It’s been a challenging time for the disability services sector as recommended changes land from all directions. One of the more contentious is a proposal by the National Disability Insurance Agency (NDIA) that would see a complete restructuring of the assistive technology space. It would subject to tender the product and supplier selection process with only the successful achieving a ‘preferred’ status with the NDIA.
Interestingly, in the discussion paper the NDIA wants to ensure that participants are actively engaged in decision-making, exercising choice and control in gaining access to assistive technology solutions to meet their reasonable and necessary support requirements, while ensuring the NDIS remains financially sustainable. Herein lies the dilemma.
ATSA executive officer, Chris Sparks, makes the point that everything about the NDIS hinges on just this, “control and choice that leaves the user in charge of their destiny. The individual gets the funding to choose what services they get and from whom and the experience from most countries is that this self-management system works best and is the most affordable.
Sparks said the changes proposed by the NDIA for a new assistive technologies procurement scheme challenge this because if they are implemented it will achieve the opposite: limiting people’s choice. “Participants will be obliged to use the suppliers and products preferred by the NDIA. The NDIA not the individual will select a limited number of products and suppliers,” he told F2L.
ATSA has submitted a response to the NDIA on the discussion paper that presented the views of ATSA members and others which showed overwhelmingly that such a scheme as recommended would be unworkable.
He gives an example: “Client wants a wheelchair, a back rest and pressure care cushion that need to be delivered as promptly as possible and adjusted as necessary. Under the proposed scheme each item may well be supplied by three different people. Who assemblies it? What happens if there is a problem?
“You end up with three companies, three administrative processes and three delivery costs. So the cost of the transaction goes through the roof. He offers another example: “I know that company B has the wheelchair I need. It is light enough for my partner to lift and put in the car. It has the accessories I want. What I don’t want is to shop around to three or four different suppliers when I can get it from one supplier that I know and trust.
“The NDIA seems to be overlooking the fact that assistive technology is a service-based industry, so who carries out the ‘human services’ side of the business now? We are talking about client assessment, set up, delivery, training and potential maintenance. That is how it works. We are not buying a box of paper clips here.”
He maintains that for someone in a wheelchair unable to get what they want the proposed scheme cannot work. And Sparks is blunt when he said that people with disability and the disability services sector need to take a stand and speak up on this issue,” because the evidence is piling up on the likely failure of such a scheme.”
He also disputes the NDIA argument that the changes are based on confirmed likely cost savings. “There has been no transparent independent audit of the claims, often costs are just transferred and I don’t believe the NDIA will achieve the savings they are pursuing without serious reductions in service levels, quality and outcomes.”
As for the NDIA idea that decreasing choice and supplier numbers will result in increased competition he responds thus: “The reality is that fewer competitors means less competition and prices inevitably go up.”
At this stage the NDIA is primarily focused on assistive technology solutions derived from aids and equipment. Home and vehicle modifications and prosthetics have not been explored in the same level of detail and will be the subject of further work.