MARK BUTLER, MINISTER FOR HEALTH AND AGEING, MINISTER FOR DISABILITY AND THE NDIS: Thanks for coming out this afternoon. I know it’s been a busy day, a busy week.
The NDIS is truly one of Australia's great modern reforms. In just 15 years really it has transformed the lives of literally hundreds of thousands of people living with a disability, and their families and their carers, and their loved ones. A scheme that was dreamed about, literally, for generations is now a deeply cherished institution and something that we should all be deeply proud of. There's nothing really like it anywhere else in the world. It's the centrepiece of the most comprehensive suite of supports you’ll find, particularly within the OECD, for people with disability.
But as Jenny and I and other members of the government have said for some time, it's grown too big. It covers people who were not envisaged to be a scheme that was set up for people with permanent and significant disability. The costs have grown far too quickly and, frankly, it has become a soft target for shonks and for fraudsters and for sharp practice, something that Minister McAllister has been particularly focused on. We as a Government, have been very focused for all of our four years on getting costs under control, improving the sorts of measures that constrain fraud and the integrity, and generally making sure that this is a scheme that will last for decades.
Over the last several months, though, it's become clear that that more work needs to be done. When Jenny and I went to the Press Club back in April, we laid out a plan with four major pillars that would secure the future of the NDIS and get it back on track. Even just in April, we had to report that since December, so only in four months, costs in the NDIS had blown out by a further $13 billion. It was clear that the measures, good as they were, that we had put in place in the first few years of our Government, simply weren’t delivering the results that we needed. We are pursuing more fundamental reform to ensure that we return it to its original purpose, that we get those sorts of controls on fraud and integrity that Minister McAllister has talked about.
And those measures, that plan that Jenny and I announced back in April, have been incorporated into the bill which I'm confident will pass the Senate tonight. That bill will be substantially amended with 33 amendments in the Senate following the 30 amendments that we supported in the House of Representatives. What that reflects is a government that is willing to listen.
We said when we announced this plan in April that we would engage deeply with the disability community, but also with other parliamentarians. Although this is a Labor reform, another great Labor social reform, it's also a reform of which the Parliament very broadly is justifiably proud and has strong views. We've engaged with parliamentarians right across the aisle in both houses of parliament. And I'm confident, I know Jenny is as well, that the 63 amendments, 30 in the House and now 33 in the Senate, some are relatively technical, but some are relatively substantial as well, will ensure that this bill is the best version that it can be of itself and of the announcements that I made back in April.
I'm going to hand to Jenny to say a few things about the Senate process, I don't understand that myself, and the amendments that have been negotiated largely with the Opposition. Can I say a particular thanks to the Shadow Minister Melissa McIntosh. She was particularly focused on some of the amendments Jenny will talk about around fraud and integrity and kickbacks and incentives. But more broadly, she’s been firm but constructive in her approach to try to make that we get a bipartisan approach to these essential reforms. Over to you, Jenny.
JENNY MCALLISTER, MINISTER FOR THE NDIS: Thanks Mark. As Mark said, we have sought to listen, that's meant listening to people across the Parliament, but it's also meant working with the disability community since April to talk through the practical implementation of the reform program we announced.
I do want to thank everybody who provided evidence to the Senate Committee process, which you will know reported on Friday. Like Mark, I acknowledge colleagues in the Coalition, in particular the Shadow Minister. They have taken a constructive approach to these negotiations.
Today we do have an agreement to pass these reforms, and I believe they will deliver an NDIS which is strong, safe, sustainable and has a strong social licence. This is a result of the discussions across the Parliament, and we've been doing that work to make sure that the bill reflects the government's genuine intentions to reform the NDIS so that it can provide supports for the disability community long into the future.
Now, we will make a series of amendments in the Senate. Some of them go to ensuring that the bill, the legislation, reflects the government's policy intent. We were very clear from the outset that we wouldn't let support determinations compromise the care needs of participants who need 24/7 care. We've been working through the necessary operational arrangements for that commitment, and I want to acknowledge the representatives of the disability community who've engaged with us on that question. I also want to acknowledge the Greens who were willing to share their proposed amendments about this challenge as well. Building on those contributions, we will move an amendment in the Senate to establish an escalation pathway. This will make sure that a high risk participant can apply for a plan variation so their needs can continue to be met.
I'm also happy to confirm that we've been able to work with the Coalition to strengthen the bill further in relation to fraud. This has been a key area of focus for the government, but there is more we can do. With the support of the Coalition, we will move amendments that deliver new criminal and civil penalties for offering or providing a kickback. There will be tough new aggravated integrity offences including obtaining funds by deception, providing false or misleading information, or abuse of position as a participant's nominee, or for intentionally destroying records. There will be further whistle-blower protections and these will add to the measures that are already in the bill that seek to preserve the Scheme's social licence.
The existing measures including greater monitoring, investigation and enforcement powers for the NDIA, new penalties for refusing to provide information to the NDIA or when nominees fail in their duty to participants, and a genuine plan to reform the market for NDIS services beginning with fixing how the market for plan management works.
This is all complemented, of course, by the investments we made in our most recent budget, registration of all high-risk providers so that by the end of the decade 90 per cent of funding will go to agency-approved providers; a new payment system to ensure the legitimacy of claims and provider; and, extending funding for the Fraud Fusion Task Force, an institution that has contributed so much to building the enforcement architecture for this scheme.
BUTLER: Thanks Jenny. Happy to take questions. Phil.
JOURNALIST: Minister, just a few question on that after this bill passes there's still much work to do. Could you sort of speak to that? I assume you’re talking about setting up these Thriving Kids and the over-9’s and the states having to get their act together. And in the context of that, the $25 billion you've offered the states in extra hospital funding in return for them lifting, helping you in the NDIS, is that still a contingent now? I mean, are you still prepared to, you know, use that funding as leverage in that way?
BUTLER: It's a question of honour, really, for states. They signed an agreement with the Prime Minister, the Premiers and the Chief Ministers signed an agreement earlier this year. A grand bargain I think we called it at the time that set up five years of very significant increases in Commonwealth support for our terrific public hospital system. But a reaffirmation of the commitment they made back in 2023 to work with the Commonwealth to get the NDIS back on track, and that includes the foundational supports system.
As to what I said in the Chamber a short while ago, there is still much work to do. In particular, I said at the Press Club that we would set up a new eligibility system. That is not in the bill right now, although it is enabled by the bill that's currently before the Senate. A technical advisory group is currently working on establishing a test that targets, really, people with substantially reduced functional capacity. They've had two meetings. I've been at both of them with a series of very highly qualified experts on developing that tool. That tool will have to be incorporated into NDIS rules which will require the agreement of states. We want to do that by the end of this year so that people are very clear what that eligibility system will look like and well ahead of its introduction on 1 January 2028. That's one piece of work.
The very substantial piece of work is to start to put together the foundational supports systems for children over the age of eight and other adults who might be exited or diverted because of the new eligibility arrangements that return the NDIS to its original purpose.
Thriving Kids is going very well. We've got implementation plans finalised by every jurisdiction except Queensland. Queensland Government needs to answer for its inability so far to live up to the agreement that it signed, that the Premier signed earlier this year. But we've got a lot of work to do to develop the equivalent systems, effectively, for kids over the age of nine and for other adults who might be impacted by these eligibility arrangements.
That's a tonne of work, but it is incredibly important. Now the bill, it hasn't passed yet, but if the bill passes tonight, really, that work must begin quickly. Natassia.
JOURNALIST: Minister, a quick follow up if that’s, sorry.
BUTLER: Just a quick follow up, yeah.
JOURNALIST: Janetzki, the Queensland Treasurer, was here today. Did you have any discussions with him, or do you know if the Treasurer had any discussions with him?
BUTLER: I haven't met with him. Not sure about the Treasurer.
JOURNALIST: On the eligibility, just a question. I recall there being quite a bit of back and forth over the course of the inquiry about this requirement that people have exhausted other treatment options to be eligible for the scheme and there being a bit of a negotiate on that. Could you clarify it from a participant consumer perspective just where that has landed and what that means for people? And then also wondering, because there is a section in the amendments that says, the amendment confirms that participants in the scheme before 2028 can't have their access revoked if they meet the alternative support requirements. Could you step out what that means?
BUTLER: Do you want to deal with that?
MCALLISTER: Yeah. Essentially, in relation to dealing, exhausting all available treatments, it's always been the case that access to the NDIS required you to have a permanent disability. But in 2023, the independent review set out- indicated to us that it would be desirable for those permanency requirements to be made clearer and to be set out in legislation, and that's what we've sought to do. During the course of the debate in the House of Representatives, we made clear that all available treatment referred to treatments that are, essentially, publicly available and publicly funded. We're talking here about things which are available through the MBS or on the PBS.
BUTLER: And with just one of the amendments just confirms that it's prospective. From 1 January 2028, if people are on the scheme as of that time, they can't- their eligibility or retention on the scheme can't be impacted by a question of alternative treatment, so it's prospective.
JOURNALIST: Just on aged care, following last month's Four Corners and there's a push in the Senate at the moment to act on the algorithm. Why can't you stand here and just cancel the algorithm? I mean there's been hundreds of complaints, there's awful stories about people not getting the care that they deserve. Why not just get rid of it?
BUTLER: First of all, I think the Minister addressed this in the House in Question Time today. The idea of an independent assessment tool didn't drop from the sky, we didn't come up with it. It was a very important recommendation of the Royal Commission into Aged Care and, essentially, reflected the history of the home care system, which was one that saw allocation of package levels vary wildly across the country because of the lack of a single assessment tool. And so, the commission said the assessment system and the tool needed to be independent and applied through a single framework, which didn't exist before we accepted that recommendation.
I'm still a very strong supporter of the idea of a single assessment framework that gives confidence to Australians that no matter where they live, no matter what particular assessor organisation they use, that their package level will reflect their level of need. We're doing exactly the same, frankly, in the NDIS as we move to new framework planning, which will ensure much greater equity and predictability about the level of package that's provided through the NDIS as well as aged care.
Now, the number of reviews that have happened through the IAT, the new system which has assessed well over 200,000 people from memory, is pretty small, it's less than half a percent, which is pretty small for a program like this. But at the same time, the Minister has made it really clear that from the get-go we've indicated we would monitor the rollout of this scheme very closely. And he has announced that we will put in place essentially another level of control on the scheme that allows an escalation pathway for people. That is -
JOURNALIST: But in extreme circumstances though. So, a 96-year-old woman who can't get extra funding in a decade, I mean, is that a sign that this computer system is working as it should?
BUTLER: I don't accept your description of this as a computer system. There is a very significant role of clinical assessors through this -
JOURNALIST: [Indistinct]
BUTLER: If you just let me finish, there's a very significant role of clinical assessors through the process. I don't know the full details of every case that has been the subject of a review. And aged care is an area that throws up, frankly, some very confronting stories, and I think there were confronting stories on Four Corners last night.
We're doing everything that we can to make sure this tool delivers the sort of predictability and consistency that the Royal Commission recommended. We're doing everything we can to monitor the rollout of this scheme closely. And where we think we need to modify it, we've indicated a commitment to do that, and the Minister has done that. Yeah?
JOURNALIST: You said you, before when you thanked the Greens, but still, even today, they've been quite scathing of the changes. They've accused the Government of throwing people with disabilities under the bus. I guess my question to you is, what is your response to that criticism with those changes? And secondly, do you have, there is an anxiety in the community about these changes. Well, what comments can you give to those people of reassurance or to alleviate any concerns they may have?
BUTLER: I said again in the Chamber, Jenny might want to add to this. But I said again in the Chamber earlier this afternoon that I understand this is hard reform, and I understand that it is causing anxiety among people in the community that their support arrangements might be impacted. But I and the government, and I know Jenny, are utterly convinced it is essential reform. This scheme has grown too fast. Its controls are not working. It's gone well beyond the original intent of the scheme.
And I've said, I don't just worry about the fiscal sustainability of this scheme although, obviously, that that is an issue for a government with limited means and lots of demands upon it. Much more profoundly, I'm worried about the social licence and level of community support for a scheme that only some years ago was seen I think as a very, very deep source of community pride.
We've got to do everything we can as a government to give the community confidence, whether they are participants or their families or the broader community that pay for the scheme, confidence that this scheme is well designed and operating as it was originally intended to. I get this is hard. I get it is causing anxiety. We are engaging very closely all the time with the disability community and advocates to ensure that we listen to them, and we take into account their suggestions as we have over the last few months. And you see that reflected in the final version of the bill. Do want to say something?
MCALLISTER: Look, I'd simply say this, that of course change is frightening. But what would be significantly more frightening would be a loss of community confidence in this life-changing scheme. And it's on that basis that we're proceeding. In about 10 years, there will be a little boy or a little girl, and they will be born with a disability, a very significant disability, and I want that child and their family to know that this scheme is here.
JOURNALIST: One of the aspects most heavily criticised by disability advocates and other groups is the power for the Minister to apply reductions to category supports up to 99 per cent. So, I just want to know why there wasn't any consideration for a potential appeal right [inaudible], particularly vulnerable participants that might be relying on that funding to be able to leave their room in certain situations, for example.
BUTLER: Jenny addressed this, and I'll ask her just to go back over that material again. Because we are proposing an appeal right through an amendment that Jenny addressed in her introductory remarks. But this community participation stream of support has grown very significantly from I think about $4 billion four or five years ago to $12 now, projected to grow to $20 billion - just this one stream of support if some checks weren't put in place.
This is a significant part of the change that we announced at the Press Club and put through the Budget. It would return that total budget to about where it was in 2025. And we are making sure that we construct the implementation of that in a way that protects participants. For example, in the House, I think we supported amendments or proposed amendments that would carve out any impact on employment or disability-related health supports. And as Jenny said in her introduction, we are proposing amendments over the course of today and tonight that would allow an escalation pathway for people with high support needs, which is broadly that very vulnerable group that you talk about who require 24/7 care.
MCALLISTER: Yeah. So I can step through it in a little more detail. We've previously said that these changes will not impact budgets for critical care, Support at Home, to keep a participant safe. Might be help with eating or drinking or dressing or toileting or laundry or any such things. And the reset will not affect products like home or vehicle modifications or personal mobility equipment and consumable products to help with continence. All of these things are out of scope.
But we do recognise that there is a need to safe guard against risk to participant health and safety, particularly for that group of people who require support 24 hours a day. And so we are establishing a new plan variation pathway for people who have high support needs. This is intended to address participants who require continuous care over a 24 hour period. These participants will be able to apply for a plan variation within 90 days of a support determination applying to them. That’s after that plan is assessed or renewed. If necessary, the NDIA will be able to vary the participant’s plan to increase their support funding and ensure that 24-7 support is maintained.
JOURNALIST: One of the concerns that Jordon Steele-John has raised fairly consistently with you, Minister McAllister, is the notion that because of the powers given to the Minister, somebody may need to seek treatment and exhaust all avenues of treatment that isn't actually available in their jurisdiction. I know there's been considerable concern raised from disability groups of what that means for disabled people in regional areas. Why hasn't there been any kind of pathway for them to be able to appeal the decisions made there?
MCALLISTER: Look, this is an existing feature of NDIS access, and the provisions essentially elevate existing NDIA policy into the legislation to provide clarity for participants and the community. We consider that it is important that we establish that a person has a permanent disability before they're accepted into the scheme. And if a person is able to be treated for a condition such that they wouldn't have a disability, we would want them to obtain that treatment. You’ll know that our Government is making very significant investments right across the public health sector. We want people to be able to access necessary treatments. But we also need this scheme to serve the population that it was intended to serve. It was always intended for people with permanent and significant disability and this, for the first time, actually sets out how that will be assessed. There are also provisions within the legislation that allow the Minister to make rules, to make it clear that certain kinds of treatment would not be required of a person. It's also true that at the moment, as we do currently, if a person is being assessed, if a person's permanence is being assessed, we would rely on evidence from their treating medical practitioner.
JOURNALIST: Sorry. So just to clarify, if someone lives in a regional area, for example, where they don't have access to certain treatment that is required to establish the permanence of their disability, what will that look like in practice?
MCALLISTER: Look, I think that we want people to access the treatments that would assist them, and it's why we are making an $8.5 billion investment in Medicare, for example.
JOURNALIST: Just on financial supports. No doubt there's many parents of children with mild to moderate autism who are still unsure about what's happening with Thriving Kids, in particular in Queensland as well. Are you able today to, now that this bill is going forward, guarantee that those parents and those families won't lose that support over the next few years?
BUTLER: If you're talking about kids under nine, so the cohort that we identified when I announced, I guess, the move to Thriving Kids, I'm very pleased. Queensland is obviously an issue that we need to work through. But all of the other states have got their implementation plans in place. They're all ready to start ramping up those services from the 1st of October, as is the Commonwealth. In terms of the things we've committed to as part of the $4 billion allocation to Thriving Kids, remember that children under the age of nine will continue to be enrolled in the NDIS up until the end of next year in the usual way. Effectively you'll have two support streams running alongside each other up until the end of 2027, Thriving Kids ramping up to the end of next year but the NDIS continuing to be there for parents even of children with low to moderate support needs. I'm very confident that by the 1st of January 2028 Thriving Kids programs will be rolled out fully and therefore the children that I identified when I first spoke at the National Press Club about our reform intentions. Again, this was something ticked off by state and territory governments as part of their acceptance and endorsement of the NDIS review back in 2023. It just hadn't shifted fast enough. And I think in the general community, there is a level of concern about the fact that across the country, one in six junior primary boys were enrolled on a scheme designed for permanent and significant disability. In some parts of the country, that figure was as high as one in four and continuing to climb. Something had to be done to ensure that families with children with that level of need were given a system of supports or access to a system of supports that is appropriate for children with those needs, not for people with permanent and significant disability. Natassia?
JOURNALIST: What about the over nines come January 28? Like given how long it's taken for Thriving Kids to get to this point, what supports are being planned and not just kids, for adults as well [indistinct]?
BUTLER: As I said, now the bill passes, really that's the next piece of work we need to move to very quickly. Very shortly we'll be in a position to start those discussions formally with states. I think we'll learn a lot from the work that was done for children under nine, the Thriving Kids cohort, to allow us to move more quickly through a process of designing a system of support for older children. When I speak to high school principals, they often say we need thriving teens, we need this program for children older than nine. But I, look, I'm not going to gild the lily.
JOURNALIST: But will there be a gap in that timeline given that Thriving Kids is only going to start on January 21 [indistinct]?
BUTLER: No, we need to have that other, those other systems ready to start on the 1st of January 28 as well. We'll sort of roll out a time frame for our discussions with the states that reflect that but I don't gild the lily here. That is a lot of work for all governments. It's not particularly a Commonwealth responsibility. It's a responsibility all heads of government signed on to again earlier this year after doing that in 2023. We've got a lot of work to do between now and the end of 2027.
JOURNALIST: If the bill passes tonight with the 63 amendments, is the Government still forecasting $37.8 billion saved in the Budget over the next four years? Is that still the current projection?
BUTLER: Yeah, we'll update our figures in the usual way at MYEFO towards the end of the year and that will reflect a range of changes as is usual in this sort of complex reform, refinements to modelling, the impact of amendments that we have been talking to you about this afternoon. Broadly speaking, we are very confident that that update will reflect the numbers that were published at Budget in May.
JOURNALIST: How would you sort of characterise the, that there's been dozens of amendments to this bill. How would you sort of characterise the change? Is this like a quite significant change to the NDIS bill or are there some tweaks in your words? Because it just feels like it’s happening kind of quickly for other parliamentarians or people in the community today finding out about certain changes.
MCALLISTER: Look, we laid this out at the Press Club in April to give people a very clear picture about where the Government was going well ahead of the Budget. And as you know, we introduced the amendment, the legislation very quickly after Budget. We've been grateful for the engagement that we've had with the community around some of these changes, which, as Mark has indicated, are challenging conversations in some instances. Most of the reforms or the amendments that are being proposed refine the legislation so as to better deliver on government policy intent. There's been some additional changes around fraud that we've been pleased to work on with the Coalition. They reflect the advice that we received from Libby Coker and the committee process that she ran that looked at fraud and integrity questions. But for the most part, we are proceeding with the, in the direction that Mark laid out in April. We are really convinced that this is a sustainable way to put the scheme back on track that can deliver on the human rights objectives that were originally imagined when we set up the scheme.
JOURNALIST: If you're a participant, now these laws go through tonight, October 1 was obviously the start like for the cuts to social and community participation budgets. What should you expect now over the next few months? Like does everyone's budget get cut on that date? Will it be a phase thing? Can you just talk the participant experience now through the rest of the year?
MCALLISTER: I think our message for participants from tomorrow is that you should still keep using your plan, you should still keep participating in the NDIS as you have. As people's plans come up for renewal from October, we will start to apply the changes to social and community participation and people will have plenty of information provided directly to them about the changes that apply to them. We'll also keep talking with the disability community. As Mark's already indicated, there are a lot of additional pieces of work that will be enlivened if this legislation passes this evening. That will involve deep engagement with the disability community on reforms to supported independent living, on setting up the inclusive communities fund, on changing the way that we offer plan management services into the scheme. There is a very large volume of work that we need to do with the disability community and it will involve a lot of conversations and discussion.
BUTLER: Thanks, everyone.
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