NDIS users pay the price when systems serve the bureaucracyadmin
The Tune review into the National Disability Insurance Scheme should have the government very concerned, not just about the NDIS, but about its collective capacity to deliver government services more broadly.
The release of the NDIS review during one of the government’s largest mobilisations of support to bushfire-affected communities and businesses may prove to be a mistake if the public witnesses further evidence of a bureaucracy lacking agility and lacking a person-centred focus in the delivery of essential services.
Government programs, state or federal, are all too often maligned for being overly bureaucratic and cumbersome for those accessing them. Criticisms aired by the users of the aged care, disability and health systems have one familiar theme – they are difficult to navigate for those unfamiliar with them.
Despite decades of experience in designing and implementing significant public policy service systems such as the NDIS and My Aged Care, review after review shows that governments continue to get it wrong.
For schemes like the NDIS, one might argue that many of its issues are teething or transitional in nature. In reality, the NDIS and aged care systems in particular have deeper flaws that go to the heart of their design and those charged with their development.
Both the NDIS and aged care systems place a priority on the principles of user choice and control. Both systems highlight the centrality of the end user, yet both systems regularly fail that objective.
In March 2019, the Joint Standing Committee on the NDIS issued its interim report. The committee highlighted comments from the executive director of the National Disability and Carer Alliance, who said that poor communication out of the National Disability Insurance Agency is one of the top issues for people with disabilities and their families.
The government must ultimately decide on the balance between user experience and the administrative hoops it expects users to go through in order to access the services they need.
The committee was told: “There are a number of cheat sheets floating around in the sector that translate how the NDIA speak with everyday language that the rest of us would use, which is necessary so that people can translate what is on the NDIS website, what might be on the NDIA portal, what might be in people’s plans.”
The interim report of the royal commission into aged care dedicates an entire chapter, titled “Finding the Door”, to the difficulty in accessing and navigating the aged care system.
“Successive governments have been at pains to stress that changes to aged care programs, and new programs, are aimed at providing greater choice for older Australians,” the report said. “Despite the rhetoric, the My Aged Care website falls far short of being able to support choice by providing meaningful information or to connect people with services.”
The aged care and NDIS systems are but two examples that should concern the Prime Minister and his government.
The failures highlighted in the NDIS and aged care systems are not simply a result of omission or poor performance; they are structural. Those charged with the design and implementation of government systems all too often fail to prioritise the needs of the user, instead giving priority to the development of a system that is government-centric in design.
Addressing this problem post-implementation is difficult and costly, likely requiring a complete overhaul of the system’s user interface. Such an overhaul requires money and, more critically, a cultural shift in the government’s thinking around unnecessary red tape and regulation.
The NDIS and aged care systems operate in what can best be described as quasi-markets. In these markets, the government is in effect a monopsony, controlling price, supply and eligibility. So the system design necessarily includes a capacity to manage who is eligible and for what, as well as how much the government is prepared to pay for services. These elements all too often become the priority, relegating user experience to a second-tier consideration.
The Thodey review into the Australian Public Service and the Prime Minister’s announcement that he will merge several departments will do little to address the problems facing most Australians trying to navigate and access government services. The fact that our newest system, the NDIS, requires cheat sheets to navigate, provided by those familiar with the disability sector, speaks volumes to the challenge ahead.
The government must ultimately decide on the balance between user experience and the administrative hoops it expects users to go through in order to access the services they need. Reducing the regulatory complexity of the system will bring some additional risks, but as long as it doesn’t affect the quality of service, it is a risk worth taking.
Developing a new user-focused service system should be the priority of the government and, until and unless that is done, the government at the very least must better fund the intermediary sector to help users navigate the various government service systems.
The Prime Minister’s overhaul of the public service, announced in the shadow of Christmas, will need to deliver more than a restructure if he is serious about delivering easy-to-use services for the Australian people. For the sake of all Australians, especially our most vulnerable citizens, let’s hope that it does.