Expert urges NDIS providers to learn from the UK’s mistakes

An international expert in economics and social services has warned Australia to learn from the UK’s mistakes in its transition to the NDIS.

In an interview with Pro Bono News, Dr Shereen Hussein from King’s College London, said attention needs to be given to implications on care service quality and integration with health and other social services.

She also said consideration needs to be given to increased risks of worker stress and burnout in a market-based model.

“There are workforce pitfalls that we are also struggling with in the UK. These relate to the concept of the viability of the market.”

“That care is now a commodity and for the market to progress you want a competitive arena, and for consumers to be able to exercise authority in their choices.”

“The geography and diversity of the Australian population call for careful considerations of potential challenges associated with the NDIS, such as thin markets, viability of services for people with multiple or complex needs, and availability of quality workers.”

“If you are a person with complex needs you may not have enough markets to meet those needs. There are organisations that cannot provide for all of those needs simply because there are not enough consumers in that group. So then you would be left with no choice or a very expensive choice. So the market forces are quite weak.”

Dr Hussein said there had to be a system in place and a compliance system that empowered people so as to create competition for those services.

“This is OK in urban areas but in regional or remote areas this may not work well,” she said.

“A market-based approach is not the [only] solution and without the proper mechanisms in place it may fall. And it may not provide services to everybody especially the most vulnerable,” she said.

“There is a huge role for not-for-profit organisations here to fill the gaps where the market cannot, especially for people with complex needs.”

She also warned of the impacts of increased casualisation of care workers, which was highlighted in the recent Australian Disability Workforce Report.

The report revealed a sector growing rapidly and experimenting with work arrangements and recruitment approaches, tracking six quarters of workforce data that showed consistent net growth, increased casual employment, and increased use of fixed-term employment.

It also found casual turnover rates much higher and less predictable than those for permanent workers.

Dr Hussein said the UK is already seeing the impact of increased casualisation as companies seek to reduce costs.

“You’re reducing job security, reducing the hourly rate and maximising the amount of work within a limited time.”

“There are two differences between flexibility and casualisation. You can still create flexibility but you have to put protections in place.”

“If you remove the protection under the guise of flexibility then you create insecurity and you create categorisation and also you create the turnover of people and that will have a direct impact on quality of care.”

“Here in Australia it’s the right opportunity to discuss these things because this is a workforce that is likely to see huge growth in the future and huge demand from people who are vulnerable and who need to be assured the person who will look after them has minimum standards and qualifications.”

“The UK experience can provide many lessons to Australia of what can work well, and what to watch out for particularly in relation to the potential implications on care service quality and integration with health and other social services,” Dr Hussein said.

“Safeguarding individuals using care services, their families and workers should be at the heart of these policy developments.”

“Collecting adequate and comprehensive data would allow timely and evidence-based interventions and policy developments,” she said.

Source: Pro Bono News 


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