Open letter: The risks of bundling disability into Health and Aged Care portfolio

The 2025 Albanese cabinet made the same Minister responsible for Health and Ageing as well as Disability and the National Disability Insurance Scheme.  It also brought a commitment from the Prime Minister that “together we will make our way forward with no-one held back and no-one left behind”.

Will rolling Health, Ageing and Disability (including NDIS), in together make it easier to honour the PM’s commitment when it comes to the disabled community?

As a middle-aged wheelchair user, the mega-portfolio makes me nervous.

Historically, disability has commonly been approached from a medical perspective.  When I was a child, the focus was on my diagnosis, what was “wrong with me” and how I could be “fixed”.  It meant several very painful bouts of surgery.

It also meant no one would consider sending me to a mainstream school until I had learned to walk, despite the fact that I was reading by the age of 3.  Even though I did learn to walk and go to mainstream school, many people, including employers, held an expectation that “people like me” didn’t work.

I have 3 degrees and I’ve held quite a few jobs, but I still find many people are surprised by that.

The medical approach treats disability as a problem located within the individual.  It’s a problem to be fixed and if it can’t be fixed the person is considered irretrievably broken.  They are offered a Disability Support Pension.

A pension is a payment that means you are never expected to work again.  It’s like being put on the scrap heap.  That’s the result of the medical model of disability.

It’s an approach I expect might increase again in prominence by putting disability into the same ministerial portfolio as Health. The medical model focuses strongly on limitations and what can’t be done.

The Social model of disability appeared in the 1970s.  It considers disability not as a problem located within the individual but as barriers created by the choices made by our society.  Choices can be changed.

As a wheelchair user, stairs deny me access to a lot of spaces that walking people can get to.  That means I can’t participate in anything that happens there.  Providing ramps to those spaces means I can be included.  It’s a change to the environment, not my body.  It doesn’t make me able to walk but it makes walking less essential.

The Social model identifies ways to adjust the environment to suit the packages people come in, not the other way around.  It doesn’t give up on people.  It uses creative thinking to work with the possible.

It led to disabled people living full lives, some entering the workforce by adjusting environments and others finding different ways to contribute in their communities.  I want to see that approach continue to thrive.

In Australia, Disability is now also in the same portfolio as Ageing.  People who don’t live with disability are inclined to assume that the needs of disabled people of any age are similar to the needs of elderly people, who are likely to experience declining health and mobility.

Sure, there is some common ground.  Both groups will include wheelchair users.  Both groups will include people who require assistance with personal care, domestic duties or accessing the community.    But there are significant differences.

I’m concerned that older people without existing disability will be assumed to have more in common with disabled people of all ages than they do and that the life and opportunities of disabled people will be limited as a result.

We are still battling to get younger disabled people who need high levels of support out of nursing homes. They don’t belong there.  I’m concerned that this new portfolio arrangement could make that battle much harder.

I’ve worked in aged care facilities.  Many older people were happy to join in a sing along that included “Daisy Daisy” and “The Road to Gundagai”.  Younger people want Taylor Swift and The Kid Laroi.  Differing musical tastes are only the tip of the iceberg.

Everyone deserves the opportunity to have friends of their own age and to engage in the activities that are typical for their age group and culture.  You can’t go out to pub to see a band, as a 40 year old, when the place you live expects you home for dinner at 5PM and in bed by 7.

Combining disability and ageing into the same portfolio seems likely to encourage the assumption that because disabled people and ageing people have some common needs, they can all be met in the same way.  I’m concerned that the system will become less inclined to recognise and cater to the significant differences between people of very different life experience.

I’m 55 years old.  As I head towards my senior years, I don’t want to slow down until I’m ready to.  I don’t want the system to decide that because I’ve reached a certain age, I no longer deserve the supports I need to have a full and satisfying life.

I don’t want to lose access to the good quality power wheelchair I receive through the NDIS, that gives me a great deal of independence, just because other people my age, who acquire mobility impairments later in life, prefer to stay at home.

I don’t want to lose access to the specialised therapy that helps me maintain my ability to shower and dress myself because “people my age” with limited mobility get personal care support, not therapy.  My body will always have different needs to those of my non-disabled peers as a result of my disability.  I want the system to continue to recognise that.

Every new government makes changes to how things are done.  The 2025 Albanese government has changed how the portfolios fit together.  Let’s hope that in doing so they honour their commitment to a society where, “together we will make our way forward with no-one held back and no-one left behind”.  Disabled people deserve a full and satisfying life, alongside everyone else.

Jane Scott,
Working to make disability inclusion really ordinary

Visit my blog Rolling Through