Dr PurcalProviding infrastructure support for people with disability is critical if the NDIS is to be a financial success. It is not only the NDIS which looks after supports that will help people with disabilities achieve a valued life. Appropriate government investment in housing, transport, health, education and the physical environment, as promised under the National Disability Agreement and the National Disability Strategy, also has to take place.

According to Dr Sachi Purcal, from the Macquarie University Centre for the Health Economy, not funding these essential services has the potential to increase cost pressures on the NDIS purse.

He told F2L it was important to develop an appropriate physical environment in order for people to work, participate in society and the community: “catch a train, move around a building without being confronted by narrow corridors or worse, no lifts.

“The NDIS is not the silver bullet or the fix to all the problems of disability. The NDIS will look after the daily living requirements of people with disability but if you want them to become contributing members of society they have to be able to function in the community. Get around, get an education. So infrastructure remains a big issue. It has to be a co-ordinated effort with all levels of government – federal, state and local.”

Such investment is needed so people with disability can be included in Australian society, he said. “Indeed, the financial sustainability of the NDIS requires it. Any expectation that the NDIS can fulfil these roles as well will send its costs spiralling and doom it to ultimate failure.”

What potentially can happen is what Purcal described as an “intersection”. He explained: “where say a young person with disability is going to school with his disability needs catered to by the NDIS. But if there is an issue with perhaps the school infrastructure this then becomes an education department problem. Then the education department directs responsibility to the NDIS to rectify, leaving this cost-shifting exercise to push up the costs of the NDIS which is not what the NDIS was designed for.” This likely scenario between services has to be resolved as more people transition to the scheme over the next few years, he said.

He believes NDIS costs should remain stable, currently estimated at $22 billion a year, unlike the previous rationed care model which had become unsustainable. However getting people with disability into the work force remains contentious with Purcal acknowledging it does come with problems. “Presumably as the scheme rolls out it is expected that these people will become empowered   by the NDIS – that mental change will happen and there is a very good chance that employment prospects will improve.” But he admits it is a long term process.

“In the past when we looked at people with disability they were a product of system of rationed care. With the NDIS it is a system of individual care catering to individual needs. People get what they want. So if they want the best wheelchair in order to get out and work they will get it if that makes them better contributors to the economy. This targeted benefit with an individual focus on funding hopefully means that people with disability can make a greater contribution to society. That must be ultimately recognised. I am sure the government is trying to encourage this but it takes time.”

There are changes ahead too when it comes to the provision of disability services with a huge shakeup in the area as a result of the NDIS. Purcal said for people providing disability services this is one of the biggest things that can happen to them as existing services cease to exist. “Someone has to pick up the slack so for the NGOs and private disability service providers, there is a new marketing opportunity out there.”