Minister for Financial Services and Superannuation, Bill Shorten, today thanked the National Injury Insurance Scheme (NIIS) Advisory Group which met to discuss and further consider NIIS design and implementation.
The Advisory Group has issued a Communiqué on the outcomes of the meeting, which outlines the fundamental principles that underpin the design of the NIIS. The Advisory Group considers that these principles are necessary to give effect to the model proposed by the Productivity Commission in its report into Disability Care and Support.
The Advisory Group supports the key objectives of the NIIS and National Disability Insurance Scheme (NDIS) to improve care and support to those with a significant and permanent disability and called on all governments to work together to implement these critical reforms.
The Group has highlighted the importance of a NIIS for the disability care and support system reforms. The NIIS will work to reduce the large inequities in lifetime care and support that currently exist across jurisdictions and ensure the long‑term fiscal sustainability of the NDIS.
Minister Shorten also congratulated John Walsh on his acceptance as Chair of the NIIS Advisory Group. Former Chairperson David Bowen will remain on the Advisory Group, having stepped down due to his commitments as CEO of the NDIS Launch Transition Agency.
The Advisory Group also welcomed the announcement that Andrew Pesce has been appointed the Chair of the working group on medical indemnity, which will progress work on the broadening the NIIS to cover the lifetime care and support needs of patients who experience catastrophic injuries.
23 November 2012
Attachment
NIIS Advisory Group Communiqué
The National Injury Insurance Scheme (NIIS) Advisory Group met in Sydney today to discuss and further consider NIIS design and implementation. The Advisory Group was established by the Minister for Financial Services and Superannuation the Hon. Bill Shorten to advise on issues associated with the establishment of a NIIS.
The NIIS is a critical element of the disability care and support system reforms proposed by the Productivity Commission (PC). The NIIS will significantly reduce the cost and improve the financial sustainability of the National Disability Insurance Scheme.
The NIIS should commence in the area of motor vehicle accidents, building upon the well-established arrangements in place in some jurisdictions, including schemes that provide no-fault lifetime care and support. Large inequities currently exist across States and Territories, as some states provide no-fault accident cover while others rely on establishing fault to receive compensation.
The Advisory Group called on both the Commonwealth and State and Territory governments to work together to take steps to implement the NIIS. The Advisory Group considers that the following principles should underpin the design of the NIIS to give effect to the PC model.
Principles
The NIIS would deliver:
- reasonable and necessary lifetime care and support to people who suffer a catastrophic injury;
- no-fault cover – cover regardless of whether an individual has legal recourse to sue for compensation;
- comprehensive cover – no gaps across motor vehicle accidents, medical accidents, workplace accidents, criminal injury and general accidents at home or in the community;
- greater choice and control to injured persons over the services they receive;
- access to early interventions;
- best practice data and information sharing principles;
- a scheme funded in accordance with insurance principles – building on existing insurance arrangements; and
- incentives for appropriate behaviour and increased risk management.
In advancing the design of the NIIS the Commonwealth, States and Territories should:
- draw on the experience of existing lifetime care and support schemes such as the Victorian Transport Accident Commission and NSW Lifetime Care and Support Authority; and
- have specific regard to the design principles underpinning the implementation of the NDIS.
The Case Studies
Below are two case studies taken from a PricewaterhouseCoopers report that highlight some of the inequities experienced by individuals in a fault-based scheme compared to individuals in a no-fault scheme.
Case Study: Fault-based Scheme
An individual sustained a traumatic brain injury following a motor vehicle accident. He did not receive any compensation for the injury. The client spent 16 months in a residential rehabilitation and accommodation program where he initially required physical assistance with all activities of daily living tasks amounting to around 24 hours of care per day.
On discharge from the rehabilitation program, the client's care needs had dropped to 77 hours per week and he went back to his own accommodation, in a rural community. He continues to require assistance with budgeting, planning, community activities, communication and general supervision for day to day activities.
Because he did not receive compensation, he had to rely on the health and welfare system. Furthermore, it was noted that the client was 'lucky' to have accessed residential rehabilitation. It was reported that the alternative discharge options would have consisted of a group house in Perth or a nursing home in his rural community. While the lesser of three evils, almost 1.5 years in residential rehabilitation setting would not be viewed as a good outcome. The better alternative would have been transition to community-based rehabilitation earlier in the journey.
While delayed discharge from rehabilitation can also happen in no-fault systems for various reasons, these cases are the exceptions rather than the rule. Moreover the time spent in rehabilitation is more likely to be goal oriented and planned. A more common scenario is earlier discharge from an acute setting, and accelerated and supported participation, such as in the following case study.
Case Study: No-fault Scheme
Julie was only weeks away from sitting her HSC final exams when she was involved in a motor vehicle accident that resulted in her becoming a C6 ASIA B level quadriplegic. Julie was admitted to Royal North Shore hospital for a four week period. During this four week period Julie met several times with a vocational consultant.
The program included an individual case coordinator, provided access to vocational rehabilitation services during inpatient rehabilitation and was integrated into the overall inpatient rehabilitation program. Julie discussed her pre-accident plans and goals with the coordinator and how she hoped she could still follow some of her dreams.
After four weeks, Julie was transferred to a rehabilitation unit to test if her goals were realistic. She was awarded her HSC on the basis of her prior assessments to the final exams and she was assisted to see if she would be able to train and ultimately work in catering. It was agreed that becoming a pastry chef or decorating cakes may be possible, and a kitchen with a range of lightweight equipment was set up to simulate the TAFE environment in the rehabilitation unit. This set up showed that Julie may be able to mix and decorate cakes, with assistance to open and access containers, using specialised equipment.
Julie has been accepted into a 10-week bridging course, one day a week, which will determine if she can enrol and complete a 3-year pastry chef apprenticeship. She is being provided with one-on-one support from a TAFE teacher during this period to assist her to learn ways of improving her speed of work and adapting to new tasks. This is funded by the LTCS. She is also trialling a standing wheelchair that will enable to use her body as a support for holding a mixing bowl. It is still very early in Julie's recovery, but already she is getting out of the rehabilitation unit setting one day a week and catching the bus to TAFE. It is a massive adjustment for Julie but she is still able to follow her dreams with support.
Members of the NIIS Advisory Group:
Mr John Walsh, AM (Chair)
Partner, PriceWaterhouseCoopers and Associate Commissioner, Productivity Commission Inquiry into long term care and support for Australians with disability.
Mr David Bowen
CEO of NDIS Launch Transition Agency. Was a Member of the Independent Panel appointed to advise the Productivity Commission and Government during the Inquiry into long-term care and support for Australians with disability.
Mr John Cain
Managing Partner, Herbert Geer Law Firm.
Dr Rhonda Galbally AO
Chair of the National People with Disabilities and Carer Council. Member of NDIS Advisory Group. Was a Member of the Independent Panel appointed to advise the Productivity Commission and Government during the Inquiry into long-term care and support for Australians with disability.
Ms Julie Ligeti
Manager, Policy and Government Relations, Melbourne, Slater and Gordon
Ms Ged Kearney
President, Australian Council of Trade Unions.
Mr Peter Martin
Australian Government Actuary
Ms Genia McCaffery
President, Australian Local Government Association.
Mr Paul O'Connor
Chief Executive Officer, Comcare.
Dr Andrew Pesce
Immediate Past President, Australian Medical Association. Was a Member of the Independent Panel appointed to advise the Productivity Commission and Government during the Inquiry into long-term care and support for Australians with disability.
Mr Alex Sanchez
General Manager, Economic and Taxation Directorate, Insurance Council of Australia