Embed GPs in NDIS legislation: RACGP

If GPs were enshrined in legislation for the National Disability Insurance Scheme (NDIS), many of the problems facing the embattled program ‘are less likely to have happened’, says an RACGP expert.
 
In a new submission to Parliament, the RACGP is calling for the role of GPs to be formally embedded in legislation for the NDIS, as the Federal Government undertakes major reform to slash costs it says are due to ‘shonks and fraudsters’ rorting the scheme and participants not getting the quality support they need.
 
Last week, Federal Health and Ageing Minister Mark Butler announced a major review of the NDIS in an attempt to arrest soaring costs and rein in participation, with 160,000 of the current 760,000 participants due to be cut from the scheme.
 
The NDIS is projected to spend $46.2 billion this financial year, with the current cost growth around 10% annually.
 
Dr Tim Jones, Chair of RACGP Specific Interests Child and Young Person’s Health, told newsGP that if GPs were embedded in access and planning for their patients’ NDIS participation, supports would be better targeted and ‘inappropriate use of resources’ avoided.
 
‘If we had been allowed to make recommendations around which resources are really appropriate, a lot of the problems that are talked about in terms of inappropriate use of resources are less likely to have happened,’ he said.
 
‘The sole financial responsibility for the NDIS and what is delivered to each person with a disability sits with the Government; no one else has any accountability to that, whereas we know the NDIS providers in our area, we know who’s good, we know what works for our patients.
 
‘In terms of how we use the resources in our community, we are responsible custodians. It’s not about how much money can we get for our patients; it’s about how we make sure that within what we’ve got as resources, our patients get the most benefit.’
 
The RACGP has long advocated for the role of GPs to be enshrined in NDIS legislation.
 
GPs already prepare reports on patients’ disabilities and service needs for NDIS applications, but it is work that is often not remunerated, while GPs also remain excluded from a formal role in the program.
 
In its submission to a Parliamentary investigation into the integrity of the NDIS, the RACGP recommends GPs be included in the access and planning process for patients’ NDIS support, and to be formally recognised as medical specialists, given they regularly help patients apply for funding by providing evidence of disability and functional impact.
 
In the submission, RACGP President Michael Wright noted the college’s previous advice that such inquiries ‘presented an opportunity to legislate the need for GP expert opinion to be considered when someone applies for the NDIS or their plan is being reviewed’.
 
‘Unfortunately, this advice was not heeded,’ he wrote.
 
‘The RACGP’s position has always been that greater involvement of GPs in the NDIS can result in more efficient allocation of funding.’
 
As of 1 October, children aged eight and under with developmental delay and/or autism with low to moderate support needs who may previously have qualified for NDIS support will begin enrolment in the Federal Government’s new $2 billion Thriving Kids program.
 
Dr Jones says while autism has ‘perhaps been unfairly singled out’ in the NDIS overhaul, that is due more to current funding simply being determined by ‘whether you are autistic’.
 
‘There are plenty of kids out there with autism whose support needs are very high, and I really believe Minister Butler when he says the NDIS will still exist for those kids and families,’ he said.
 
‘There are many people who live with autism, who may not need that support every year, but if you’re not in the NDIS, you get nothing.’
 
That is why Dr Jones believes Thriving Kids, a program for which he is an advisory group representative for general practice, will be better suited for many people living with autism, as it is designed to be a system that participants can ‘drop into and drop out of’, depending on when support is needed.
  
And GPs will be ‘one of the key front doors’ to the program, he says.
 
‘One of the things that Thriving Kids is really hoping for GPs to do is identify families early who need some extra support, who may not have a high-level disability that needs lifelong care, but who, if they don’t get the right support at the right time will really struggle,’ he said.
 
‘We need to be looking closely at what we can deliver, and if there’s any extra Medicare support coming for us to do this work, to care for people with disability, then I think we really need to show our strengths as GPs by doing that right from the start and doing it really well.’
 
Dr Jones said intellectual disability health assessment is one example of care that GPs ‘don’t deliver as much as we could’.
 
‘It’s just one of those areas where there is Medicare support to deliver wraparound care, but we forget about it,’ he said.
 
‘Now is the time to be really proving to government that we have all the skills and all of the connection to our patients and community that we need to be able to show that we can really help with this.’
 
In the RACGP submission, Dr Wright said GPs have proven through the use of GP Chronic Condition Management Plans that they are ‘adept at utilising allied health resources efficiently and effectively to meet the greatest needs of their patients and respect service workloads’.
 
‘Embedding a greater role for GPs in the NDIS via legislation will contribute to a more sustainable NDIS, ensuring people with disability get the support they need when they need it,’ he said.
 
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allied health Chronic Condition Management Plan National Disability Insurance Agency National Disability Insurance Scheme NDIS Thriving Kids