The "capitalist", market-based approach underpinning the National Disability Insurance Scheme has failed in regional and remote Australia and new models need to be considered, according to the peak body for service providers.
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The scheme was designed on the assumption participants would be able to turn to the private market to purchase support and services using their budgets.
But almost a decade after the NDIS was established, major gaps in the disability care market have become apparent, particularly outside the capital cities.
The term "thin market" is often used to describe the problem.
But Laurie Leigh, the chief executive of National Disability Services (NDS), said that was a euphemism.
"Let's just call it what it is. The market has failed in those areas," she said.
"It's an old capitalist theory that if you put enough money into the market, then providers or services would spring up to deliver that.
"I think almost 10 years in (to the NDIS) we have found that there are significant examples of market failure across the length and breathe of the NDIS."
ACM, the publisher of this masthead, spoke to Ms Leigh as part of its new series, We need to talk about the NDIS.
She said there were a number of alternatives to the market-based approach to service provision which could be considered for disability care, which she argued was an essential service like health and education.
Ms Leigh mentioned the so-called "capitation" model used in health care overseas, through which doctors are paid an annual sum for each patient.
NDS, which represents more than 1200 non-government service providers, wants alternative models to be examined as part of the major new review of the scheme.
Ms Leigh said one of the clearest examples of market failure was participants not being able to find a service provider in their area, leaving funds unspent in their budgets.
The discrepancy in so-called budget "utilisation rates" between participants in major cities and regional and remote communities is stark.
For example, the roughly 9100 participants in Canberra are using up an average of 74 per cent of their budgets, according to the latest NDIS figures.
Out in in the Kimberley-Pilbara region of WA, the average utilisation rate for its 1420 participants is just 56 per cent.
In another example of market failure, in particular the workforce shortages in allied health, Ms Leigh said an NDS survey last year found 77 per cent of providers were getting requests for services which couldn't be met.
"That's just another example of where the market just has not delivered," she said.
We need to talk about the NDIS
Read more from ACM's series examining the future of the scheme:
- Australia, this is why we need to talk about the NDIS
- 'No longer sufficient': Former top cop's NDIS fraud warning
- Marcus 'needs to stay in his home': a mother's fight for her son
- 'Marking their own homework': Why Shorten rejected advice on NDIS review
- 'Like same-sex marriage vote': How NDIS costs debate is harming people with a disability
Dan Jervis-Bardy
Dan covers federal politics from Parliament House, with a special focus on climate policy and the NDIS. He has previously reported on ACT politics and urban affairs since joining the Canberra Times in 2018.
Dan covers federal politics from Parliament House, with a special focus on climate policy and the NDIS. He has previously reported on ACT politics and urban affairs since joining the Canberra Times in 2018.
