Submission 2715
Submission on the NDIS Amendment Bill
Name:
I am a: Provider (Psychologist)
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My connection to this issue This issue concerns me in my role as a provider to many NDIS participants. The possible negative impacts of these proposed changes are already causing real and significant fear and distress to a vulnerable population. I would like to do what I can to ensure that some of the negative outcomes plausibly expected to arise from this amendment Bill either do not materialise, or are mitigated as much as possible.
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My overall view of this Bill I have serious concerns about the Bill and do not support it in its current form, or without clearer stipulations around the proposed changes.
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My main concerns: I am unable to speak exhaustively to all my concerns with the Bill, but I have outlined some key ones below:
Supports can only be funded if directly linked to an eligible impairment As demonstrated in the recent Federal Court ruling (Eastham vs NDIA), it is neither commonsensical nor logical to isolate an individual’s disability needs, and more often than not, there are interacting effects between a person’s chronic conditions, where the lack of treatment/support in one area will likely have a detrimental impact on other areas of their functioning.
An NDIS participant whose eligible impairment is a physical one, for example, but has a co morbid psychological condition (e.g. depression, bipolar disorder), is likely to experience a deterioration in their physical condition due to untreated mental health symptoms. The relationship between chronic physical health conditions and mental ill-health is well documented, where social isolation, hopelessness, stigma, and low self-esteem are commonly experienced as a result of a physical disability. In fact, research has suggested that individuals who have comorbid chronic physical and mental health conditions are likely to have more severe symptoms of both illnesses. This is because a physical disability
Submission 2715
not only increase stress and depression symptoms, which in themselves can exacerbate physical symptoms (e.g. pain, inflammation), but it can also reduce engagement in activities that are physically beneficial (e.g. physio exercises, eating properly).
It is often, therefore, impossible to delineate clear boundaries between an ‘eligible’ and ‘non-eligible’ impairment and certainly does not make sense to distinguish between the two when it comes to the treatment and support of a disabled person.
Eligibility and assessment changes
There is a lack of clarity around the proposed changes to functional capacity assessment, and I would be seriously concerned if any assessment framework is too heavily automated. A person’s circumstances and the nuances surrounding their disability are unlikely to be a ‘one-size-fits-all’ situation, and we cannot afford to get it wrong, particularly when it comes to a vulnerable population that we, as a society, have a responsibility to protect.
NDIS participants are often unable to fully advocate for themselves, and because of their disabilities, are also in a more disadvantaged position when it comes to managing the fall out of any negative changes, particularly when the means of challenging those negative decisions are restricted. I know of many participants who have had plan reviews recently, who have already experienced significant amounts of ongoing distress as a result of reduced funding and (quarterly) limits on access to funds. The Robodebt saga is a sobering reminder of the dire consequences that can arise from the automation of something that should never have been automated. The disabled community is certainly not one that you want to risk running such an experiment with.
I also have serious reservations around the re-assessment of existing participants, where their current level of functioning may be used to determine the level of support they need. People whose functional capacity may have improved through accessing support services funded by the NDIS in recent years, may be unfairly assessed as having a high level of capacity, and have their funding cut as a result. This would effectively be penalising individuals who are ‘doing too well’ or ‘not disabled enough’, a fear and sentiment I have unfortunately encountered often, and is a sad indictment of the proposed changes. Any re assessment of existing participants, therefore, has to take into account their pre-funding capacity, as would be the case for any new applicant to the scheme. Importantly, the fact that someone responds well to having support systems in place should be a reason to continue funding, rather than a reason to take it away.
Reasonable and necessary supports from families and informal supports
Submission 2715
Proposed changes to the Bill increases the amount of support that the NDIA expects from families and other informal supports. My primary concern, beyond adding to the pressure that the majority of families of NDIS participants already experience, is the unfair expectation that this change places on families who have more than one disabled person.
I have serious concerns about the way in which these assessments have and will take place, where there is no avenue to consider how, for example, a disabled parent is meant to be taking on more responsibility of care for their disabled child or children, or vice versa. Especially if functional assessments are meant to be automated, there has to be a provision for this expectation of ‘reasonable and necessary’ support from families to be adjusted, on the basis of co-occurring disabilities. It is not an isolated event where disabilities run in families, and this must be recognised and addressed in any proposed changes to the scheme.
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What I would like the committee to consider This rights and dignity of disabled individuals should be honoured and protected. Too often, disabled individuals have felt a lack of respect when it comes to decisions that have a huge impact on them, where they have not been heard or given a fair chance to speak-up. The fact that they have had to defend their rights tirelessly and ferociously, sometimes for things that most of us take for granted, like being able to have a shower, or go to the shops, eats away at their ability to live a dignified existence. This isn’t right. No one should have to fight tooth and nail, and prove themselves over and over again, just to access basic human services.
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My position on this Bill I do not support the Bill in its current form. More consultation and clarification are needed in order for informed decisions to be made.