WEBVTT - ‘Thriving Kids’ and the plan to shrink the NDIS 0:00:01.120 --> 0:00:09.360 I'm Ruby Jones and you're listening to seven AM. The 0:00:09.360 --> 0:00:12.680 federal government says too many children are on the NDIS 0:00:12.880 --> 0:00:16.400 because there's simply nowhere else for them to go. Health 0:00:16.440 --> 0:00:20.320 Minister Mark Butler has unveiled a new plan called Thriving Kids, 0:00:20.720 --> 0:00:23.560 pitched as a way to save the NDIS by bringing 0:00:23.600 --> 0:00:27.400 back mainstream supports for children with autism and developmental delay 0:00:27.560 --> 0:00:31.640 that over time were defunded. But the announcement raises questions 0:00:31.960 --> 0:00:34.760 who decides what counts as mild or moderate when it 0:00:34.800 --> 0:00:37.720 comes to these disabilities and the level of care these 0:00:37.840 --> 0:00:42.560 children need. Today journalist and author Rick Morton on whether 0:00:42.600 --> 0:00:46.600 Thriving Kids will save the NDIS or just shift the 0:00:46.600 --> 0:01:02.360 costs elsewhere. It's Thursday, August twenty eight, So Rick. Last 0:01:02.400 --> 0:01:05.720 week the Minister for the NDAs, So that's Mark Butler. 0:01:05.800 --> 0:01:10.000 He announced this plan, this new scheme called Thriving Kids. 0:01:10.480 --> 0:01:14.400 Children with mild to moderate developmental delay or autism need 0:01:14.440 --> 0:01:18.240 a robust system of support to help them thrive. A 0:01:18.319 --> 0:01:20.800 program for Thriving Kids. 0:01:20.760 --> 0:01:22.360 And he said that that's a key part of the 0:01:22.360 --> 0:01:26.399 government's plan to secure the ndas's future. So maybe we 0:01:26.440 --> 0:01:30.120 can begin by talking about thriving kids. Tell me what 0:01:30.160 --> 0:01:31.080 you know about what it is. 0:01:31.600 --> 0:01:34.880 I think we don't know a lot yet. Mark Butler 0:01:34.920 --> 0:01:38.720 announced Thriving Kids, much to the surprise of almost everyone 0:01:39.200 --> 0:01:42.600 who didn't see this coming, including the states and territories 0:01:42.600 --> 0:01:44.800 with whom the Conwealth is trying to do a deal 0:01:44.840 --> 0:01:47.400 on this kind of support funding outside of the NDAs. 0:01:47.440 --> 0:01:49.880 But what we do know is that for a very 0:01:49.880 --> 0:01:52.760 long time, both the Coalition and now Labor have had 0:01:53.280 --> 0:01:55.880 what they describe as a problem with the number of 0:01:55.960 --> 0:01:59.919 children accessing the National Disability Insurance Scheme. It has always 0:02:00.360 --> 0:02:03.200 been the case that there were more children approaching the 0:02:03.240 --> 0:02:06.680 scheme than the initial modeling suggested, either by the Productivity 0:02:06.680 --> 0:02:10.440 Commission by the allowances made for in the legislation, and 0:02:10.639 --> 0:02:13.320 governments have struggled to figure out what to do with 0:02:13.400 --> 0:02:13.960 that number. 0:02:14.360 --> 0:02:17.680 Diverting this group of kids over time from the NDIS 0:02:18.200 --> 0:02:21.880 is an important element of making the scheme sustainable and 0:02:21.960 --> 0:02:26.040 returning it to its original intent servicing people with permanent 0:02:26.120 --> 0:02:27.400 significant disability. 0:02:27.639 --> 0:02:30.160 There are more than seven hundred and forty thousand people 0:02:30.639 --> 0:02:33.799 on the NDIS now, and children make up just under 0:02:33.800 --> 0:02:37.320 half of that number, and the primary disability for those groups. 0:02:37.360 --> 0:02:38.799 Mary in mind that people could have more than one 0:02:39.560 --> 0:02:43.440 is autism and developmental delay, particularly for children under the 0:02:43.440 --> 0:02:47.280 age of nine, and as Mark Butler points out the 0:02:47.360 --> 0:02:51.880 prevalence of autism and developmental delay, he says across the country, 0:02:51.919 --> 0:02:56.040 wonning ten six year olds is on the NDAs he 0:02:56.120 --> 0:02:59.160 calls that a failure of government. He says, I don't 0:02:59.160 --> 0:03:02.160 think parents that he says, we don't want it. 0:03:02.480 --> 0:03:06.480 Families who are looking for additional supports in mainstream services 0:03:06.520 --> 0:03:10.600 can't find them because they largely don't exist anymore. And 0:03:10.639 --> 0:03:13.440 in that all governments have failed them. 0:03:13.680 --> 0:03:17.120 And so thriving kids is kind of a throwback to 0:03:17.160 --> 0:03:19.240 the past where what they want to do, and this 0:03:19.280 --> 0:03:23.160 is Mark Butler speaking, is to take children with what 0:03:23.240 --> 0:03:26.680 he calls mild to moderate disability. It's quite a controversial concept. 0:03:27.320 --> 0:03:31.280 How do you define what is mild autism or moderate 0:03:31.320 --> 0:03:35.320 autism and divert them from the National Disability Insurance scheme 0:03:35.760 --> 0:03:41.320 with lower intensity support, perhaps some therapy, perhaps, as he says, 0:03:41.360 --> 0:03:46.840 some Medicare line items for allied health, some therapy giving 0:03:46.840 --> 0:03:50.520 them help that isn't to the same standard and according 0:03:50.520 --> 0:03:53.280 to the government, isn't required to the same standard as 0:03:53.280 --> 0:03:55.840 the National Disability Insurance scheme which has as its kind 0:03:55.840 --> 0:04:01.440 of feature individualized support packages one on one for people 0:04:01.480 --> 0:04:05.720 to receive quite intensive assistance with daily living and being 0:04:05.720 --> 0:04:06.960 able to be in the community. 0:04:07.280 --> 0:04:12.160 And frankly, many of those children are being overserviced. The 0:04:12.240 --> 0:04:15.480 extent of therapy provided to those children now in the 0:04:15.560 --> 0:04:20.080 NDIS is extremely high compared to anything that you would 0:04:20.080 --> 0:04:21.320 see in the health system. 0:04:21.400 --> 0:04:23.039 Yeah, let's talk about that. What do you think he 0:04:23.120 --> 0:04:25.640 means when he says that, and is there such thing 0:04:25.640 --> 0:04:26.640 as being overserviced? 0:04:27.080 --> 0:04:30.240 I don't know what evidence he's relying on, but there 0:04:30.279 --> 0:04:32.640 is a clinical judgment that is made, and a therapy 0:04:32.720 --> 0:04:35.440 judgment and allied health practitioner judgment that is made where 0:04:35.440 --> 0:04:37.520 they know they will tell you if they think therapy 0:04:37.600 --> 0:04:40.480 is useful or not. I think what Mark Butler was 0:04:40.520 --> 0:04:43.200 trying to say but did not come out and directly say, 0:04:43.320 --> 0:04:45.800 was that he thinks that there are some providers who 0:04:45.800 --> 0:04:48.919 are not expressing that judgment because they're getting paid to 0:04:48.960 --> 0:04:52.320 see the child anyway via the National Disability Insurance Camp 0:04:53.360 --> 0:04:56.000 who makes that judgment in terms of the government, And 0:04:56.440 --> 0:04:58.200 you know, for how many children are they going to 0:04:58.240 --> 0:05:01.160 say you've been over serviced? I'd like to see the 0:05:01.720 --> 0:05:06.160 evidence and the assessment on which they base that, because 0:05:06.960 --> 0:05:10.960 by their own metrics. The National Disability Insurance Scheme in 0:05:11.000 --> 0:05:15.919 their last quarterly report has been absolutely crowing about the 0:05:15.960 --> 0:05:18.880 successes they've had with children in the scheme. It was 0:05:18.920 --> 0:05:20.880 released just a week before the National Profit Club. They 0:05:20.880 --> 0:05:25.279 say children between starting school and age fourteen had improvements 0:05:25.320 --> 0:05:29.000 of more than ten percentage points across all domains. Daily 0:05:29.040 --> 0:05:32.880 living is the strongest one which helps children in their 0:05:32.920 --> 0:05:35.320 kind of day to day life. And so what does 0:05:35.360 --> 0:05:38.560 overservicing mean and does overservicing also mean that children are 0:05:38.640 --> 0:05:39.320 faring better? 0:05:39.640 --> 0:05:42.400 Can we talk a bit more about what the original 0:05:42.520 --> 0:05:45.760 vision for the NDAs was in terms of how big 0:05:45.800 --> 0:05:49.320 it would be versus where we're at now, because obviously 0:05:49.400 --> 0:05:51.880 we hear all the time that the cost of running 0:05:51.920 --> 0:05:56.520 the NDAs has ballooned, it's gone beyond its original intent 0:05:57.320 --> 0:06:01.680 and this is one attempt to save some money. So 0:06:02.360 --> 0:06:04.160 talk to me about I guess how we've gotten to 0:06:04.200 --> 0:06:04.680 where we are. 0:06:04.880 --> 0:06:07.240 Yeah, it's a great question because there's a little bit 0:06:07.240 --> 0:06:10.280 of blame shifting now going on, I think between the 0:06:10.320 --> 0:06:14.280 federal government and what's happened with the NDIS. So when 0:06:15.240 --> 0:06:17.680 the Gillard government and then the rud government in its 0:06:17.680 --> 0:06:22.800 second iteration, we're desperately trying to get bilateral agreements approved 0:06:23.120 --> 0:06:27.360 between each state and territory and the federal government. They 0:06:27.360 --> 0:06:30.120 made all sorts of deals which I essentially say, yeah, 0:06:30.200 --> 0:06:33.320 by the way, you can close all your existing community 0:06:33.320 --> 0:06:37.000 health support services. They put the numbers in and they said, 0:06:37.000 --> 0:06:38.760 here's how we're going to pay for it. We'll roll 0:06:38.800 --> 0:06:42.600 these programs in, and those programs disappeared. The entire Department 0:06:42.640 --> 0:06:45.800 of Service Delivery disappeared because of the NDS. All of 0:06:45.800 --> 0:06:49.920 community mental health in Victoria disappeared because of the NDIS. 0:06:50.440 --> 0:06:55.320 The Helping Children with Autism Commonwealth package disappeared because of 0:06:55.360 --> 0:06:58.920 the NDIS. I could keep going, better Start for Children 0:06:59.040 --> 0:07:03.120 disappeared because of the NDAs. Partners in Recovery disappeared, and 0:07:03.160 --> 0:07:06.200 the NDAs became as Mark Butler says, the only poured 0:07:06.240 --> 0:07:08.520 in the storm because of those decisions. 0:07:08.760 --> 0:07:11.760 Yeah, it sounds like the problems that we're saying now 0:07:11.800 --> 0:07:16.000 were not only foreseeable, but were in some ways kind 0:07:16.040 --> 0:07:18.200 of baked into the system. 0:07:18.400 --> 0:07:20.880 You know, every single person that's on the National Disability 0:07:20.920 --> 0:07:24.840 Insurance Scheme now is there because the legislation allows them 0:07:24.840 --> 0:07:27.800 to be now the government doesn't like the cost of it, 0:07:27.880 --> 0:07:30.320 and the cost of the NDIS has gone up. I mean, 0:07:30.360 --> 0:07:32.360 you know, the product Committy Commission modeled four hundred and 0:07:32.400 --> 0:07:35.440 ten thousand participants originally at a cost of about thirteen 0:07:35.440 --> 0:07:37.960 point six billion dollars a year, and of course, now 0:07:38.080 --> 0:07:40.000 you know, more than a decade later, we've got a 0:07:40.040 --> 0:07:43.520 scheme that's forecast to cost about sixty four billion dollars 0:07:43.720 --> 0:07:47.640 a year. Thriving Kids is a two billion dollar Commonwealth 0:07:47.640 --> 0:07:50.640 commitment which has to be matched by the states and territories. 0:07:51.120 --> 0:07:54.080 So that's a four billion dollar commitment. And so there 0:07:54.160 --> 0:07:56.600 is still going to be money paid to these children, 0:07:56.680 --> 0:07:58.280 maybe not quite as much as it would have been 0:07:58.280 --> 0:08:01.560 in the NDAs, but there will be a whole parallel 0:08:01.680 --> 0:08:06.720 kind of increase in bureaucracy elsewhere, and increase in funding elsewhere, 0:08:07.040 --> 0:08:09.840 and increasing gap fees elsewhere, and so you know, it's 0:08:09.880 --> 0:08:12.520 going to make the NBAS look better in terms of 0:08:12.560 --> 0:08:16.200 pure numbers, but the numbers are still going somewhere else. 0:08:18.240 --> 0:08:21.000 Coming up, how the federal government is strong arming the 0:08:21.040 --> 0:08:30.160 states on disability funding. Can we talk a little bit 0:08:30.200 --> 0:08:32.560 more about the relationship between the federal government and the 0:08:32.559 --> 0:08:36.360 states and territories as they try and get this through. 0:08:36.600 --> 0:08:41.000 We've now recently heard the Treasurer say that the states 0:08:41.160 --> 0:08:44.199 need to kick in this funding matching the federal governments 0:08:44.320 --> 0:08:48.200 or they could risk losing their hospital fundings. So talk 0:08:48.240 --> 0:08:51.319 to me a little bit about that approach and what's 0:08:51.320 --> 0:08:54.080 at risk here if the federal government can't get agreement 0:08:54.080 --> 0:08:54.720 from the states. 0:08:55.000 --> 0:08:56.760 I think there's a broader point here, but they have 0:08:56.960 --> 0:09:01.400 deliberately held up hospital funding in a really broken hospital system. 0:09:01.640 --> 0:09:04.240 The commoal said we're not getting your hospital cash unless 0:09:04.240 --> 0:09:06.720 you do a deal on disability, and that hasn't happened. 0:09:07.120 --> 0:09:09.000 So it got to the point where just before the election, 0:09:09.120 --> 0:09:12.040 the government the Comalth had to institute a rollover of 0:09:12.040 --> 0:09:16.720 the original funding agreement for hospitals of just an extra year. 0:09:18.160 --> 0:09:20.120 They sold it as a big win, saying more cash 0:09:20.160 --> 0:09:23.080 for hospitals, but the reform work is tied to the 0:09:23.120 --> 0:09:25.440 actual new agreement, which has not been done because it 0:09:25.480 --> 0:09:29.280 has been held a negotiating tactic. And I think more broadly, 0:09:29.320 --> 0:09:32.160 this speaks to a concern in the community. So right 0:09:32.160 --> 0:09:35.440 after the election, Mark Butler was made Minister for Health 0:09:35.440 --> 0:09:39.160 and Aging and Disability and the National Disaility Insurance scheme. 0:09:39.200 --> 0:09:43.280 He's Cabinet Minister for the NDAs. The NDAs was moved 0:09:43.720 --> 0:09:48.480 from social services social policy to health, which in the 0:09:48.520 --> 0:09:50.920 disability community is a big red flag because they see 0:09:50.920 --> 0:09:53.400 that as going back to a medicalized model of looking 0:09:53.440 --> 0:09:56.800 at disability. It's not about social support, it's about intervention. 0:09:57.080 --> 0:10:00.400 The NDAs is not a medical scheme, it is a 0:10:00.440 --> 0:10:02.800 support scheme, and so a lot of people saw this 0:10:02.840 --> 0:10:05.120 as foreshadowing what we seem to be having now where 0:10:05.160 --> 0:10:08.000 we've got you know, Medicare line items been introduced to 0:10:08.080 --> 0:10:12.120 some kind of potential problem solver for children with autism 0:10:12.920 --> 0:10:16.720 as part of thriving kids and hospital negotiations tied to 0:10:16.760 --> 0:10:19.360 disability negotiations. It's a bit of a mess at the moment, 0:10:19.440 --> 0:10:20.200 to be quite honest. 0:10:20.559 --> 0:10:22.760 And can we talk a little more concretely about what 0:10:22.840 --> 0:10:27.040 this means for a kid with mild or moderate autism. 0:10:27.200 --> 0:10:30.120 You know, the difference it means if it's picked up earlier, 0:10:30.240 --> 0:10:32.480 and the quality of care that they get. 0:10:32.760 --> 0:10:35.480 If it is. Yeah, I mean it's basically with any 0:10:35.480 --> 0:10:39.920 developmental condition development to delay autism, the earlier you pick 0:10:40.000 --> 0:10:42.200 these things up, the better. You can't go all the 0:10:42.200 --> 0:10:44.079 way back to point zero. We don't have a test 0:10:44.160 --> 0:10:47.120 for autism. You've got to have a family that is 0:10:47.200 --> 0:10:52.760 engaged with GPS, with midwives for follow up care, with 0:10:52.880 --> 0:10:56.880 the community through universal access childcare, which Mark Butler says 0:10:56.880 --> 0:10:58.720 will help a lot with thriving kids, and I suspect 0:10:58.760 --> 0:11:01.920 that's true. The more referral points you've got, the better 0:11:02.000 --> 0:11:04.760 right and the individual here might be as gentle as 0:11:04.920 --> 0:11:08.640 understanding the child's communication needs and you know, as they 0:11:08.679 --> 0:11:10.920 grow up and develop over time, figuring out what it 0:11:10.960 --> 0:11:12.920 is that child needs to make the world around them 0:11:13.000 --> 0:11:15.760 more accessible to them, and that at its best is 0:11:15.800 --> 0:11:18.760 exactly what the NDIS does. As long as there is 0:11:18.840 --> 0:11:22.840 something that gets to the children of all kinds before 0:11:23.120 --> 0:11:25.760 you know problems kick in, then you can they can 0:11:25.800 --> 0:11:27.760 live a pretty good quality of life. But it's important 0:11:27.760 --> 0:11:30.280 to note that Mark Butler appeared to stumble over this 0:11:30.360 --> 0:11:31.559 where he said that. 0:11:31.960 --> 0:11:37.079 Remember, the NDIS was established to support people with significant 0:11:37.120 --> 0:11:39.120 and permanent disability. 0:11:38.840 --> 0:11:41.960 And so there was some angst that people were thinking 0:11:41.960 --> 0:11:43.840 that maybe he was trying to suggest that autism is 0:11:43.880 --> 0:11:47.800 not an ongoing permanent disability, which it absolutely is. He 0:11:47.920 --> 0:11:50.320 was asked to clarify this in subsequent radiohen it views, 0:11:50.320 --> 0:11:52.719 which he did. He said, no, no, it's a permanent disability. 0:11:53.120 --> 0:11:55.760 We're not trying to find a cure. But he reiterated 0:11:55.760 --> 0:11:58.360 that the NIS is for people with significant disabilities. 0:11:59.040 --> 0:12:01.959 Rick, I think a lot of Australians are very proud 0:12:02.080 --> 0:12:04.320 of the NDAs. They think it's a good thing that 0:12:04.440 --> 0:12:07.439 was put in place by Julia Gillard and we're one 0:12:07.440 --> 0:12:09.600 of the few countries in the world to have something 0:12:09.720 --> 0:12:13.440 like this. But the commentary from the federal government for 0:12:13.480 --> 0:12:16.000 many years now has been that it is too big, 0:12:16.280 --> 0:12:19.160 it's too expensive, changes will have to be made. So 0:12:20.000 --> 0:12:21.760 do you think that as a result of that there 0:12:21.800 --> 0:12:25.840 has been erosion in the public support for the scheme 0:12:26.040 --> 0:12:30.480 and the public's appetite for spending on looking after people 0:12:30.520 --> 0:12:31.359 with disabilities. 0:12:31.800 --> 0:12:33.680 I think there has been, and I think it's almost 0:12:33.800 --> 0:12:38.240 entirely at the feet of federal politicians starting with the Coalition. 0:12:38.640 --> 0:12:41.640 But turbocharged, I might say, by Bill Shorten when he 0:12:41.679 --> 0:12:44.600 was Minister, who very deliberately set out on a kind 0:12:44.640 --> 0:12:47.240 of machiavellian, I guess way of trying to implement his 0:12:47.280 --> 0:12:50.800 own NBAS reforms after having stood very publicly in the 0:12:50.840 --> 0:12:53.040 way of the coalition's ones which did much the same 0:12:53.080 --> 0:12:55.200 thing and are almost exactly the same when you read 0:12:55.240 --> 0:12:58.200 the draft legislation changes that were put up in two 0:12:58.240 --> 0:12:59.920 in twenty one and that were put up by him, 0:13:00.600 --> 0:13:03.560 and then he commissions red Bridge Group to do this 0:13:03.679 --> 0:13:06.960 social research that looks at how they can sell reform 0:13:07.200 --> 0:13:10.920 to people. And the key takeaway from four different tranches 0:13:10.960 --> 0:13:13.760 of research there is that they can induce, as they 0:13:13.760 --> 0:13:18.599 call it, qualified tolerance, qualified tolerance for unpopular changes to 0:13:18.679 --> 0:13:23.320 eligibility and more difficult reform in the NDAs if people 0:13:23.360 --> 0:13:26.360 think that there's a problem with fraud and routing, and 0:13:26.840 --> 0:13:28.839 you know, I keep seeing it because of Robodet here. 0:13:28.880 --> 0:13:30.679 But you know, the way they sold Robodett is the 0:13:30.679 --> 0:13:32.920 where they sold the NDAs reforms, which is to talk 0:13:32.960 --> 0:13:35.719 about all of the fraud, all of the routing, all 0:13:35.760 --> 0:13:38.839 of the time. And when you're playing with that kind 0:13:38.880 --> 0:13:44.439 of fire retric loose language using the tabloid media to 0:13:44.480 --> 0:13:47.679 get your message across, you're going to lose trust in 0:13:47.800 --> 0:13:49.800 this scheme. And that's exactly what we're seeing and I 0:13:49.800 --> 0:13:52.400 think it is an appalling use of power. 0:13:53.559 --> 0:13:56.200 Well, Rick, thank you for speaking with me today. 0:13:56.520 --> 0:13:58.280 Thanks rebby always pleasure. 0:14:13.520 --> 0:14:16.520 Also in the news today, the Prime Minister Anthony Albernezi 0:14:16.640 --> 0:14:20.040 says he takes the threat of the sovereign citizen movement seriously. 0:14:20.680 --> 0:14:23.560 The man accused of shooting dead two police officers in 0:14:23.680 --> 0:14:28.160 Victoria's northeast, Deisi Freeman, is a self identified sovereign citizen. 0:14:28.680 --> 0:14:30.760 The Prime Minister says the government is aware of the 0:14:30.840 --> 0:14:33.920 dangers of the spread of extremism and ASIO has been 0:14:33.960 --> 0:14:37.160 warning about it. And Britney Higgins has been ordered to 0:14:37.160 --> 0:14:40.240 pay almost three hundred and fifty thousand dollars in defamation 0:14:40.360 --> 0:14:44.720 damages to the former Defense Minister Linda Reynolds. A judge 0:14:44.760 --> 0:14:48.360 ruled yesterday that reynolds reputation was damaged by social media 0:14:48.400 --> 0:14:51.320 posts made by Britney Higgins in July twenty twenty three. 0:14:52.120 --> 0:15:04.560 I'm Ruby Jones. This is seven am. Thanks for listening. 0:15:01.320 --> 0:15:03.880 You m