21 November 2013
(Second Reading Debate, 5.40pm 19 November 2013, Legislative Assembly, NSW Parliament)
The National Disability Insurance Scheme (NSW Enabling) Bill 2013 facilitates the transfer of the State's public sector disability services, assets and employees to the non-government sector and other necessary public sector agencies for the National Disability Insurance Scheme.
Disability care is vital to prevent social isolation and financial burden for the most marginalised people. If done properly, this investment will help people reach their full potential and enable them to contribute to the community. It is fundamental if we are to meet our obligations under the Convention on the Rights of Persons with Disabilities. People with severe disabilities and their families can suffer poor quality of life. They experience barriers to full-time employment and high-paid positions, socialising, and reduced autonomy over care and living arrangements, and as a result can suffer mentally.
We have long needed a new approach to disability care that shifts the focus away from crisis care to one that promotes independence and choice. The National Disability Insurance Scheme is a significant breakthrough to disability care and brings hope to people with permanent and significant disabilities and their families that the personalised support and care they need will be available. I was proud when New South Wales became the first State to sign up to the scheme and I congratulate the former Minister on his hard work in support of people with a disability. Although I strongly support the National Disability Insurance Scheme, I am concerned about a new approach to disability care enabled by the bill, which is the full exclusion of the public sector disability services, assets and staff that the Minister says will occur by 1 July 2018.
The Government's existing Ageing, Disability and Home Care agency provides care for some of the most vulnerable people in the disabled community, many of whom I understand the non-government sector cannot or will not help. One of the most important features of the National Disability Insurance Scheme is that it provides choice to people with a disability. I do not understand how disability clients will have greater choice if the entire government sector, which currently covers 40 per cent of disability care in the State, is devolved. Many clients have strong relationships with their service providers and want and benefit from little change. A sense of loss, safety and security can be brought about by change and many clients, particularly those with an intellectual disability, benefit from routine and familiarity.
The Government frequently touts that the non-government sector is more innovative and efficient but it fails to explain how or why. Governments develop new and better ways to deliver service if there is the will and the resources. Why is it not possible for the public service to provide new and improved benefits to people with a disability? Many of the claimed problems of government agencies such as inefficiency and bureaucracy will occur as non-government organisations grow and provide additional services, staff and assets. Of great concern is how the monitoring and review of complaints will occur under the National Disability Insurance Scheme. A system is needed that covers not only the National Disability Insurance Scheme agency but also those organisations that provide funded support and services. The NSW Ombudsman currently administers a mechanism but it does not appear to apply to disability clients who transfer to the National Disability Insurance Scheme.
I share the concern of organisations such as People with Disability and the Australian Centre for Disability Law that this bill should include provisions that enable the Commonwealth to designate this existing consumer protection mechanism until a Commonwealth system is established. People with a disability are often the least enfranchised to engage in a process if they are denied assistance or treated unfairly, even when internal reviews are available. Under a new system, which may cause new teething problems and is provided predominantly by the non-government sector, more than ever people will need access to affordable and specialist legal advocates if there is no safety net through the public sector. As part of this package the Government should increase funds to disability advocacy groups. Alarmingly, however, I understand that it plans to cease funding to peak disability and advocacy groups by 30 June 2015.
The National Disability Insurance Scheme does not absolve the State Government of all disability care responsibilities. The Government must continue to have a role in a number of fields, including education, transport, housing, health, policing and criminal justice, child protection and other community services. The Government should retain an oversight agency in the long term that sets targets and coordinates other agencies. The Government should continue to work with the peak bodies on these issues. In the long term the Department of Premier and Cabinet should establish an office of the status of persons with a disability with whole-of-government coordination functions while maintaining its existing disability advisory body, which is the Disability Council NSW.
I am deeply concerned that people with a disability who are lesbian, bisexual, gay, transgender and intersex or have HIV or AIDS could be worse off under a system that has no public providers. It is likely that the big religious organisations will take over some of the publicly run services and assets. Unlike public sector agencies, religious bodies are exempt from provisions under the Anti-Discrimination Act 1977. I have already heard reports of lesbian, bisexual, gay, transgender and intersex people experiencing discrimination and unfair treatment from religious service providers, particularly in aged care. Examples include being forbidden to display affection with their same-sex partner while visiting them in supported accommodation. Whether or not this is widespread, it should not be permitted. Without a safety net provided by government care, I am concerned that people with a disability will be vulnerable.
Similarly, I am concerned about staff transferring from Ageing, Disability and Home Care to the non-government sector. If they transfer to a religious organisation they could be subject to discrimination due to exemptions in the Anti-Discrimination Act. This not only would make lesbian, bisexual, gay, transgender and intersex staff vulnerable, but also may affect people with a disability who rely on and have working relationships with lesbian, bisexual, gay, transgender and intersex disability workers. I have raised these concerns with the Minister and have proposed an amendment to protect disability care clients and workers. I believe it is essential that people with a disability are given a guarantee that they will not be worse off under the bill, regardless of their race, religion or sexuality. At a meeting with the Minister's office and an Ageing, Disability and Home Care officer I was given a strong assurance that the Government will include provisions in all contracts for the transfer of disability care to prevent any form of discrimination against disability clients or staff.
I believe the words of the former Minister in his second reading speech are sincere and show that the Government will ensure disability clients and staff are not subject to discrimination. I will work with advocacy groups to ensure this occurs and that no-one slips through the cracks. I am also concerned that the transfer of public disability care premises to religious bodies as well as to other private or not-for-profit organisations will result in consensual sexual activity—same-sex and opposite sex—being forbidden in supported accommodation. Sex currently occurs in some government-run premises between residents and visiting sex workers, and between consenting residents. Some families also take relatives in care on outings to brothels. Sex can be therapeutic to people with a disability and provide pleasure and companionship. People with a disability have sexual desires. The Government needs to ensure that those people with a disability will not lose such benefits and that it will monitor this aspect in the transfer.
If the National Disability Insurance Scheme is to run effectively, I believe there needs to be a service of last resort that captures services that cannot be contracted competitively because of remoteness or challenges presented by a particular group. This happens now and I do not believe we are at a stage in the National Disability Insurance Scheme to be confident that the non-government sector can pick up this role. What consultation has occurred with people in supported care about these proposed changes? If the decision is made from the top down it will completely undermine the aims and benefits of the National Disability Insurance Scheme such as choice, autonomy and personalised care. I strongly support the National Disability Insurance Scheme and I am grateful to the Minister and his office for addressing my concerns concerning the lesbian, bisexual, gay, transgender and intersex community—people with a disability and workers—but I am very concerned about the loss of State Government responsibility for disability care, which could put the security and safety of some of the State's most vulnerable people at risk.