Health Services Union
SUBMISSION
Joint Standing Committee on the National
Disability Insurance Scheme
NDIS Workforce Plan (Supplementary Submission)
August 2021
About the HSU …………………………………………………………………………………………………………….. 3
HSU Disability Coverage …………………………………………………………………………………………………… 3
Overview ……………………………………………………………………………………………………………………. 4
HSU Concerns with the Development of the Plan ……………………………………………………………….. 4
HSU Feedback on the Plan ……………………………………………………………………………………………… 5
Priority 1 – Improve Community Understanding of the Care and Support Sector ……………………. 6
Priority 2 – Train and Support the NDIS Workforce ……………………………………………………………… 6
Priority 3 – Reduce Red Tape, Facilitate New Service Models and Innovation ………………………… 7
Concluding Remarks ……………………………………………………………………………………………………… 7
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About the HSU
The Health Services Union (HSU) is one of Australia’s fastest growing unions with over 90,000 members working in the health and community services sectors across the country.
Our members work in aged care, disability services, community health, mental health, alcohol and other drugs services, private practices and hospitals. Members are health professionals, paramedics, scientists, disability support workers, aged care workers, nurses, technicians, doctors, medical librarians, clerical and administrative staff, managers and other support staff.
HSU Disability Coverage
The HSU is the primary disability services union in Victoria and Tasmania, representing support
workers at the frontline of service delivery. Furthermore, the HSU represents allied health
professionals in every jurisdiction, including those engaged in providing services to NDIS participants.
Additionally, we represent a number of disability support workers in New South Wales, Western Australia and the Australian Capital Territory, however, the HSU is not the primary union for direct disability support workers in those jurisdictions.
Our broad disability membership across a range of professions gives us a unique insight into the rollout of the National Disability Insurance Scheme (NDIS), how the scheme is interfacing with other mainstream services and the market and workforce issues critical to the scheme’s success.
This submission has been authorised by:
Lloyd Williams, National Secretary, Health Services Union
For questions regarding this submission, please contact:
Mark Farthing, National Campaigns & Projects Officer, Health Services Union
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Overview
The Health Services Union (HSU) welcomes the opportunity to provide a further submission to the
Joint Standing Committee on the National Disability Insurance Scheme (the Committee) specifically
on the NDIS National Workforce Plan 2021-2025 (the plan). This submission is structured into two sections, the first of which outlines the HSU’s concerns about how the plan was developed and, secondly, our views on the plan itself.
HSU Concerns with the Development of the Plan
The first time the HSU became aware that the Department of Social Services (DSS) was seeking broad stakeholder feedback on the development of the plan was on 6 March 2020 following a media release from the then Minister for the NDIS, The Hon Stuart Robert MP. However, it came to our attention that DSS’ consultation survey had opened one week prior on 28 February 2020 and originally was only scheduled to be open for two weeks – closing on 13 March 2020. While the survey was subsequently extended to close on 27 March 2020, as the Committee would be aware this coincided with the escalation of the COVID-19 pandemic in Australia. Due to the need to respond to members who were at-risk of losing their jobs due to the closure of community, group based disability services such as day-programs (alongside providing support and advice to HSU members in other severely impacted industries such as public health, aged care, pathology, etc.) the HSU did not have the resources to complete the consultation survey and we are concerned that many other stakeholders were similarly constrained. Despite the fact the DSS would have been aware of the dislocation being caused by the pandemic’s escalation, the HSU is aware of no measures put in place to allow stakeholders to meaningfully provide feedback.
Despite being one of the largest unions in Australia with a substantial number of members working in NDIS services across a range of occupations, DSS did not conduct any outreach to the HSU. Instead, the HSU along with the other two primary NDIS unions, the Australian Services Union (ASU) and the United Workers Union (UWU), wrote to the Deputy Secretary of DSS on 24 November 2020 expressly seeking consultation on the plan. A meeting was subsequently convened between the three unions and DSS on 7 December 2020. At this meeting Senior DSS Officials advised that the plan was in the final stages of completion, but that the HSU could provide a written submission for consideration.
The HSU provided a written submission on 18 December 2020, which highlighted:
- Attraction and retention issues brought about by a proliferation of insecure work, decreasing access to training and supervisory support, low pay, and unpaid work. These issues were highlighted through findings from our commissioned research from the Social Policy Research Centre (SPRC) at the University of New South Wales (UNSW). The research report Working in new disability markets: A survey of Australia’s Disability Workforce (Cortis and Van Toorn, 2020) has previously been shared with the Committee. We highlighted:
o Insecure work arrangements are the norm. Half of all workers said they worried about their rosters, 45% said their shifts change unexpectedly and the same proportion said their employment arrangements did not feel secure.
o Many workers report a lack of access to training and diminishing levels of supervision. 1 in 4 workers said they received less than 1 day of training in the previous 12-months, and over half of all workers agreed that they had to make important decisions about client safety and support on their own.
o The NDIS workforce has low pay satisfaction and is increasingly being called on to donate their unpaid time to deliver services. For every paid hour of work, low-paid
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disability workers donated an average of 4.6 minutes of unpaid time (equivalent to 36.8 minutes for a full working day).
The HSU also endorsed the bipartisan and unanimous recommendations of this Committee contained in its December 2020 Interim Report on the NDIS Workforce and further recommended that the plan:
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Set out a process for clarifying the industrial obligations of service providers and self- managed participants when engaging disability support workers to ensure that this large component of the NDIS workforce is being properly paid.
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Have regard to the fundamental pricing changes in Supported Independent Living (SIL) services that the NDIA imposed on the sector with little warning in July 2020.
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Examine how best to implement a positive disability worker registration and accreditation scheme that sits within the NDIS Commission and is integrated into the NDIS Quality and Safeguarding framework.
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Highlight the need for better workforce data collection, supported by funding to undertake a robust census of the NDIS workforce alongside a broader review of ANZSCO to ensure that it is fit-for-purpose.
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Make clear the roles and responsibilities of the Commonwealth for NDIS workforce development, particularly between the DSS, NDIS Commission and NDIA.
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Set out a process to establish a workforce committee comprising unions and other sector stakeholders (provider and participant representatives), which brings together officials from DSS, the NDIA and the NDIS Commission to work together on workforce policy matters such as market intervention strategies, market stewardship and price controls.
In the same correspondence containing our submission, the HSU sought a meeting with the DSS to discuss our recommendations. DSS Officials advised that 11 January 2021 was when they could next meet, however, relevant HSU staff were on annual leave and offered instead to meet in late January or early February 2021. On 5 February 2021, the HSU emailed DSS Officials to again try and secure a meeting and received a reply from DSS on the same day advising they would find an appropriate time as soon as possible. After hearing nothing from the DSS, the HSU emailed again on 3 March 2021 asking whether a suitable time was available to meet and received a reply from DSS on 9 March 2021 stating that the HSU’s written feedback was being considered and we would be contacted again soon. The HSU never heard back from DSS and had no further contact. As the Committee is aware the plan was then released three-months later on 10 June 2021.
The HSU provides this account to show that despite its best efforts, it had little opportunity to contribute to the plan. It remains our position that a truly valuable and representative workforce plan must include those who are its subjects, i.e., the workforce and its legitimate representatives. Our experience suggests that, at best, the DSS Officials tasked with the development of the plan were woefully under resourced to do an effective job. At worst, it suggests a deliberate disdain for the voices of the NDIS workforce in the making of policy which affects their daily lives.
HSU Feedback on the Plan
With regard the final plan, the HSU would submit the following assessment of the priorities expressed in the plan and some of the individual measures under each priority.
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Priority 1 – Improve Community Understanding of the Care and Support Sector
The plan states that “working in the care and support sector is often poorly perceived by the public as a low paid job with limited career potential.” The HSU submits that the reason for this perception is because it is true.
As the Committee is no doubt aware, the NDIA bases NDIS prices used to engage Disability Support Workers on its Cost Model. The Cost Model assumes that the average Disability Support Worker is paid at Level 2.3 of Schedule B of the Social, Community, Home Care and Disability Services Industry Award (SCHADS). On 1 July 2020, the weekday daytime hourly rate for this classification was $30.17, however, many disability workers are paid much less than this – particularly those engaged by NDIS providers who opt to pay their workers under the Home Care stream of the Award (a classification choice the HSU contests, but which nevertheless is used). The table below shows the hourly rate for a Schedule B, L 2.3 worker (SACS); a Schedule E, L 4.1 (Home Care) worker; and the median hourly rate for all employees based on Single Touch Payroll data from the ABS, with the second row showing the hourly rate as a percentage of the median hourly rate.
August 2020 1 July 2020 1 July 2020
ABS Median Hourly
SCHADS (SACS) 2.3 SCHADS (Home Care) 4.1
Earnings
Hourly Rate $30.17 $25.18 $36.00
% of Median Hourly Rate 84% 70% 100%
The HSU submits it is farcical to claim that there is merely a perception of low pay for disability support work when the top hourly rate imposed by the NDIA’s own Cost Model is only 84% of the median wage (or 70% for a home care worker). The reality is that disability work is low-paid and while it remains as such, we will continue to face challenges attracting and retaining a high-quality workforce. Disappointingly, the plan makes little to no attempt to engage with this reality and instead proposes to rely on “high unemployment” to incentivise jobseekers into these roles, a recommendation that flies in the face of wanting to ensure that new workers have the right attributes and values before entering the NDIS workforce. While the HSU supports the promotion of the sector to prospective entrants as called for in the plan, we believe that while the extrinsic benefits of disability work are missing (poor pay, limited career paths and institutional undervaluation) the sector will continue to suffer workforce shortages.
Priority 2 – Train and Support the NDIS Workforce
The HSU has always been a strong advocate for a well-trained and supported NDIS workforce and we support many of the recommendations contained in this section of the plan, with a few caveats.
On the need for accredited micro-credentials, this is simply new parlance for skill-sets under existing Training Packages. The HSU is supportive of micro-credentials/skill-sets as long as it does not come at the expense of full qualifications. These smaller components of training must be able to operate together to enable the completion of a full qualification, with those offering more advanced skills only open to learners who already possess a relevant Certificate III or IV level qualification.
Similarly, we support the recommendation for a “Care and Support Worker Professional Network” to address the known (and growing issues) of an atomised, isolated workforce without access to appropriate debriefing. However, if NDIS price-caps continue to exclude an appropriate margin for supervision, training and reflective practice – it cannot be expected that a significant proportion of the disability support workforce will engage with such a network if it is to be done in unpaid time.
On the concept of a skills passport, the HSU offers qualified support. We would be concerned that elevating the importance of non-accredited training will diminish the value of accredited qualifications and micro-credentials/skill-sets. The HSU would note that such a skills passport might be better embedded in the sector through a registration standard for continuing professional development (CPD) like that proposed by the Victorian Disability Worker Commission.
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Finally, on the matter of increasing the uptake of traineeships the HSU is very supportive. However, as the plan notes, “Providers have reflected that supply for traineeships and student placements is low as they lack resources to provide supervision, cover costs of administration relating to placements, and guarantee work hours” showing, yet again, that it is the NDIS pricing model which precludes the option for widespread uptake.
Priority 3 – Reduce Red Tape, Facilitate New Service Models and Innovation
The HSU is supportive of the plan’s suggestion to align regulation across sectors, however, we would note that the plan says nothing about the two-tier regulatory system currently operating within the NDIS itself. The most recent NDIA Quarterly Report (30 June 2021) identifies that only 20% of 466,619 had their plans managed by the Agency. This means that 80% of all participants can use unregistered providers which are not obligated to, among other things, ensure they engage workers who have passed the NDIS Worker Screening Check. The HSU is concerned that the plan envisages a future state-NDIS that has few quality checks and balances to ensure the safety of NDIS participants or promote the growth of a high-quality workforce – all in the name of removing barriers to entry.
The HSU rejects the idea that growing the NDIS workforce must be subservient to the need for quality and safety. Indeed, such an idea is nonsensical and offensive. There are currently barriers to entry for a range of professions across the country (allied health, nursing, teaching, early-childhood education) yet no reasonable person suggests we should dispense with minimum entry requirements for these professions just because positions are hard to fill. Lack of supply of disability support workers has more to do with pay and conditions and artificially low NDIS pricing – not overburdensome regulation.
On the plan’s recommendation to support participants to find more services and supports online, we note that a well-functioning market needs well-informed consumers, so the HSU is supportive of measures to enable this. However, we are cautious that this recommendation is simply code for a desire to see more participants use on-demand, gig-economy platforms which use “independent” contractor arrangements to bypass minimum wage, WHS and other employment-related laws. Such a concern is not unfounded, given the NDIA itself identified platforms such as Mable on its website during the height of the pandemic in 2020 and promoted this webpage with taxpayer-funded advertising on Facebook.
Concluding Remarks
Once again, the HSU welcomes the opportunity to provide feedback on the plan and thanks the Committee for inviting the HSU to make this supplementary submission. In closing, we would like to re-iterate the evidence we gave to the Committee during its September 2020 hearing about the what we see as the biggest barrier to coherent workforce planning in the NDIS: the separation of responsibility for workforce development between the NDIA, the DSS and the NDIS Commission. Whilst DSS has responsibility for workforce policy and the NDIS Commission is charged with promoting quality services and applying sanctions when things go wrong—this model fails because the NDIA controls the primary levers to influence workforce development and quality assurance – namely by controlling the prices payable for services. Additionally, this model means that the primary Commonwealth agency responsible for the implementation of the scheme – i.e. the NDIA – fails to take workforce matters into account in its decision-making. Until the broken workforce policy architecture within the scheme is fixed, we have little hope of achieving the high-quality NDIS that people with disability so rightly deserve.
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