7 June 2021

Could NDIS changes prove to be a godsend?

Comment NDIS TheHill

I’m curious. How do you feel about independent assessors being used to determine a person’s access to NDIS funding?

As of July this year, people applying for or renewing an NDIS plan will, if their application fits the eligibility criteria, be interviewed by one of these independent assessors either in person or via a video link using a standardised assessment framework to determine what and how much support is needed.

No longer will applicants need to present reports and assessments from their treating clinicians, allied health professionals and other support personnel in order to verify the degree of disability they have and the nature and range of services needed.

At the risk of being seen to be swimming against the tide, and please don’t shoot me, but my first reaction to this was one of relief.

And it’s not my laziness that I’m admitting to (really, I can count on one hand the number of reports I’ve had to do), it is more that these reports are perceived by the patients to be the rate-limiting step between them and access to significant funding. And in some cases it is. Regardless of how the treating clinician feels, patients view these reports less as independent assessments and more as patient advocacy.

In justifying the new arrangement, the NDIS points out the inherent problem in having an applicant’s treating doctor provide the assessment. According to them, health professionals have a “sympathy bias” towards their patients/clients.

I have read a number of opinions where clinicians feel outraged at such a suggestion. And claims we have been sidelined from the whole process because of this erroneous assumption. But really?

To me it seems obvious – of course we have a “sympathy bias”. We want the very best for our patients. In any report, I imagine we would all feel compelled to highlight the areas where we feel a patient could benefit from extra resources. It is relatively easy in most cases to be prescriptive when assessing a physical disability, but when trying to quantify the impact of a mental illness on a patient’s life and what services they might need to manage in society, well, that can be very tricky.

And that’s the other advantage I can see from having independent assessors. Consistency. I’m not sure of your experience with the scheme, but I have some patients whom I consider terribly impaired who can’t seem to get any help at all for things like a suitable bed, while others who present reasonably well are getting hours of help, including being chauffeured to language classes or employing other sight-impaired friends (with no qualifications) to look after their finances – all on the NDIS.

Did it all come down to the eloquence of the treating clinician’s report? Was it the quantity of specialist opinions perhaps?

There have been reports of parents of children with autism not being able to access funding because of the public system waitlist to see a child psychologist and receive the formal diagnosis, whereas more affluent families can access a psychologist privately and expedite the NDIS funding. Surely the new arrangement will help level the playing field.

Much of the criticism levelled at the introduction of independent assessors has come from patient advocacy groups. How can someone, a stranger who see the patient for three hours really judge the degree of disability?

There is also the argument that the whole initiative is a cost-cutting measure, with the independent assessors more interested in shoring up the NDIS reserves than actually looking after needy patients.

These criticisms need to be addressed. These independent assessors will need to be very well-trained and professional if the system is going to work. And surely there will still be a place for information-gathering from those who care for the person undergoing the assessment. You would have to hope so.

As for the assessors not having the patient’s interest as their primary concern, I suspect people might be equating this situation with that of assessments for insurance claims – where the assessor is acting on behalf of a private insurance firm. However, the NDIS is not a private company. It has no shareholders and no one expects it to make a profit. Having said that, it not a magic pudding either.

There will need to be some rationalisation of how the funds will be distributed to make sure that everyone who needs help will get help. Maybe they will be more hard-nosed than the treating clinician, but maybe that is needed for a sustainable NDIS.

I am a great believer in the NDIS and am very grateful such a scheme exists for those vulnerable patients who need help just to get through their day-to-day lives. But I also recognise its flaws and this recent initiative is an attempt to address these with the introduction of independent assessors.

I, for one, am happy to relinquish any gatekeeper role I had to the scheme in the hope that the new process will be more consistent, less complicated and provide faster access to funding for those that need it.

That’s the hope, anyway.

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5 Comments on "Could NDIS changes prove to be a godsend?"

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Partha Modak
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Partha Modak
7 months 15 days ago
I am surprised with NDIS’ conclusion “health professionals have a “sympathy bias” towards their patients/clients.” Surprised because a bureaucratic organization can have the ability to grasp the truth! Now I shall hold my breath to see how long before Centrelink comes to the same conclusion about the Disability Support Pension report by the treating doctor and Motor Vehicle Registry about the driver’s medical assessment for a non-commercial (class C) licence. I may be in for a trans-state like Himalayan yogis. The big difference I suppose NDIS can eye savings here, whilst MVR will lose money and as for Centrelink? perhaps… Read more »
Dr Raymond Yeow
Guest
7 months 16 days ago

As a GP; I support independent assessors because otherwise too much pressure is put on the GP and the GP-patient therapeutic relationship to “dress-up/ embellish” the form’s details.
In fact, I believe we need independent assessors for the PRIVATE driving licence sign -off; and long term centrelink disability forms .
As a GP, if there is any knock back by the govt dept re paying of of social security benefits…it is not of my doing/fault

Melita Cullen
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Melita Cullen
7 months 19 days ago
Interesting article, Linda. Definitely food for thought. I think it is accurate to say that I’m one of the GPs Dr Lane talks about who is good at doing NDIS applications and reviews. I lost count of how many applications I’ve done after about 100, and that isn’t counting reviews. My applications usually take me 1.5 hours and reviews take 3 hours. Developmental Child health is my bread and butter and NDIS comes with that. I also have 2 children on NDIS. Initially our local NDIS provider had wonderful Local Area Coordinators (LAC). However, over the last couple of years,… Read more »
Dr Andrew Lane
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Dr Andrew Lane
7 months 20 days ago
Thanks for the article, Linda. I appreciated it. Like most debates this one also seems to have become rapidly politicised and polarised. We have 3 sides: The officious government, the outraged applicants, and the bewildered GPs. Things and people are categorised as good or bad. I will go out on a limb here and say I think things are a little more complicated that that. A few thoughts. 1. I am a GP. I am not an OT. I have no training in occupational or disability medicine. Few GPs do. Yet it seems the prevailing premise is that GPs are… Read more »
Mary
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Mary
7 months 20 days ago

If the sole assessment is done by a person talking to the would be recipient of care there is also likely to be bias. Seems to me some cross checking is still important- just like GP wants best for patients ..the person themselves can “emphasize” their disability to obtain more than their fair share of the limited pool of taxpayer funds. This NDIS industry is a frightening behemoth with an insatiable appetite.

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