Thursday 16 March 2023
Ms Libby Coker MP
Member for Corangamite
Chair
Joint Standing Committee on the National Disability Insurance Scheme Email: Libby.Coker.MP@aph.gov.au
RE - NDIS General Issues Inquiry
Dear Ms Coker
I refer to Submission 14 provided to this inquiry. It is disappointing to see that a minority of registered NDIS providers continue to engage in self-interested, misleading, fear-mongering in an attempt to seek regulatory intervention to protect and advance their business interests. Mable contends that a successful NDIS requires a mixture of registered and non-registered providers competing in a healthy and vibrant support marketplace, respecting the NDIS’ proportionate quality and safeguarding framework.
What is often lacking from the debate around registration and calls for more regulation is — what Mable would contend — the most important voice: that of people with disability. As such, Mable encourages the Committee to consider the excellent work of Professor Helen Dickinson of UNSW Canberra. Professor Dickinson recently published a study Exercising meaningful choice and control in the NDIS - Why participants use unregistered providers.¹ Professor Dickinson and her colleagues explain:
There has been some debate concerning the quality and safety of unregistered providers compared to that of registered providers. While these debates generally feature the voices of providers and public servants, the voice of NDIS participants is often absent. This research aimed to capture the voices of NDIS participants and some plan nominees explaining why they choose to use unregistered providers and the steps that they take to ensure the quality and safety of services for themselves and their workers.²
Specifically, in relation to unregistered (or non-registered) support workers in the NDIS, Professor Dickinson reports that NDIS participants:
…described advantages associated with using unregistered support workers, including increased flexibility with shift times, having choice of workers, having consistency of workers, being able to set worker wages, being able to move away from ‘agency rule book’ limitations, and increased empowerment and control within
¹ Dickinson H; Yates S; West R, Exercising meaningful choice and control in the NDIS: Why participants use unregistered providers, UNSW Canberra, Canberra, 2022, link. ² Ibid, p. 2.
the support interaction. Several participants told us that they’d had negative experiences with support workers from registered agencies and felt safer and better supported using unregistered workers they were able to choose.³
Perhaps most significantly, NDIS participants reported that they felt registration was no guarantee of safety or quality and argued for the right to the dignity of risk.⁴ These issues and Professor Dickinson’s research is further explored in an article by Dr George Taleporos⁵ and in his Reasonable and Necessary podcast.⁶
In a similar vein, Megan Topping and Professor Jacinta Douglas of La Trobe University undertook in-depth interviews with 12 NDIS participants about what they value in support workers. Participants highlighted support workers attitudes and willingness to learn as more important than formal qualifications and training. The participants also called for the ability to choose and direct their support workers and to build relationships with support workers that they are comfortable with, rather than with a specific provider.⁷ To this end it is worth keeping in mind that 48 per cent of all relationships on the Mable platform are six months or older and this number continues to increase as our marketplace matures. This demonstrates the ability of platforms such as Mable to facilitate long-term relationships between support workers and NDIS participants based on mutual choice.
Given the feedback from these academics — based on insights from NDIS participants — and at a time when there is broad concern across parliament of the cost of the NDIS, it is important that the self-interested lobbying of a minority of registered providers in favour of mandatory registration and increased regulation is treated with appropriate scepticism as to whether this is of benefit to NDIS participants and the Scheme. In a similar manner, calls for mandatory worker registration should be subject to scrutiny. A truly co-designed system requires the voice of people with disability to be heard and understood. It also recognises that people with disability are diverse and there is no one size fits all solution for people who need support nor the people who offer support.
Mable would welcome the opportunity to facilitate the Committee meeting with members of our community — both self employed support workers and NDIS participants — to hear first hand why they choose to use the Mable platform. We would also be happy to arrange a briefing with our Independent Advisory Council, led by Dr George Taleporos and which also includes Nicole Rogerson, Dr Dinesh Palipana OAM and Catherine Hogan.
³ Ibid, pp. 2-3. ⁴ Ibid, p. 3. ⁵ Dr George Taleporos, “NDIS Provider Registration: Our lives, our homes, our bodies, our choice”, Linkedin, 28 February 2023, link. ⁶ See: Unregistered NDIS Providers: What Participants Really Think - Reasonable & Necessary with Dr George, Youtube, February 2023, link. ⁷ Topping M, Douglas J, “They treat you like a person, they ask you what you want’: what NDIS participants value in support workers”, The Conversation, 26 September 2022, link.
Please don’t hesitate to contact me if you have any questions or concerns.
Yours sincerely
Peter Scutt Co-Founder and Executive Director
CC - Hollie Hughes, Deputy Chair, Joint Standing Committee on the National Disability Insurance Scheme