Summing up the National Disability Summit by Prof Niki Ellis

Credit: This blog post is taken from “From the CEO’s Desk” and written by Professor Niki Ellis, CEO of the Institute of Safety, Compensation and Recovery Research.

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I got a good sense of where the NDIS is up to by attending the 3^rd Annual National Disability Summit in Melbourne this week.

Minister Jenny Macklin opened the conference by congratulating the disability community for getting disability from being a private struggle to front page news. She called for ongoing input to the design of the NDIS from the disability community, but did not give an indication of how that might occur.

Graeme Innes, Disability Discrimination Commissioner gave an update on community access for people with disability.  He said that Australia is doing better on transport and communications than previously but with regard to employment, we are amongst the worst performing countries in the OECD.  After not supporting targets for years, Commissioner Innes has concluded this will have to be done.  He thinks governments as employers should be doing more to lead by example.  Innes made specific reference to research in his talk saying that the NDIS will need to invest in research as the personal injury compensation sector has done for example in assistive technology.  I talked to him afterwards and let him know that ISCRR’s Neurotrauma Research Strategy for the TAC includes assistive technology and increasing community participation as priorities. He said he had heard of ISCRR and accepted my proposal that when ISCRR is further down the track with research on improving return to work for people who have had catastrophic injuries we meet.

Nick Hartland, Group Manager, Disability Long Term Care and Support Taskforce, FaHCSIA (a key Commonwealth public servant for this work) explained the principle of social insurance that families should not bear the costs alone and the insurance principle defining and managing the total obligation over time. He emphasised this was not just the expected costs of people on the scheme now, but also anticipated demands of people yet to be identified. He said that the work has been more intersectoral than any other social policy he has worked on. The Federal budget this year allocated 1 billion dollars to the scheme for four pilots due to commence in July 2013. A transition agency is being established in Canberra and recruitment is underway for a CEO.  COAG has accepted the Productivity Commission report as a basis for the design work.  Advisory Groups have been established for Control and Choice, Eligibility and Assessment, Workforce and Quality and Standards.

The next daySenator Mitch Fifield, Shadow Minister for Disabilities, Carers and the Voluntary Sector confirmed that the Opposition supported the establishment of the NDIS.  He explained that the Leader of the Opposition’s comments about the budget surplus and the NDIS, saying that Tony Abbott did not mean no work on the NDIS before the budget was in surplus, rather that work towards both budget surplus and the NDIS would occur in parallel.  The Opposition had proposed a bipartisan Parliamentary Oversight Committee for the establishment of the NDIS, but the Government rejected that.  The Opposition also considers that it would have been useful to have established a Chair and Board by now. Questions to the Senator included funding for the launch sites: the Productivity Commission proposed the Commonwealth funding the top up needed after pooling existing Commonwealth and State funding; and also described what a phased roll-out of the NDIS would look like.  Maree Dyson advocated for young people in nursing homes as a priority, outside pilot sites.

John Della Bosca, National Campaign Director, Every Australian Counts Campaign,responded to a plea to reassure families that they will be better off under the NDIS than they are now. He claimed that overall, the support for families will be double what it is now and they will be a part of a better system. So yes, they should be, but it would be unwise to guarantee this to absolutely everyone.  This discussion reflected some other comments from Senator Fifield regarding feedback he was receiving from people who are blind and deaf and as such concerned about their position in the NDIS.

John Walsh, health actuary at PricewaterhouseCoopers and Assistant Commissioner for the Productivity Commission Reportargued the need for better data (well as an actuary he would wouldn’t he. He explained how the data needed to run a scheme based on insurance principles is different to the data which exists in the disability services sector now.  Essentially for a person-centred service the data will be based on needs, not supply, and for a scheme run on insurance principles the data will be proactive (what are the outstanding liabilities) not just reactive (what have we spent).  A passing comment he made was that how much choice clients have and how much respect they are shown are the kind of criteria he would expect to see in the assessment of the quality of services purchased through self-directed funding.  There was a good discussion on the potential for duplication of data collection, especially between sectors, eg NDIS and education sector.

Andrew Fronsko, TAC, gave a brilliant presentation where he reviewed the rationale for the separation of the NIIS and the NDIS, but argued strongly that the links between the two schemes as they were developed should be strong. He said there was much value for each to provide to the other, and cheekily hinted that maybe they should be merged, sooner rather than later.

I left at morning tea on day 2, but heard Michelle Wilkinson from the Accident Compensation Commission in New Zealandtalk before I left about a service improvement project they had run in which the system for the assessment of clients was shifted from that based on expert opinion to that based on evidence.  From her presentation it was clear that the project had a well-structured change management plan which contributed to its successful implementation.  I got some useful tips from her presentation for ISCRR’s work on the development of new models of care for life time support for catastrophic injuries.  One idea that stuck in my mind was joint training of service providers and claims managers.

I was there to advocate for establishing the research function early. ISCRR has found that having a team of researchers working alongside a team developing and trialling an innovation is productive.   A common practice is for an evaluation team to be called in after an innovation to determine whether it worked or not – a summative evaluation.  In our experience an ongoing evaluation is more productive.  As well as undertaking work on the evaluation, the research team can contribute to development work, eg through rapid reviews of evidence.  The more the researchers are working in the business, the better they understand the business, and the more effective will be their contribution.  Positioning an interdisciplinary research team experienced in participative action research at a systems-level alongside the proposed pilot sites for the NDIS from the outset would be a good investment.