P O L I C Y, L O B B Y I N G & A D V O C A C Y U P D A T E
Positive change and a growing presence Michael Barrett, OTA General Manager, Government and Stakeholder Relations
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his issue’s theme “Brighter Futures” is appropriate given that, as I write, occupational therapists and their clients across Australia are applauding the recent decision by disability ministers to abandon NDIS independent assessments. All who opposed independent assessments as envisaged by the National Disability Insurance Agency have good cause to celebrate. OTA fought the proposed individual assessments with great determination, skilled advocates, and, most importantly, irrefutable evidence. At first glance, it is terrific news. An NDIS architect and compelling critic of independent assessments, Professor Bruce Bonyhady, said OTA’s submission to the Australian parliament’s Joint Standing Committee was “immensely powerful”–and OTA sincerely thanks the scores of members who supported its long campaign to defeat independent assessments. It was their clinical evidence–and passion–that won the day. However, a note of caution. The NDIS is costing more than envisaged, and over time is likely to cost even vastly more–all at a time of historic budget deficits. As governments strive to pull in the reins, we are likely to see new ways of cutting costs. We must remain vigilant to ensure these do not come at the expense of client care or the professional responsibilities of our members. We are pragmatic enough to realise that if the NDIS is to be sustainable, some form of eligibility screening process will ultimately be introduced.
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We know the Morrison government is convinced of this and, significantly, any future Labor government will also have to oversee a screening process that ensures access and equity without rendering the scheme unsustainable. The important thing, surely, is to develop a screening process that also allows the NDIS to remain true to its foundational principles: principles such as scheme co-design, reasonable and necessary supports, and enhanced choice and control for participants. In the spirit of co-design and collaboration, we will work with our colleagues at Allied Health Professions Australia to facilitate the work of the NDIA–an agency that must become genuinely consultative if it is to regain the trust of the sector. We have already recommended a screening process that is effective, evidencebased, and, most importantly, involves a comprehensive assessment conducted by a discipline-specific allied health professional the client knows and trusts. So, in terms of the NDIS, the future does appear brighter, but we must remain vigilant. The future is certainly a little brighter for Australian war veterans and widows who scored an occupational therapy victory in the May 11 federal budget. After almost 20 years without a meaningful increase in the fee paid to occupational therapists, the Department of Veterans’ Affairs has raised it 27 per cent. While modest in the context of a multi-billion-dollar budget, it is hugely important in making work sustainable for this
particularly dedicated group of occupational therapists and their clients. Until now, many of these experienced occupational therapists had worked at a loss–continuing out of loyalty to long-standing and highly complex clients–and had survived through cross subsidies from more viable work. OTA fought long and hard for these members, raising the issue at every opportunity, and even establishing a standalone website that declared: “This is not the way a grateful nation treats the people who treat its veterans.” OTA acknowledges those members who worked with veterans from the goodness of their hearts for so long, and who helped us campaign for a fairer deal. Once again, we know this fight is not over, and we must ensure a fee schedule never becomes so outdated again. The federal budget has unprecedented expenditure on mental health and suicide prevention, which emerged as urgent problems long before natural disasters and the Covid-19 pandemic threw them into even sharper focus. After a year’s delay due to Covid-19, the federal government late last year released the findings and recommendations of the numerous committees reviewing aspects of the Medicare Benefits Schedule. The committee charged with reviewing mental-health-related items (i.e. BAMHS) was unable to make decisive recommendations, opting instead to recommend another review. Significantly, it recommended that the make-up of the new
