Four years ago, Labor prime minister Julia Gillard choked back tears as she stood in federal parliament to introduce new laws that had the potential to change the lives of millions of Australians.
The National Disability Insurance Scheme (NDIS) represented a tectonic shift, promising to finally give people with a disability the support and care they needed to lead happy, fulfilling lives.
It also heralded a complete transformation in the way these services were organised and delivered, replacing hundreds of rigid state-based programs with a network of local, non-government services that people could access in their own way.
In the ensuing years, the NDIS has been rolled out across the country and in the past 12 months the tide has finally reached the NSW northern rivers.
The administrators of the NDIS estimate that 6,000 locals will be enrolled in the scheme by June this year and that by June next year that number will have increased to 7,300.
But local disability service managers, workers and carers interviewed by The Echo say the transition has been anything but smooth.
They say that while many more local people with a disability have been able to access services and care in ways they never could before, the region’s disability sector is facing staff shortages, a flawed funding model, and threats to small providers from big companies chasing fast cash.
Promising to revolutionise care and support for people with a disability is one thing, actually doing it is another.
Somewhat ironically given the high rates of unemployment in the region, one of the biggest challenges for the NDIS in the northern rivers is finding enough workers who are willing to make it happen.
According to the NDIS Market Position Statement for NSW, the northern rivers will need between 2,500 and 3,100 disability service workers by the end of next financial year to meet demand from the NDIS.
There are just 1,300 – barely half the number required.
Tony Pooley from National Disability Services, the peak industry body for non-government disability service organisations, says staff shortages are ‘unquestionably a challenge’.
‘It is particularly hard in regional areas such as the northern rivers because there isn’t a large population base to draw on,’ Mr Pooley says.
‘We need to induct a new supply of workers into the sector.’
This is a common refrain from the local disability sector.
Social Futures, one of the non-government organisations leading the NDIS roll-out locally is optimistic that the demand can be met.
‘Rather than being concerned we are encouraging the regional education providers and Registered Training Organisations (RTOs) to seize this opportunity to offer more courses to more students, because there will be lots of opportunities for meaningful work created,’ the Social Futures’ spokesperson Geoff Webb says.
But at the moment the number of graduates coming into the sector is a trickle rather than a torrent.
Just 36 people graduated from disability services TAFE courses in the northern rivers region in 2016, and there are challenges in enticing more people into the industry.
Workers interviewed by The Echo described supporting and caring for people with a disability as rewarding, but also challenging both physically and emotionally.
They said it was also not highly-paid.
The challenge of staff shortages is already being felt at the coalface, with workers having to take on extra shifts – sometimes back-to-back – to ensure their clients are properly cared for.
Local disability carer Arthur* told The Echo that he recently did a 25-hour shift at a local high-care group home where he works, because no one could fill in for an injured colleague.
‘When the time came that my shift was scheduled to end there was no one to come on and replace me,’ Arthur says.
‘I just thought “I have to do this, I have a duty of care to my clients.” So I stayed on for the afternoon shift, and then did a sleep-over and stayed until the next shift started at 8am the next day. There were not enough staff on the books. A lot of the staff have families so they can’t fill-in at short notice or do sleepovers.’
Nevertheless, Arthur remains committed to his job and the work of caring.
‘Even if I’ve been screamed at, hit, or abused, I still care.’
The care and commitment shown by Arthur highlights the opportunities offered by the NDIS.
But the mechanisms created by the NDIS to fund and support their work do not to them justice according to local service providers.
One key flaw is the nature of the new payment system.
In the past, service providers were paid for their work three months in advance.
Now, they are required to do the work and then invoice the government, via the National Disability Insurance Agency (NDIA).
Rob Watkins, the NSW/Act executive general manager of The House With No Steps says this system can create serious cash-flow problems.
‘We’re fortunate that we have enough reserves to manage, but for much smaller organisations it’s very hard,’ he said. ‘I know that some have been close to the brink because of this.’
Exacerbating the situation is the fact that the NDIA is not only responsible for paying providers but also for deciding how much each particular service is worth.
‘The price that has been set by the NDIA doesn’t allow us to invest in frontline services in the way they deserve,’ Mr Watkins says.
‘It encourages the casualisation of the workforce rather than taking on full-time staff with a strong connection to the service and the clients.’
‘I’m still optimistic about the future but it’s been very frustrating at times.’
Both service providers and NDIS clients have called for the job of deciding the price of services to be given to an independent body that does not also hold the purse strings.
Enter the corporations
It may have a flawed payment system, but the NDIS still has an enormous $22 billion budget.
Local service providers say this has lured a number of big corporations into the local disability sector including one large insurance company.
They say this creates a risk that care will become homogenised, and smaller organisations forced out.
‘You sort of get this CocaCola management style,’ said one disability support worker who asked not to be named.
‘You get these managers who don’t know the staff and they don’t know the clients.
‘The services end up being run like corporations rather than care providers. You end up with disengaged staff and, ultimately it’s the clients who suffer.’
Despite the very bumpy start, there have also been local NDIS success stories.
One of these is Shaping Outcomes, a Suffolk Park-based organisation which helps children aged 0–6 with a disability to access services.
The organisation’s executive director, Zoe Cluff, says that part of this work is helping children and their families to develop support plans that are funded via the NDIS.
‘There have been big challenges along the way,’ Ms Cluff says.
‘But I can say that there has been a really significant increase in families being able to access support in that 0–6 bracket.
‘The quantity of support has dramatically increased.’
She says this is largely attributable to the passion and care of staff.’
‘We have been very fortunate that our staff have been able to do it and there has definitely been a lot of love involved.’
There can be little doubt that a lot more love and dedication will be needed if Julia Gillard’s promise of a revolution in disability support is to succeed.
*Not his real name