SOME THOUGHTS ABOUT DISABILITYCARE

 

I am sure that the news that WA has signed up for DisabilityCare (previously the National Disability Insurance Scheme) was greeted with joy by the majority of Western Australians.

 

While there has been a great deal of rhetoric around how much better the lives of disabled Australians will be under the scheme, the “proof of the pudding will be in the eating” – as they say. I am only now getting my head around the scheme, and have had a number of reservations about just how well it will really serve persons with a disability.

 

While the scheme promises that all persons with a disability will be able to access “the services they need”, the question of service availability is never mentioned. Our own service is an example: we have such a huge waiting list that, even were funding available, (and currently it isn’t) it would take us a year or more to increase the size of our service to accommodate all those wanting our service. If DisabilityCare increases demand across the sector, agencies everywhere will have to find increased personnel and facilities. Finding suitable personnel to meet existing levels of demand is difficult enough, to find more will be nigh impossible. Additional facilities take time and money to build, and few organizations can easily access the latter. It is thus unlikely that the DisabilityCare scheme will enable better access to services, except perhaps in the much longer term.

 

Other more individual concerns also have come to mind.

 

First, (although the situation will be little different to that which exists currently) is the issue of eligibility. Who decides who is eligible for DisabilityCare, and what mechanisms are in place for appeal if an applicant is deemed ineligible?

 

Second, while the scheme is touted as putting choice in the hands of the consumer (or his or her parent/guardian/advocate), the reality is that the disabled person will have to sit down with a DisabilityCare Advisor and discuss what services are needed/wanted, and they will “jointly” decide on what services will be provided. This raises several issues: firstly, what happens if the consumer and Advisor cannot agree? Secondly, what sort of qualifications/expertise will Advisors have that will ensure they can give sound advice and/or make sound decisions?

 

Thirdly, Advisors are – well, Human, – with all the individual variability that suggests. All Advisors will be aware that they are approving expenditure of (often) large sums of taxpayers’ money, and some will be exceptionally liberal when it comes to doing this, while others will be much more mindful of costs, and conservative in their approach. This could lead to inequities where one person with a disability gets a plethora of services as a result of seeing a liberal Advisor, while another person with the same disability gets very little as a result of seeing a conservative Advisor. Further the “pushy” person with a disability is likely to get more services than his or her less assertive peer (although, I am well aware, this already happens in the current system)

 

Finally, DisabilityCare is establishing maximum fees which it will pay for various services. From my limited knowledge and perspective, the fees which I have seen seem reasonable, but unless they are indexed, the day might come, and probably sooner rather than later, where the level of fees which DisabilityCare are willing to pay, will be less than those for which many providers are willing to work. This would have an impact on both the quality and quantity of services available to the disabled person.

 

If I had the time to research, I’m sure there are already answers (or as they say in bureaucratese, “strategies in place to address”) at least some of the questions and issues I have raised here. As I said at the beginning, however, the proof of the pudding will be in the eating.

 

Daryl Cooper