Submission by the Melbourne Office of Just Better Care.
John Roberts 24/01/2013
We are submitting this to support the proposition that choice of service for people covered by the NDIS funding and support model is made as open as possible.
Our submission is based on the right of the individual and their right to make choices as a consumer. This right is accorded nearly everyone in the Australian population (excluding prisoners etc.) And of course this right is available to all people including people who do not fit the perceived mould of the ‘general consumer’, like people with disability.
The character of the right to choose is universal in our society. That right is not to be restricted by others who presume that they have the authority, either assumed or formal, to make decision that in effect limit of restrict or deny the range of choices that people have the make as consumers.
Of course the right to make choices in our society also comes with the responsibility to make choices that do not have negative consequences for others; whether intentional or unintentional.
For the majority of people with disability this capacity to make rational choices and to make those choices with the knowledge of the responsibility and the consequences that flow from such decisions is evident. The person with disability, like fully able people, makes choices every day that enable them to survive and develop as individuals within our society.
However, it is acknowledged that there is a small percentage of the population of people with disability, including children and those with mental impairment who certainly do not have the capacity to make rational choices that will usually result in positive outcomes for them. In these cases, there is certainly an argument for the supporting of decision-making for them to have supports that will promote their quality of life within the society.
Therefore, we are strongly of the view that as true, unconstrained consumers that the majority of people with disability should have the right to select supports from as wide a choice as possible of the assistance that is available to them.
There is an argument that right to choose by people with disability should be limited or restricted to the panel of selected service providers to ensure that the services provided to people with disability are first scrutinised by others, whom it is presumed have the knowledge, interest and authority to appropriately exclude and include.
The problem with this argument is twofold.
Firstly it unfairly limits the right to choose by consumers of services and products anywhere in our society for legally available services. All people who are consumers have the right to choose any legally available services from the huge, unrestricted range of goods and services available in our society. Clearly, people with disability should have the same right to choose.
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Secondly, it is not clear who or which organisation has the expertise and capability to accurately decide which service providers are indeed worthy of being selected for inclusion into some form of register. It is a role peppered with issues and those organisations relegated to the margins clearly have a right to appeal any exclusion from the list; another problem in itself.
Our view is that once a person has the benefit of support and funding from the NDIS they would have the right to make a choice of the service provision that assists them to live out their aspirations and goals.
The RIS analyses four options for market regulation:
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Choice is limited to government-funded service providers;
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Choice is limited to providers (including new providers) that meet regulatory standards;
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Choice is unrestricted, except for higher risk circumstances defined by service type (personal care, for example) and the cognitive capacity of the consumer; and
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There are no limits to consumer choice. From my assertions and arguments above it is clear that the preferred option is the third one above.
I believe that there is a strong push in some quarters to have choice limited to level 2 which is unacceptable for the reasons given above.
Indeed, as a service provider it could be argued that we should be seeking to be a member of a smaller group of select providers. This would bring financial benefits of minimised competition. There would also be an effective guarantee that we would always be on a list of limited providers from which the NDIS client would have to choose and thus improve our chances of gaining more paid services to deliver.
Taking that institutional view is clearly in conflict with the principles of consumer directed care that underpins the structure and function of the NDIS and would be quite unacceptable to our organisation.
In summary, anything less than level 3 I think would severely limit the choice and control that PWD are able to exercise. We are therefore strongly committed to Option 3 for the reasons provided above.
Regards
John Roberts, Director Just Better Care Melbourne East, West and Geelong
B.Ed., M.Ed., M. Tax Law. Grad Dip. Bus Admin., Grad Cert Migration Law.
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