Assessing the Disability Royal Commission report

After four years, 32 public hearings, 8,000 submissions, and almost 10,000 people sharing their experience, the Disability Royal Commission has handed its final report to the federal government. Throughout the investigation, the commission heard horror stories of abuse, neglect, coercion, unscrupulous NDIS providers, and severe underpayment of workers with disability.

With more than 200 recommendations, the government has an enormous task ahead of it to improve the lives of Australians with disability. This podcast pinpoints some of the most important recommendations, and identifies where the government should start.

The report release coincides with the launch of Grattan Institute’s Disability Program, supported by the Summer Foundation. Grattan’s podcast host Kat Clay is joined by our Disability Program Director, Sam Bennett, and researcher Hannah Orban.

Transcript

Kat Clay: After four years, 32 public hearings, 8, 000 submissions, and almost 10, 000 people sharing their experience, the Disability Royal Commission has handed its final report to government. Throughout the investigation, we’ve heard horror stories of abuse, neglect, coercion, unscrupulous NDIS providers, and severe underpayment of workers with disability.

With over 200 recommendations, The federal government has an enormous task ahead of them to improve outcomes for people with disability. Today we’ll look at some of those recommendations and where governments should start. The report release coincides with the launch of Grattan’s disability program, graciously supported by the Summer Foundation.

To discuss the report are Grattan’s new disability team. Sam Bennett, program director and Hannah Orban, associate.

First, I do want to start off with a very warm welcome to you both. And I think it would be great for our listeners if they could find out a little bit more about you both.

So I was wondering, Sam, if you could tell us about your experience in this sector.

Sam Bennett: Firstly, just so delighted to have joined Grattan. We’re in week four with the program and a busy four weeks it has been up to up to now. It’s such an important time for disability policy in Australia, not least for the reasons of the Royal Commission, which is what we’re here to talk about. I joined the Grattan Institute from the National Disability Insurance Agency where I worked for the last five and a half years running their policy and research division. And I’ve had almost a 20 year career now in the UK and Australia working on disability and health reform.

And just delighted to have the opportunity to work now at Grattan. And hope to continue to have a really positive influence on the development of disability policy in Australia.

Kat Clay: That’s fantastic.

What about you, Hannah?

Hannah Orban: So my experience in disability starts with my family. I have three brothers who are the light of my eyes and two of them have developmental disabilities.

So in one way or another, disability has always been a part of my life. In my professional life, I worked on disability policy in the New South Wales Department of Education. And that’s where I really got to see how policy impacts people’s day to day lives. Recently I studied a master of public policy in the United States as a Fulbright scholar.

And I got to work in Washington DC on disability policy and a couple of think tanks. And now I have the enormous privilege and pleasure of working on the new disability program at the Grattan Institute.

Kat Clay: And we’re very lucky to have you in both your professional and lived experience with your family.

So it’s a very warm welcome to you as well. Sam, you also wanted to tell us about the other member of the team.

Sam Bennett: Thanks, Kat. Yeah, so we’re really pleased that we have Alistair McEwan AM who’s currently one of the commissioners for the Royal Commission joining the team when he’s finished up with his responsibilities there.

He’s got a well earned break to take, but he’ll be joining the program together with another of Grattan’s researchers in the middle of November.

Kat Clay: So one of the things I wanted to ask you and to start off to give us a broader overview of the Royal Commission is why is this Royal Commission so important?

Sam Bennett: It may seem, given recent experience, that there’s a Royal Commission every, every 10 minutes. There’s a lot of them that have happened in the last few years in Australia, but it’s worth remembering, firstly for our listeners that this is the highest form of inquiry that can be done in Australia it can compel witnesses to provide evidence and it provides recommendations to government, which is where we’ve got to with the Disability Royal Commission following its report being handed to government.

I think this one’s particularly important for a few reasons. First is just the sheer number of people that will be impacted by this. There are 4. 4 million people in Australia that have some form of, of disability. And it’s shocking that the research in the Royal Commission… Showed that two thirds of them will have experienced some form of violence in their lifetime.

And the people with disability are twice as likely to experience violence in any 12 month period than someone without disability. So it’s, it’s an expansive problem that this commission was established to address. The second reason it’s important is just the scope. of it in respect of the different parts of Australian life, its recommendations will touch.

The terms of reference for this Royal Commission were enormous and they’ve been interpreted. And that’s why we’ve got an 11 volume report with 222 recommendations to work through, which made for a very a very busy weekend. But it means that we’ve got education, employment, domestic violence, healthcare, housing, the particular experience of First Nations people with disability, women with disability.

There isn’t a Canberra department or a level of government or an agency that isn’t going to be impacted by some of these recommendations. So it will be very wide ranging in terms of its impact. The final point as to why it’s important is that this represents a very significant. Phase in what’s been a longer term evolution of disability policy in Australia.

So people with disability will see this as a, as a necessary next step on the journey towards full inclusion in Australian life. That began right back in the late 1970s and and eighties with Deinstitutionalization. Ran through the Disability Discrimination Act in 1992. Then Australia making its commitments to the United Nations Convention on the Rights of People with Disability in 2008 and the National Disability Insurance Scheme that’s been running 10 years now.

This was a next step forward. So it’s worth thinking about the report in that context, because, because that’s, that’s kind of how people with disability will be, will be understanding this.

Kat Clay: I think it’s a really important point that it sits on this timeline of progress and there’s still so much progress to be made.

And we will talk a little bit more about, the issue of segregation and inclusion later in the podcast as well. Now, Sam I wanted to clarify something cause it did come up for me because the NDIS review is coming up as well. And, for our listeners, for myself, I wanted to know how these two reports relate and do they share similar scope, are they going to cover the same things?

Sam Bennett: Government’s going to be very busy. You’re right, the NDIS review is due to report at the end of October. The Royal Commission preceded it by three and a half years and I mentioned the terms of reference already. So, so the NDIS is an important part of that, but it is only one part and there are recommendations that go much wider.

Across many federal departments and different areas of public policy. Its terms of reference as well dictate that when it’s looking at the NDIS, it’s doing so through a lens of uncovering and preventing violence, abuse, neglect, and exploitation. And that means that the issues of NDIS design as they relate to key decision making criteria for access and planning are not really within the scope of the Royal Commission’s report, nor is the critical issue of NDIS sustainability which is very much front and centre now of the NDIS review given recent growth projections and National Cabinet’s target to bring that back to within 8%. So when The review presents its findings.

There will be some overlaps, and I suspect that they will primarily relate to recommendations around the role of the NDIS Quality and Safeguards Commission. Which does have a whole section within the Royal Commission reports in terms of their role in managing and regulating the market. So it’ll be interesting to see what alignment there is in that area and whether there are different views and we don’t thankfully have very long to wait.

Kat Clay: Yes, and I am looking forward to talking to you more about that topic. We will be talking about it on the podcast, so do stick around and hit that subscribe button. Now, Hannah, I really want to get into the findings of the Royal Commission. Can you take us through those please?

Hannah Orban: So through the tomes of the Royal Commission’s final report, it’s really clear that people with disabilities aren’t living equal lives compared to other Australians.

So being disabled puts people at a far higher risk of violence, abuse, neglect, and exploitation. And the discrimination and low expectations people endure on account of their disability means that across education, work, pay, health, even social life, people with disability just aren’t getting a fair go compared to other Australians.

It’s a devastating finding and what’s worse is that it’s probably not a surprise.

So for example, people with disability are more than twice as likely to have experienced domestic partner violence or sexual assault than a person without a disability. 23 percent of people with disability, that’s nearly a quarter, have experienced 15, compared to 11 percent of people without disability.

So more than double the rate for people with disability. Women and girls with intellectual or psychological disabilities are especially vulnerable to violence with 72 percent having experienced violence since the age of 15. And that’s an astonishing number. First Nations or LGBTQIA plus people with disability are at a much greater risk as well.

You know, just recently we saw reports on the ABC about violence, abuse, neglect, and exploitation of people with disability in disability services. It’s including the NDIS and the disadvantages and discrimination that people with disability are experiencing impacts school and work too. So disabled Australians tend to have poor education outcomes.

Employment rates have been flat for decades at about 48 percent compared to 80 percent of people without disability and disabled Australians tend to earn quite a lot less on average too. Now, the government called the Royal Commission because we knew some of this already but we needed a better understanding of what people with disability are experiencing, why it’s happening, and how we can fix it.

And most importantly, people with disability need the chance to testify about their lives, to lead the way on changing policy and to have all of us as Australians, to hear what’s really going on. So what’s also clear from the Royal Commission report is that so many of the barriers and ableism that people with disability face is the result of policy.

You know, these are, these are policy choices. So the commission has brought together evidence, witnesses, stories and research that cover the breadth of life for disabled Australians. And it also uncovers some of the connections between policy issues. Segregation, as you said, was a really persistent theme for the Royal Commission and it connects a lot of policy problems together.

The commission found that segregation is contributing to violence, abuse, neglect, and exploitation of disabled people, and segregation is really widespread in Australia. From school, kids with disability can be learning in separate settings where they have hardly any contact with kids who don’t have disabilities.

Nearly 20, 000 people with disability are working in sheltered workshops, what we now call Australian disability enterprises, where they can earn as little as 2. 50 an hour, and they don’t get to interact with their non disabled peers, or have opportunities to upskill and find a job in the open labour market.

So people are getting stuck. And housing can be really segregated too, which Sam will talk about a little bit more in a sec. So, these are all policy choices. And now that we’ve heard the evidence, we’ve got literally volumes of it. It’s time to weigh up our policy options because we can be more equitable.

And people just really can live more equal lives if our policies affirm that.

Kat Clay: These aren’t surprising, necessarily, some of the findings, and these sobering statistics are really horrific, but I think it’s the scope of the findings that has been shocking to a lot of Australians to hear. The level and the numbers are so huge in those kind of, especially in those abuse cases towards women.

I think it’s been a big wake up call to a lot of Australians who don’t necessarily have experience with disability to hear these stories. So Sam, I wanna know, what are some of the strengths and weaknesses you’ve found in the report?

Sam Bennett: There’s a lot to, like in here. Kat, there’s lots of great recommendations.

So I’ll start with some of the, the strengths and I, I really like the recommendations around supportive decision making which is neatly defined in the report as decision making with the support. That’s incredibly important, particularly for people with an intellectual disability or a cognitive impairment, but for many people as well, important stages in their life.

And it’s essentially about people with disability being assumed at all times to have the ability to make their own decisions and to have a range of supports that protect their autonomy in doing so. The opposite of supportive decision making, substitute decision making, which is when someone is legally appointed to make decisions on your behalf because you’re assumed to lack capacity.

There’s evidence the Royal Commission uncovered that rather than that being a last resort, it is being used rather more commonly than we should hope. The report proposes some really great recommendations for addressing this issue. A national framework and principles for supportive decision making, changes to state and territory guardianship legislation to make sure that supportive decision making is reflected and that substitute decision making is used only as a last resort, adopting common terminology including around the importance of decisions reflecting the person’s will.

So these will make a very significant difference in the lives of people with disability if government adopts them. There’s important stuff in here as well on wider legal reform. There’s a big focus on human rights as you would expect. throughout the whole report and the proposed introduction of a new disability rights act and the creation of a new disability commission to monitor and enforce its application.

And the intention with that is to take the rights outlined in the United Nations Convention Australia has signed up to and to codify that into domestic law in such a way that it’s enforceable in practice and that that will have a significant impact. on protecting people with disability from violence, abuse, neglect, and exploitation.

There are machinery of government changes proposed alongside this. A new disability portfolio overseen by a new Minister for Disability Inclusion. including a new Equality and Inclusion Department within that portfolio which would absorb the disability and carer related functions that are currently with the Department for Social Services and also house that new National Disability Commission.

There’s a lot of devil in the detail with that. There are risks that standing all of that up takes a lot of time and money for little impact in the, in the short term. But there is also real potential there if the right design choices are made. There are really positive changes in here relating to tighter regulation of restrictive practices which are still It’s not too often used.

Hannah already made reference to the shocking documentary on the ABC the other week, which I’m sure many listeners will also have seen. And it will be front of mind for those that did see that some of the appalling scenes of restrictive practices, illegal ones in that case, being used. So these are very welcome recommendations.

And I made reference as well to Sections of the report that make recommendations around the functions and processes of the NDIS Quality and Safeguards Commission, which is the regulatory agency for the NDIS, and those are very welcome to, I should say, better categorization and prioritization of reportable incidents.

That’s clearly critical given that the commission reported it had. Frankly, unworkable volumes of those last year, 1. 4 million to sift through and not the resources to do so, although recent additional funding from the federal government will help their more clearly defined timeframes and protocols for complaints handling, including new powers for the commissioner.

To require providers to undertake an investigation and to involve the complainant in that investigation, and then for the commission to have oversight of this resolution, which is clearly also a very good thing. And there are also recommendations there relating to the current registration process for providers.

And the requirements for that to make it easier to reduce the barriers to more providers choosing to register. And I’m pleased they’ve not gone too far as well with that one because I believe there’s a fine balance that needs to be struck. So as not to impinge unduly on participant choice and control.

On the weaknesses, my first point might sound a bit pedantic and I don’t mean it to, but the structure of the report and the story it tells, It’s not as coherent as it could be for me, because I think an inquiry that’s so vast in this scope could really have done with a stronger framework to bring it all together.

I found it quite hard to draw the connections as I was going to understand the logic behind the sequence of the sections. And. I think something could have been been done to make that a little clearer, perhaps a kind of life stage journey approach. There are also some glaring omissions for me, and I find that strange given the four and a half years and the 32 hearings, there is nothing at all on transport.

Both accessible public transport.

Kat Clay: That’s huge.

Sam Bennett: And disability specific, it is indeed. And it’s quite clear that that’s a massive exclusionary force in the lives of many people with, with disability. So to not have that covered, to not have. Broader recommendations looking at the, the, the built form. There are recommendations in here that go to accessible housing, but not more broader sort of systemic issues in that, in that regard.

There’s also nothing specifically on day programs. Which seems a lot of gap to me, particularly in that segregation narrative.

Kat Clay: So just for listeners, what is a day program?

Sam Bennett: It’s essentially a service that brings people with disability together with other people with disability in a group, often in a center for daytime activities.

Essentially, so it’s another service that separates people with disability, and this is glaringly absent, albeit there were aspects of the hearings that went to this, it’s not particularly clear in the final report. There’s precious little in here on the experiences of children with disability in early childhood, and the section on health and treatment.

includes good recommendations around cognitive disability health. But it feels very partial in comparison to some of the other sections, given the significant access disparities that exist across primary and secondary health and the unavoidable deaths and the levels of those as they compare to the general population.

I found that section a little underwhelming.

In respect of how comprehensive some other aspects of it, of it are, and then there’s the main weakness and Hannah has touched on this to an extent already, and it is the divided nature of the Commissioner’s recommendations in Section 7 of the report relating to issues of segregation in education, employment, and employment.

And in housing, we have some commissioners, including those with disabilities, which I think is very important, recommending phasing out segregated settings, while others see an ongoing role. For listeners, segregation is where people with disability are separated and excluded from the broader community.

The definition provided in the report. is that it describes situations where people with disability live, learn, work, or socialize in environments designed specifically for people with disability, separate from people without disability. So in housing, that refers to group homes. Places of four to six people who live together, all of whom have a disability, in a setting where they receive support, much of it shared support, sometimes some of it around the clock, but very often people don’t have a choice of who they live with and how those supports happen.

Hearing 3 went to this in considerable detail in the experience of group homes in Victoria, which also provided some evidence of the much higher risks of violence, abuse, neglect, and exploitation in those settings, and we’ll touch a bit more on that in a moment. In employment, segregation means Australia’s disability enterprises that Hannah talks about where at the subject of hearing 22, we heard about many examples there, including one that stays with me, Katie’s daughter, Emily, who works 17 years doing picking and packing for wages not exceeding 8 dollars an hour.

And the actual average across the countries is around the five and a half. And in education, we’re talking about special schools, which, which Hannah will talk about in some more detail in a moment. The position from some commissioners is that these services are incompatible with inclusion and with the UN Convention, and that led them to propose phasing them out.

The position taken by the Chair and Commissioner Ryan, which they outlined at the beginning of the report, is that depending on the nature and purpose of the separation, And the extent of the interaction that there is with the broader community. Not all such services warrant the term segregated. I believe that any argument whose justification relies on redefining the key terminology to which it relates, when those terms have already been defined, including by the very people to which they apply, doesn’t hold a lot of water.

There is, in my view, quite a clear roadmap offered in the Royal Commission’s final report to move away from segregated settings entirely. over a measured timeframe. That’s bold. It’s, it’s complex, but I believe it’s the right course of action for Australia. Sadly, given the divided recommendations, it will be open to government now to pick and choose between those recommendations on probably the most important part.

Kat Clay: Well, we can only urge the government to take the bold road. Hannah, I think this is a great spot to talk to you about some of those recommendations and what the government can do now and where you think that they should be putting that emphasis. And I think given your experience on education. Is that an area you see the government being able to make progress in?

Hannah Orban: There are some big, bold recommendations in the report on education. And there’s one recommendation in particular that I think if the government committed to it, it would have a very big impact on the lives of people with disability and on education in Australia. One of the big themes throughout the Royal Commission was exclusion and segregation, as we’ve mentioned a couple of times and how segregation can lead.

To violence, abuse, neglect, and exploitation. So the antidote to segregation is inclusion. So promoting inclusion in schools is a really big focus for the report. The recommendation that would be really impactful if the government accepted it is the recommendation to end segregated schooling in a generation.

So that means no more separate schools for students with disability. And it also means no more support units for students with disability in mainstream schools. So all students learning and playing together in the same place. Not all the commissioners agree on this. There were three commissioners who called for it.

Bennett, Gobley and McEwen. The last two of whom have disabilities. It’s a really long term recommendation, phasing in over 28 years. So you might wonder why the commissioners would call for such a big change to education. And there are three main reasons. The first reason is legal. The commissioners argue that ending segregated schooling is necessary if Australia wants to meet its obligations under international human rights law, namely the Convention on the Rights of Persons with Disability.

It’s worth pointing out that the other commissioners, Sackville, Ryan and Mason, don’t think that this is the case. The second reason that Bennett, Gobley and McEwen call for the changes cultural, which is integrating kids with disabilities and kids without disabilities will create a more inclusive society in the long run.

And the fact that kids are separated from each other at school is really quite damaging. The third reason is economic research for the commission indicated that there’s a correlation. Between segregated classrooms for students with disability and poor employment outcomes in the long run. This means that children with disabilities learning in segregated schools tend not to get jobs in the open labor market.

It does seem to be the case that some schools are pushing students with disability into sheltered workshops. And so I’m going to upskill and join the open labor market. On the other side is the chair, Ronald Sackville, Casey, and commissioners Mason and Ryan. They agree that schools are not nearly inclusive enough, and that there’s a lot more schools should be doing to integrate students with and without disability.

And to make sure that kids with disability are getting the education that they deserve. However, they don’t agree that separate settings Are a violation of human rights and that if students and families choose to enroll in support units or separate schools, then that isn’t segregation. So they call for more inclusion, but non, not for an end to separate settings.

So these commissioners recommend that kids with disabilities should be at the same school as mainstream students or nearby, so that schools can more easily create opportunities for non-disabled and disabled students. to interact and play.

Kat Clay: Just a follow up question on that. One of the things we’ve heard previously is that it’s difficult for teachers to integrate and teach students with disabilities at the same time.

One of the things I’m assuming that in this roadmap and this plan there’s a lot more that needs to be done in schools in order to integrate disabled students directly into the school.

Hannah Orban: That’s right. There would need to be substantial guidelines and changes over the 28 year period to help teachers prepare for this change.

The report does make some recommendations on the kinds of guidelines and changes to data collection that we would need. However, it is a little bit light on implementation. There’s disagreement on ending segregated schooling. The jury’s still out. And frankly, what’s missing from this discussion is very much empirical evidence.

It’s notoriously difficult to evaluate schools, and so it’s really hard to judge what the best arrangement for students with disability is.

Kat Clay: This is a conversation we’ve had with our education team, which is empirical evidence in school education is hard to come by. So it’s the call certainly for more data.

Hannah Orban: Indeed.

Kat Clay: And that’s a big call in this report as well. So Sam, now that the Royal Commission has happened, the reports come out, what are the next steps?

Sam Bennett: The next steps for government are that the commission provided them with six months to prepare the response. There will be a formal response where they look at each of those recommendations and say whether it’s supported, say whether it isn’t, or whether there is support in principle and some further work that needs to be done.

That’s a large task because of the number of departments involved, the different layers of government, the other agencies that will need to play. A part in that and subsequent to that, there’s a very significant implementation task that will last many years, given some of the very significant systemic and long term changes that the commission has recommended.

And as we mentioned at the beginning, give it another four weeks. Another report lands specific to the NDIS with more recommendations for reform. Government will be swimming in more recommendations than it knows what to do with by early November. They’re going to need to really be able to see the wood for the trees and to continue to identify where the bold and necessary choices are to push forward disability policy in Australia and to continue to make Australia more inclusive.

Kat Clay: Thank you so much, Sam and Hannah for your expertise and sharing your insights into the Disability Royal Commission. We’re looking forward to seeing the research that you produce as a team and to talking more about disability on this podcast.

We are a not for profit organization, and we do rely on donations from our lovely listeners like you. If you’d like to support Grattan’s work and our research, please go to grattan. edu. au forward slash donate. As always, please take care, and thanks so much for listening.