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House of Assembly - Fifty-Fifth Parliament, First Session (55-1)
2024-02-08 Daily Xml
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Parliamentary Committees

Social Development Committee: NDIS Inquiry

Adjourned debate on motion of Ms Wortley:

That the 46th report of the committee, entitled 'Inquiry into the impact of the National Disability Insurance Scheme (NDIS) on South Australians living with disability who have complex needs and are, or are at risk of, residing for long periods in inappropriate accommodation', be noted.

(Continued from 30 November 2023.)

Ms PRATT (Frome) (11:15): I thank members opposite for creating this vacancy of time so that the opposition may address what has been a significant report in front of the Social Development Committee for the better part of 12 months. As the lead and only speaker, I seek the house's indulgence to work through what has been a significant report.

The 46th report of the Social Development Committee was an inquiry into the impact of the National Disability Insurance Scheme (NDIS) on South Australians living with disability who have complex needs and are, or are at risk of, residing for long periods in inappropriate accommodation.

At the outset, I would like to sincerely thank the work of the secretary to our committee, Robyn Schutte, and our research officer, Mary-Ann Bloomfield, who provided such thorough administrative support to the committee members. I also take this opportunity to thank my committee members.

This report resulted in a 230-page document with 38 written submissions, 22 oral submissions and, of significance, 53 recommendations. It was referred to the Social Development Committee on 17 May 2022 and has, in fact, taken well over 12 months for the committee to deliberate, confer, approve, table and now note this report. It is of some minor note that I record my disappointment that it has taken yet another five months since the tabling for the opposition to respond—but here we are.

The terms of reference paid special attention to the significant issue that is inappropriate accommodation for those living with a disability. The submissions that we received certainly spoke to the impact that has on the hospital system, as well as residential aged care, for those who present to hospital with complex needs and the medical practitioners find that they cannot then be discharged back to that accommodation because it is inappropriate in its provision for that individual.

As a committee, we spent a lot of time reflecting on the impact on the hospital system, on the health system and discussing hospital avoidance programs. Since five months have passed and this report does exist, I am going to refer literally to a lot of the content that is in the report. I note that our report found that many South Australians who visited the emergency department of a hospital because of a lack of anywhere else to turn, and have non-medical hospital admissions, resulted in long stays and sadly a decline in participants' health, wellbeing and opportunities.

Of significance, the committee learnt through those submissions that the longest delayed discharge time for an NDIS patient in South Australia waiting for appropriate accommodation supports as of March 2023 was 1,184 days in hospital.

We were presented with the reality of the challenges in the health system when it comes to a flow problem: presentations through emergency or by referral, bed stays and then the discharge process. What seemed to be reported at the time was that if you were an elderly person aged 65 years and over, your average stay was very much reduced because the aged-care sector was in a position to support that discharge. For someone on an NDIS package, their length of stay is much longer, as we know; the average was about 125 days. So there is certainly a long way to go.

We spent a lot of time reflecting on inappropriate housing, including recognising that it is quite a thin market. There has been high demand and no supply for some time and, in fact, recommendation 26 speaks to that. I will come back to the recommendation shortly, but of course workforce shortages in this space, high demand and no supply in the housing sector, as I said, and impacts to the hospital discharge process have added to those lengthy hospital stays. The effect of COVID on the housing market certainly pushed prices up and the stock dried up. We saw that affordable housing had reduced, which meant that people were, sadly, languishing in hospital. We know the impact that this continues to have on our health system.

On a positive note, the committee really did embrace the people who presented a submission in person, and we heard from and visited one extraordinary individual, Allan Hunter, who had designed and built his own modified home which was compliant with the specialist disability accommodation standard. I do not have the time to sing the praises of Allan but he is an extraordinary individual. Allan has lived for 20 years as a quadriplegic and he deserves special mention, given the intelligence and sophistication that he brought to designing his own home. While designing and paying for that home himself, Allan used the Livable Housing Australia platinum standard as a construction guide for anyone living in a wheelchair. Along the way, he completed a Master's thesis in complying with the Livable Housing Design Guidelines, and is certainly a model example of what the system could be studying and identifying for people's needs down the track.

In the 12 months from the year 2022-23, the committee found that the NDIS had provided funded supports to a total of 600,000 people to the tune of $34 billion. The committee, as we reflect on our recommendations, had to look at the national cost and, as the federal minister has also done in his review, sought opportunities for reform. While we were focused on people who are living with a disability and their housing opportunities, these statistics rang through. There were 31,000 people with an allocation or access to supported independent living (SIL) options, at a total cost of $11 billion. By contrast, there are 23,000 people who are living with an allocation for specialist disability accommodation (SDA), at a cost of $230 million. So there is a difference there: $230 million compared with $11 billion.

The committee's takeaway was that the NDIS participants with SIL living packages only make up 5 per cent of the total number in the NDI Scheme, and the total cost of the SIL service makes up 33 per cent of that total NDIS funding. So there is a lot of opportunity for the federal government now to turn its mind to value for money and to look much more closely at funding specialist disability accommodation.

The committee, with its 53 recommendations, noted that seven of them required the state government's urgent attention. I note that from the time we tabled this report, the Minister for Human Services has been very forthcoming in reviewing our recommendations and writing back to the committee with her feedback. From the minister's own letter to the committee, the minister confirms that 33 of those recommendations are supported by the South Australian government, 17 are supported in principle and three are listed for further consideration.

I take this opportunity to reflect on the links that are being made or the similarities of the references across a number of reports—our committee report, the state government's response to them and federal Minister Shorten's most recent NDIS review—where there is a national commitment from the federal minister that all state governments, all national cabinet, should agree to jointly invest in psychosocial supports outside the NDIS to assist people with severe and persistent mental health conditions who are currently unable to access support.

I put the challenge back to the state government and the health minister that investment in psychosocial supports is being recognised by the federal government. In the Mid-Year Budget Review it seems that only $500,000 has been allocated for the rest of this financial year, and I am calling on the state government to make sure that investment in psychosocial services outside of the NDIS is a priority going forward.

Motion carried.

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