Public Policy Update from Around the World A National Disability Insurance Scheme in Australia
Overview • The Australian Public Policy Landscape – Federal, State and Local Government structure
• Disability in Australia – Prevalence – Funding and Programs
• The Case for a National Disability Insurance Scheme – Productivity Commission’s Inquiry – The future of disability services in Australia
The Australian Public Policy Landscape • • •
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The Commonwealth of Australia is made up of six states and two mainland territories. It is an independent Western democracy with almost 22 million people. Australia is a constitutional monarchy, recognising Queen Elizabeth II of Great Britain as head of state. Her representative in Australia is the Governor-General. The nation's political structure, as well as its legal and educational institutions, is based on British and American models. The Constitution gives the Federal Government power over defense, foreign affairs, trade and commerce, taxation, customs and excise duties, pensions, immigration and postal services while other powers are held by the States. The main political parties are the Labor Party, Liberal Party and the National Party. The Commonwealth of Australia was created in 1901 when the former British colonies— now Australia’s six states—agreed to federate. All citizens over the age of 18 must vote in both federal and state government elections.
The Australian Public Policy Landscape
Disability in Australia •
One in five people in Australia (3,958,300 or 20%) reported a disability in 2003. A further 4,149,000 (or 21%) had a long term health condition that did not restrict their everyday activities.
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The severity of people’s disabilities varies significantly. At the more severe end of the spectrum, people are classified by the Australian Bureau of Statistics as having either: – a profound activity limitation, meaning the person is unable to do, or always needs help with, a core activity task (core activity tasks are self care, mobility and communication); or – a severe activity limitation meaning the person sometimes needs help with a core activity task and/or has difficulty understanding or being understood by family or friends and/or can communicate more easily using sign language or other non-spoken forms of communication.
Disability in Australia •
Labour force participation rate of people with disability is 53% people without disability
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Unemployment rate of people with disability 8.6% without disability
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Median gross income for people with a disability $255 per week per week for people without disability
81% for
5% for people
$501
Disability in Australia •
In 2003, approximately 595,000 people (3.0%) reported a profound disability and a further 650,000 people (3.3%) reported having a severe disability. Generally speaking, the prevalence of severe and profound disability increases with age and is of particular significance for an ageing population.
Disability in Australia: •
The National Disability Agreement is funded by both the Australian and State and Territory Governments.
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Currently approximately 30% of funding comes from the Australian Government and 70% from the State and Territory Governments.
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The services provided under the NDA include: – Accommodation support (large and small residential/institutions, hostels, group homes, attendant care/personal care, in-home accommodation support and alternative family placements) – Community support (therapy support for individuals, early childhood intervention, behaviour/specialist intervention, counselling, regional resource and support teams, case management and local coordination) – Community access (learning and life skills development and recreation/holiday programs) – Respite (own home, centre-based, host family/peer support, flexible, other) – Employment services (open and supported) – Advocacy, information and print disability
Disability in Australia Joint Responsibilities • under the National Disability Agreement • Home and Community Care • Respite • Research and development Australian Government • Income support ( >$A6 billion per year)
NSW Government • Accommodation • Post School and Day Programs
• Employment services • Education • Advocacy and information services • Children’s Services (therapy etc)
Disability in Australia •
In 2006/07, total expenditure was approximately $4.35 billion of which $3.92 billion (or 90%) was spent on direct service delivery.
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Over the period 2003/04 to 2006/07, real growth in expenditure on direct service delivery averaged 5% per annum.
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The National Disability Agreement paves the way for significant reforms to the disability services system, with disability ministers agreeing to an ambitious National Disability Reform agenda.
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Reform under the NDA is intended to create a disability services system that is: – – – – – –
effective, efficient; equitable; focuses on early intervention; person-centred approaches; and lifelong planning.
Disability in Australia •
In total, around $20 billion is spent annually by Australian governments on the community care and income support of people with disabilities (including ageing), outside of the formal health system, residential aged care and “bricks and mortar” accommodation: – $6.92 billion is spent on community care/disability support services (CSTDA, HACC and Australian Government aged community care programs). Of this $6.92 billion, approximately $4.8 billion is spent on under 65 year olds – $2.7 billion is spent on payments to carers of people with disabilities – $8.7 billion is spent on income payments to people with disabilities – $130 million is spent on aids and appliances – Total expenditure on transport subsidies in Australia is unknown; however, in NSW; $19.6 million is spent on the Taxi Transport Subsidy Scheme. Further, $106.4 million is spent by the Australian Government on the Mobility Allowance – There is additional spending on education support, on correctional facilities and drug and alcohol services that assist people with disabilities
Disability in Australia •
The ageing of the population has a major impact on the number of people with severe and profound disabilities as older people are more likely to have a severe or profound disability.
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Over the next 40 years, there will be a steady increase in the number of people with severe and profound disabilities (from 1.4 million to 2.9 million) and an increase in the proportion of the population that people with severe and profound disabilities represent (from 6.7% to 10.2%).
Disability in Australia •
This increase in the number and proportion of people with severe and profound disabilities will have a major impact on the current disability system.
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The need for formal services will increase and further pressure will be placed on the informal care sector.
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Further, life expectancy has been increasing in Australia. In 2003, life expectancy at birth was 77.8 years for males and 82.8 years for females.
Disability in Australia
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Family dynamics lead to the following likely converging pressures on the future availability of informal care: – A reducing pool of “relatives in a caring role” as more females enter the workforce – A reducing pool of extended families (siblings and cousins) as family sizes continue to reduce and single-parent families increase – A reducing pool of children (especially daughters) available to care for their ageing parents with a disability, through both reducing family sizes and increased workforce participation – An “ageing carer” pressure as the current predominance of baby-boom carers (especially mothers aged 50 to 60 or older) need to withdraw from the role of caring for their children with a disability
Disability in Australia •
In addition to these “natural forces” of change, there are also (anecdotally) two social, philosophical and/or political pressures: – The apparent lifestyle choices of the baby boom generation, whereby the tendency may be to expect and rely on organised care rather than recognise a wish or obligation to provide it gratuitously – Recognition of the “rights” of people and preference of people with disabilities to increase their independence of restrictions and family dependency
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The likely diminishing informal care sector will put further pressure on a formal system that is not currently meeting need (discussed below). Without intervention now to improve and support this informal network more costly services (such as accommodation support) are likely to be required in the future.
The Case for an NDIS • Gained prominence at the 2020 Summit • Strong advocacy by people with a disability, their families and carers and the organisations that support them • Strong support from outside the sector – eg media, ACTU, AMA • Productivity Commission Inquiry into Disability Care and Support began in 2010
The Case for an NDIS • Productivity Commission findings: – The disability system is “inequitable, underfunded, fragmented, and inefficient and gives people with a disability little choice”. – Recommended two schemes – National Disability Insurance Scheme and the National Injury Insurance Scheme – NDIS – support for all people with a disability that has a significant impact on their daily lives – NIIS – support for people who are catastrophically injured
The Case for an NDIS: What is it? • The National Disability Insurance Scheme would create a secure, consistent pool of funds from which support for people with a disability, their families and carers could be drawn • It would create a nationally consistent, fair, efficient and effective system of support • The scheme would be person-centred and individualised, based on the choices of the person with a disability and their families.
The Case for an NDIS: Who would be eligible? • A person receiving support from the NDIS would have a permanent disability, and : – Have significant limitations in self care, mobility or communication – Have an intellectual disability – Have a condition for which early intervention would result in an improved level of functioning – Be a person for whom intervention would have significant benefits
The Case for an NDIS: What’s available? • Once a person has been deemed eligible and their support needs assessed they would be entitled to a package of supports and services. People would then be able to: – Choose their own service providers – Ask a disability support organisation to assemble a package on their behalf – Cash out parts of their funding allocation and direct the funding to those supports which best meet their needs.
The Case for an NDIS: How much will it cost? • An effective system would require an additional $6.3 billion (total $12 billion investment) • The Productivity Commission recommends the Commonwealth Government assume responsibility for funding • Funding should come from consolidated revenue rather than a levy • Funds should be quarantined • Insurance premium amounts to $280 per Australian
The Case for an NDIS: How will it work? • Pilot project in one region in 2015 • Target groups in 2015 • Fully functional by 2018
The Case for an NDIS: Why now? • Demand for specialist disability services is already growing at 5 -7 per cent per annum - will need to double the amount currently spent in the next 10-15 years. • The number of people willing and able to provide unpaid care will fall during the same period. • Standing still is not actually standing still – it will be going backwards. • Families urgently need support – can’t have this reform opportunity put in the ‘too hard basket’.
The Case for an NDIS: • If we get this right, there are major benefits for individuals and the nation. • People with a disability will finally get the support they need to reach their full potential and participate more fully in the economy and the community. • We will ease the responsibility currently shouldered by families and carers. • We will unlock the productive capacity of thousands of people who could with a little support be participating in the labour market.
The Case for an NDIS: • Australia has skills shortages in key sectors that can be fixed if people with a disability and their carers into work. • People with a disability have about twice the unemployment rate of people without. • This means more employment and less welfare. It means more spending in the economy from more people back at work and increased tax income to Government. • The Prime Minister has identified workforce participation as a priority. The NDIS can be help address this.
The Case for an NDIS:
The Case for an NDIS:
The Case for an NDIS:
Questions and Further Information • NDIS, visit: www.everyaustraliancounts.com.au • National Disability Services, visit: www.nds.org.au • Email: patrick.maher@nds.org.au
Session Evaluation Information
SESSION TITLE: World SESSION CODE: GA-T900