Episode Transcript
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Speaker 1 (00:01):
I'm Ruby Jones and you're listening to seven AM. The
federal government says too many children are on the NDIS
because there's simply nowhere else for them to go. Health
Minister Mark Butler has unveiled a new plan called Thriving Kids,
pitched as a way to save the NDIS by bringing
(00:23):
back mainstream supports for children with autism and developmental delay
that over time were defunded. But the announcement raises questions
who decides what counts as mild or moderate when it
comes to these disabilities and the level of care these
children need. Today journalist and author Rick Morton on whether
Thriving Kids will save the NDIS or just shift the
(00:46):
costs elsewhere. It's Thursday, August twenty eight, So Rick. Last
week the Minister for the NDAs, So that's Mark Butler.
He announced this plan, this new scheme called Thriving Kids.
Speaker 2 (01:10):
Children with mild to moderate developmental delay or autism need
a robust system of support to help them thrive. A
program for Thriving Kids.
Speaker 1 (01:20):
And he said that that's a key part of the
government's plan to secure the ndas's future. So maybe we
can begin by talking about thriving kids. Tell me what
you know about what it is.
Speaker 3 (01:31):
I think we don't know a lot yet. Mark Butler
announced Thriving Kids, much to the surprise of almost everyone
who didn't see this coming, including the states and territories
with whom the Conwealth is trying to do a deal
on this kind of support funding outside of the NDAs.
But what we do know is that for a very
long time, both the Coalition and now Labor have had
(01:53):
what they describe as a problem with the number of
children accessing the National Disability Insurance Scheme. It has always
been the case that there were more children approaching the
scheme than the initial modeling suggested, either by the Productivity
Commission by the allowances made for in the legislation, and
governments have struggled to figure out what to do with
(02:13):
that number.
Speaker 2 (02:14):
Diverting this group of kids over time from the NDIS
is an important element of making the scheme sustainable and
returning it to its original intent servicing people with permanent
significant disability.
Speaker 3 (02:27):
There are more than seven hundred and forty thousand people
on the NDIS now, and children make up just under
half of that number, and the primary disability for those groups.
Mary in mind that people could have more than one
is autism and developmental delay, particularly for children under the
age of nine, and as Mark Butler points out the
prevalence of autism and developmental delay, he says across the country,
(02:51):
wonning ten six year olds is on the NDAs he
calls that a failure of government. He says, I don't
think parents that he says, we don't want it.
Speaker 2 (03:02):
Families who are looking for additional supports in mainstream services
can't find them because they largely don't exist anymore. And
in that all governments have failed them.
Speaker 3 (03:13):
And so thriving kids is kind of a throwback to
the past where what they want to do, and this
is Mark Butler speaking, is to take children with what
he calls mild to moderate disability. It's quite a controversial concept.
How do you define what is mild autism or moderate
autism and divert them from the National Disability Insurance scheme
(03:35):
with lower intensity support, perhaps some therapy, perhaps, as he says,
some Medicare line items for allied health, some therapy giving
them help that isn't to the same standard and according
to the government, isn't required to the same standard as
the National Disability Insurance scheme which has as its kind
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of feature individualized support packages one on one for people
to receive quite intensive assistance with daily living and being
able to be in the community.
Speaker 2 (04:07):
And frankly, many of those children are being overserviced. The
extent of therapy provided to those children now in the
NDIS is extremely high compared to anything that you would
see in the health system.
Speaker 1 (04:21):
Yeah, let's talk about that. What do you think he
means when he says that, and is there such thing
as being overserviced?
Speaker 3 (04:27):
I don't know what evidence he's relying on, but there
is a clinical judgment that is made, and a therapy
judgment and allied health practitioner judgment that is made where
they know they will tell you if they think therapy
is useful or not. I think what Mark Butler was
trying to say but did not come out and directly say,
was that he thinks that there are some providers who
are not expressing that judgment because they're getting paid to
(04:48):
see the child anyway via the National Disability Insurance Camp
who makes that judgment in terms of the government, And
you know, for how many children are they going to
say you've been over serviced? I'd like to see the
evidence and the assessment on which they base that, because
by their own metrics. The National Disability Insurance Scheme in
(05:11):
their last quarterly report has been absolutely crowing about the
successes they've had with children in the scheme. It was
released just a week before the National Profit Club. They
say children between starting school and age fourteen had improvements
of more than ten percentage points across all domains. Daily
living is the strongest one which helps children in their
(05:32):
kind of day to day life. And so what does
overservicing mean and does overservicing also mean that children are
faring better?
Speaker 1 (05:39):
Can we talk a bit more about what the original
vision for the NDAs was in terms of how big
it would be versus where we're at now, because obviously
we hear all the time that the cost of running
the NDAs has ballooned, it's gone beyond its original intent
and this is one attempt to save some money. So
(06:02):
talk to me about I guess how we've gotten to
where we are.
Speaker 3 (06:04):
Yeah, it's a great question because there's a little bit
of blame shifting now going on, I think between the
federal government and what's happened with the NDIS. So when
the Gillard government and then the rud government in its
second iteration, we're desperately trying to get bilateral agreements approved
between each state and territory and the federal government. They
(06:27):
made all sorts of deals which I essentially say, yeah,
by the way, you can close all your existing community
health support services. They put the numbers in and they said,
here's how we're going to pay for it. We'll roll
these programs in, and those programs disappeared. The entire Department
of Service Delivery disappeared because of the NDS. All of
community mental health in Victoria disappeared because of the NDIS.
(06:50):
The Helping Children with Autism Commonwealth package disappeared because of
the NDIS. I could keep going, better Start for Children
disappeared because of the NDAs. Partners in Recovery disappeared, and
the NDAs became as Mark Butler says, the only poured
in the storm because of those decisions.
Speaker 1 (07:08):
Yeah, it sounds like the problems that we're saying now
were not only foreseeable, but were in some ways kind
of baked into the system.
Speaker 3 (07:18):
You know, every single person that's on the National Disability
Insurance Scheme now is there because the legislation allows them
to be now the government doesn't like the cost of it,
and the cost of the NDIS has gone up. I mean,
you know, the product Committy Commission modeled four hundred and
ten thousand participants originally at a cost of about thirteen
point six billion dollars a year, and of course, now
you know, more than a decade later, we've got a
(07:40):
scheme that's forecast to cost about sixty four billion dollars
a year. Thriving Kids is a two billion dollar Commonwealth
commitment which has to be matched by the states and territories.
So that's a four billion dollar commitment. And so there
is still going to be money paid to these children,
maybe not quite as much as it would have been
in the NDAs, but there will be a whole parallel
(08:01):
kind of increase in bureaucracy elsewhere, and increase in funding elsewhere,
and increasing gap fees elsewhere, and so you know, it's
going to make the NBAS look better in terms of
pure numbers, but the numbers are still going somewhere else.
Speaker 1 (08:18):
Coming up, how the federal government is strong arming the
states on disability funding. Can we talk a little bit
more about the relationship between the federal government and the
states and territories as they try and get this through.
We've now recently heard the Treasurer say that the states
(08:41):
need to kick in this funding matching the federal governments
or they could risk losing their hospital fundings. So talk
to me a little bit about that approach and what's
at risk here if the federal government can't get agreement
from the states.
Speaker 3 (08:55):
I think there's a broader point here, but they have
deliberately held up hospital funding in a really broken hospital system.
The commoal said we're not getting your hospital cash unless
you do a deal on disability, and that hasn't happened.
So it got to the point where just before the election,
the government the Comalth had to institute a rollover of
the original funding agreement for hospitals of just an extra year.
(09:18):
They sold it as a big win, saying more cash
for hospitals, but the reform work is tied to the
actual new agreement, which has not been done because it
has been held a negotiating tactic. And I think more broadly,
this speaks to a concern in the community. So right
after the election, Mark Butler was made Minister for Health
and Aging and Disability and the National Disaility Insurance scheme.
(09:39):
He's Cabinet Minister for the NDAs. The NDAs was moved
from social services social policy to health, which in the
disability community is a big red flag because they see
that as going back to a medicalized model of looking
at disability. It's not about social support, it's about intervention.
The NDAs is not a medical scheme, it is a
(10:00):
support scheme, and so a lot of people saw this
as foreshadowing what we seem to be having now where
we've got you know, Medicare line items been introduced to
some kind of potential problem solver for children with autism
as part of thriving kids and hospital negotiations tied to
disability negotiations. It's a bit of a mess at the moment,
to be quite honest.
Speaker 1 (10:20):
And can we talk a little more concretely about what
this means for a kid with mild or moderate autism.
You know, the difference it means if it's picked up earlier,
and the quality of care that they get.
Speaker 3 (10:32):
If it is. Yeah, I mean it's basically with any
developmental condition development to delay autism, the earlier you pick
these things up, the better. You can't go all the
way back to point zero. We don't have a test
for autism. You've got to have a family that is
engaged with GPS, with midwives for follow up care, with
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the community through universal access childcare, which Mark Butler says
will help a lot with thriving kids, and I suspect
that's true. The more referral points you've got, the better
right and the individual here might be as gentle as
understanding the child's communication needs and you know, as they
grow up and develop over time, figuring out what it
is that child needs to make the world around them
(11:13):
more accessible to them, and that at its best is
exactly what the NDIS does. As long as there is
something that gets to the children of all kinds before
you know problems kick in, then you can they can
live a pretty good quality of life. But it's important
to note that Mark Butler appeared to stumble over this
where he said that.
Speaker 2 (11:31):
Remember, the NDIS was established to support people with significant
and permanent disability.
Speaker 3 (11:38):
And so there was some angst that people were thinking
that maybe he was trying to suggest that autism is
not an ongoing permanent disability, which it absolutely is. He
was asked to clarify this in subsequent radiohen it views,
which he did. He said, no, no, it's a permanent disability.
We're not trying to find a cure. But he reiterated
that the NIS is for people with significant disabilities.
Speaker 1 (11:59):
Rick, I think a lot of Australians are very proud
of the NDAs. They think it's a good thing that
was put in place by Julia Gillard and we're one
of the few countries in the world to have something
like this. But the commentary from the federal government for
many years now has been that it is too big,
it's too expensive, changes will have to be made. So
(12:20):
do you think that as a result of that there
has been erosion in the public support for the scheme
and the public's appetite for spending on looking after people
with disabilities.
Speaker 3 (12:31):
I think there has been, and I think it's almost
entirely at the feet of federal politicians starting with the Coalition.
But turbocharged, I might say, by Bill Shorten when he
was Minister, who very deliberately set out on a kind
of machiavellian, I guess way of trying to implement his
own NBAS reforms after having stood very publicly in the
way of the coalition's ones which did much the same
(12:53):
thing and are almost exactly the same when you read
the draft legislation changes that were put up in two
in twenty one and that were put up by him,
and then he commissions red Bridge Group to do this
social research that looks at how they can sell reform
to people. And the key takeaway from four different tranches
of research there is that they can induce, as they
(13:13):
call it, qualified tolerance, qualified tolerance for unpopular changes to
eligibility and more difficult reform in the NDAs if people
think that there's a problem with fraud and routing, and
you know, I keep seeing it because of Robodet here.
But you know, the way they sold Robodett is the
where they sold the NDAs reforms, which is to talk
about all of the fraud, all of the routing, all
(13:35):
of the time. And when you're playing with that kind
of fire retric loose language using the tabloid media to
get your message across, you're going to lose trust in
this scheme. And that's exactly what we're seeing and I
think it is an appalling use of power.
Speaker 1 (13:53):
Well, Rick, thank you for speaking with me today.
Speaker 3 (13:56):
Thanks rebby always pleasure.
Speaker 1 (14:13):
Also in the news today, the Prime Minister Anthony Albernezi
says he takes the threat of the sovereign citizen movement seriously.
The man accused of shooting dead two police officers in
Victoria's northeast, Deisi Freeman, is a self identified sovereign citizen.
The Prime Minister says the government is aware of the
dangers of the spread of extremism and ASIO has been
(14:33):
warning about it. And Britney Higgins has been ordered to
pay almost three hundred and fifty thousand dollars in defamation
damages to the former Defense Minister Linda Reynolds. A judge
ruled yesterday that reynolds reputation was damaged by social media
posts made by Britney Higgins in July twenty twenty three.
I'm Ruby Jones. This is seven am. Thanks for listening.
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