It’s been a difficult year for so many people. Many of us are battling adversity of one type or another and we are reminded very often that the world is a dangerous and – at times – ugly place. Closer to home, we’ve seen a dispiriting revival of zero-sum politics, supercharged by a media cycle geared to making news consumers feel things as opposed to thinking about them.
But rather than slide into a funk, let’s consider two positive things that happened during the final parliamentary sitting week of 2023. The first was (as Bill Shorten, the minister for the national disability insurance scheme, put it) “for a moment in time, federation worked”. That was Christmas miracle number one: a productive national cabinet meeting on Wednesday. Anthony Albanese struck a deal with the states and territories to split the cost of disability services outside the NDIS in return for a further three years of GST funding.
Number two was the release of the NDIS review by the economist and disability advocate Bruce Bonyhady and former senior public servant Lisa Paul. This is a quality piece of work. The review starts from an important and (dare we say) uplifting premise: sometimes, the governments of Australia decide to change Australia for the better. It characterises the NDIS, legislated in 2013, as a “public policy miracle” – a world-leading scheme supported across the political spectrum.
Given there are so many incentives for acting like a numpty in politics, the reviewers are dead right. The existence of the NDIS is a miracle, and the effect of the reform has been life-changing for many Australians. I know this from experience. Some people near and dear to me are supported by the NDIS. The scheme covers costs of care that are well beyond the means of most households. If you luck out, with a great team providing support, everybody benefits, not just the 610,000 current recipients.
But anyone with any exposure to the scheme also knows it’s not perfect. Navigating the NDIS is so complicated that many people opt for having plan managers rather than approaching the labyrinth themselves. Decisions and reassurance are not instant, and that causes anxiety. Some of the prices being charged for goods and services are also, very obviously, extortionate.
It’s clear Bonyhady and Paul come to save the NDIS, not to kill it. The case for change is shared in clear and accessible language. NDIS users and their families sit at the centre of the policy thinking. Bottom-up empathy gives the review, for this reader at least, considerable authority.
Let’s step through the story it tells quickly. The NDIS is supporting 101,000 more participants than was projected by the Productivity Commission back in 2017. The scheme cost taxpayers more than $35bn in 2022-23 – $8bn more than was projected in 2017. More than half of scheme participants are kids. There are a number of drivers of growth. For most people, help is the NDIS, or nothing. People with disabilities lack access to foundational supports. There are few inclusive mainstream services, and that vacuum “pushes people towards the NDIS” – an uncapped scheme where “what is considered reasonable and necessary isn’t well defined”.
Given the reality is NDIS or bust, if you qualify, you don’t want to leave. Once inside, because of the way the scheme operates, with a “use it or lose it” mentality, people get anxious their care will be cut if they don’t use everything in their plan. The National Disability Insurance Agency is viewed as inflexible. People don’t want to run the gauntlet of trying to get more services if their circumstances change.
These dynamics are symptomatic of a structural problem. The review says “poor design and implementation issues are driving the behaviour of everyone in the system”. Pricing is out of whack. Because there is not enough visibility of transactions, it can be hard to identify fraud.
To keep a firmer hand on the number of new entrants, the review says eligibility for the NDIS should be determined by a person’s functional capacity rather than a more generic medical diagnosis. A navigation function would also replace the current system of plan managers. Shorten this week characterised the current arrangements as a form of glorified ticket clipping – a person with a disability having to reserve a portion of their NDIS package to pay someone “who you send an invoice to, who then sends it to the government”.
Bonyhady and Paul say the scheme has to be adjusted because the NDIS will lose its social licence if things continue the way they are. This is a clarifying thought.
Another clarifying thought: reform has to be implemented holistically. That means looking at what’s not working in the NDIS, and filling the measurable gaps in support and services outside the scheme. These are two halves of a whole. The review is very clear: governments will not fix the NDIS problems if they aren’t prepared to fix all the problems.
This brings us back to national cabinet, and the miracle of the week. While much of the intra-day punditry of the final parliamentary sitting week fixated on Albanese’s political “crisis” after the high court’s ruling on indefinite detention, and whether or not Mark Dreyfus should have shouted at a journalist from Sky News – the national cabinet pushed forward on NDIS 2.0.
Albanese, premiers and chief ministers agreed that states and territories would increase their contributions in line with growth in the NDIS from 2028, and Canberra and the states would jointly design the missing foundational supports recommended by the review. The additional costs of those services would be split 50-50.
National cabinet comity always comes at a price. To help prioritise that and other service delivery, Albanese agreed to extend GST funding for three years from 2027-28. That three-year extension will cost the federal budget $10.5bn. There was additional health funding as well.
Let’s be clear. Securing that handshake is the easiest part of an NDIS-plus redux. A system overhaul, watched intently by hundreds of thousands of stretched and stressed stakeholders, is politically fraught. It’s also fair to say that no political agreement with a five-year transition timeline (which is what the review recommends) is ever set in stone, given the frequency of election cycles.
Doing what the reviewers recommend, as opposed to talking about it, will be extremely hard. Achieving the preferred best practice will involve precision policy work and a degree of goodwill on the part of governments and oppositions that feels ludicrously utopian after the year we’ve just had.
But let’s persist with our clarity. This week’s national cabinet handshake is the foundation of all the policy work to come. That makes it a big deal. Without that agreement, any best-practice overhaul would have been dead on arrival. Another worthy review would gather dust on a shelf.
While the road ahead is arduous, and the potential for squibbing and backsliding absolutely, depressingly, endless – it seems reasonable to speculate that Albanese and Shorten will want to future-proof one of the great Labor policy achievements.
Whether Peter Dutton will rise to the occasion feels more moot given the long list of important issues the opposition leader has been prepared to weaponise over the past 12 months. But let’s allow hope to triumph over experience for a moment on a sunny summer Saturday. Let’s also agree there has been reverse weaponisation – Labor in opposition made it hard for previous Coalition governments to go anywhere near NDIS reform.
Returning finally to the public policy miracle of getting the scheme off the ground in the first place – Julia Gillard managed to legislate the scheme in a minority parliament. Unlike the carbon price, the NDIS managed to survive Tony Abbott’s precision partisan ferocity.
Albanese has said often one of the most difficult lessons he learned from the 43rd parliament was seeing how easy it was for Abbott to rip up important reforms by the roots. This trauma informs the stylistic and substantive objectives of Albanese’s prime ministership. This experience made Albanese focused on trying to run an orderly government capable of staying in office long enough to make change durable.
But the lesson of this year is you can’t control the play. Events, and the objectives of opponents, shape a prime minister’s political destiny as much as strategy.
The brutal atmospherics over these past few months, the weaponisation of the voice referendum and the grim opportunism since, has reminded me of 2013. Albanese is in a different position to Gillard in many significant respects, but the hyper-partisanship and the febrile media climate sometimes feels analogous.
Rather than taking Abbott’s wrecking as the primary lesson of a decade ago, Albanese could take something valuable, too, from Gillard’s pluck. Gillard pushed ahead in sustained adversity, declining to take a backward step.
Sometimes, when something’s important, orderly and incremental won’t do the job.
You have to pin back your ears, and go for it.
