Kymberly Martin

Erosion of business confidence affecting disability services

Ken Baker FINAL

National Disability Services (NDS) report reveals disability service providers under increasing cost and staff pressures. The State of the Disability Sector Report 2017 also found there was a big gap between National Disability Insurance Scheme (NDIS) demand and the availability of services to meet that demand.

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Speaking to F2L at an NDS meeting to announce the report, CEO, Dr Ken Baker (pictured), said the report rings an alarm bell because the service sector is not growing at the rate it needs to grow in order to provide support to the number of people coming into the scheme. “That is a big risk because if that gap between supply and demand of services widens there will be many people with disability missing out. And that’s not what we want.” He said having more service providers in the sector would be fine but they are not being attracted to the sector at present as there are too many factors depressing business confidence.

The survey of 516 service providers found that 82 per cent expected demand would increase for their services but only 43 per cent expected to be able to satisfy that demand. And, 58 per cent were planning to expand their services, down from 68 per cent in 2015 while just 34 per cent made a profit of four per cent  or greater and 23 per cent reported a loss. Only 41 per cent rated their financial position as strong or very strong, down from 53 per cent in 2016. The report also found that 75 per cent felt their future was uncertain while 46 per cent believed the NDIS roll out should slow down and 50 per cent said to continue to provide services they would have to reduce the quality of services to meet NDIS prices. Not surprisingly, just 6 per cent of respondents thought the government was responding well to the needs of organisations.

As for the most important action needed in order to continue to provide services in the year ahead, establishing NDIS prices that accurately reflect the actual cost of supply was ranked number one. This clearly reflected what the Productivity Commission said in a report published in October. The commission concluded that the National Disability Insurance Agency (NDIA) had a conflict of interest and price-setting should be removed from the agency and placed with an independent entity, recommending the new NDIS Quality and Safeguard Commission. The commission has already been established and has a strong interest in the NDIS, and importantly would allow a connection to be drawn between quality and price. “Whether the government will do that is unknown and is probably unlikely but it is an important message for the government and the agency,” Baker said. “Prices are a key factor when it comes to shaping business confidence.” The McKinsey Independent Price Review is expected to be released late 2017 or early 2018.

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Recruiting and retaining staff is also becoming more arduous as the NDIS expands, particularly when it comes to occupational therapists, with 66 per cent of organisations describing it as ‘difficult’ or ‘very difficult’ to recruit OTs. This is up significantly from a year ago, indicating that allied health professionals are difficult to employ at this time.  According to Baker, one solution is to provide more graduates however he said there were other solutions that go hand-in-hand with this. An example was that while an OT might be there to provide assistance and guidance the situation requires that any equipment report must be provided by an OT, which he thinks in many cases is unnecessary. “There are people who have been using wheelchairs for years and know what they want and don’t need an OT to tell them.”

Baker also confirmed a proposal to establish a partnership forum with the National Disability Insurance Agency (NDIA) in recognition of  the need for a stronger relationship between the services sector and the agency. “We should be working more closely at both a strategic level to ensure that the NDIS is heading in the right direction and a technical level because it is important that whatever the NDIA does is user-friendly, both for providers and participants.”

As to why business confidence is weak, Baker said it comes down to a number of reasons, mainly the lack of information about financial matters, how much a business should invest and where to invest. Another is workforce shortages and unresolved policy issues for emergency support with unclear boundaries between the NDIS and healthcare systems. There are concerns too around transport, education, accommodation and the red tape administrative burden also needs to be reduced along with more flexibility within the NDIS that allows for more local decision making.

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