Editorial
Cold hard facts and figures don’t tell the whole NDIS story
When federal Health and Disability Minister Mark Butler used a National Press Club address on Wednesday to announce plans to divert children with autism or a developmental delay from the NDIS into a new program called Thriving Kids, Treasurer Jim Chalmers used his seat at the government’s economic roundtable to say “the timing of that is perfect”.
Chalmers and Butler are keenly aware of the challenge spending growth in the National Disability Insurance Scheme presents to federal budget repair. When former minister Bill Shorten handed over responsibility for the scheme in January, he declared it was “no longer the major problem child” – an unfortunate choice of words, since it is the place of children in the scheme that is being reassessed.
Butler is right to say the NDIS needs to be put on a sustainable footing, and right now, the main obstacle is large numbers of young children coming into the scheme having been diagnosed with autism. Fresh data shows more than one in 10 children aged five to seven in Australia are participants: 13.7 per cent of boys and 6.4 per cent of girls.
Still, his bid the following morning to reassure parents that “there’ll be no gap between the stools” highlighted the many questions still surrounding the government’s ambitious proposal. The first is to do with timing. Butler insists a well-designed system will be established by July next year and fully rolled out by July 2027.
Even the chief executive of Children and Young People with a Disability, Skye Kakoschke-Moore, who describes Thriving Kids as having huge potential, told this masthead, “the government can’t seriously expect to set up a fully functional system to replace NDIS supports in under a year”.
The second question regards the platform for delivery. Wednesday’s announcement made it clear that Thriving Kids will operate, at least in part, in schools and childcare centres. Yet readers of The Age will know that schools are already operating under enormous funding and staffing pressure, and that childcare centres are in the midst of a crisis over how they are managed.
If such places are to function as alternatives to provision of one-on-one services through the NDIS, a truly gargantuan set of reforms will be required.
These are also areas that come under the authority of the states, which is where the third question arises. When Shorten first sought to address the cost of the NDIS, in 2023, the federal government proposed a new system of “foundational supports” through state health and educational systems. State governments, wary of being saddled with their own runaway costs, grudgingly signed up and subsequently complained.
If Thriving Kids is an expansion of this model, how does Butler intend to secure buy-in from premiers and chief ministers?
Victorian Premier Jacinta Allan, already up to her waist in a sea of red ink (one which The Age has called out her role in creating), was quick to note that the National Press Club speech was her first knowledge of this particular plan. Other states made similar remarks.
Even more important than bringing politicians to the table is convincing parents that this proposal is what’s best for their children. As our federal political correspondent Natassia Chrysanthos points out, “their anxiety has been triggered for two years”. There are already signs, in social media groups and on talkback, that they will mobilise against these changes.
There is no question that people of all ages with lifelong and permanent disabilities need an NDIS that works for them. It is also true that most early childhood intervention now aims to help children fit in to places where their peers play and learn.
Even if Butler can keep his promise of gapless stools, if one is seen to provide better support than the other, families and the health professionals dealing with them will again find themselves in a competition for resources, which, as a 2023 review of the NDIS put it, compels them “to present the worst versions of themselves or their children to make the case for support”. As three academics working in this space noted, “costs and pricing also need to be harmonised across systems, so families are not incentivised to access services through one system over the other”.
It is clear that on one level, the creation of Thriving Kids involves a calculation about rising costs. If the NDIS is “cured” of its cost problem and its “social licence” restored, what is to prevent Thriving Kids simply inheriting those issues?
Ahead of the economic roundtable, Prime Minister Anthony Albanese ruled out major tax reform, reform that could be additional income for services like Thriving Kids, saying he would advance only tax policy endorsed at the election.
Mark Butler insists Thriving Kids is not a mandateless bolt from the blue for parents and the states but something that “we’ve been talking about ... for two years”. That is unlikely to wash with people in a daily juggle of portfolios of specialists and health bureaucracy logjams. Butler will need to convince these families that he is talking and listening when it comes to this intensely emotive policy area.
There is a policy and economic logic to the government’s actions but there are also real human risks, and those who bear the consequences are children. That should weigh heavily on the policymakers making decisions now that will have a strong bearing on those young people’s futures.
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