The National Disability Insurance Scheme (NDIS) has been a focal point of discussion and controversy since its inception. The current Labor Government is striving to rein in spending increases and return the scheme to what they deem its original purpose.
A significant step in this direction is the introduction of legislation by NDIS Minister Bill Shorten, which aims to exclude certain services, including sexual support services, from the scheme.
However, advocates for the sexual rights of people living with a disability have voiced their concern regarding this move in a recent SBS News podcast.
In a landmark 2020 ruling, the Federal Court upheld the right of an NDIS participant to use their funds to access a sex worker. Senator Jordan Steele-John highlighted that this ruling followed a lengthy battle between a woman with multiple sclerosis and the National Disability Insurance Agency (NDIA), which had spanned four years.
“The NDIS has been fighting this participant’s desire to use some of their plan funding this way, in line with their goals, for four whole years,” Steele-John remarked.
Despite the court ruling, these services have remained largely inaccessible to NDIS participants. Anita Brown-Major, an occupational therapist in Melbourne, noted the discrepancy between the ruling and actual practice.
“It does not mean every person with a disability, their only access to sex is with a sex worker,” Brown-Major explained. “If I have a hundred clients coming through, you might have four that we will end up with some sort of report with the NDIS for sex work. And of those, all of those have been rejected in the last year that we’ve seen.”
Minister Shorten confirmed that out of 100 million invoices processed annually by the NDIS, there were 228 requests for sexual support services in the last 12 months, none of which were approved.
The new legislation before the Senate aims to formalise the exclusion of these services from NDIS funding. Minister Shorten emphasised the government’s intent to clarify permissible expenditures under the scheme.
“Why do journalists keep asking me about it? I answer the questions I get. I’m not banging on about it… What the government wants to do is just be very clear about what you can spend your NDIS money on. So yes, we don’t think it should be spent on certain services.”
The broader goal of the bill is to curtail the growth in NDIS spending to ensure its sustainability. The annual cost of the NDIS is projected to exceed $50 billion by 2026, surpassing the cost of Medicare. Minister Shorten articulated the necessity for the scheme to focus on the most complex cases.
“The NDIS cannot be the only lifeboat in the ocean. That’s the idea that if it’s the only support a person with disability can get everyone’s going to swim to that. Understandably so. But that doesn’t mean that scheme is sustainable.”
State and territory governments are expected to shoulder the responsibility for services that the NDIS cannot or should not cover. South Australian Premier Peter Malinauskas confirmed that discussions regarding the roles of State and Federal governments in providing foundational supports are ongoing.
“The State governments will have a role in the development and the design of those foundational supports. That’s important because it means we’ve got a clear eye around what will be the State government’s responsibility and what will be the Federal Government’s responsibility, and how much it will cost.”
Dr. Martin Laverty, involved in the original NDIS design, stressed the importance of legislative support for collaborative reforms between the States and the Federal Government.
“The impact of delay is queuing other reform necessities for both the agency and the service sector to deal with… And specifically the co-design commitment that has been given… A further delay to that co-design – that won’t commence until after the bill is passed – increases the queue of reform. And at this time, the urgency to reform the NDIS cannot be understated.”
However, concerns persist among disability groups regarding the proposed changes. Darryl Steff, CEO of Down Syndrome Australia, expressed unease over the lack of clarity about the future disability support system and the NDIS’s role within it.
“There are some important reforms contained within this legislation, and it is really important that these reforms happen in the future. However it’s disappointing that the legislation has come in advance of a full response to the NDIS review so that there is not a complete picture of the implementation roadmap, and how everything will or could sequence through the changes that need to come in order to manage the sustainability of the scheme.”
Anita Brown-Major highlighted the resistance from the NDIA towards expert recommendations on sexual support services for people with disabilities.
“We have (in the practice) an OT (occupational therapist) who is also a sexologist that has – I think they did about five reports over a year ago… All the reports that we’ve written talk about what that person can and can’t do, what we’ve tried up until this point… And we will do – the NDIS will spend money on these experts reports and then every single one of them have been ignored… The amount of money that has been wasted on court cases and lawyers’ fees – and even reports from myself – is ridiculous.”
Misunderstandings and stereotypes about sexual support services for people with disabilities remain a significant barrier. Marayke Jonkers, president of People With Disability Australia, emphasised the importance of specialised services.
“Two people who both have a physical disability – and the Australian courts have recognised sex is a human right, a part of everyday life. Now (if) this couple need assistance to get into position to have sex. Do we expect anyone who cooks, cleans, or provides other services in the house to assist them in the act of having sex? Or perhaps would that best be performed by someone with specialised services?”
Brown-Major echoed the need for education and awareness about sexuality and disability.
“Folks with disabilities are often seen as you don’t have a right to that education or you don’t need it because you won’t ever be a sexual being in the future. But we know that the evidence is that young folk with disabilities are more at risk of sexual assault because often they’re not given the education. So we do a lot of work within the younger population about body awareness, body parts, working a lot of the time with teachers and other professionals about consent for touch.”
The debate over the exclusion of sexual support services from the NDIS reflects broader concerns about the scheme’s sustainability and the need for a comprehensive, inclusive approach to disability support.
The foundational services being negotiated between State and Federal governments aim to address unmet needs, but the details remain uncertain. Advocates like Catherine McAlpine from Inclusion Australia insist on a collaborative approach to defining these supports.
“I don’t want anyone telling me exactly what they are. I want to be part of the conversation and for our community to be part of the conversation to decide what they are.”
As the legislation progresses, the inclusion and exclusion of services within the NDIS will continue to be scrutinised, with the aim of creating a sustainable, fair, and comprehensive support system for all Australians with disabilities.
Does a person get a wheel chair that can deal with their declining functionality from MND or does that NDIS money get spent on sexual support services for some other people ?
It’s not a great example and I am not moralising but the NDIS is not an endless money machine.
I favour getting the basics right first. My wife and I have been carers for our son for 52 years. PLEASE Don’t stuff up the NDIS because of unrealistic expectations