Dear Ministers for Disability
We are pleased to transmit the final report of the Independent Review of the National Disability Insurance Scheme - Working together to deliver the NDIS.
Thank you for placing your trust in us.
Thank you for giving us space to engage deeply with people with disability, their families, carers, and providers and workers, as we all grappled with the challenges the NDIS faces.
Thank you for allowing us to do this Review differently. Throughout our work, we were committed to keeping people informed and working together with people with disability, their families, carers, national and local organisations and many others. This is a major departure from the conduct of most reviews.
The extent of our engagement is reflected in the extraordinary number of submissions we received. We received 3,976 submissions. This is more than three times the number of submissions received by the Productivity Commission in 2011. Engaging much more deeply than is usual was essential to building trust between us and the disability community.
Our recommendations are also about continuing to build trust.
We hope and believe all governments in Australia will work together, rising to the challenge of rebuilding trust, to renew the promise of the NDIS resulting in a more accessible and inclusive Australia for people with disability. To achieve this shared goal, hard work will be required.
This requires everyone to continue the engagement and trust created through this Review in the implementation of the recommendations. It is vitally important that implementation is done by all governments working together in partnership with people with disability, their families and carers.
We would like to thank our fellow Panel members - Ms Judy Brewer AO, Professor Kirsten Deane OAM, Mr Dougie Herd, Mr Kevin Cocks AM and Dr Stephen King - for their expertise and commitment to our shared purpose.
Panel members owe a debt of gratitude to the outstanding Secretariat supporting this Review. David Hazlehurst, the head of the Secretariat, has demonstrated faultless leadership as he and the team tackled an extremely difficult and complex task with challenging deadlines. We also want to thank James Kelly who established the Secretariat in the early part of the Review. All staff in the Secretariat have impressed us with their skills, expertise, experience and commitment. Without our Secretariat, this Review could not have happened.
Our terms of reference gave us three overarching objectives:
- putting people with disability back at the centre of the NDIS
- restoring trust, confidence and pride in the NDIS
- ensuring the sustainability of the NDIS for future generations.
We make 26 recommendations and 139 supporting actions. They are interdependent, based on evidence and are practical. All recommendations and actions must be implemented as a package to achieve a more inclusive and fairer Australia for all people with disability.
We urge all governments to commit to creating a unified ecosystem of supports for people with disability. This should be made up of inclusive and accessible mainstream services, a thriving foundational support system for all people with disability, and a reformed participant pathway in the NDIS for those needing individualised budgets.
This unified ecosystem of supports should be governed by a new disability agreement between governments. This agreement would overcome the separation of the NDIS from the broader disability support ecosystem. It would build on the Australian Disability Strategy to create a single framework for inclusion. It should include transparent sharing of funding and funding risk.
Our reforms recommend a complete rethink of the participant journey. We must return to the principle that NDIS eligibility is based first and foremost on functional impairment rather than medical diagnosis. We must ensure the NDIS experience is centred around the whole person and their disability-related support needs.
We also recommend better support for children and their families in mainstream services through the significant expansion of foundational supports. These services should identify children with developmental concerns as early in life as possible and support them and their parents in their communities. These changes will ensure we get better outcomes for children and their families. New foundational supports are also needed for adolescents and young adults
We recommend governments take a more active stewardship role in NDIS markets and change incentives to achieve greater efficiency and effectiveness. To ensure better support is available for people with disability, we make recommendations about solving workforce challenges. The scheme will continue to grow, along with the demand for skilled workers, especially allied health workers. Attracting, training and retaining the right workforce is a critical issue to support our reforms and needs to be an immediate priority.
We find that improving service quality and ensuring appropriate safeguards and risk proportionate regulation is essential to improve safety and quality of life for people with disability.
It is in the interests of all people in Australia to secure the future sustainability of the NDIS. Our recommendations, if implemented as a package, will secure the future sustainability of the NDIS as well as delivering better supports for people with disability and a better experience for those in the NDIS.
In addition, we argue that sustainability is more than costs, it also includes the benefits of the NDIS.
Designing, building and operating the ecosystem as a whole, and improving the operation of the NDIS will, together, deliver better outcomes for people with disability. It will also enable governments to provide support in a more responsive, efficient and cost effective way.
Finally, and most importantly, we thank the thousands of people with disability, their families and carers, advocates and representative organisations, providers and workers, for trusting us with their stories and vision for a more inclusive Australia. Ministers, we urge you to listen to their call to be involved in what comes next. The success of implementation depends on governments working in partnership with the disability community.
We commend these reforms to you. Leadership is required by governments, business and community to respect, protect and fulfil the human rights of Australians with disability.
Ten years into the great Australian idea that is the NDIS, the moment has come to renew its promise. To learn from its first decade and to work together to deliver an NDIS that is fit for the future and part of a better Australia for all people with disability.
Yours sincerely
Professor Bruce Bonyhady AM
Co-chair, Independent Review of the National Disability Insurance Scheme
Ms Lisa Paul AO PSM
Co-chair, Independent Review of the National Disability Insurance Scheme
27 October 2023