House of Assembly Fifty-Fifth Parliament Parliament, First Session (55-1) 55 1 Parliament of South Australia House of Assembly published Grievance Debate National Disability Insurance Scheme National Disability Insurance Scheme The Hon. A. PICCOLO House of Assembly Light The Hon. A. PICCOLO (Light) (15:33): Today, I would like to talk about some of the services which I think are important for governments to deliver and some of the reforms which have taken place over the last few years. I also want to highlight an area of reform which I believe is necessary if older people are to live dignified lives. Some years ago under the previous federal Gillard government, when I think the Hon. Bill Shorten was assisting the Minister for Disability Services, at the commonwealth level we introduced the National Disability Insurance Scheme, which was premised on two key principles: choice and control for people living with disability in terms of the care they received. It was an important and major reform, on the same sort of level that Medicare was a major reform initially under the Whitlam government and then under the Hawke/Keating government. Despite some of the difficulties with the scheme itself—and I am sure that MPs in this place are receiving complaints about some of the issues regarding the current scheme—it is a very important reform because it actually helps people live more independent lives with a greater quality of life. Putting aside for one moment some of the market failure that is occurring now in that service sector—just like any new sectors or new service areas, there are often issues of market failure and things that need to be improved—I think the move towards establishing a National Disability Insurance Scheme was the correct one. It also ensured that people living with disability are treated with dignity and can live with dignity. There is another vulnerable group in our community that I think requires major reform in terms of the way they are cared for as well. It took us some decades to understand that putting people living with disability into institutions and hiding them away was not the right way to treat people. It was not the right way to see them develop as individuals and not the right way to ensure they met their potential. The people in this group are involved in our aged-care system, people living in various nursing homes or in institutional care. I think that the time has come—as we have done with the delivery of disability services—to start taking people who are now living in nursing homes, etc., out of institutions and find a new way of living. I think it is very important that people towards the end of their lives are also able to live fulfilling lives and not only to live a life that is full of dignity but also to be treated with dignity. In saying that, I am not suggesting that any providers are doing the wrong thing. I think that even the best providers in the aged-care sector are still providing what you might call institutional care. Like all institutions, to some extent they are run on efficiency principles, which means that individuals have very little choice and control about their lives. As a society, we need to do much better in how we treat people who need full-time care in that part of their life. The reality of institutional care in most cases is that people eat at a certain time, shower at a certain time and do all sorts of things at a certain time. There is very little personal autonomy for the individuals in these institutions. Often these are people who have lived quite fulfilling lives and who have often worked in a whole range of different careers, etc., and in this part of their life they are treated in a way that I think is not the most dignified. I think that we need to reform the way in which we deliver these services. We need to rethink how we care for people who need full-time care and to break down institutions and to bring the services to people in different settings. We can learn from what we did with disability services. I think that is important, but to just building institutions and putting people into institutions is the wrong direction. We need to make sure that people at the end their lives can live with dignity. We need also to make sure that we can deliver services to those people who live in their homes. We need to make sure that health services and other services can be delivered to those people's homes to ensure that they get proper care.