it sustainable because there are none more deserving people in our society than those for whom it was originally designed.

If this government does not act, then the next one will have to, Labor or Liberal.