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Final report: Inquiry into Queensland's NDIS market

21 Dec 2021

The Queensland Productivity Commission’s inquiry into the National Disability Insurance Scheme (NDIS) market in Queensland has been released, with 20 findings and 56 recommendations particularly focused on market issues faced by providers.

The NDIS was introduced in Queensland in 2016 and now supports nearly 84,000 Queensland participants. There are over 5,000 active registered providers in the state. The scheme aims to deliver more tailored, responsive and innovative services to people with disability that will improve their life outcomes.

The QPC found that to date the focus of the NDIS has largely been on transitioning people with disability into the scheme. However, the QPC believes the scheme now needs to shift its focus to making the NDIS market work more effectively and efficiently as a way of securing the scheme’s objectives, achieve its potential and improve outcomes for people with disability.

Importantly, the QPC found the scheme’s regulatory and policy framework is operating in a way that impedes the effective and efficient functioning of the NDIS market.

NDIS participants believed they were receiving more disability supports, and had more choice and control over their lives, but they struggled with the scheme’s complexity, inadequate information and assistance with developing and utilising a plan, and limited supply of supports in some areas, particularly rural and remote areas, and for some types of supports, such as allied health.

Challenges for providers include deficiencies in market coordination, price regulation, quality regulation and workforce issues.

It found there are opportunities to address suboptimal market performance, and improve outcomes for participants by adopting a targeted and balanced approach to reforming aspects of the scheme by:

  • increasing information and supports to allow better decision-making
  • realigning participant, provider and agency incentives to deliver market outcomes consistent with scheme objectives
  • simplifying processes and reducing regulatory compliance burden to decrease costs and inefficiencies
  • providing greater flexibility to participants and removing restrictions to allow participants, providers and agencies to operate more effectively and efficiently, and
  • improving the governance of the scheme to support oversight of performance monitoring and a sharper focus on scheme objectives.

The QPC suggested reforms should be made to facilitate participant choice and provider investment including:

  • providing greater plan flexibility, within some constraints; and more effective use of participant
  • goals so demand for supports better reflects participant preferences and aspirations
  • making market information available, for example, on the needs and location of participants:
    • the housing market, in particular, would be supported through better market information and efficient mechanisms to match participant demand with housing supply
  • facilitating the development of digital marketplaces and better support coordination
  • reviewing regulation to ensure it is the minimum necessary to achieve its objectives, and
  • introducing a ‘provider guarantee’ to reduce policy and regulatory risk facing providers.

A ‘one-size-fits-all’ approach is not appropriate for the stewardship of markets. Some NDIS submarkets, mainly in rural and remote areas, will not meet participants’ support needs in their current form and will require alternative approaches, such as demand pooling, to support market supply or direct commissioning of support provision.

Read the final reports, submissions and transcripts, plus the Queensland Government's response.