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The tyranny of being an existing service provider: a view from inside the NDIS

Many thanks to The Power to Persuade for allowing us to cross post this piece by Jeff Thompson.

Jeff Thompson is community development manager at a disability service provider in the ACT. In this post he explains the implications of the NDIS for existing service providers in an environment that favours the “new” over the known.

Jeff writes:

I met Luke* in 1997. He was 18 – I was 25. I was working as a disability support worker at a youth centre and Luke came in every afternoon to a make ham, cheese and tomato pizza and play pool very badly. Last week I was invited to Luke’s 40th birthday party at a local club. It made me think of my career working in the disability sector and some of the ongoing connections I’ve made. I’m not close friends with Luke but I say G’day when I see him at the bus interchange and I know enough to ask him a few questions about his life.

If this was a Hollywood movie I’d have grown emotionally attached to Luke and shared in his suffering to help him overcome his barriers and in the moving final scene I’d donate my kidney to him in a dramatic love-at-all-costs moment. Cue the string orchestra. In reality Luke and I are associates who’ve worked together, had a few laughs and enjoy a brief catch up when our paths cross. Not much more than that I’m afraid.

Having worked in the sector now for 20 years in the same small city I’d say there are about 300 people with disability who I know to wave and smile at – say a quick hello. I know their names, maybe who their parents are, and possibly a quirky anecdote or two from the past. I work for a medium sized service that supports over 450 people with disability in the Canberra region. The service started in 1990 with the implementation of the Disability Services Act that closed large institutions. Innovation was forced upon them and a group of staff and parents sat at a kitchen table and decided they’d try and get jobs for seven young people in real work. It was a brave new world.

Almost 25 years later the NDIS is being implemented and once again governments are calling for innovation from the sector and new ways of doing business that are person directed and community based. Unfortunately the service I work for seems to be suffering from the commonly held view that established services are inherently inflexible, welded to old service models that are disempowering for people and their families. New services are called for. New players. New ideas. New ways of doing things.

Don’t get me wrong: after 20 years in the sector I’ve seen some shockers, undertrained workers with no people skills, criminally negligent services that foster abuse, the death of innocent people at the hands of the system set up to care for them. Fortunately for me I’ve been surrounded by committed professionals with a passion to respond to systemic injustice and change the system one small step at a time. As an organisation we’ve struggled with different policy environments over the years as governments waxed and waned.

Frustratingly, we looked to international innovators and tried to influence local debate but it’s a big ship and the HMAS Disability is hard to turn. Just ask anyone who’s been involved with the implementation of the NDIS. We welcomed the new approach and immediately developed a new service model that would allow people to design and purchase the service they want in the areas of employment and skill development. We put our hand up for every training and innovation grant, sector development fund and community grant. We adopted the Supported Wage System dismissing the BSWAT as unfair.

Unfortunately, it seems that despite the many years of local experience and our willingness to adapt, the service I work for suffers from being ‘an existing service provider’ in an environment that demands ‘new’.

This is not sour grapes. Bring on as many creative community based services as we can! But where are they? Big national church based charities and high profile services from other states. They’re just ‘existing services’ by any other name. Small innovative services running cafés and micro businesses with no links to the disability employment network and no post placement experience in the employment sector. Risky. Family collectives exploring respite options for their children without any experience in the supported accommodation sector. Noble but misguided. Collaboration is required.

The most successful outcomes from the NDIS have come when the person with disability, the individual planner, and the best fit service that is trusted by the person and the family all work together to develop and implement the plan. Fortunately the NDIS has a built-in trapdoor. People can vote with their feet. But services can also stay true to their core values and only offer the services they want to deliver.

Previously we were shoehorned into providing service within narrow policy definitions, often at odds with our organisational philosophy. Now we can make a business decision to only offer person-directed community-based services that provide pathways to employment and skill development. We won’t do respite. We won’t do centre-based care. We won’t waste your time. We will shrink in size. We will lose a few clients. We’ll gain a few more. We won’t do it for a price we can’t afford. We will pay our people the award wage and expect excellence of them. We will respond to individual need because when the opportunity was provided this ‘existing service’ changed and adapted very quickly to the NDIS

I didn’t go to Luke’s party – I sent him a Happy Birthday text. I’ll say happy birthday to him next time I see him on the bus.

*Name changed to protect identity.

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Cultural Solutions - Healing Foundation forum 2014
Lowitja Institute Continuous Quality Improvement conference 2014
National Suicide Prevention Conference 2014
Racism and children/youth health symposium 2014
Rural & Remote Health Scientific Symposium 2014
2015 conferences
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#HSR15
#NRHC15
#OTCC15
Population Health Congress 2015
2016 conferences
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#AHMRC16
#ANROWS2016
#ATSISPEP
#AusCanIndigenousWellness
#cphce2016
#CPHCEforum16
#CRANAplus2016
#IAMRA2016
#LowitjaConf2016
#PreventObesity16