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- W3025366355 abstract "To the Editor: The National Disability Insurance Scheme (NDIS) is one of the largest health reforms in Australia's history.1 The scheme aims to give people with a disability choice and control over their daily lives.2 It is designed to operate as nation-wide disability “markets” from which services can be “purchased”.2 NDIS participants are allocated a budget from which they purchase the services they require. The NDIS is very different from our previous disability models, which saw people receiving standardised services from a more limited number of government and not-for-profit organisations, and a less decentralised workforce. The NDIS is a visionary reform; however, we are now seeing that it is also designed to spread an epidemic such as coronavirus disease 2019 (COVID-19) to thousands of people with a disability. The NDIS has created a “gig economy” within the disability services sector. Individuals are paid for discrete services, from showering and feeding, to social support activities, to household tasks. This means as many as ten different carers entering a participant's home, performing a care service, and then moving on to another home. The workforce is now predominantly casual, and there are growing numbers of self-employed.3 This structure is primed to spread infection because: Unfortunately, many people who are part of the NDIS have comorbidities,4 making them vulnerable to COVID-19 by both physiology and system design. Previous research has raised concerns about the readiness of the workforce to handle complex disability under normal circumstances, let alone in the context of a pandemic.5 While government agencies are working to communicate hygiene practices with NDIS participants, challenges such as personal protective equipment shortages and high worker motility need to be addressed. Otherwise, the health care system will need to ready itself for a disproportionate number of people with disability. I am an investigator at the NHMRC Centre of Research Excellence in Disability and Health. No relevant disclosures." @default.
- W3025366355 created "2020-05-21" @default.
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- W3025366355 date "2020-07-01" @default.
- W3025366355 modified "2023-10-18" @default.
- W3025366355 title "The National Disability Insurance Scheme and <scp>COVID</scp> ‐19: a collision course" @default.
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- W3025366355 doi "https://doi.org/10.5694/mja2.50690" @default.
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