"I think that Australia is in danger of building the world’s
worst system of individualised funding" Simon Duffy 2012
"The design of NDIS needs to be radically revised - at every point. Minor tinkering and good intentions are not enough. The problems are deep in the DNA of the current design."
Simon Duffy has been a frequent speaker and advisor on the reform of support systems in disability and mental health for 28 years. He is Director of the Centre for Welfare Reform UK, and is therefore listened to as an 'overseas expert' by governments, providers and academics in Australia who would never listen to the same insights if they came from Australian users of services or family carers.
In 2012, as many users of services and family carers warned that NDIS would become a bureaucratic nightmare and jeopardise the development of a proper system of self-directed supports and individual budgets, Simon Duffy outlined his "ten biggest concerns:
1. The design is financially unsustainable - there are multiple design flaws at every point; these will then quickly drive up costs. The inflationary pressure that this will unleash will then lead to increasing levels of bureaucratic control: increasing eligibility thresholds, caps on spending, clawbacks and rationing by ‘appropriateness’.
2. The design is fiscally irresponsible - the decision to strip fiscal responsibility away from everyone beneath the Federal government (States, communities, services, citizens and families) is extraordinary and guarantees cost pressures will be created by every person and every agency. No one has an incentive to work within budget and the Federal government will be left with only the worst kinds of controls when it is forced to respond.
3. The delivery system is inherently expensive - so many elements of the design seem extraordinarily wasteful in the short-run: new computer systems, new staff roles, major consultancy contracts. In the modern world I am astonished at this wasteful approach to spending money that should rightfully belong to Australians with disabilities. Instead of building on existing systems, cutting out waste and building on the extraordinary and positive capacities of Australians with disabilities and their families, Australia is in danger of wasting enormous amounts of money as the State’s infrastructure is demolished, only to be replaced with something that will end up (because of its poor design) even more expensive.
4. The design assumes Australians with disabilities are less competent than government at making decisions about their own lives - despite all international evidence to the contrary, including Australia’s own pilots, the model assumes incapacity and locks people into an infantile and degrading relationship with a powerful Federal facilitator. This then guarantees sub-standard outcomes, unhealthy relationships and crisis inducing behaviours.
5. The system will undermine the human rights of Australians with disabilities - although the system may begin by spending more money on meeting people’s basic ‘right to support’ in every other respect it will damage human rights, limit basic human freedoms, invade privacy and damage the perceived dignity of Australians with disabilities.
6. Social innovation has been designed out - the intention to lock the design of NDIS into legislation and to deliver its goals through one centralised system will kill social innovation at every level. The whole system will be slow to change, there will be no space for innovation at the State, community or citizen level.
7. Thinking about equity is confused - equity does not mean offering the same bureaucratic response to every community across Australia. It is not more equitable to give more money to people in communities that have failed to invest in social inclusion, accessible mainstream services, community connections and families. It is not more equitable to give more money to people from families that have disintegrated. This kind of approach to equity kills social innovation, rewards failure and drives down quality.
8. States will be drawn back in anyway - similar models internationally have always led to local government being bolted back into the system at a later point. More importantly, the nature of disability supports means that States will be driven to pick up the pieces very quickly: some people will be found not to meet the ever-tightening eligibility criteria, and so States will be forced to respond, particularly when institutional services breakdown at great cost and when people with lower level needs end up excluded from the system.
9. The thinking is old fashioned - the architecture of the design is archaic and bureaucratic. Australia is building the equivalent of a 1970s IBM super mainframe computer in an era of mobile devices and the Cloud. Modern systems push control and responsibility out towards citizens, allow for networking, assume capacity and enable open source innovation at every level.
10. The project will become politically unsustainable - the design is deeply patronising to people with disabilities and their families and will lead to deep disappointment as the design is revealed, implemented and as the financial problems it will then create, force further unattractive changes. The only organisations that will celebrate NDIS will be management consultancies and the worst kind of service providers - who will see it as a guarantee of funding for their low quality supports.
I am sure that my remarks will seem extreme, but I am not exaggerating my concerns for NDIS. But the design of NDIS needs to be radically revised - at every point. Minor tinkering and good intentions are not enough. The problems are deep in the DNA of the current design.
I cannot believe that it is too late for Australia. I hope that States, better service providers, families and - most importantly of all - people with disabilities, get the chance to influence the design and ask for a radical rethink. Otherwise, I'm afraid that many people, not just in Australia - but in the international disability movement - will be deeply disappointed.”
Simon Duffy 2012