Submission on the National Disability Insurance Scheme Amendment (Getting

the NDIS Back on Track No. 1) Bill 2024

Name:Victoria Lascelles Twiss Date:11/07/2024

I am an NDIS Participant’s family member/Carer/ Person Responsible/advocate/friend of an NDIS participant/person with disability.

I want to respond to the proposed changes to the NDIS represented in this Bill.

I don’t want this Bill to pass into law, as I’m concerned about the mass harm and loss of life the proposed changes can, and likely will cause to disabled people.

Please reject this Bill, as I’m concerned that if this Bill passes, it will allow a hostile government to do the following to disabled people:

• unfairly raise debts against disabled people for fraud committed by others

• raise debts – even potentially years after the fact – against disabled people for using supports that a new government does not agree with for any reason whatsoever

• invade the privacy of disabled people by being able to demand any arbitrary information on threat of being removed from the NDIS. Which costs them all their supports, even potentially their life!

(Mere consideration of a disabled person’s circumstances is not protection enough against such a dire outcome!)

• similarly, demand information from a disabled person’s health professionals on a time frame not realistic for our currently overloaded and inaccessible medical system. At a cost born by the disabled person, likely living below the poverty line. On penalty of the disabled person losing access to the NDIS, and potentially their life, as before

• can force vulnerable disabled people – including children – to undergo examinations by strangers at a particular time and place, without regard for their consent, health, or safety.

With the same threat of losing all support, and their life

Concerns Regarding the Bill

I am particularly concerned that the Bill does the following even from the moment it passes:

• Bases the assessment of a disabled person’s support needs potentially for years off of a once-off interaction with a stranger, who does not even have to be a medical professional.

Who has to follow rules we don’t know yet, use assessment tools as yet made, that somehow will capture the entire complexity of a persons life, disabilities, and future needs

• Will not allow disabled people to redo or challenge this needs assessment unless the CEO of the NDIA agrees its needed.

(Which, given the current behaviour of the NDIA around existing internal review, particularly their Model Litigant Obligation breaking, law-breaking behaviour? The NDIA’s CEO will likely never agree to a new needs assessment, even if ordered to by a court.)

• Will not involve disabled people - or potentially anyone but bureaucrats - in the design of these assessments, as the Bills latest amendments about co-design only say they should be included, not that they must or will.

And that even if sought, said input can be ignored, as the disabled community doesn’t get the right to say no to these rules

• let’s a bureaucrat decide what supports a disabled person can get, for them - not their medical team, not the disabled person themselves.

Even the quantity of supports , the frequency of those supports , even the quality of supports and who they are provided by - despite medical evidence, despite the desires or needs of the disabled person involved

• let’s a bureaucrat decide that entire groups (“classes”) of disabled people don’t deserve any support at all - as has already happened illegally for ADHD and other disabilities

• limits the assistive technology that the NDIS can fund to just mobility aids - ignoring that not even all physical disabilities are mobility related, and that other types of disability can benefit from assistive technology.

This limit ignores the huge cost savings and life saving power of white goods, some commodity tools, and specialised medical equipment to minimise the need for far more expensive ongoing in-person support work, even hospitalisation

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12. Creates a system that ignores that disabilities overlap, and can add, sometimes multiply the impairment they bring.

The way the replacement to “reasonable and necessary” supports - “NDIS supports” - are defined? The NDIS can effectively force a person without functional arms or legs to have to use a manual/arm-powered wheelchair.

Just because the rules about support funding for “people without functional legs” can say the only type of wheelchair they can be funded for is a manual one, for cost cutting reasons.

(And anyone who - rightfully - attempts to get a wheelchair that’s actually appropriate to their needs? That will be considered ‘fraud’, and said person likely kicked off the NDIS, losing their other supports, and potentially their life.)

13. Undoes many existing case law, legal precedent, and appeal court decisions by removing the term “reasonable and necessary” from what supports are funded by the NDIS.

As labelling an entire budget this instead does not permit existing court decisions and order to continue to hold power against a law-breaking agency, the NDIA, implying determined to deny disabled people any support beyond what a flawed “Typical Support Package” algorithm (aka “RoboNDIS”) decides for them

14. Ignores that the “foundational supports” that disabled people deemed “low needs”, or otherwise “unworthy” of the NDIS are supposed to get instead, when they’re diverted potentially immediately from the NDIS once this Bill passes? Don’t exist. Were, in fact, dismantled by the states a decade ago.

Kicking someone off the Scheme now – by any mechanism, even if their needs are comparatively low? Is throwing them off the “only lifeboat in the desert”, to no support at all.

This is immediate, deliberate mass harm of disabled people

So, again, please reject this Bill.

I think disabled people should be treated equally to other people, and should have the same right to healthcare without having it approved in advance by a bureaucrat. And I echo the dismay many in the disabled community have expressed about how this Bill was introduced by Labor without genuine co-design by the disabled community - feedback after legislation is written and introduced to parliament is not co-design!

New Medicare

So I would like to lend my support to an idea that some in the disabled community are discussing right now – an expanded Medicare. “New Medicare”.

This would be a merger of NDIS into Medicare – using the combined funding to restore bulk billing to everyone, and expanding Medicare to cover all of the services the NDIS covers now.

As they’ve all been deemed medically, reasonable necessary via medical evidence before.

(Plus adding dental care, because this can be disabling if not accessible to everyone too!)

I would like to see a system where anyone can see their regular GP, for free. Bulk billed for everyone, as was the norm in ‘80s when Labor first introduced Medicare.

And they can get a referral to a disability service provider if their doctor agrees they need ongoing support. Where they can see an Occupational Therapist, bulk billed too, and get any assistive aids and support they need to make them able to fully participate in society.

And so continuing to support the huge 2x times multiplier to the economy that supporting disabled people to do so gives.

I would like to see an expansion to social housing to build housing for disabled people that meets their needs, that’s accessible to everyone, too as they age. So that disabled people can live in homes of their choice, that meets their accessibility needs. With whom they choose – not whom a bureaucrat or a corporation chooses that they live with. Just like everyone else.

I would like to see this expanded social housing provide the equivalent of current supported disability accommodation and supported independent living arrangement by the government providing the housing to disabled people. With the disabled people themselves with their GP and their OT deciding the support they need in that situation. Not the company that owns the property, not some bureaucrat that’s never met them.

I would like to see disabled people able to change support providers the same way everyone else can change doctors or specialists, and get bulk billed regardless of who they see.

• Just go see someone else.

Not need to get approval from a bureaucrat to change that, as is the norm for the NDIA’s “agency management” of disabled people’s supports.

I would like to see people regardless of age be able to access the same supports if they need them - because we become all less and less able as we get older.

Similar services are provided under MyAgedCare as to under the NDIS - we could provide them under New Medicare, at the same (high) quality to everyone.

I know this model can be cheaper than the NDIS as it is now, because public health is well known to economists to be cheaper than privatised health care like the NDIS.

This worked in the ’80s, due to the government’s buyer side control of purchasing, and competition on price and quality in open, accountable, and public tendering processes. If we can stock and staff hospitals this way, we can supply consumables and assistive aids this way too. Provide disability services that are more central, and not in-home this way, too.

If social housing plus support work plus any required capital modifications could be done in competition with workers directly employed by the government, who are given good wages and fair conditions? This could enable a fair transition to the New Medicare system that realises cost savings quickly.

One far, far cheaper than the present system under the NDIS, as 30-100+% profit margins don’t have to be involved in every single aspect of disability support like it is now. (The ‘wedding tax’ Bill Shorten talks about.)

I know that this model can have less fraud than the NDIS does now - and not involve intrusively checking every bit of spending made by disabled people, as the NDIS does now.

Because Medicare manages to do statistical fraud detection across every health professional who uses it.

I know that dodgy providers can be dealt with without thin-market-worsening mandatory registration, because we have watchdogs like AHPRA already on the beat - they just need to be told to keep an eye on everyone providing health services.

Similarly, the ACCC can keep an eye on competition for anything else not covered by AHPRA.

With the cost and fraud savings from a disability system that actually works, that can react almost instantly to disabled people’s needs, rather than taking 6 months to a year to changing circumstances, as NDIS now? That can truly focus on prevention of further disablement, and deliver ongoing savings – as prevention is cheaper than cure after all?

I can see that a combined Medicare, NDIS, and MyAgedCare can not only be provide bulk billed health care to every Australian, like it was in the ‘80s.

But create a net gain in our national health, even our national productivity, as public health is known to science and economics to do when adequately funded, when equally, equitably accessible to all.

As per Labor’s original vision for Medicare.

I would like Labour, as the party of Medicare, to consider a return to this positive vision for health care in Australia.

And I’d like to give the disabled community time to properly create such a proposal, designed by them, for them

To let them draft a replacement Bill.

To that end, I ask the Senate committee to please reject this Bill, and to please encourage their party members to support the disabled community when they bring a replacement Bill to the House of Representatives.

I hope the Committee will take all submissions seriously in preparing its report.

Thank you for your time.