National Disability Insurance Scheme Amendment (Securing the NDIS for Future Generations) Bill 2026

Senator ANANDA-RAJAH (Victoria) (10:35): The NDIS is a vital piece of social infrastructure in Australia. It was first introduced by the Gillard government with bipartisan support, and it has transformed the lives of thousands and thousands of people with disability, and, indeed, provided relief and confidence to their carers. I was a member of the committee that heard testimony over the last eight weeks from numerous stakeholders in this sector.

This was a community affairs inquiry that received over 4,000 pieces of evidence. We can tell that the community is highly invested in this scheme, and we understand that. What was telling though was that while we heard evidence that people were trenchantly opposed to any changes in this bill, we also heard testimony that NDIS was failing other families—and sometimes even failing people within the same family.

We heard examples where one child would be receiving supports and another child, a sibling, with similar needs was not getting those kinds of supports. There was a real paradox here. We, as a government, understand the vital importance of the NDIS—after all, it is a Labor scheme—but we also understand that we need to protect it for future generations.

This means that we need to confront some hard truths. The first is that growth in the NDIS has been unsustainable. The scheme currently costs $50 billion for 760,000 participants.

This contrasts, for example, with Medicare which costs $40 billion for 28 million Australians. The scheme, without any changes, is on track to hit $70 billion in 2030 and, a decade from now, in 2035, it will hit $100 billion if no changes are introduced. This is clearly unsustainable and it is pulling and tearing at the social licence of the scheme with the Australian taxpayer.

In addition, we know that the scheme has been riddled with fraud and rorts. It has become a honey pot for syndicated crime. This is why this government introduced a package of $1½ billion to combat fraud in the system.

We introduced, for example, the Fraud Fusion Taskforce. We strengthened that further with the NDIS safeguards and integrity legislation. And we have further empowered the agency, the NDIA, to strengthen integrity and chase down these fraudsters.

The NDIS has effectively become a honey pot for shonks and criminals and that is not a costless crime. In addition, we have problems with eligibility. That was evident throughout the inquiry, even within families with children with similar needs.

There is far too much inconsistency around eligibility, and this has really been born from the fact that eligibility has been determined by diagnosis. As a doctor, I trenchantly oppose any medicalisation or pathologising of health conditions. In fact, what has happened is these access lists have become a gateway for entering into the NDIS when actually we are trying to shift it to a more functional test.

So, the NDIS was established to help and to assist those with permanent and significant disability. We are moving away from the diagnostic gateway—frankly, it has led to diagnostic inflation—to one threshold that is more based on functional needs. Those thresholds will be determined by a technical advisory group that we have stood up that is chaired by a person with expertise in occupational therapy.

It's this group that will provide evidence to the government as to how we should set thresholds for entry into the scheme, but it should not be based on medical diagnosis because those lists are as long as your arm, and they have not worked. In fact, what we are doing instead, I think and I fear, is pathologising a whole range of conditions, and that can lead to other problems.

The NDIS is there to support people with permanent and significant disability, so we want to really dial back some of the scope creep that has entered the NDIS. As architects of the NDIS, we are absolutely determined to secure its future, and that is what this bill does. It builds on four pillars: fighting fraud and stopping the rorts; slowing the rapid cost increases; clarifying eligibility requirements, which I've talked about; and ensuring that we continue to deliver quality services and supports to participants both now and well into the future.

The scheme is far too important to allow these to slide. Under the coalition, in the 10 years that they were in power, the scheme completely went off the rails. The growth of this scheme was in the order of 22 per cent when we came to government.

We halved that growth to 10 per cent, but it wasn't enough. The actuary clearly told us that the scheme was on track to cost $100 billion in less than a decade, so we have to make further changes. That's why, in January of this year, National Cabinet agreed on bringing the cost down to five to six per cent.

The scheme will still continue to grow—I just want to make that clear—but it will grow at a lower, more sustainable rate, and one that retains integrity and preserves its social licence. We know that this growth cannot come at the expense of other services Australians need, whether that be Medicare, hospital funding, regional and rural health services and so on.

Importantly, in creating a more sustainable NDIS, it allows us to look at other groups who have, I think, been neglected for too long. In my practice, I saw a lot of patients with psychosocial disability. What does that mean?

For example, it might mean people with burnt-out schizophrenia. These are people—often young people, I might add—who are heavily medicated, who have really challenging psychiatric disorders that require ongoing specialist input, and they are unable to work. They rely on the state.

They rely on the safety net. The problem is the safety net is sometimes not adequate for these people. They end up homeless.

They go from boarding house to boarding house. They enter the hospital system like a carousel—in and out, in and out. Sometimes they fall through the cracks.

We as a government recognise that this is a problem. This has been discussed with the subnational governments. We want to help these people and try to enable the NDIS to provide that kind of support to these people.

I agree with that because the current status quo cannot be upheld for this particular group. So we will continue to work with the states on creating space in the NDIS for groups that have been neglected. We're also working with the states on restoring wider supports in the community.

Those are called, broadly speaking, foundational supports. One such is the Thriving Kids program, which is due to open in October of this year and will officially go live on 1 January 2028. This will be pitched towards children who are eight years or less with autism and/or developmental delay but with lower needs.

We have seen a massive growth of autism spectrum disorder in the NDIS. We have around 300,000 participants with this diagnosis. The problem with autism spectrum disorder—and don't take it from me; take it from the neuroscientist who did the seminal research in ASD, Professor Uta Frith—is that it has become so inclusive as to be meaningless.

What we are trying to do now is move away from this diagnostic labelling gateway to a more functional assessment that determines entry into the NDIS. Creating the Thriving Kids program will ensure those children—and this is a good thing—spend more of their time in the community, in schools, in playgrounds and on sporting fields while still receiving their supports.

Children do not need to be spending time in the waiting rooms of doctors and specialists and therapists. That is not in their best interest, absolutely not. I say this as a medical professional.

That's not all we're doing. We're also going to be introducing a new scheme that builds on community and social participation. Right now, this particular element of the NDIS has seen rapid growth.

It has seen a tripling in just the last five years. It's not clear that it's actually serving its intended purpose. We heard a lot of testimony from participants.

Mind you, the people who come to the hearings are a very small sample size, and for them this was an enabler of employment and participation in broader society. We absolutely heard that loud and clear. But, when you scratch beneath the surface, this scheme is not working for a lot of people.

We're seeing people with disability who have support workers with them out in the community. Support workers are on their phones. You can't tell me that that is actually doing any favours to these participants or embedding them in any type of social program.

It isn't. We're seeing far too much of that. So we need to restore some integrity to the scheme.

We're going to be creating a $200 million fund, the Inclusive Communities Fund, in order to rebuild capability in mainstream society, in community organisations and in sporting clubs. I think this is really important. I don't want to see people with disability tucked away in a corner of a cafe with a support worker on their phone and no interaction going on.

What I would like to see is people with disability actually participating in mainstream programs. Not only will that be good for them, but it'll be good for everyone else—people without disability. It helps build bridges.

It helps build empathy. It helps build understanding. That's where we need to get to.

That is the purpose of establishing this Inclusive Communities Fund. In addition, we're bringing in changes to provider registration. Currently, there are around 1,400 plan management providers.

What we've seen is a massive growth in an industry around plan management. There are a lot of people clipping a ticket here and not necessarily providing the quality or the integrity. This is a vulnerable group of Australians who are at high risk of exploitation.

We will be requiring all providers of high-risk NDIS supports—for example, people who need suctioning, ventilation support and so on—to register. This is a safeguard and integrity measure designed to protect these vulnerable Australians from harm, and I fully support it. Registration is commonplace for healthcare professionals, whether they be nurses or doctors or allied health professionals.

It should absolutely be the case with providers who are provisioning high-risk care to NDIS participants. It will also give participants and their carers and families the confidence that there is an oversight mechanism here. Once these providers are swept up into the umbrella of registration, it means that they are then bound by rules, and that is a really important oversight mechanism.

There are a lot of different elements to this bill, but in addition we will be strengthening some of the powers of the NDIA in ensuring that integrity is maintained in the scheme and Australians can have confidence in the scheme going forwards. As I said, the NDIS is a vital piece of social infrastructure. Prior to its beginnings, people with disability were segregated and living in the shadows, with families under enormous carer stress.

We will, as a Labor government, always protect the NDIS, but we need to ensure it is sustainable and secure going into the future.