The Albanese Labor Government commissioned a Review of the NDIS, after winning the 2022 Federal Election. The Review was headed by Bruce Bonyhady, commonly known as the grandfather of the NDIS because he was responsible for the NDIS being proposed at the 2008 “2020 Summit”. The Review was made public in December 2023.

I have concerns about the NDIS Review, mainly around the Review wanting so much government intervention in the NDIS Market. Rodd Simms of the ACCC spoke in 2018, saying: 

“Do you intervene to prevent market failure, or to correct it once it has already begun? If you do intervene, do you do so with a light-touch, or a heavy-touch?”

I feel like the Review is asking for changes that have a “heavy touch”.  

The Review says that the NDIS Market is not working well, and that this justifies them recommending what I see as heavy intervention by the government and the NDIA. At the same time the Review says it is impossible to know where the thin markets are, and what the problems are. So this seems to be a contradictory approach. If the Review can’t get enough information about the problems with the NDIS Market, then how can it know it is accurately identifying the right problems and coming up with solutions for them?  

The main things I am concerned about are the Review’s emphasis on what they refer to as “market visibility”; the proposals about the collection of information and data about participants; and some details about the design of a new “unified disability ecosystem”. 

Market Visibility 

The Review proposes to make all providers Registered so that the market is visible to the NDIA and to participants and Navigators. Being visible means that every provider in Australia will be listed in a database. I have several unregistered sole trader providers now, and I would hate to lose them because the registration process is not worth their time and effort. I also do not think some of my providers would want to be on a provider database for Navigators and participants to use, as some of them only have me as an NDIS client, and do other jobs most of their time.

I don’t think it is a good idea to eliminate Support Coordinators and Recovery Coaches and replace them with Navigators who work in an organisation that wins a tender from the NDIA. Local Area Coordinators — currently done by organisations with tenders from the NDIA — will be eliminated and their role in doing planning will be transferred to the NDIA. I am not against planning being done by the NDIA but it will make a big change. I do not think that Navigators will be better than Support Coordinators and Recovery Coaches, I would rather keep these supports in the free market, rather than have the service done by organisations who win a tender by the NDIA, and where the workers are similar to bureaucrats.

Similarly there is a proposal to make all payments electronic, again so that the market is visible, with all payments being on an NDIA database. I am not actually against this, and I think it might make things easier for me as a participant. But I think we need to think about and discuss the issue of digital surveillance of NDIS participants.

Information and data collection

As we have seen in the section on market visibility the Review speaks a lot about increasing the collection of data and information. Another example of this are  the functional assessments that will be used in the proposed NDIA Planning process. During the controversy over the Independent Assessments we learned that there is no comprehensive assessment tool to use on all disabilities, and that it is very difficult to compare the results of various functinal assessment tools to get fairly ranked functioning and funding results. I would like to see the development of NDIS specific functional assessment tools by Australian Universities. I do not believe the NDIA has the capacity to develop a holistic set of functional assessment tools. These assessments will create a lot of information about us, which will be kept in NDIA databases. 

The Review also talks about measuring the outcomes we have with our NDIS plans, which would also require the collection of data on us, and the storage of the data by the NDIA. The data on outcomes could lead to higher payments for the providers who are seen to produce better outcomes, but there is no information on how this would be measured and compared. This concept of rewarding better outcomes is central to the Review’s goal to improve the quality of providers. 

So the NDIS would have data on every Australian NDIA provider, they would have data about us from our functional assessments, they would have data about the outcomes we have from using our NDIS funding, they would have data on every transaction we make to use our NDIS funding. That is a lot of data to have on every individual in the NDIS. I cannot think of another government body that would collect and store that much information on its service users.  This raises questions for me — How much data do we want collected on us? Will we have any control over this? What if our information was hacked? How can disabled people and DPOs be involved in data collection similar to how Closing The Gap involves indigenous people and their organisations in data collection and dissemination. I believe strongly that we need to have a discussion about the NDIS and data collection. We do not want NDIS participants to become the most suveilled people in Australia. 

Design Details

There are three main issues that concern me about the design of the new system. First the shift to create two separate levels in the disability support system — NDIS and Foundational Supports — without it being clear where the boundary is between the two levels. Will the NDIS have the same eligibility criteria as it does today? Or will the eligibility criteria be changed and some people shifted off the NDIS into Foundational Supports? To do a cost benefit someone would need need to look at both costs of the NDIS and costs of the proposed Foundational Supports. We do not even know how many people are expected to use the Foundational Supports at the moment, let alone the cost.

Second, the proposal for a separate Psychosocial Pathway makes me very anxious. It will mean that people with Psychosocial Disability, like me, are treated differently from other people in the NDIS, and signals — by saying that they should remain on the Early Intervention pathway for 3 years — that people with Psychosocial Disability are not seen as having the same level of disability or permanence of disability as other participants in the NDIS. How do we know that an Early Intervention approach for Psychosocial Disability won’t actually increase the number of Psychosocial participants by having a lower eligibility threshold? I am concerned about the focus on Personal Recovery and capacity building supports, as the Review appears to think that Personal Recovery (which means living our best life as a person with mental illness) would mean we need fewer supports. In my opinion it is Clinical Recovery not Personal Recovery that could mean someone needs fewer supports, and in fact in order to maintain Personal Recovery we may need more supports to live our best life despite the symptoms and impairments that go with lifelong mental illness. 

Third, the Review does not go into a lot of detail of the design of the new disability ecosystem, and I am worried that there is a lack of details for some of the proposals, and also worried that without a proper cost benefit analysis of the new system being made public, we can’t even know if these proposals are going to help with the financial sustainability of the NDIS which was the main reason for the Review. Are we just going to be back here in another 5 years, with the media saying it’s NDIS participants’ fault that the NDIS is costing too much? I really hope not.