Doctor and activist

NDIS- National Disability Insurance System. 1/7/17

I have grave fears for this system. I am unsure even of the goodwill of some of its advocates.

I was on the Social Issues Committee of the NSW Parliament and we looked at Disability services and the way that these were delivered. Basically if you ask how big the disability problem is no one can answer you. There are basically two answers. You can either get the number of people getting disability benefits, or you can take the percentage of the population with a disability, and multiply it by the population that you are considering. The problem is that the latter number is about ten times the former. So a lot of people who have disabilities are not claiming benefits! You can break down levels of disability, support needs etc, but the bottom line is that a lot of parents and carers are labouring on, unrecognised and minimally supported. There was and is a number of facilities offering services, and the governments want to close some of these, (? perhaps all) and give the task to the private sector, giving parents and carers an allowance and ‘choice’ of what services they buy. The government will then have only a financial obligation to pay the different allowances, dependent of the level of disability. The private, flexible, market-responsive services will then improve the care from the staid institutions that currently deliver it. Yeah Right. The government is also very keen to sell off the facilities and land that deliver disability services.

For many years Peat Island in the Hawkesbury River housed developmentally delayed (who used to be called mentally retarded) people. No new people were moved in for years, so some of these folk had died and the rest had aged so much that they could only use the lower floors of the buildings. Those who remained were rehoused and the Island was sold off. The disabled facility at Stockton, a large area on the beach just north of Newcastle is similarly under threat. Developers cannot wait!

In our inquiry, parents waited for years to get their disabled child into accommodation, and were desperate to do so before they died or aged too much to care for their now middle-aged disabled child. They went to all the facilities and tried to get in and then assumed that their names were on waiting lists, but it seems that few lists were kept, and certainly no central registry. It really looked as though no one really wanted to know the extent of the problem, nor work out a systematic solution. It was too expensive to contemplate, let alone commit a government to.

Just recently in the pre-Christmas goodwill time, I visited a neighbour, a 90 year old widower with good mental ability, but having a lot of difficulty getting around in his walking frame. He has taken in a refugee, who is being less helpful than he had hoped, and he gets services from a private provider at $65 an hour. The actual carer is paid $20. An alternative scheme sends him people to interview himself and takes 15% of his payments to the carer he selects.

When Rudd had his 2020 Vision summit and asked for submissions I wrote and suggested that the government have TAFE courses for carers and a registration and insurance scheme so that people could get help from a perfect market of carers without corporate middlemen taking most of the money. I never even got a reply.

We have seen mental health facilities sold off and now people are discharged more disturbed than they used to be when they were admitted. When there is a random murder now, we seem relieved if it was a mental health problem rather than a terrorist attack. So much for changing standards!

We have seen TAFE dismembered and Education loans and courses left to a market with no meaningful accreditation scheme so that the public do not know what they are buying and a lot of money is wasted while profiteers provide highly shonky courses.

Parents or carers of disabled people are in great danger of being ripped off by shonky operators with dodgy programs and high profits margins, if past experiences with government supervision of privately provided services is anything to go by.

The actual carers are also in danger of getting very lowly paid jobs while the profits go elsewhere. The steep costs of nursing homes and retirement villages and the paltry pay in some of these is already a problem as wage awards increasingly become unenforced.

There is also the problem that there will be a lot more people eligible for disability benefits than were previously visible.

The government’s track record in letting things like the Medicare rebates to doctors fall by 50% against inflation might be noted. Will NDIS payments keep pace with inflation? I doubt it.

I recognise that warehousing disabled people in big institutions has its problems. But taking them from a large facility with the ability to have a circle of peer friends and the numbers to have outings and services, may not be good if they are put in rented houses, (small institutions), where they may be even more socially isolated, and the facilities become ‘for profit’. The cliche ‘in the community’ may have a rather hollow ring.

I also recognise that in some cases tailored solutions with a variety of carers may be an improvement. But this could be done now. The word ‘choice’ is supposed to have the connotation of empowerment, but is often used by neo-liberals to justify highly asymmetrical resource allocation.

I am frankly worried that the NDIS is an ideological cover for a wholesale privatisation of disabled services, and I am not seeing too much to reassure me.

Please let me know if I am wrong.

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